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FITNESS AND FATNESS IN GREEK ADOLESCENTS
A recent spike in adult mortality rates from coronary heart disease (CHD) in Greece led researchers to investigate the association between CHD risk factors and lifestyle parameters in Greek children. After examining fitness, fatness, fat intake, and physical activity in over 200 children, and comparing with several primary CHD risk factors, they found that the presence of such factors depended mainly on the level of physical activity and were independent of the other lifestyle covariates. The authors warn that physical activity has to be increased in early life if adult CHD mortality rates are to be reduced. (
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MALNUTRITION GUIDELINES NEED IMPROVEMENT
Current WHO guidelines for health workers in developing countries need further improvement if malnourished children are to be correctly and consistently identified. Nurses in a hospital in the Gambia were trained to identify severe protein-energy malnutrition using the WHO Integrated Management of Childhood Illness (IMCI) algorithm. Their findings were then compared with those of a trained observer, and the results showed that the nurses identified only half of the children who had severe malnutrition, and incorrectly identified several more as having the disorder. The authors suggest that the possibility of including low, mid, and upper arm circumference measurements in the guidelines should be explored as one way of increasing their effectiveness. (
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HOSPITAL FACTORS AND CHILDBIRTH OUTCOME
Better outcomes in childbirth are achieved by hospitals that take a more interventionalist approach and in those with higher levels of consultant obstetric staffing. Data on over 500 000 births over a two year period in an English area were analysed and compared with information on hospital factors, such as staffing and facilities. A higher intervention score and greater number of consultant obstetricians per 1000 births was independently and significantly associated with lower stillbirth rates, while no apparent associations were found between neonatal death rates and the hospital factors measured. The authors advocate further work to confirm their findings and determine possible causes. (
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INTERNATIONAL LEUKAEMIA AND DIABETES EPIDEMIOLOGY
A significant positive correlation exists between acute lymphoblastic leukaemia (ALL) and type 1 diabetes. Researchers examined the incidence rates and national characteristics of both diseases in 40 countries worldwide and found that countries with high or low rates of either disease were likely to have a corresponding rate of the other condition. Affluent countries were more likely to have a high incidence of both, lending weight to the “hygiene hypothesis” for type 1 diabetes and the “delayed infection” hypothesis for ALL. The authors suggest that “an exploration of common causal pathways linked to the immune response in early life and underlying genetic susceptibility in individuals would be fruitful.” (
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HIGHER HEPATITIS B HAZARD FOR SOUTH ASIANS
South Asian people in England and Wales are at a higher risk of acquiring hepatitis B virus (HBV) infection than non-South Asians, particularly in childhood. Researchers examined HBV infection rates between 1988 and 2000, and used software to assign ethnicity by the names of those infected. Incidence of infection was 3.1 times higher in South Asians, who had an estimated lifetime infection risk of 1.4% compared with 0.4% for non-South Asians. South Asian children had a much higher infection rate than their non-South Asian counterparts, at 9% and 1.7% of total cases respectively. (
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MORE HOSPITALISATION BUT LESS DEATH
There has been a threefold increase in the hospitalisation rate for infants with respiratory synctial virus (RSV) over the past 25 years. At particular risk are preterm infants who require neonatal ventilatory support and those discharged from hospital who receive home oxygen therapy. Hospitalised children under 2 years of age with a respiratory illness were studied over three consecutive RSV seasons and the results showed that despite higher hospitalisation rates than 25 years ago, serious adverse outcomes are uncommon, even in those infants identified as high risk. (
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CHILDHOOD INJURY SURVEILLANCE
In an effort to prevent childhood injury, researchers in France, have compiled a database on such events since 1998. In keeping with the “Safe Community” programmes introduced by the UN in several countries, all children presenting to local paediatric trauma centres were followed up with a telephone questionnaire. While the final evaluation has yet to be performed, this brief report suggests that this first step will be positive. It has already identified roller skating as a potential problem and the authors are confident that the programme will act as an effective early warning system. (
) O Mukhtar
SOCIOECONOMIC STATUS AND MEXICAN CHILDHOOD SAFETY
Socioeconomic status is an important predictor of parental knowledge and practice in childhood safety say researchers in Mexico. A questionnaire based survey assessed parents in two distinct areas; their approach to “safe” behaviour (the use of caution and safety devices) and their attitude relative to specific location (home, recreation, and transport). The most apparent difference was that 47% of “upper” socioeconomic parents used safety devices correctly (for example, cycle helmets, child car seats, etc) compared with only 15% of parents from lower socioeconomic backgrounds. Ultimately, the authors hope that future efforts to prevent childhood injury will take account of this socioeconomic variation. (
) O Mukhtar
ETHNICITY AND OBESITY IN UK CHILDREN
UK childhood obesity rates differ by ethnicity and sex, but not social class. Researchers examined data on over 5000 people aged between 2 and 20 years old and found that 23% were overweight and 6% were obese. Girls were generally more likely to be affected than boys, with British Afro-Caribbean and Pakistani girls most likely to be obese, while Indian and Pakistani boys have a higher risk of being more overweight than the general population. No significant prevalence differences were observed in children from different social classes. The authors recommend that initiatives should target those children most at risk of becoming obese. (
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