No Country for Old Men

Within affluent societies, people who grow up in deprived areas begin reproduction much earlier than their affluent peers, and they display a number of other behaviors adapted to an environment in which life will be short. The psychological mechanisms regulating life-history strategies may be sensitive to the age profile of the people encountered during everyday activities. We hypothesized that this age profile might differ between environments of different socioeconomic composition. We tested this hypothesis with a simple observational study comparing the estimated age distribution of people using the streets in an affluent and a socioeconomically deprived neighborhood which were closely matched in other ways. We were also able to use the UK census to compare the age profile of observed street users with the actual age profile of the community. We found that people over 60?years of age were strikingly less often observed on the street in the deprived than in the affluent neighborhood, whereas young adults were observed more often. These differences were not reflections of the different age profiles of people who lived there, but rather of differences in which residents use the streets. The way people use the streets varies with age in different ways in the affluent and the deprived neighborhoods. We argue that chronic exposure to a world where there are many visible young adults and few visible old ones may activate psychological mechanisms that produce fast life-history strategies.     

Examining the Social Porosity of Environmental Features on Neighborhood Sociability and Attachment

The local neighborhood forms an integral part of our lives. It provides the context through which social networks are nurtured and the foundation from which a sense of attachment and cohesion with fellow residents can be established. Whereas much of the previous research has examined the role of social and demographic characteristic in relation to the level of neighboring and cohesion, this paper explores whether particular environmental features in the neighborhood affect social porosity. We define social porosity as the degree to which social ties flow over the surface of a neighborhood. The focus of our paper is to examine the extent to which a neighborhood''s environmental features impede the level of social porosity present among residents. To do this, we integrate data from the census, topographic databases and a 2010 survey of 4,351 residents from 146 neighborhoods in Australia. The study introduces the concepts of wedges and social holes. The presence of two sources of wedges is measured: rivers and highways. The presence of two sources of social holes is measured: parks and industrial areas. Borrowing from the geography literature, several measures are constructed to capture how these features collectively carve up the physical environment of neighborhoods. We then consider how this influences residents'' neighboring behavior, their level of attachment to the neighborhood and their sense of neighborhood cohesion. We find that the distance of a neighborhood to one form of social hole–industrial areas–has a particularly strong negative effect on all three dependent variables. The presence of the other form of social hole–parks–has a weaker negative effect. Neighborhood wedges also impact social interaction. Both the length of a river and the number of highway fragments in a neighborhood has a consistent negative effect on neighboring, attachment and cohesion.     

The Evolution of a Kleptoparasitic System under Adaptive Dynamics

Kleptoparasitism, the stealing of food items, is a common biological phenomenon which has been modelled mathematically in a series of recent papers. A common assumption, following early work, was that mixed strategy solutions were not possible. In this paper we consider the evolution of mixed strategies under adaptive dynamics and show that such mixed strategies can be stable solutions under certain assumptions. In particular we revisit the recent paper of Broom et al. (Bull math Biol 66, 1645–1658, 2004) which assumed pure solutions only, and reanalyze the model under this new formulation. The second author was supported by the UNCG New Faculty Grant.     

Residential density,social overload,and social withdrawal

The effects of residential density were examined in the following study through a comparison of experiences of tenants living in 14-story apartment buildings and those in three-story walkups within the same low-income housing project. It was hypothesized that tenants in the high-rise buildings would come into contact with large numbers of others in the public spaces of their buildings. As these contacts exceeded residents' interaction capacity or ability to process relevant incoming social stimuli tenants would experience social overload. This experience would be manifested by tenants' perceptions of crowding in the building, feelings of less control, safety, and privacy in the immediate residential environment, problematic social relationships among tenants and alienation and dissatisfaction with the residential environment generally. These experiences were not expected to occur for tenants in the low-rise walkups. Interview data supported these hypotheses and revealed, in addition, that high-rise apartment residents were less socially active beyond their building and felt a greater sense of powerlessness in effecting management decisions. Correlational analyses provided further evidence of the vast differences between residents' experiences of the two building types.     

Perception of neighborhoods by city and suburban residents

A number of neighborhood studies have supported the view that urban areas are a mosaic of local communities or neighborhoods with clear boundaries and a high degree of identity. However, many of these studies are based on highly identifiable innercity natural areas in large metropolitan centers; thus, the generalizability of these findings is limited. Two studies broadened the investigation of these issues by looking at neighborhood perceptions of residents living in relatively undifferentiated innercity, outercity, and suburban areas of a middle-sized metropolitan area. In both studies, residents were asked to draw and describe their neighborhood. The first study (N=72) indicated that the content of neighborhood images differed by area of the city: city residents ascribed the same number of positive characteristics, but more negative characteristics to their neighborhood than did suburban residents. Moreover, suburban residents in both studies drew neighborhoods that were substantially larger than the innercity neighborhoods. The second study, conducted with 24 immediate neighbors from the inner city and suburb, indicated that in both areas there was a high degree of agreement among neighbors on the neighborhood limits, but little consensus on a neighborhood name. These results support and extend the local community model of neighborhoods: From city to suburb the imagability of neighborhood does not differ; it is both high and consensual. But the content of the image does change; suburban neighborhoods are seen as larger and less negative.The authors, a sociologist and a psychologist, respectively, are colleagues in the Urban Analysis Concentration program, University of Wisconsin-Green Bay, Green Bay, Wisconsin.     

The Crested Lark Galerida cristata as an example of a bird species that benefits from agricultural management in western Poland

ABSTRACT

Capsule: The Crested Lark Galerida cristata as an example of a species which selects habitats which have undergone agricultural intensification.

Aims: To describe habitat preferences of the Crested Lark in western Poland.

Methods: We surveyed 30 randomly chosen study plots (1?km²) in western Poland to detect breeding pairs of Crested Larks. Sentinel and direct observations in the field were used to provide habitat data. Generalized linear mixed models were used to determine what type of environments habitats were selected by the Crested Larks.

Results: We recorded a total of 106 pairs of Crested Larks in 30 study plots. Birds inhabited farmland environments, where their preferred habitats included buildings, silage, and arable land with cereals.

Conclusion: Silage, which is associated with agricultural intensification within agricultural landscapes, increased the chances of the occurrence of Crested Larks.     

Application of CT images in the diagnosis of lung cancer based on finite mixed model

ObjectiveInvestigating the application of CT images when diagnosing lung cancer based on finite mixture model is the objective. Method: 120 clean healthy rats were taken as the research objects to establish lung cancer rat model and carry out lung CT image examination. After the successful CT image data preprocessing, the image is segmented by different methods, which include lung nodule segmentation on the basis of Adaptive Particle Swarm Optimization – Gaussian mixture model (APSO-GMM), lung nodule segmentation on the basis of Adaptive Particle Swarm Optimization – gamma mixture model (APSO-GaMM), lung nodule segmentation based on statistical information and self-selected mixed distribution model, and lung nodule segmentation based on neighborhood information and self-selected mixed distribution model. The segmentation effect is evaluated. Results: Compared with the results of lung nodule segmentation based on statistical information and self-selected mixed distribution model, the Dice coefficient of lung nodule segmentation based on neighborhood information and self-selected mixed distribution model is higher, the relative final measurement accuracy is smaller, the segmentation is more accurate, but the running time is longer. Compared with APSO-GMM and APSO-GaMM, the dice value of self-selected mixed distribution model segmentation method is larger, and the final measurement accuracy is smaller. Conclusion: Among the five methods, the dice value of the self-selected mixed distribution model based on neighborhood information is the largest, and the relative accuracy of the final measurement is the smallest, indicating that the segmentation effect of the self-selected mixed distribution model based on neighborhood information is the best.     

Who Will Manage American Patients With Diabetes? Residents’ Career Preferences and Perceptions of Diabetes Care

ObjectiveTo identify the factors that encourage or discourage internal medicine and pediatric residents regarding specializing in endocrinology with a focus on diabetes.MethodsWe conducted an electronic survey of internal medicine and pediatric residents using a $10 participation incentive. A total of 653 residents responded to the survey (estimated response rate of 9.2%)—626 from residency programs that were contacted for our survey and 27 from referrals.ResultsAmong internal medicine and pediatric residents surveyed, 39 respondents (6.0%) planned to specialize in endocrinology, and 27 of these (4.1% of total respondents) planned to focus on diabetes. “Intellectual satisfaction, ” “emotional satisfaction, ” and “work-life balance” were identified by respondents as the most important factors in their choice of a specialty, with ratings of 5.5, 5.4, and 5.3 on a 6-point Likert scale. Among these factors identified as most important to a medical career, endocrinology with a focus on diabetes scored poorly with regard to intellectual and emotional satisfaction but received high ranking with regard to lifestyle. With regard to other factors, endocrinology was rated negatively on “compensation, ” “number of procedures, ” and “patient adherence to prescribed treatment.” Exposure to diabetes during training had no major influence on the decision to enter endocrinology.ConclusionEndocrinology with a focus on diabetes care is not an attractive specialty for most internal medicine and pediatric residents. Therefore, new strategies to attract residents to the field of diabetes care are needed. (Endocr Pract. 2011;17:235-239)     

Scales of Environmental Engagement in an Industrial Town: Glocal Perspectives from Gladstone,Queensland

ABSTRACT

Gladstone, Queensland, is one of Australia’s largest coal ports and the site of many industries. Few of the 65,000 residents of the region are socially and economically independent of the fossil fuel industry. Environmental engagement is fragmented. The city epitomises, in a striking way, the double bind of growth and sustainability. The Australian environmental movement is generally seen as distant and irrelevant to local concerns. The article analyses conditions for, forms of and implications of environmental engagement in a city where coal, gas and industry are taken for granted as necessary conditions for prosperity and economic security. To what extent are ecological relevant to the residents; and how can they be dealt with within the parameters that define their lifeworlds? What can the Gladstone experience teach us about possible solutions to the double bind of growth and sustainability?     

Management of Inpatient Hyperglycemia: Assessing Perceptions and Barriers to Care Among Resident Physicians

Objective:To develop insight into resident physician attitudes about inpatient hyperglycemia and determine perceived barriers to optimal management.Methods:As part of a planned educational program, a questionnaire was designed and administered to determine the opinions of residents about the importance o inpatient glucose control, their perceptions about what glucose ranges were desirable, and the problems they encountered when trying to manage hyperglycemia in hospitalized patients.ResultsOf 70 resident physicians from various services, 52 completed the survey (mean age, 31 years; 48% men; 37% in first year of residency training). Most respondents indicated that glucose control was “very important” in critically ill and perioperative patients but only “somewhat important” in non-critically ill patients. Most residents indicated that they would target a therapeutic glucose range within the recommended levels in published guidelines. Most residents also said they felt “somewhat comfortable” managing hyperglycemia and hypoglycemia and using subcutaneous insulin therapy. whereas most residents (48%) were “not at all comfortable” with use of intravenous administration of insulin. In general, respondents were not very familiar with existing institutional policies and preprinted order sets relating to glucose management. The most commonly reported barrier to management of inpatient hyperglycemia was lack of knowledge about appropriate insulin regimens and how to use them. Anxiety about hypoglycemia was only the third most frequent concern.ConclusionMost residents acknowledged the importance of good glucose control in hospitalized patients and chose target glucose ranges consistent with existing guidelines. Lack of knowledge about insulin treatment options was the most commonly cited barrier to ideal management. Educational programs should emphasize inpatient treatment strategies for glycemic control. (Endocr Pract. 2007;13:117-125)     

Reducing cooling load and lifecycle cost for residential buildings: a case of Lahore,Pakistan

Purpose

Buildings consume a large amount of energy for space cooling during the summer season, creating an overall sustainability concern. The upfront cost associated with sustainability repels the decision-makers to often end up adopting solutions that have huge operations and maintenance costs. Therefore, the purpose of this study is to assess the lifecycle cost (LCC) implications of optimum configurations of active and passive strategies for reducing the cooling load in buildings.

Methods

Several green building active and passive strategies and technologies were assimilated and their thermal performance in a hot semi-arid climate of Lahore in Pakistan using DesignBuilder V6.1 was simulated to obtain the most optimum cooling load configuration. Furthermore, LCC is estimated, and overall efficiency is evaluated to identify the most effective space cooling configuration.

Results and discussion

The results suggest that a configuration of EPS for external wall insulation, vertical louvers for external shading, 6 mm blue HRG (low-E soft coated)?+?12 mm air space?+?6 mm clear glass for windows, polystyrene as roof insulation, cross ventilation through windows, and LED lighting system has the best performance. This is the first-of-its-kind study in the hot semi-arid climate of South Asia with the city of Lahore in Pakistan as the test case and can be generalized for places with similar conditions. The findings will help the decision-makers in selecting the most load-efficient and cost-effective green building technologies to help improve overall sustainability.

Conclusion

The implementation of the proposed strategies not only aids in providing user-friendly and effective decision-making but also promotes the adoption of sustainability in buildings by leveraging the existing green building technologies to enhance the environmental and economic aspects. This is a promising approach to facilitate the spread of green building construction in developing countries. It is recommended to utilize the strategies grouped in Scenario 8 to achieve a reduced cooling load and LCC of a residential building throughout its lifecycle.

     

Goats and garbage in Khartoum,Sudan: A study of the urban ecology of animal keeping

Waste management in developing world urban areas is an acute problem which is linked to high growth rates and abatement methods less advanced than in the developed world. Existing neighborhood waste management practices often include the use of organic waste as a feed supplement for urban livestock (mainly goats, but also sheep and cattle). These urban animals bring economic benefits to less affluent residents, who would suffer an economic loss if their supply of urban waste was reduced or eliminated by an organized waste collection and disposal strategy. This paper employs a survey of 319 Greater Khartoum households to derive an estimate of waste intake per urban animal, and illustrate demographic factors (e.g., rural or urban roots, income, education, number of children) which influence animal keeping. A loglinear/logit model is developed to predict animal-keeping households. This model can be applied by waste management planners to estimate the frequency of urban animals in developing world urban areas.     

Social vulnerability among cancer patients and changes in vulnerability during their trajectories – A longitudinal population-based study

BackgroundIdentification of socially vulnerable cancer patients in the health care system is difficult. Only little is known concerning changes in the patients’ social circumstances during the trajectory. Such knowledge is valuable regarding the identification of socially vulnerable patients in the health care system. The objective of this study was to use administrative data to identify population-based characteristics of socially vulnerable cancer patients and investigate how social vulnerability changed during the cancer trajectory.MethodologyA registry-based social vulnerability index (rSVI) was applied to each cancer patient prior to their diagnosis, and used to assess changes in social vulnerability after the diagnosis.ResultsA total of 32,497 cancer patients were included. Short-term survivors (n = 13,994) died from cancer from one to three years after the diagnosis, and long-term survivors (n = 18,555) survived at least three years after the diagnosis. 2452 (18 %) short-term survivors and 2563 (14 %) long-term survivors were categorized as socially vulnerable at diagnosis, of these 22 % and 33 % changed category to not socially vulnerable during the first two years after the diagnosis, respectively. For patients changing status of social vulnerability, several social and health-related indicators changed, which is in line with the complexity of the multifactorial social vulnerability. Less than 6 % of the patients categorized as not vulnerable at diagnosis, changed to become vulnerable during the following two years.ConclusionDuring the cancer trajectory, social vulnerability may change in both directions. Surprisingly, more patients, who were categorized as socially vulnerable when their cancer was diagnosed, changed status to not socially vulnerable during follow-up. Future research should attempt to increase knowledge on identifying cancer patients, who experience deterioration after the diagnosis.     

Identifying unique neighborhood characteristics to guide health planning for stroke and heart attack: fuzzy cluster and discriminant analyses approaches

Background

Socioeconomic, demographic, and geographic factors are known determinants of stroke and myocardial infarction (MI) risk. Clustering of these factors in neighborhoods needs to be taken into consideration during planning, prioritization and implementation of health programs intended to reduce disparities. Given the complex and multidimensional nature of these factors, multivariate methods are needed to identify neighborhood clusters of these determinants so as to better understand the unique neighborhood profiles. This information is critical for evidence-based health planning and service provision. Therefore, this study used a robust multivariate approach to classify neighborhoods and identify their socio-demographic characteristics so as to provide information for evidence-based neighborhood health planning for stroke and MI.

Methods and Findings

The study was performed in East Tennessee Appalachia, an area with one of the highest stroke and MI risks in USA. Robust principal component analysis was performed on neighborhood (census tract) socioeconomic and demographic characteristics, obtained from the US Census, to reduce the dimensionality and influence of outliers in the data. Fuzzy cluster analysis was used to classify neighborhoods into Peer Neighborhoods (PNs) based on their socioeconomic and demographic characteristics. Nearest neighbor discriminant analysis and decision trees were used to validate PNs and determine the characteristics important for discrimination. Stroke and MI mortality risks were compared across PNs. Four distinct PNs were identified and their unique characteristics and potential health needs described. The highest risk of stroke and MI mortality tended to occur in less affluent PNs located in urban areas, while the suburban most affluent PNs had the lowest risk.

Conclusions

Implementation of this multivariate strategy provides health planners useful information to better understand and effectively plan for the unique neighborhood health needs and is important in guiding resource allocation, service provision, and policy decisions to address neighborhood health disparities and improve population health.     

The relationship between ethnicity,social deprivation and late presentation of colorectal cancer

IntroductionTumour staging at time of presentation is an important factor in determining survival in colorectal cancer. The aim of this paper is to investigate the relationship between ethnicity and deprivation in late (Stage IV) presentation of colorectal cancer.MethodsData from the Thames Cancer Registry comprising 77,057 colorectal cancer patients between the years 2000 and 2012 were analysed.ResultsA total of 17,348 patients were identified with complete data, of which 53.9% were male. Patients from a Black Afro/Caribbean background were diagnosed with CRC at a much younger age than the White British group (median age 67 compared with 72, p < 0.001). In multiple regression, ethnicity, deprivation and age were positive predictors of presenting with advanced tumour stage at time of diagnosis. Black patients were more likely to present with Stage IV tumours than white patients (OR 1.37, 95% CI 1.18–1.59, p < 0.001). Social deprivation was also a predictor of Stage IV cancer presentation, with the most deprived group (Quintile 5) 1.26 times more likely to be diagnosed with Stage IV cancer compared with the most affluent group (CI 1.13–1.40, p < 0.001). Sub-group analyses demonstrated that Black & Affluent patients were still at greater risk of Stage IV CRC than their White & Affluent counterparts (OR 1.24, 95% CI 1.11–1.45, p = 0.023). Patients with rectal cancer were less likely to present with Stage IV CRC (OR 0.66, 95% CI 0.61–0.71, p < 0.001).ConclusionRacial and age related disparities exist in tumour presentation in the United Kingdom. Patients from black and socially deprived backgrounds as well as the elderly are more likely to present with advanced tumours at time of diagnosis.     

The visual remaking of urban space: Relocation and the use of public housing in “modern” Cairo

Focusing on an urban group that was moved from the center of the capital during 1979–1981 to public housing in a neighborhood in northern Cairo,1 this article explores some of the strategies used by the relocated population to articulate their daily needs and cultural dispositions with the state's hegemonic construction of “modern” space. The discussion focuses on the visual manifestations of these strategies that localize change in durable forms. It is the visibility of these transformations, the article shows, that makes them important signs of distinction and markers of social status. At the same time, it is this visibility that transforms the housing project and remakes the image of Cairo that the state envisaged.     

Influence of Socio-Economic Inequalities on Access to Renal Transplantation and Survival of Patients with End-Stage Renal Disease

BackgroundPublic and scientific concerns about the social gradient of end-stage renal disease and access to renal replacement therapies are increasing. This study investigated the influence of social inequalities on the (i) access to renal transplant waiting list, (ii) access to renal transplantation and (iii) patients’ survival.MethodsAll incident adult patients with end-stage renal disease who lived in Bretagne, a French region, and started dialysis during the 2004–2009 period were geocoded in census-blocks. To each census-block was assigned a level of neighborhood deprivation and a degree of urbanization. Cox proportional hazards models were used to identify factors associated with each study outcome.ResultsPatients living in neighborhoods with low level of deprivation had more chance to be placed on the waiting list and less risk of death (HR = 1.40 95%CI: [1.1–1.7]; HR = 0.82 95%CI: [0.7–0.98]), but this association did not remain after adjustment for the patients’ clinical features. The likelihood of receiving renal transplantation after being waitlisted was not associated with neighborhood deprivation in univariate and multivariate analyses.ConclusionsIn a mixed rural and urban French region, patients living in deprived or advantaged neighborhoods had the same chance to be placed on the waiting list and to undergo renal transplantation. They also showed the same mortality risk, when their clinical features were taken into account.     

Refurbishment of office buildings in New Zealand: identifying priorities for reducing environmental impacts

Purpose

In recent years, the building sector has highlighted the importance of operational energy and efficient resource management in order to reduce the environmental impacts of buildings. However, differences in building-specific properties (building location, size, construction material, etc.) pose a major challenge in development of generic policy on buildings. The aim of this study was to investigate the relationship between energy and resource management policies, and building-specific characteristics on environmental impacts of refurbished office buildings in New Zealand.

Methods

Life Cycle Assessment (LCA) was performed for 17 office buildings operating under seven representative climatic conditions found in New Zealand. Each building was assessed under four policy scenarios: (i) business-as-usual, (ii) use of on-site photovoltaic (PV) panels, (iii) electricity supply from a renewable energy grid, and (iv) best practice construction activities adopted at site. The influence of 15 building-specific characteristics in combination with each scenario was evaluated. The study adopted regression analysis, more specifically Kruskal-Wallis and General Additive Modeling (GAM), to support interpretation of the LCA results.

Results and discussion

All the chosen policies can significantly contribute to climate change mitigation as compared to business-as-usual. However, the Kruskal-Wallis results highlight policies on increasing renewable energy sources supplying national grid electricity can substantially reduce the impacts across most environmental impact categories. Better construction practices should be prioritized over PV installation as use of on-site PV significantly increases the environmental impacts related to use of resources. The GAM results show on-site PV could be installed in low-rise buildings in regions with long sunshine hours. The results also show the strong influence of façade elements and technical equipment in determining the environmental performance of small and large buildings, respectively. In large multi-storied buildings, efficient HVAC and smaller window area are beneficial features, while in small buildings the choice of façade materials with low embodied impacts should be prioritized.

Conclusions

In general, the study highlighted the importance of policies on increasing renewable energy supply from national grid electricity to substantially reduce most of the impacts related to buildings. In addition, the study also highlighted the importance of better construction practices and building-specific characteristics to reduce the impacts related to resource use. These findings can support policy makers to prioritize strategies to improve the environmental performance of existing buildings in New Zealand and in regions with similar building construction and climate.

     

Effect of a Diabetes Curriculum on Internal Medicine Resident Knowledge

ObjectiveTo determine the effect of a year-long, multifaceted diabetes curriculum on the knowledge of internal medicine residents.MethodsIn this controlled, prospective study, diabetes knowledge assessment was performed with a published questionnaire to measure baseline knowledge, determine change in knowledge at 1 year, and compare resident knowledge with attending knowledge. The questionnaire was administered to residents at the beginning and end of the 2007-2008 academic year. As controls, internal medicine attendings and diabetes care providers were also given the questionnaire. The educational curriculum over the course of the year included order sets, pocket cards, lectures, and rounds. Although all residents were exposed to the education intervention, teaching targeted the postgraduate year (PGY)-1 residents.ResultsOf 91 participating residents, 85 (93%) completed at least 1 questionnaire for a total of 103 questionnaires. Baseline and year-end assessments were completed by 18 residents. Among 25 attendings, 22 (88%) completed questionnaires. Eleven diabetes care providers participated. PGY-3 residents scored 72 ± 10% and PGY-2 residents scored 72 ± 8%, which was significantly greater than the PGY-1 residents’ score of 62 ± 12% (P = .004 and P = .006, respectively). Lectures were associated with knowledge improvement over time (P = .04). The mean attending score of 67 ± 13% was not significantly different from the residents’ scores. Diabetes care providers had the highest score (92 ± 7%).ConclusionsInpatient diabetes education targeted to PGY-1 residents modestly improves resident knowledge, especially in the targeted population. Traditional educational methods may not be adequate, and improved education is needed for trainees and attendings to provide optimal diabetes care. Strategies to improve resident education may include developing more comprehensive lectures that address fundamental concepts, focusing on all PGY levels, frequent consultation with diabetologists, and case-based discussions. (Endocr Pract. 2010;16:408-417)     

Overweight/Obesity and Respiratory and Allergic Disease in Children: International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two

BackgroundChildhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated.MethodsCross-sectional studies of stratified random samples of 8–12-year-old children (n = 10 652) (16 centres in affluent and 8 centres in non-affluent countries) used the standardized methodology of ISAAC Phase Two. Respiratory and allergic symptoms were ascertained by parental questionnaires. Tests for allergic disease were performed. Height and weight were measured, and overweight and obesity were defined according to international definitions. Prevalence rates and prevalence odds ratios were calculated.ResultsOverweight (odds ratio = 1.14, 95%-confidence interval: 0.98; 1.33) and obesity (odds ratio = 1.67, 95%-confidence interval: 1.25; 2.21) were related to wheeze. The relationship was stronger in affluent than in non-affluent centres. Similar results were found for cough and phlegm, rhinitis and eczema but the associations were mostly driven by children with wheeze. There was a clear association of overweight and obesity with airways obstruction (change in FEV1/FVC, −0.90, 95%-confidence interval: −1.33%; −0.47%, for overweight and −2.46%, 95%-confidence interval: −3.84%; −1.07%, for obesity) whereas the results for the other objective markers, including atopy, were null.ConclusionsOur data from a large international child population confirm that there is a strong relation of body mass index with wheeze especially in affluent countries. Moreover, body mass index is associated with an objective marker of airways obstruction (FEV1/FVC) but no other objective markers of respiratory and allergic disorders.