Recognition of Childhood Overweight during Health Supervision Visits: Does BMI Help Pediatricians?

Objective: To assess, in diverse pediatric practices, the frequency of overweight/obesity (OW/OB) identification during health supervision visits and its association with BMI curve use. Research Methods and Procedures: Pediatricians in public and private practice in St. Louis, MO, participated in a study of the care of chronic conditions during health supervision visits. Requested information from 30 visits per pediatrician of children 6 to 17 years of age included the visit note, the growth chart, and a one‐page questionnaire about patient demographics and visit content. Pediatricians indicated the presence and discussion of common chronic conditions, including OW/OB. Identification was compared with patient BMI category, and associations between identification and patient and visit characteristics, including BMI curve use, were examined. Results: Twenty‐one (40%) of contacted pediatricians returned information from 557 visits. Pediatricians identified OW/OB in 27% of children with a BMI at the 85th to 94th percentile and 86% of children with a BMI at or above the 95th percentile. Identification was higher in adolescents but was not associated with patient sex or race, practice setting, insurance type, or visit length. Only 41% of growth charts were current, and 6.1% had BMI plotted. BMI plotting was associated with OW/OB identification when the BMI was at the 85th to 94th percentile but not when the BMI was at or above the 95th percentile. After controlling for BMI percentile, OW/OB identification was significantly associated with diet counseling (odds ratio, 7.46; 95% confidence interval, 3.42 to 16.24) and exercise counseling (odds ratio, 5.57; 95% confidence interval, 2.61 to 11.90). Discussion: Despite low BMI curve use, pediatricians recognized most overweight/obese children with a BMI at or above the 95th percentile. BMI plotting may increase recognition in mildly overweight children.     

Does Help in Decision-Making in Biology Help in Decision-Making in Human Sciences and Conversely?

A link between biological and human sciences may be established, under the condition that we should admit the existence of reciprocal influences between them. The model for the regulation of agonistic antagonistic couples (MRAAC) is built from the study of biological systems and gives rise to specific types of control. This model can be helpful in decision processes in some human sciences such as management, economical and political strategies. The reason for such an opportunity lies in the fact that MRAAC is a general and phenomenological model able to incorporate the whole of the agonistic antagonistic systems. This type of regulation might be related to the concept of the viability of a system (yet also valid for human science systems) and to a functional and structural pattern which is the basis for agonistic antagonistic networks.     

Does Further Education in Adulthood Improve Physical and Mental Health among Australian Women? A Longitudinal Study

Objective

We analyzed whether further education in young adult and mid-life [adult educational mobility] influences physical functioning and depressive symptoms in women.

Methods

14247 women born 1973–78 (younger cohort) and 13715 women born 1946–51 (mid-aged cohort) from the Australian Longitudinal Study on Women’s Health were followed for 14–16 years. Measures were the Short-Form 36 Health Survey physical functioning subscale (SF-36 PF) and Centre for Epidemiologic Studies 10-item Depression Scale (CESD-10). Linear mixed modelling, accounting for time varying covariates, assessed the influence of further education on physical functioning and depressive symptoms over time. Sensitivity analysis to assess the impact of missing data was conducted using multiple imputation.

Results

Compared to younger women with a pre-existing high level of education, women gaining further education (up to age 39 years) from low levels had lower SF-36 PF scores (poorer physical functioning) (fully adjusted beta estimates (95%CIs) -1.52 (-2.59, -0.44)) while those gaining further education from middle to high levels showed equivalent SF-36 PF scores (-0.08 (-0.61, 0.44)). A similar pattern was shown for CESD-10 scores (0.78 (0.29, 1.25); -0.02 (-0.26, 0.21), respectively) where higher scores represented more depressive symptoms. For mid-age women, further education from a middle to high level resulted in equivalent SF-36 PF scores (-0.61 (-1.93,0.71)) but higher CESD-10 scores (0.49 (0.11, 0.86)), compared to highly educated women.

Conclusion

Women who delay further education until they are aged between their 40s and 60s can improve or maintain their physical functioning but may have missed the critical time to minimise depressive symptomatology. Public health policy should focus on encouraging women to upgrade their educational qualifications earlier in life in order to potentially offset the negative associations between their initial lower socio-economic position class of origin and their mental health.     

Linguistic Relativity: Does Language Help or Hinder Perception?

A recent study has explored the interplay between language and perception through the brain's visual pathways. The results suggest an influence of linguistic categories on the speed of colour discrimination.     

Does Genetic Diversity Predict Health in Humans?

Genetic diversity, especially at genes important for immune functioning within the Major Histocompatibility Complex (MHC), has been associated with fitness-related traits, including disease resistance, in many species. Recently, genetic diversity has been associated with mate preferences in humans. Here we asked whether these preferences are adaptive in terms of obtaining healthier mates. We investigated whether genetic diversity (heterozygosity and standardized mean d²) at MHC and nonMHC microsatellite loci, predicted health in 153 individuals. Individuals with greater allelic diversity (d²) at nonMHC loci and at one MHC locus, linked to HLA-DRB1, reported fewer symptoms over a four-month period than individuals with lower d². In contrast, there were no associations between MHC or nonMHC heterozygosity and health. NonMHC-d² has previously been found to predict male preferences for female faces. Thus, the current findings suggest that nonMHC diversity may play a role in both natural and sexual selection acting on human populations.     

Does School-Based Health Promotion Affect Physical Activity on Weekends? And,Does It Reach Those Students Most in Need of Health Promotion?

ObjectiveTo determine whether a school-based health promotion program affects children’s weekend physical activity and whether this effect varies according to socioeconomic-status.MethodsThis was a quasi-experimental trial of school-based programs on physical activity levels implemented in disadvantaged neighborhoods in Alberta, Canada. In 2009 and 2011, 7 full days of pedometer data were collected from cross-sectional samples of grade 5 students (age 10–11 years) from 10 intervention schools in low-socioeconomic neighbourhoods and 20 comparison schools in middle-socioeconomic neighbourhoods. Multilevel models assessed differences in step-counts between intervention and comparison groups over-time by weight (objectively measured) and socioeconomic status subgroups.ResultsIn 2009, children from intervention schools were less active on weekends relative to comparison schools (9212 vs. 11186 steps/day p<0.01). Two years later, daily step-counts on weekend days among children in low socioeconomic intervention schools increased such that they approximated those of children from middle socioeconomic comparison schools (12148 vs. 12121 steps/day p = 0.96). The relative difference in steps between intervention and comparison schools on weekends reduced from -21.4% to 0.2% following the intervention. The normalization of weekend step counts was similar for normal weight (–21.4% to +2.0%) and overweight (-19.1 to +3.9%) children, and was balanced across socioeconomic subgroups.ConclusionsThese data suggest that school-based health promotion is effective for reducing inequities in physical activity levels outside school hours. Investments in school-based health promotion lead to behavior modification beyond the school environment.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01914185","term_id":"NCT01914185"}}NCT01914185     

Consequences of Cathodal Stimulation for Behavior: When Does It Help and When Does It Hurt Performance?

Cathodal Transcranial Direct Current Stimulation (C-tDCS) has been reported, across different studies, to facilitate or hinder performance, or simply to have no tangible effect on behavior. This discrepancy is most prominent when C-tDCS is used to alter a cognitive function, questioning the assumption that cathodal stimulation always compromises performance. In this study, we aimed to study the effect of two variables on performance in a simple cognitive task (letter Flanker), when C-tDCS was applied to the left prefrontal cortex (PFC): (1) the time of testing relative to stimulation (during or after), and (2) the nature of the cognitive activity during stimulation in case of post-tDCS testing. In three experiments, we had participants either perform the Flanker task during C-tDCS (Experiment 1), or after C-tDCS. When the Flanker task was administered after C-tDCS, we varied whether during stimulation subjects were engaged in activities that posed low (Experiment 2) or high (Experiment 3) demands on the PFC. Our findings show that the nature of the task during C-tDCS has a systematic influence on the outcome, while timing per se does not.     

Can Score Databanks Help Teaching?

Background

Basic courses in most medical schools assess students'' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students'' grades.

Methodology/Principal Findings

We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378–4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495–3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern.

Conclusion/Significance

An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student''s performance.     

Does Arts Education Develop School Readiness? Teachers’ and Artists’ Points of View on an Art Education Project

More than 98 percent of children in Finland attend preschool, where different kinds of projects are carried out in order to strengthen the children's abilities. This article focuses on the effects of one arts education project from a school readiness point of view. The main question was, How did the Helsinki arts education project affect the children's learning skills and attitudes? The target groups were children aged three to nine years who participated in the arts project in day care centers and schools. A multidimensional evaluation method was used for the analyses. The research data consisted of interviews of the program artists and educators (n = 23), follow-up reports (n = 9), and other materials. The results show that the program motivated children and aroused their interest in thinking, problem-solving, practicing, and learning. It offered children opportunities to experience success, which increased their self-confidence and skills. The project also strengthened their abilities in listening, goal-oriented work, evaluating others’ work, and receiving feedback, which are all abilities required for school entrance. The subject matter of their school courses was also integrated into their achievements.