Structural analysis of dental fear in children with and without dental trauma experience

The aim of the study was to evaluate dental fear in children with and without dental injuries in a randomly selected children in Croatia (59 girls and 88 boys). Children were divided into three groups depending on dental trauma experience. They were also divided into two age groups: 5-8 and 9-12 years. Only dental trauma to the permanent teeth was included in the study. The CFSS-DS, CDAS and CMFQ were used for evaluation of dental anxiety and the ISP Hollingshead Index of Social Position was calculated for evaluation of social status. The mean values of CDAS, CFSS-DS and CMFQ tests revealed that the anxiety level decreases with increasing experience of dental injury. The analysis of variance performed for CDAS showed a significant difference between children with and without dental trauma (p = 0,010). Regarding the groups, the analysis of variance for CMFQ (p = 0,021) and CFSS-DS (p = 0,001) showed a significant difference, as well as regarding age (CMFQ; p = 0,001 and CFSS-DS; p = 0,016). Cronbach's alpha coefficients revealed the highest reliability for CFSS-DS (alpha = 0,910). Pearson's correlation coefficients revealed significant correlations between the anxiety scores, age and ISP values for children without dental trauma, and between the anxiety scores and age for children with repeated dental trauma. The results of the ISP Hollingshead Index exhibited the highest frequency in children with dental injuries who belonged to the families with poor social background (ISP = 44-60). No significant difference was obtained between children with and without dental injuries depending on either gender or the ISP value.     

Mental Health Problems and Educational Attainment in Adolescence: 9-Year Follow-Up of the TRAILS Study

BackgroundThis study examines if mental health problems at age 11 and changes in mental health problems between age 11 and 16 predict educational attainment of adolescents at age 19, overall and stratified by gender.MethodsData from 1711 adolescents (76.8% from initial cohort) of the Tracking Adolescents'' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9year follow-up, were used. Mental health problems (externalizing, internalizing and attention problems) were measured by the Youth Self Report and the Child Behavior Checklist at ages 11 and 16. Difference scores for mental health problems between age 11 and 16 were calculated. Educational attainment was assessed at age 19.ResultsExternalizing, internalizing and attention problems at age 11 were significantly associated with low educational attainment at age 19 (crude model). When adjusted for demographic variables and the other mental health problems, only the association for attention problems remained significant (odds ratio (OR), 95% confidence interval: 3.19, 2.11–4.83). Increasing externalizing problems between age 11 and 16 also predicted low educational attainment at age 19 (OR 3.12, 1.83–5.32). Among girls, increasing internalizing problems between age 11 and 16 predicted low educational attainment (OR 2.21, 1.25–3.94). For boys, no significant association was found for increasing internalizing problems and low educational attainment. For increasing attention problems between age 11 and 16 no significant association with low educational attainment was found.ConclusionsExternalizing, internalizing and attention problems at age 11 and an increase of these problems during adolescence predicted low educational attainment at age 19. Early treatment of these mental health problems may improve educational attainment, and reduce socioeconomic health differences in adulthood.     

Umbilical Cord Blood Testosterone and Childhood Internalizing and Externalizing Behavior: A Prospective Study

Antenatal testosterone exposure influences fetal neurodevelopment and gender-role behavior in postnatal life and may contribute to differences in developmental psychopathology during childhood. We prospectively measured the associations between umbilical cord blood testosterone levels at birth and childhood behavioral development in both males and females from a large population based sample. The study comprised 430 females and 429 males from the Western Australian Pregnancy Cohort (Raine) Study where umbilical cord blood had been collected. Total testosterone concentrations were determined by mass spectrometry and bioavailable testosterone (BioT) levels were calculated. At two, five, eight and ten years of age, the participants completed the Child Behavior Checklist (CBCL). Linear regression models were used to analyse the relationship between BioT concentrations (in quartiles) and CBCL scores (total, internalizing, externalizing and selected syndrome). Boys had higher mean CBCL T-scores than girls across all ages of follow-up. There was no significant relationship between cord blood BioT quartiles and CBCL total, internalizing and externalizing T-scores at age two or five to ten combined. In the syndrome score analyses, higher BioT quartiles were associated with significantly lower scores for attention problems for boys at age five, eight and ten, and greater withdrawal symptoms in pre-school girls (age five). We did not identify a consistent relationship between antenatal testosterone exposure and total, internalizing or externalizing behavioral difficulties in childhood. Higher umbilical cord BioT levels were associated with lower scores for attention problems in boys up to 10 years and more withdrawn behavior in 5-year-old girls; however, these findings were not consistent across ages and require further investigation in a larger sample.     

Differences in physical activity between non-overweight, overweight and obese children

The purpose of the study was to find out differences in moderate to vigorous physical activity among non-overweight, overweight and obese children, and between boys and girls. The sample included 364 children (179 boys and 185 girls), aged 6.4 years (+/- 0.3 SD). Physical activity was assessed by 7-day questionnaire. Age adapted BMI was used as overweight and obesity indicator. The children were divided into non-overweight, overweight and obese groups. It was found out, that there are significant differences in non-overweight, overweight and obese children (p < 0.05). Boys were significantly (p < 0.05) less moderate to vigorous physical active than girls, especially in indoor activities. There were also significant differences (p < 0.05) in moderate to vigorous physical activity among non-overweight and obese boys and among overweight and obese boys in weekends and total weekly activity. In girls there are significant differences (p < 0.05) in non-overweight, overweight and groups in weekends and total weekly activity. It is possible to conclude, that obese boys and overweight and obese girls, are prone to less physical activity.     

Effectiveness of motivational interviewing and physical activity on prescription on leisure exercise time in subjects suffering from mild to moderate hypertension

Background

Depression and anxiety disorders have a high disease burden and as many as 15% of young people report mental health problems. Binge drinking, which is a particularly harmful way of consuming alcohol, is common among secondary school students. The aim of this study was to examine the association between binge drinking and self-reported mental health in boys and girls aged 12 to 18 years.

Findings

This cross-sectional analysis was performed on data collected by the Community Health Service (GGD) Brabant Zuidoost, the Netherlands, in 2007. In this Youth Survey, 10 090 randomly selected adolescents aged 12 tot 18 years were each sent a letter, a questionnaire, and a user name and log-in code for if they preferred to complete the Internet version of the questionnaire. Mental health was assessed using the Mental Health Inventory (MHI-5), a short 5-item questionnaire to detect feelings of depression and anxiety. Participants were asked about current alcohol consumption, their relationship with their parents, drug use, and sociodemographic data. Corrected for confounders, binge drinking and mental health problems were associated in the 12 to 15 year old girls (OR 2.43; 95% CI 1.86-3.17, p = 0.000) and boys (OR 1.64, 95% CI 1.19-2.27, p = 0.003). The majority of the 16 to 18 year old adolescents had been binge drinking in the previous 4 weeks (69.6% boys and 56.8% girls). In this age group, boys with mental health problems were less likely to be classified as binge drinkers than were boys without mental health problems (OR 0.63, 95% CI 0.45-0.87, p = 0.005). No such association between binge drinking and mental health was found in girls of this age.

Conclusion

Girls and boys aged 12-15 years were classified as binge drinkers significantly more often when they reported poor mental health. Because binge drinking damages the brain, especially at a young age, it is important that health professionals are alert to possible binge drinking when young adolescents report mental health problems and should ask their patients about their drinking behaviour. Likewise, if youngsters under 16 present with binge drinking, they should be asked whether they are anxious or depressed.     

Serum selenium levels in healthy slovak children and adolescents

Blood serum selenium levels were measured in 891 healthy children and adolescents (aged 11–18 yr, 450 girls and 441 boys) residing in both rural and urban areas from eight regions of Slovakia. Subjects were divided into four age groups (11–12 y, 13–14 y, 15–16 y, and 17–18 y). Serum selenium concentration was determined by the electrothermal atomic absorption spectrometric method. The mean (±SD) serum selenium concentrations were 0.750 ±0.255 μmol/L in girls and 0.773 ±0.235 μmol/L in boys. A large proportion of the individuals (25.7% in girls, 18.1% in boys) exhibited serum selenium levels under 0.57 μmol/L (45 μg/L). An increasing trend of the serum selenium values with age has been observed in both boys (p < 0.01) and girls (p < 0.05). Boys had higher serum selenium levels in the all age groups but the differences were not statistically significant.     

Physical fitness differences between prepubescent boys and girls

The purpose of this study was to analyze in which physical capabilities boys and girls are closer or distant. An additional objective was to find which of the body fat, physical activity, and somatotype factors have a greater effect on prepubescent children's physical fitness. This was a cross-sectional study involving 312 children (10.8 ± 0.4 years). The physical fitness assessment employed sets of aerobic fitness, strength, flexibility, speed, agility, and balance. The boys presented higher values in all selected tests, except tests of balance and flexibility, in which girls scored better. Gender differences in the physical fitness were greatest in the explosive strength of upper (p ≤ 0.01, η(p)(2) = 0.09) and lower limbs (p ≤ 0.01, η(p)(2) = 0.08), although with a medium-size effect of gender, and smaller in the abdominal (p > 0.05, η(p)(2) = 0.007) and upper limbs (p > 0.05, η(p)(2) = 0.003) muscular endurance, and trunk extensor strength and flexibility (p > 0.05, η(p)(2) = 0.001). The endomorphic (p ≤ 0.01, η(p)(2) = 0.26) in the girls, and the ectomorphic (p ≤ 0.01, η(p)(2) = 0.31) and mesomorphic (p ≤ 0.01, η(p)(2) = 0.26) in the boys, had the high-sized effect on the physical fitness. The physical activity in the girls, and the endomorphic and body fat in the boys, did not have a significant effect. These findings can help in the planning of activities that take into account the success and motivation of both boys and girls and thus increase levels of physical activity and physical fitness at school. However, in prepubescent children, one cannot neglect the influence of genetic determinism, observed from the morphoconstitutional point of view.     

Cardiorespiratory fitness and sedentary activities are associated with adiposity in adolescents

Objective: To determine whether physical activity, sedentary activities, and/or cardiorespiratory fitness are related to waist circumference in adolescents, as previously reported in adults. Research Methods and Procedures: The study subjects were a representative sample of Spanish adolescents (N = 2859; 1357 boys, 1502 girls; age, 13 to 18.5 years), all of whom were involved in the AVENA (Food and Assessment of the Nutritional Status of Adolescents) study. BMI, waist circumference, pubertal maturation status, and cardiorespiratory fitness were measured in all. Leisure‐time physical activity, sedentary activities, active commuting to school, and socioeconomic status were assessed by self‐reported questionnaires. Results: No relationship was found between leisure‐time physical activity and BMI or waist circumference. In contrast, and in both boys and girls and after adjustment for confounding variables, cardiorespiratory fitness was found to be inversely associated with waist circumference and BMI, independent of sedentary activities or physical activity (p ≤ 0.001). The maximum oxygen consumption explained 13% of the variance in waist circumference in boys and 16% in girls. Sedentary activities were independently and directly related to waist circumference in both boys and girls (p ≤ 0.05) and to BMI in boys (p ≤ 0.05). Sedentary activities explained 10% of the variance in waist circumference in boys and 18% in girls. The BMI‐adjusted waist circumference was inversely correlated with cardiorespiratory fitness in overweight‐obese boys (p ≤ 0.05) and showed a trend toward significance in girls (p ≤ 0.1). Discussion: Both moderate to high levels of cardiorespiratory fitness and sedentary activities, but not physical activity, are associated with lower abdominal adiposity, as measured by waist circumference.     

A Longitudinal Study: Changes in Cortical Thickness and Surface Area during Pubertal Maturation

Sex hormones have been shown to contribute to the organization and function of the brain during puberty and adolescence. Moreover, it has been suggested that distinct hormone changes in girls versus boys may contribute to the emergence of sex differences in internalizing and externalizing behavior during adolescence. In the current longitudinal study, the influence of within-subject changes in puberty (physical and hormonal) on cortical thickness and surface area was examined across a 2-year span, while controlling for age. Greater increases in Tanner Stage predicted less superior frontal thinning and decreases in precuneus surface area in both sexes. Significant Tanner Stage and sex interactions were also seen, with less right superior temporal thinning in girls but not boys, as well as greater decreases in the right bank of the superior temporal sulcus surface area in boys compared to girls. In addition, within-subject changes in testosterone over the 2-year follow-up period were found to relate to decreases in middle superior frontal surface area in boys, but increases in surface area in girls. Lastly, larger increases in estradiol in girls predicted greater middle temporal lobe thinning. These results show that within-subject physical and hormonal markers of puberty relate to region and sex-specific changes in cortical development across adolescence.     

Factors affecting the motivation for dental check‐ups and anxiety in the elderly in Tokyo

Objectives: The purpose of this study was to identify factors influencing the motivation for regular dental check‐ups and anxiety about future dental problems in the elderly. Background: Regular dental check‐ups are important to maintain oral health. Anxiety affects the quality of life of the elderly. However, few studies have investigated the factors influencing the motivation for regular dental check‐ups and anxiety in the elderly. Materials and methods: Among 452 elderly persons, 215 participants provided useful answers to our questionnaire. The questionnaire consisted of items concerning oral and living conditions of the subjects. Logistic regression analysis was conducted. Results: The mean age of the study sample was 75.7 ± 5.8 years. The percentage of edentulous subjects was 12.1%. The motivation for regular dental check‐ups was significantly positively correlated with the number of teeth present (p < 0.01), using inter‐dental brushes (p < 0.01), being on regular prescribed medication (p < 0.05), and having experience of providing oral care for the bedridden (p < 0.05). Anxiety about future oral problems was significantly associated with self‐rated health status (p < 0.01) and the presence of dentists who could be counted on to provide domiciliary visits (p < 0.05). Conclusion: The participants of this study had a high motivation for regular dental check‐ups, but were concerned about the future, particularly if they became bedridden.     

Do Media Use and Physical Activity Compete in Adolescents? Results of the MoMo Study

PurposeThe displacement hypothesis predicts that physical activity and media use compete in adolescents; however, findings are inconsistent. A more differentiated approach at determining the co-occurrence of physical activity and media use behaviors within subjects may be warranted. The aim of this study was to determine the co-occurrence of physical activity and media use by identifying clusters of adolescents with specific behavior patterns including physical activity in various settings (school, sports club, leisure time) and different types of media use (watching TV, playing console games, using PC / Internet).MethodsCross-sectional data of 2,083 adolescents (11–17 years) from all over Germany were collected between 2009 and 2012 in the Motorik-Modul Study. Physical activity and media use were self-reported. Cluster analyses (Ward’s method and K-means analysis) were used to identify behavior patterns of boys and girls separately.ResultsEight clusters were identified for boys and seven for girls. The clusters demonstrated that a high proportion of boys (33%) as well as girls (42%) show low engagement in both physical activity and media use, irrespective of setting or type of media. Other adolescents are engaged in both behaviors, but either physical activity (35% of boys, 27% of girls) or media use (31% of boys and girls) predominates. These adolescents belong to different clusters, whereat in most clusters either one specific setting of physical activity or a specific combination of different types of media predominates.ConclusionThe results of this study support to some extent the hypothesis that media use and physical activity compete: Very high media use occurred with low physical activity behavior, but very high activity levels co-occurred with considerable amounts of time using any media. There was no evidence that type of used media was related to physical activity levels, neither setting of physical activity was related to amount of media use in any pattern.     

Competence and behavioral/emotional problems in Croatian children--parents' and teachers' reports: pilot study

Achenbach's Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were administered to school children aged between 7-11 comprising a non-referred sample (n = 349) drawn from the whole country. Those were the first data on the CBCL and TRF in Croatia. Both in the CBCL and TRF boys had higher scores compared to girls in the Externalizing and Total Problems scale (p < 0.01 and p < 0.05). Parents rated higher scores to the Internalizing and Externalizing scales and the Total Problems scale in both sexes (p < 0.01 and p < 0.05), with the exception of the Internalizing scale in boys. Parents are very important observers of mental health problems in children.     

Serum leptin concentration and its effect on puberty in Naqu Tibetan adolescents

This study aimed to clarify the regularity of leptin in Naqu Tibetan adolescents. This study investigated the concentration of fasting serum leptin and clarified its relationship between BMI and other indices. Healthy Naqu Tibetan adolescents aged 12-18 were investigated randomly in the study. They were divided into seven groups (each year as one group, 12 boys and 12 girls in each group); serum concentrations of leptin, estradiol, testosterone (T), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were analyzed. The height and body weight of the 168 healthy Naqu Tibetan adolescents were also assessed. The leptin level in boys decreased with age but increased in girls; in boys and girls they both differed between groups (p<0.05). In boys, the leptin level was inversely correlated with body mass index (BMI), FSH, and T (p<0.05), while in girls, it was positively related to BMI, FSH, LH, and E2 (p<0.01).These findings suggested that during puberty the serum leptin concentration increased with age in girls while it decreased in boys; in the same age group, the leptin level in girls was significantly higher than in boys. Leptin may have some relationship with puberty in Tibetan adolescents.     

Effect of strength training and the practice of Alpine skiing on bone mass density, growth, body composition, and the strength and power of the legs of adolescent skiers

This work examines the influence of practicing strength training and Alpine skiing over 2 years on bone mineral density (BMD), growth, body composition, and the strength and power of the legs of adolescent skiers. The study subjects were 20 adolescent skiers (10 girls and 10 boys) and 19 sedentary adolescents (9 girls and 10 boys), all 13-16 years of age. The BMDs of the lumbar column (L2-L4) and hip (neck of the femur, trochanter, and Ward's triangle) were determined by dual x-ray photon absorptiometry at the beginning and end of the experimental period. The increase in height and the percentage fat and muscular masses of the subjects were also recorded, as was their ability to jump (countermovement jump [CMJ]), their leg strength and power (squat test), and their leg anaerobic power (continuous jump test [CMJ15″]). No significant differences were seen in the increase in height, body weight, or percentage fat mass between the skiers and sedentary subjects, although the boy skiers showed a significant increase in percentage muscular mass (p < 0.05) compared to the sedentary boys. The improvement in the values of the different CMJ variables was significantly greater among the boy skiers than among the sedentary boys (p < 0.001-0.01). The same was true for the girls (p < 0.001), except for CMJ15″. The skiers experienced a significantly greater increase in L2-L4 BMD than the sedentary subjects (boys p < 0.05; girls p < 0.01). These results suggest that Alpine skiing combined with rational strength training involves no special risk for the physical development of young people, has a positive effect on the power and the percentage of muscle mass in the legs, and helps to have a higher bone density in the lumbar spine (L2-L4).     

Adolescents’ Use of Care for Behavioral and Emotional Problems: Types,Trends, and Determinants

Objective

While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10–19 years.

Methods

We obtained longitudinal data on 2,230 adolescents during ages 10–19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.

Results

Overall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).

Discussion

Adolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.     

Sex, age and caste differences in somatotypes of Rajput and scheduled caste adolescents from the Sirmour District of Himachal Pradesh, India

Somatotypes of a cross-sectional sample of 544 rural adolescents ranging in age from 11 to 17 years are described. The sample included 269 Rajput (141 girls and 128 boys) and 275 Scheduled Caste (135 girls and 140 boys) subjects. Each subject was somatotyped using the Heath-Carter anthropometric somatotype protocol (Carter & Heath 1990). In all, ten anthropometric measurements namely height, weight, bicondylar diameters of humerus and femur, flexed mid-upper-arm and calf circumferences, and triceps, subscapular, supraspinale and calf skinfolds were taken. The mean somatotypes of the Rajput boys and girls were 1.62- 3.30-3.85 (mesomorphic-ectomorph) and 2.42-2.90-3.99 (balanced ectomorph), respectively. The mean somatotypes of the Scheduled Caste subjects were 1.51-3.02-3.74 (mesomorphic-ectomorph) for boys and 2.38-2.64-3.70 (balanced ectomorph) for girls. A one-way ANOVA revealed that females of both the caste groups were significantly (p < or = 0.05) more endomorphic than the males. The sex differences in other two components were not significant (p +/- 0.05). Caste differences, as revealed by a one-way ANOVA analysis, were not significant (p +/- 0.05) in both sexes. With the exception of the Rajput girls, the differences in whole somatotypes between those in an early phase of adolescence and those in an advanced phase of adolescence were not significant (p = 0.05). The results indicate that populations exposed to same environmental situations for a long period of time tend to show similarity in physique. A one-way MANOVA analysis, which used Wilk's Lambda as test statistics, revealed that from 11-17 years there was no significant change (p < or = 0.05) in component dominance of mean somatotypes in the boys and girls of the present sample. Among males of a majority of the Indian populations, ectomorphy dominates over endomorphy and mesomorphy from 11 to 17 years.     

Psychosocial and cognitive function in children with nephrotic syndrome: association with disease and treatment variables

Background

To investigate possible differences in emotional/behavioral problems and cognitive function in children with nephrotic syndrome compared to healthy controls and to examine the effect of disease-specific and steroid treatment-specific characteristics on the abovementioned variables.

Methods

Forty-one patients with nephrotic syndrome (23 boys, age range: 4.4-15.2 years) and 42 sex- and age-matched healthy control subjects (20 boys, age range: 4.1-13.4 years) were enrolled in the study. Disease (severity, age of diagnosis, duration) and steroid treatment (total duration, present methylprednisolone dose and duration of present dose) data were collected. In order to assess children’s emotional/behavioral problems, the Child Behavior Checklist was administered. The Wechsler Intelligence Scale for Children – Third Edition was administered to assess Full-Scale, Verbal, and Performance intelligence quotient (IQ) scores.

Results

The patients presented with more internalizing problems (P?=?0.015), including withdrawal (P?=?0.012) and somatic complaints (P?=?0 .011), but not more anxiety/depression or externalizing problems. A significant association was found between severity of disease and somatic complaints (P?=?0.017) as well as externalizing problems (P?=?0.030). Years of illness were significantly more in those presenting with abnormal anxiety/depression (P?=?0.011). Duration of steroid medication was significantly higher among those presenting with abnormal anxiety/depression (P?=?0.011) and externalizing problems (P?=?0.039). IQ was not associated significantly with disease or steroid treatment variables.

Conclusions

Psychosocial factors and outcomes may be important correlates of children’s nephrotic syndrome and potential targets of thorough assessment and treatment.

     

Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: longitudinal and concurrent associations with cortisol

Research examining cortisol dysregulation is seemingly contradictory with studies showing that both internalizing and externalizing behaviors are related to high and low cortisol. One extant theory to explain divergent findings in the stress literature is that both hypo- and hyper-arousal of the hypothalamic-pituitary-adrenal (HPA) axis may be present depending on time since onset of the stressor. This theory may extend to the onset of internalizing and externalizing behaviors. Data from 96 youth participating in a longitudinal project were used to examine this possibility. Composite measures of internalizing and externalizing behaviors at both childhood and early adolescence were formed using mother and teacher reports. Multiple salivary cortisol samples were also collected over two consecutive days during early adolescence. Problematic behaviors were associated with cortisol and the direction of the association was dependent on amount of time passed since onset of the behaviors. When examined concurrently in adolescence, youth with more internalizing behaviors had higher morning cortisol; however, when examined longitudinally, youth with more internalizing behaviors in childhood had lower morning cortisol levels as adolescents. Youth with more externalizing behaviors in childhood had flattened diurnal cortisol rhythms as adolescents, and this finding persisted when examined in adolescence. Cortisol dysregulation was greatest in children with the most severe behavior problems. Findings support the theoretical model of blunting of the HPA axis over time. While the HPA axis may show hyper-arousal when youth first display behaviors, long-term exposure may lead to a hypo-arousal of the HPA axis which culminates in a dysregulated diurnal rhythm.     

Age and gender differences in the physical activity patterns of urban schoolchildren in Korea and China

Physical activity in childhood is important as it may establish adult behavior. However, few studies on physical activity in children have been conducted, especially in Asian children.We performed anthropometric measurements of 159 school children in two grades (grade 5: 10-11 years old and grade 8: 13-14 years old) from urban areas of Korea (n=79) and China (n=80). The total daily energy expenditure (TEE) was estimated for 7 consecutive days using an accelerometer.The mean height, weight, and body mass index (BMI) for boys and girls in both countries exceeded the US national reference median (CDC, 2000). Physical activity levels (PALs) were significantly higher in the grade 5 group (10-11 years old) and in girls than in boys for both grades. No significant difference in PALs or daily step-counts (STPs) was observed between 'normal' and 'overweight' subgroups based on BMI, although negative correlations were found between weight, BMI, or %body fat vs. PAL or STP among Korean girls and Chinese boys (r=0.32-0.38, all p<0.05). Daily variation in physical activity was observed in Korean children. In the Koreans (boys and girls, both grades pooled), TEE and STP were significantly lower than the 7-day average on Sundays, whereas for the Chinese population, STP did not clearly differ between the weekends and the week averages.In summary, PALs were higher in the fifth grade boys and girls than in the eighth grade children; interestingly, girls tended to have higher PALs than boys. Daily variation in physical activity was observed in Korea; children were less active on Sundays.