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PubMed1999

Soteria and other alternatives to acute psychiatric hospitalization: a personal and professional review.

The author reviews the clinical and special social environmental data from the Soteria Project and its direct successors. Two random assignment studies of the Soteria model and its modification for long-term system clients reveal that roughly 85% to 90% of acute and long-term clients deemed in need of acute hospitalization can be returned to the community without use of conventional hospital treatment. Soteria, designed as a drug-free treatment environment, was as successful as anti-psychotic drug treatment in reducing psychotic symptoms in 6 weeks. In its modified form, in facilities called Crossing Place and McAuliffe House where so-called long-term "frequent flyers" were treated, alternative-treated subjects were found to be as clinically improved as hospital-treated patients, at considerably lower cost. Taken as a body of scientific evidence, it is clear that alternatives to acute psychiatric hospitalization are as, or more, effective than traditional hospital care in short-term reduction of psychopathology and longer-term social adjustment. Data from the original drug-free, home-like, nonprofessionally staffed Soteria Project and its Bern, Switzerland, replication indicate that persons without extensive hospitalizations (<30 days) are especially responsive to the positive therapeutic effects of the well-defined, replicable Soteria-type special social environments. Reviews of other studies of diversion of persons deemed in need of hospitalization to "alternative" programs have consistently shown equivalent or better program clinical results, at lower cost, from alternatives. Despite these clinical and cost data, alternatives to psychiatric hospitalization have not been widely implemented, indicative of a remarkable gap between available evidence and clinical practice.

Antipsychotic Agents↗

PubMedDate not supplied

Topology-controlled volume rendering.

Topology provides a foundation for the development of mathematically sound tools for processing and exploration of scalar fields. Existing topology-based methods can be used to identify interesting features in volumetric data sets, to find seed sets for accelerated isosurface extraction, or to treat individual connected components as distinct entities for isosurfacing or interval volume rendering. We describe a framework for direct volume rendering based on segmenting a volume into regions of equivalent contour topology and applying separate transfer functions to each region. Each region corresponds to a branch of a hierarchical contour tree decomposition, and a separate transfer function can be defined for it. The novel contributions of our work are 1) a volume rendering framework and interface where a unique transfer function can be assigned to each subvolume corresponding to a branch of the contour tree, 2) a runtime method for adjusting data values to reflect contour tree simplifications, 3) an efficient way of mapping a spatial location into the contour tree to determine the applicable transfer function, and 4) an algorithm for hardware-accelerated direct volume rendering that visualizes the contour tree-based segmentation at interactive frame rates using graphics processing units (GPUs) that support loops and conditional branches in fragment programs.

Algorithms↗

PubMed2005

Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries.

BACKGROUND: We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland METHODS: We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation. RESULTS: The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services. CONCLUSION: We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process.

Censuses↗

PubMed2001

Employment, work disability, and work days lost in patients with ankylosing spondylitis: a cross sectional study of Dutch patients.

OBJECTIVE: To evaluate employment status, work disability, and work days lost in patients with ankylosing spondylitis (AS). METHODS: A questionnaire was sent to 709 patients with AS aged 16-60. The results of 658 of the patients could be analysed. RESULTS: After adjustment for age, labour force participation was decreased by 15.4% in male patients and 5.2% in female patients compared with the general Dutch population. Work disability (all causes) was 15.7% and 16.9% higher than expected in the general population for male and female patients respectively. In particular, the proportion of those with a partial work disability pension was increased. Patients with a paid job lost 5.0% of work days as the result of having AS, accounting for a mean of 10.1 days of sick leave due to AS per patient per year in addition to the national average of 12.3 unspecified days of sick leave. CONCLUSION: This study on work status in AS provides data adjusted for age and sex, and the differences from the reference population were significant. The impact of AS on employment and work disability is considerable. Work status in patients with AS needs more attention as an outcome measure in future research.

Absenteeism↗

PubMedDate not supplied

The cost of a preventable disease: estimated U.S. national medical expenditures for congenital syphilis, 1990.

Reported cases of congenital syphilis have increased rapidly in recent years. The purpose of this study was to estimate first-year medical care expenditures among 1990 incident cases of infants diagnosed with congenital syphilis. The authors used a synthetic estimation model to calculate expenditures for congenital syphilis as the number of treated cases multiplied by cost per case. The number of cases was derived from surveillance data adjusted for underreporting and presumptive (false-positive) treatment. Cost per case was based on expected hospital and physician charges applied to case treatment protocols appropriate to case severity. Base-case estimated first-year medical expenditure for 1990 treated cases (N = 4,400) in 1990 was +12.5 million. In sensitivity analysis, estimates ranged from +6.2 million to +47 million. Substantial reduction in congenital syphilis treatment costs could be achieved through targeted public health interventions consisting of prenatal maternal screening and contact tracing of males testing positive for syphilis. Physicians should be aggressive in presumptive treatment of newborns, since this usually prevents future disability but represents a small portion of total national expenditure for congenital syphilis. More precise data on severe cases resulting in long-term disability are needed to make reliable cost estimates.

Female↗

PubMed1991

Birth outcomes and infant mortality by income in urban Canada, 1986.

For 1986, 219,470 live births were reported for residents of Canada's 25 Census Metropolitan Areas (CMAs). For each of these births, street address information as shown on the birth registration was used to code the census tract where the mother lived. Data by census tract were obtained for 1,650 infant deaths in 1986, and from the 1986 census for the population of 4,727,770 women aged 10-49 in 1986. Births, infant deaths and census population data (adjusted for undercount) were then used to calculate rates of infant mortality, low birth weight (LBW), very low birth weight (VLBW), prematurity, small for gestational age (SGA), and total fertility. The results are presented by neighborhood income quintile group (based on percentage of low income), and by the mother's age, parity (number of live births), marital status and country of birth, as well as by CMA.

Adolescent↗

PubMed1998

Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group.

OBJECTIVES: To compare the long-term effects of finasteride (5 mg/day) and placebo in patients with moderate symptoms of benign prostatic hyperplasia (BPH). METHODS: Patients aged 50 to 75 years, with at least two urinary symptoms indicating moderate BPH, and an enlarged prostate, were followed in a 2-year double-blind, randomized, placebo-controlled multicenter study. The effects of finasteride versus placebo were assessed by total symptom score (modified Boyarsky), obstructive symptom score, maximal urinary flow rate, prostate volume, and urologic end points (acute urinary retention, BPH-related surgical intervention). RESULTS: Of the 3270 men enrolled, 3168 contributed data to the safety analysis, and 2902 to the efficacy evaluation. Significantly greater improvement with finasteride compared to placebo was observed at 12 and 24 months for total symptom score (mean -2.9 versus -1.9 at 12 months, P < or =0.001; -3.2 versus -1.5 at 24 months, P < or =0.001), obstructive symptom score (mean -1.9 versus -1.3 at 12 months, P < or =0.001; -2.1 versus -1.1 at 24 months, P < or =0.001), maximal urinary flow rate (mean +1.2 versus +0.6 mL/s at 12 months, P = 0.010; +1.5 versus +0.7 mL/s at 24 months, P = 0.002), and prostate volume (mean -14.2 versus +5.4% at 12 months, P < or =0.01; -15.3 versus +8.9% at 24 months, P < or =0.001). Greater improvements in placebo-adjusted total symptom score occurred in men with large prostates than in men with small prostates (mean -2.4 versus -1.1 at 12 months; -3.2 versus -1.3 at 24 months, placebo-adjusted data, P = 0.053). Fifteen of 1450 men (1.0%) in the finasteride group experienced an acute urinary retention event, compared with 37 of 1452 (2.5%) in the placebo group, and the corresponding figures for surgery were 51 of 1450 (3.5%) and 86 of 1452 (5.9%), respectively. The hazard rate for occurrence, computed using the log-rank statistic, decreased by 57% for acute urinary retention and by 40% for surgery accompanied by finasteride therapy compared to placebo. CONCLUSIONS: Finasteride causes long-term symptomatic improvement and reduces the risk of acute urinary retention or surgery. Men with enlarged prostates benefit most from finasteride treatment.

5-alpha Reductase Inhibitors↗

PubMed1993

The adult adjustment of offspring of parents with drinking problems.

One hundred and sixty-four 16-35-year-old offspring of parents with drinking problems, recruited from a variety of clinical and community sources, were compared with 80 respondents of similar ages from similar sources who did not have parents with drinking problems. Each was interviewed using a semistructured interview. Adult adjustment was similar in the two groups, but the offspring of parents with drinking problems did report considerably more disharmony in their families of origin, and many more childhood difficulties. Factor analysis of the adult adjustment data for the samples combined showed four factors which accounted for 41% of the variance; these factors differed little in their effect in the two groups. The groups' reports of the drinking problems of their siblings, however, suggests that this sample might be unrepresentative of the true risk to the children of parents with drinking problems for the development of alcohol-related (although not other) difficulties in adulthood: 16% of this group reported a sibling with a drink problem and a further 9% were unsure, but only one member of the comparison group reported a sibling with a drink problem, and one was unsure. Path analysis showed that both parental problem drinking and family disharmony are related in complex ways to adjustment difficulties in adulthood. 'Demoralisation', the largest of the four factors, was particularly related to disharmony in the family of origin: in the absence of disharmony, offspring versus comparison status was negatively correlated to demoralisation in adulthood, suggesting that having a parent with a drinking problem might sometimes be a strengthening experience.

Adaptation, Psychological↗

PubMed2004

The effects of genetic factors on selected indicators of the activity of the sympathoadrenal system and the renin-angiotensin-aldosterone system in twins.

BACKGROUND: There are numerous data indicating a significant role of the sympathoadrenal system and the reninangiotensin- aldosterone system in the regulation of blood pressure and the pathogenesis of essential hypertension. However, the genetic background of essential hypertension remains unclear. AIM: To determine the effects of genetic factors on selected indicators of the activity of the sympathoadrenal system and the renin-angiotensin-aldosterone system in twins. METHODS: We studied 39 monozygotic twin pairs (age 33+/-7 years) and 37 same-gender dizygotic twin pairs (age 36+/-7 years). We measured blood and urine adrenaline (A), noradrenaline (NA), dopamine (DA) and aldosterone (ALD) levels, as well as plasma renin activity (PRA) and serum angiotensin-converting enzyme (ACE) activity. Parameters of the genetic models for age- and gender-adjusted data were estimated by model fitting and path analysis technique using LISREL 8. RESULTS: The effects of genetic factors on the variability of blood and urine catecholamine levels were 69% and 65% for A, 42% and 76% for NA, and 58% and 40% for DA, respectively. We also found shared environmental components for blood NA (28%) and urine DA (17%). Genetic factors accounted for 36% of the variability of PRA and 80% of the variability of ACE. ALD levels were related only to environmental factors (including a shared environmental component, estimated at 25%, for urine ALD). CONCLUSIONS: We found significant effects of genetic factors on the activity of the sympathoadrenal system, as indicated by blood and urine catecholamine levels. We also found the effect of genetic factors on PRA and ACE, but not on aldosterone levels.

Adrenal Glands↗

PubMed1984

The measurement of mercury excretion in urine.

The determination of mercury in urine using cold atomic absorption spectrometry according to Gage and Warren is used after slight modification as standard method for the exposure test in persons exposed to its vapours in industry in Czechoslovakia. Within the concentration range between 100 and 600 nmol X l-1 of urine the relative standard deviation was lower than 4%. In workers exposed to mercury in the production of thermometers, fluctuation of urinary mercury concentration due to variations in diuresis could be greatly reduced by adjustment for endogenous creatinine. After the intake of 2.2 or 2.5 l of liquids the concentration of mercury in urine dropped considerably, but returned again to its initial value within 4 hours after fluid intake. The mercury half-life in the organism is estimated at about 30 days, but may be longer at mercury concentrations of 1 mumol X l-1. Contradictory to the original expectation, the Araki's coefficient b that is recommended for suppressing the effect of the volume of excreted urine on the concentration of urinary substances was found to be concentration-dependent: at 500 nmol X l-1 its value shifted towards 1 (0.85), at 100 nmol X l-1 towards zero (0.2-0.3). It is believed that mercury urinalysis data adjusted for endogenous creatinine are sufficiently reliable to be used for assessing the risk of human exposure to mercury.

Air Pollutants, Occupational↗

PubMed1996

A study of personal and area airborne asbestos concentrations during asbestos abatement: a statistical evaluation of fibre concentration data.

Data were collected and analysed on airborne concentrations of asbestos generated by abatement of different asbestos-containing materials using various removal practices. Airborne concentrations of asbestos are dramatically variable among the types of asbestos-containing material being abated. Abatement practices evaluated in this study were removal of boiler/pipe insulation in a crawl space, ceiling tile, transite, floor tile/mastic with traditional methods, and mastic removal with a high-efficiency particulate air filter blast track (shot-blast) machine. In general, abatement of boiler and pipe insulation produces the highest airborne fibre levels, while abatement of floor tile and mastic was observed to be the lowest. A comparison of matched personal and area samples was not significantly different, and exhibited a good correlation using regression analysis. After adjusting data for outliers, personal sample fibre concentrations were greater than area sample fibre concentrations. Statistical analysis and sample distribution of airborne asbestos concentrations appear to be best represented in a logarithmic form. Area sample fibre concentrations were shown in this study to have a larger variability than personal measurements. Evaluation of outliers in fibre concentration data and the ability of these values to skew sample populations is presented. The use of personal and area samples in determining exposure, selecting personal protective equipment and its historical relevance as related to future abatement projects is discussed.

Air Pollutants, Occupational↗

PubMed2002

Using comparison charts to assess performance measurement data.

BACKGROUND: In 1997 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announced the ORYX initiative, which integrates outcomes and other performance measurement data into the accreditation process. JCAHO uses control and comparison charts to identify performance trends and patterns that are provided to JCAHO surveyors in advance of a health care organization's (HCO's) survey. During the survey, the HCO is asked to explain its rationale for its selection of performance measures, how the ORYX data have been analyzed and used to improve performance, and the outcomes of these activities. CONSTRUCTING COMPARISON CHARTS: A comparison chart, a graphical summary of the comparison analysis, consists of actual (or observed) rates, expected rates, and expected ranges (upper and lower limits) for a given time frame. The expected range describes the degree of certainty that a given point is different from the average score (population). THE USE OF COMPARISON CHARTS: Comparison charts are primarily useful for telling an HCO whether one of its selected performance measures may be evidencing one of the three types of measurement outcomes: exemplary performance, average performance, or substandard performance (indicating an opportunity for improvement). The comparison charts compare an HCO's outcomes to those of its comparison group or to its risk-adjusted data. The charts provide guidance to an HCO about whether it should continue to monitor a process so as to maintain its current level of performance or whether it should try to improve its current performance.

Accreditation↗

PubMed2002

Chronic exposure to the ultraviolet radiation levels from arc welding does not result in obvious damage to the human corneal endothelium.

Occupational exposure of the cornea to ultraviolet radiation (UVR, e.g. in welding) is a well-known cause of 'arc eye' (photo-keratoconjunctivitis), but has also been considered to be a risk for the development of alterations in the size (polymegethism) and shape (pleomorphism) of the deeper-lying human corneal endothelial cells. Human data are however limited and so a further study was undertaken, with a control group. Non-contact specular micrographs of the central region of the corneal endothelium were obtained from 40 white males aged between 32 and 63 years; 20 were arc welders with an average of 25 +/- 7 years job experience, while the others were office workers (n = 20). All the welders reported occupational exposure to UVR (i.e. welders 'flashes') and up to 3 times per year. None of the subjects had a history of contact lens wear, major eye disease or surgery. The endothelial image was scanned, projected onto an overlay and cell border marking carried out in a masked fashion. The overlay was independently analysed, by a customised semi-automated method, providing cell-border-adjusted data on cell areas and cell shape (sides) on 124 to 260 cells per image. The endothelial cell density (ECD) values were also calculated from individual cell area values. All corneas appeared to be healthy, and showed no fluorescein staining indicating damage to the surface epithelium. Central corneal thickness values were normal at 0.531 +/- 0.031 (mean +/- SD) and 0.527 +/- 0.036 mm in the welders and non-welders respectively. All endothelia appeared healthy, with no evidence of cell oedema. The group-mean endothelial cell area was 393 +/- 35 and 392 +/- 21 microm2, ECD values were 2855 +/- 224 cells mm(-2) and 2852 +/- 210 cells mm(-2), while the percentages of 6-sided cells were 60 +/- 5.2 and 59 +/- 4.1% respectively. Cell area distributions were statistically identical (p > or = 0.8), and cell area-side relationships were marginally, but not statistically different. This study does not indicate that chronic ultraviolet radiation exposure, through occupational welding (mainly electrical arc), results in or is associated with endothelial cell polymegethism and pleomorphism. This may indicate that, despite the periodic flash welding exposures, the exposure levels are still below those needed to cause damage to the corneal endothelium. This study outcome can be taken to indicate that despite the occurrence of welders flash episodes, the eye protection habitually used by these workers was adequate to protect their corneal endothelium.

Adult↗

PubMed1996

Is medication use by community-dwelling elderly people influenced by cognitive function?

To determine whether medication use differs by cognitive status among community dwelling elderly, a survey was made of a stratified random sample of 4110 black and white participants, aged 65 or older from the Duke Established Populations for Epidemiologic Studies of the Elderly in five adjacent urban and rural counties in the Piedmont area of North Carolina. Main outcome measures were usage of prescription medications, non-prescription medications, and medicines within therapeutic classes in the previous 2 weeks as determined during an in-home interview; and total number of prescription and non-prescription medicines used in the previous 2 weeks. Multivariate analyses, using weighted data adjusted for sampling design, were conducted to assess the association between drug use patterns and cognitive status, as assessed by the Short Portable Mental Status Questionnaire, while adjusting for demographic, health status, and access to health care factors. Participants with cognitive impairment (13.7% of sample) were less likely to use any prescription medications (Adjusted OR = 0.66, 95% CI = 0.48-0.90) or any non-prescription medications (Adjusted OR = 0. 71, 95% CI = 0.56-0.89) than cognitively intact subjects. Both groups took a similar number of prescription and non-prescription medications. Those who were cognitively impaired were less likely to take analgesics (Adjusted OR = 0.66, 95% CI = 0.52-0.83), but were more likely to take central nervous drugs (Adjusted OR = 1.55, 95% CI 1.18-2.04) than those who were cognitively intact. We conclude that drug use patterns by community-dwelling elderly people differ with cognitive status. Future research needs to examine medication use by specific causes of cognitive impairment.

Activities of Daily Living↗

PubMed1997

Relationship between changes in physical activity and plasma insulin during a 2.5-year follow-up study.

The association between changes in physical activity, body weight, and diet and fasting plasma insulin was analyzed in a 2.5-year follow-up study of 146 men aged 50 to 60 years. Physical activity was assessed by a 7-day physical activity recall interview, diet by a 4-day food record, and plasma insulin radioimmunologically. Total physical activity decreased from (mean +/- SD) 45.1 +/- 10.1 to 39.0 +/- 6.1 metabolic equivalent (MET) hours (METh).d-1 and conditioning physical activity (> 5.0 METs) from 8.0 +/- 11.2 to 2.7 +/- 5.0 METh.d-1, whereas plasma insulin increased from 8.2 +/- 5.8 to 9.2 +/- 6.7 mU.L-1 and body weight from 80.5 +/- 12.0 to 81.6 +/- 11.6 kg during the follow-up period (P < or = .001 for all). The change in conditioning physical activity correlated inversely (r = -.34, P < .001) and change in body weight positively (r = .42,P < .001) with the change in plasma insulin level. With data adjusted for the baseline insulin level, cardiovascular health status, alcohol intake, change in body weight, smoking, age, and follow-up time, the odds ratio for an increase in fasting plasma insulin was 8.9 (95% CI, 2.1 to 37.1; P = .003) for men with the greatest decrease in conditioning physical activity (< -7 METh) compared with men who reported an increase in conditioning physical activity. The same logistic regression model showed an odds ratio of 9.9 (95% CI, 2.1 to 45.4; P = .003) for the increase in plasma insulin for subjects who gained more than 3.3 kg body weight compared with subjects who lost at least 0.6 kg. Men who consumed at least 12 g.d-1 alcohol at both examinations had an odds ratio of 12.8 (95% CI, 1.7 to 94.5; P = .012) compared with nondrinkers. These data suggest that in middle-aged men, a reduction in physical activity increases the risk for increased plasma insulin independently of alcohol intake and changes in body weight.

Aging↗

PubMed2004

Erythropoietin for patients with malignant disease.

BACKGROUND: Anaemia associated with cancer and cancer therapy is an important clinical factor in the treatment of malignant diseases. Therapeutic alternatives are recombinant human erythropoietin (EPO) and red blood cell transfusions. OBJECTIVES: The aim of this systematic review was to assess the effect of erythropoietin to either prevent or treat anaemia in cancer patients. SEARCH STRATEGY: We searched the Central Register of Controlled Trials, MEDLINE (01/1985 to 12/2001), EMBASE (01/1985 to 12/2001), other databases and reference lists of articles. We also contacted experts in the field and pharmaceutical companies. SELECTION CRITERIA: Randomised controlled trials comparing the use of recombinant human erythropoietin (plus transfusion if needed) with red blood cell transfusions alone for the treatment or prevention of anaemia in cancer patients. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. All authors from included studies were contacted for additional information. MAIN RESULTS: Twenty seven trials with 3,287 adults were included. Use of erythropoietin significantly reduced the relative risk of red blood cell transfusions (RR 0.67; 95% CI 0.62 to 0.73, 25 trials, n = 3,069). On average participants in the erythropoietin group received one unit of blood less than the control group (WMD -1.00; 95% CI-1.31 to -0.70, 13 trials, n = 2,056). For participants with baseline haemoglobin below 10 g/dL haematological response was observed more often in participants receiving EPO (RR 3.60; 95% CI 3.07 to 4.23, 14 trials, n = 2,347). There was inconclusive evidence whether EPO improves tumour response (fixed effect RR 1.36; 95% CI 1.07 to 1.72, seven trials, n = 1,150; random effects: RR 1.21; 95% CI 0.92 to 1.59) and overall survival (adjusted data: HR 0.81; 95% CI 0.67 to 0.99; unadjusted data: HR 0.84; 95% CI 0.69 to 1.02, 19 trials, n = 2,865). There were no statistically significant adverse effects. Evidence was inconclusive with respect to quality of life and fatigue. REVIEWERS' CONCLUSIONS: There is consistent evidence that the administration of erythropoietin reduces the risk for blood transfusions and the number of units transfused in cancer patients. For patients with baseline haemoglobin below 10 g/dL there is strong evidence that erythropoietin improves haematological response. There is inconclusive evidence whether erythropoietin improves tumour response and overall survival. Research on side effects is inconclusive.

Anemia↗

PubMed1995

Issues relating to normalization of body fat content in men and women.

OBJECTIVE: Body mass index (BMI), % body fat, and the fat:lean ratio are ratios frequently used as obesity indices. Ratios are based on an assumption that the regression between the numerator (e.g. fat mass) and the denominator (e.g. body mass) has a zero-intercept. As shown in the companion paper, non-zero intercepts cause several problems when ratios are used to adjust data and analysis of covariance (ANCOVA) is frequently the preferred statistical tool. The purpose of this paper is to examine whether BMI, % body fat and the fat:lean ratio meet the necessary criteria for suitable obesity indices using gender comparisons as an example. RESULTS: In 720 healthy men and women, BMI was higher in men (24.9 +/- 3.3 vs 23.4 +/- 3.2 kg/m2, P < 0.001), but fat mass, % fat and the fat:lean ratio were higher in women (14.8 +/- 8.4 vs 19.1 +/- 8.1 kg fat; 18.6 +/- 8.7 vs 29.9 +/- 9.7% body fat; 0.24 +/- 0.14 vs 0.46 +/- 0.20 for the fat:lean ratio; P < 0.001). Body mass (BM) was correlated with height2 in men (r = 0.40) and women (r = 0.36) with equivalent regression slopes (17.1 +/- 1.9 vs 15.6 +/- 2.3 kg per m2 in women), but the intercepts were different from zero (24.1 kg in men, 20.7 kg in women). When BM was adjusted for height2 using ANCOVA, men remained significantly heavier than women (74.4 +/- 11.0 vs 68.8 +/- 11.6 kg; P < 0.001). Fat mass (FM) was significantly correlated with BM in males (r = 0.64) and females (r = 0.78) but the regression slopes were different (0.49 +/- 0.03 vs 0.71 +/- 0.03 kg of fat per kg body mass in females; P < 0.05) and the intercepts were different from zero (-23.2 +/- 2.2 kg in males; -24.8 +/- 2.1 kg in females). FM adjusted for BM was significantly higher in women (11.7 vs 25.6 kg). FM was inversely correlated with fat free mass (FFM) in males (r = -0.17) and females (r = -0.20), with similar regression slopes (-0.16 +/- 0.05 vs -0.26 +/- 0.08 kg of FM per kg of FFM in women) and the intercepts were significantly different from zero (24.8 +/- 3.0 kg in males; 30.7 +/- 3.6 kg in females). When FM was adjusted for FFM, there was no significant difference between men (16.3 kg) and women (17.0 kg). CONCLUSIONS: It is concluded that: (a) the presence of significant intercepts does not support the use of ratios as obesity indices and regression based models should be considered; and, (b) the direction and magnitude of the difference in obesity index between men and women changes with different normalization approaches.

Adolescent↗

PubMedDate not supplied

The peer group as a context: moderating effects on relations between maternal parenting and social and school adjustment in chinese children.

This 2-year longitudinal study examined, in a sample of Chinese children (initial M age = 11 years), the moderating effects of the peer group on relations between maternal supportive parenting and social and school adjustment. Data were collected from multiple sources including peer assessments, teacher ratings, school records, and maternal reports. It was found that whereas group prosocial-cooperative functioning strengthened the role of supportive parenting in helping children develop social and school competence, group antisocial-destructive functioning undermined the contributions of supportive parenting to children's social and academic achievement. The results indicated the significance of the peer group as a social context for socialization and development in Chinese children.

Child↗