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Secular changes in growth have occurred in almost all industrialized countries during the last century. Almost all of the secular increase seen in adult height occurs during childhood. These changes can be considered to be indicators of the changes in the nutritional, hygienic and health status of a population. The secular trend in adult height has slowed down since the second world war, but is still continuing in most industrialized countries.
Since 1858, an increase of mean stature has been observed in the Netherlands, reflecting the improving nutritional, hygienic, and health status of the population. In this study, stature, weight, and pubertal development of Dutch youth, derived from four consecutive nationwide cross-sectional growth studies during the past 42 y, are compared to assess the size and rate of the secular growth change. Data on length, height, weight, head circumference, sexual maturation, and demographics of 14,500 boys and girls of Dutch origin in the age range 0-20 y were collected in 1996 and 1997. Growth references for height and weight were constructed with a method that summarizes the distribution by three smooth curves representing skewness (L curve), the median (M curve), and coefficient of variation (S curve). The relationship between height and demographic variables was assessed by multivariate analysis. Reference curves for menarche and secondary sex characteristics were estimated by a generalized additive model using a logit transformation. A positive secular growth change has been present in the past 42 y for children, adolescents, and young adults of Dutch origin, although at a slower rate in the last 17 y. Height differences according to region, educational level of child and parents, and family size have remained. In girls, median age at menarche has decreased by 6 mo during the past four decades to 13.15 y. Environmental conditions have been favorable for many decades in the Netherlands, and the positive secular change in height has not yet come to a halt, in contrast to Scandinavian countries. Main contributors to the increase in height may be improved nutrition, child health, and hygiene, and a reduction of family size.
OBJECTIVES: This study assessed the association of Jewish religious observance with mortality by comparing religious and secular kibbutzim. These collectives are highly similar in social structure and economic function and are cohesive and supportive communities. METHODS: In a 16-year (1970 through 1985) historical prospective study of mortality in 11 religious and 11 matched secular kibbutzim in Israel, 268 deaths occurred among 3900 men and women 35 years of age and older during 41347 person-years of observation. RESULTS: Mortality was considerably higher in secular kibbutzim. Cox proportional hazards analysis was used to adjust for age and the matched design; rate ratios were 1.67 (95% confidence interval [CI]=1.17, 2.39) for men, 2.67 (95% CI=1.55, 4.60) for women, and 1.93 (95% CI=1.44, 2.59) overall. Kaplan-Meier survival analysis of birth cohorts confirmed the association. The lower mortality in religious kibbutzim was consistent for all major causes of death. CONCLUSIONS: Belonging to a religious collective was associated with a strong protective effect not attributable to confounding by sociodemographic factors. Elucidation of mechanisms mediating this effect may provide etiologic insights and leads for intervention.
Secular trends in onset of menarche and obesity were examined 14 years apart in two biracial (black-white) cohorts of girls aged 8 to 17 under study for cardiovascular risk. The first cohort (N=1,190, 64% white) was examined in 1978-1979, the second (N=1,164, 57% white) in 1992-1994. The second cohort was heavier in terms of body weight and Rohrer index (weight/height3) than the first (P<0.001), except among black girls aged 12 to 13 years. Subscapular skinfold thickness increased in the second cohort of all ages (P<0.0001), while increases in triceps skinfold were less marked. The onset of menarche occurred at an earlier age in the second cohort compared with the first cohort (P<0.0001), both in black girls (11.4+/-1.3 vs 12.3+/-1.4 years) and white girls (11.5+/-1.3 vs 12.3+/-1.3 years). Furthermore, twice as many girls in the second cohort had reached menarche by ages younger than 12 years (P<0.001). All of these obesity measures were significantly associated with the age of menarche in both cohorts (P<0.001) adjusting for height, race and age at examination. These results suggest that this secular trend toward increasing frequency of early onset of menarche may be the result of increasing obesity noted in girls of both races. Since increases in body fatness and related early onset of menarche are risk factors for disorders in adult life including cardiovascular disease and breast cancer, the secular trend in the increasing incidence of obesity throughout the United States is becoming a major public health problem.
BACKGROUND: Various changes in society have created the opportunity for more sedentary behaviour and the consumption of food that is high in kilojoules, which may lead to a progressive increase in body mass over time. The purpose of this study was to examine secular changes in the body mass index (BMI) of Canadian children between 1981 and 1996. METHODS: Nationally representative data from the 1981 Canada Fitness Survey, the 1988 Campbell's Survey on the Well-being of Canadians and the 1996 National Longitudinal Survey of Children and Youth were used in the analysis. Regression analyses were used to assess population changes in BMI from 1981 to 1996 for children aged 7-13 years. Changes in the distribution of BMI results were evaluated by plotting the residuals from regression analyses of BMI on age, assessed separately by sex, using the 1981 data as baseline. The proportions of children exceeding the 85th and 95th age- and sex-specific percentiles from the 1981 (baseline) data were also calculated. RESULTS: Since 1981, BMI has increased at the rate of nearly 0.1 kg/m2 per year for both sexes at most ages, indicating a clear secular trend toward an increase in BMI of Canadian children. The prevalence of overweight among boys increased from 15% in 1981 to 28.8% in 1996 and among girls from 15% to 23.6%. The prevalence of obesity in children more than doubled over that period, from 5% to 13.5% for boys and 11.8% for girls. INTERPRETATION: Secular trends indicate that Canadian children aged 7-13 years are becoming progressively overweight and obese.
OBJECTIVE: Data from three household surveys undertaken in the city of S. Paulo, Brazil, from mid-80s to mid-90s allow to characterize and analyse secular trends in infant and child linear growth. METHODS: In the three surveys, random population samples aged from zero to 59 months (1,008 children in the period of 1974-75; 1,016 in 1984-85 and 1,280 in 1995-96) were studied. Recumbent length was obtained from children up to 24 months of age and then stature was recorded. The international growth standard was used to evaluate the child's height according to age and sex. For the study of the social distribution of growth status, tertiles of the per capita family income was taken into account in each survey. For the study of the determinants of secular trends, hierarchical causal models, multivariate regression analyses and calculations analogous to the ones used to assess population attributable risks were applied. RESULTS/CONCLUSIONS: In the period of 22 years covered by the three surveys, the secular trend of child growth in S. Paulo City showed a positive, continuous and apparently uniform curve. It was equivalent to a total average gain of 0.650 z scores of the international growth reference, or near 2.3 cm at the age of 30 months. The higher gain was observed among the third poorest fraction of the population--3.3 cm--and the lower gain--1.7 cm--among the third richest. Positive changes in distal determinants (family income and maternal schooling) and intermediate determinants (housing, sanitation, access to health services and reproductive past history) of child growth explained substantially part of the improvements seen from the mid-80s to mid-90s.
Western natural science, arising from philosophical secularism, is a potent perpetuator of secularism. Greeks view of reality, was paradoxically strengthened by Christian denigration of nature and reason and by the later, successive European stances of anti-theologism, anti-metaphysicism and scientism. Islam, by seeing the unity of reason-intuition and nature- ghayb posits scientific and spiritual meaning in nature. Western secular science has produced spiritual and natural crises while the holistic, Islamic science resolves them. The desecularisation and Islamisation of society together with the resolution of science-generated crises demands a fundamental criticism of western science and the emergence of a healthier science.
To investigate the secular change in the incidence rate of drug-induced hepatitis (DIH) due to anti-tuberculosis chemotherapy including isoniazid (INH) and rifampicin (RFP), but not including pyrazinamide (PZA), we retrospectively studied the incidence rates of DIH in patients treated with chemotherapy including INH and RFP in four periods 1980-83, 87-88, 91-92, and 1998-2000. The criteria for selection of the patients were as follows. 1. The serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured before, and one month (20-40 days) and 2 months (45-75 days) after starting anti-tuberculosis chemotherapy. When the serum AST and ALT were measured twice or more during period 20-40 days or 45-75 days after starting anti-tuberculosis chemotherapy, the data obtained nearest to 30 or 60 days after were chosen as those of one or two months after starting chemotherapy, respectively. 2. The serum AST and ALT were within normal range before starting anti-tuberculosis chemotherapy. The normal range of serum AST and ALT were < or = 40 K-A and < or = 35 K-A (in 1980-83) or < or = 31 IU/l and 34 IU/l (in 1987-2000), respectively. 3. Chronic active hepatitis and cirrhosis patients were excluded. 4. All alive after completion of anti-tuberculosis chemotherapy. The numbers of the subjects who fulfilled the above criteria were 113, 135, 128 and 154 in 1980-83, 1987-88, 1991-92 and 1998-2000, respectively. DIH was defined serologically by serum AST > or = 40 K-A and/or ALT > or = 35 K-A (in 1980-83), or AST > or = 40 IU/l and/or ALT > or = 40 IU/l (1987-2000). The DIH incidence rate of the subjects classified by the year of treatment and age were examined, and the contributions of the risk factors for DIH, such as age, sex, alcoholics, previous liver disease history, HBs ag positivity, anti-HCV ab positivity, and hypoalbuminenia were studied, and none except the age over 80 y.o. was found to be a risk factor to DIH, in our subjects. In patients with the age over 80 y.o., daily doses of antituberculosis drugs RFP, INH and ethambutol (EB) were significantly higher in patients with DIH than those without DIH, but body weight and serum albumin level were not significantly different between these two groups. There was no risk factor to DIH in our patients less than 80 y.o. and this could be explained by the above-mentioned criteria of study patients selection. To exclude the age dependence of the incidence rate of DIH in our subjects, the incidence rates of DIH were calculated in patients less than 80 y.o. by the period of treatment, and they were 10/111 (9.0%), 23/131 (17.6%), 26/123 (21.1%) and 32/117 (27.4%) in 1980-83, 87-88, 91-92, and 1998-2000, respectively. The secular increase of the incidence rate of DIH was statistically significant (p = 0.01). It is quite clear that this secular increase was not at all attributable to the above-mentioned risk factors. It is suspected that human liver has become more easily affected with INH and RFP in recent years. It is suggested that the new chemical compounds present in our increasingly complicated human milieu give heavier burdens on human liver, weaken the liver function, and enhance the capacity of INH and RFP to cause DIH.
Inter-generation differences in foot dimensions were examined using ANCOVA to determine whether aging or secular change is the more important causal factor. In examining the results, bone size was assumed not to change after the end of linear growth, while foot arches were assumed to become flatter rather than higher if there were any changes in skeletal structure. Changes in overall body build according to age were examined using statistical data collected by the government through population-follow-up. Secular changes in foot length (FL) and foot breadth, diagonal (FB) as well as the changes with age in FB were examined using data measured at ages younger than 50 years. The effects of overall body build were examined using the body mass index (BMI). Compared to the 1970 group (birth year: 1960-78) of the same FL, the 1930 group (birth year: 1909-39) had larger foot circumferences, wider breadth measurements, higher dorsal arches and ball, and greater toe 5 angle, but had shorter fibular instep lengths and shorter 5th metatarsal bones. The 1930 groups tended to have larger FB than the 1970 group of the same foot circumference. No inter-generation differences were observed in the heights at the medial and lateral malleoli, toe 1 angle, or the relationship between FB and heel breadth. These findings are discussed in terms of the effects of weight increase after the end of linear growth, changes in skeletal structure, overall body build as young adults, socioeconomic status during the growth period, as well as differential growth rates of foot bones. The conclusions are 1) changes in foot length and longitudinal arches due to aging are negligible, 2) the large circumferences, breadths, and higher dorsal arches and ball of the 1930 group for their foot length are better explained by their robust bones than by the increase in soft tissue after the end of linear growth, and 3) the larger FB of the 1930 group for their foot circumference is partly explained by their shorter fibular instep length. As a whole, factors affecting growth (secular change) are more important than changes after the end of growth (aging) in the inter-generation differences in foot morphology.
The change of living conditions in East Germany after the German reunification in 1990 led to intensive secular changes in growth and development. Anthropometric data of height, weight, BMI and thickness of the subcutaneous fat layer are compared from two cross-sectional samples of German children and adolescents aged 6 to 18 years. The first sample was measured around 1989 and the second 10 years later around 1999. Both samples contain children and adolescents from the urban as well as from the rural population. The secular changes reported here are based on the comparison of medians of height, weight, BMI and subcutaneous fat layer thickness calculated for yearly age categories. Subsequently, medians of the 10% border categories are compared. These border categories contain the 10% smallest, lightest, slimmest or leanest subjects and the 10% tallest, heaviest, most corpulent or most obese subjects respectively of a yearly age category. The young generation shifted between 1989 and 1999 to a taller stature in the small as well as in the tall category. The secular pattern of measurements, which mark corpulence, is sex-specific and differs from that of length measurements. In general the light or lean subjects changed only little, however, there are clear age- and sex-specific changes in the upper border categories. Weight and BMI increased markedly in the upper border categories in young preadolescent children, but did not change much in adolescent boys of these category aged 15 and 16 and decreased in adolescent girls. Also the subcutaneous fat layer increased in the upper border category in preadolescent children, but decreased in adolescent boys and girls.
OBJECTIVE: To analyze the secular changes of physical growth in 7-17 year old students of Zang-tribe in Tibet during 1965-2004, and to make suggestions for further improvement. METHODS: The data collected by local government in 1965 and Chinese national survey on students' physical fitness and health in 1985, 1995 and 2004 were used to analyze and find out the differences from the students' stature, body weight, chest girth, and BMI in different years, and to compare the increasing rate per 10 years in different periods of time. RESULTS: Levels on stature, body weight and chest girth were increased significantly among 7-17 year-old students of Zang-tribe in Tibet during 1965-2004. From 1965 to 1985, the levels of stature and body weight were increased 11.4 cm and 5.0 kg respectively among male Zang-tribe students, 9.1 cm and 3.9 kg among the female. During 1985-2004, stature levels of Zang-tribe students was kept rising in much less extent, while average levels of body weight were reaching up remarkably, especially in 1995-2004, in which the average increasing rate per 10 years had achieved 14.8% and 13.4% among the male and female students aged 7-17 years old respectively. Levels of chest girth were increased rapidly in 1965-1985, showing a higher increasing rate in male students (2.7%) than in female students (1.9%). In 1985-2004, the increasing rates fell obviously both in male and female students, but there existed a higher rate in 1995-2004 than in 1995-1985, especially for females (4.0%). Upon the secular changes of stature and body weight, the levels of BMI were decreased in 1985 as comparing to those in 1965, then increased rapidly in 1985-2004, especially in 1995-2004, having an increasing rate up to 12.6% and 12.4% respectively in male and female students. CONCLUSION: Secular changes on physical growth among 7-17 year-old students of Zang-tribe in Tibet were paralleled with the economic progress in 1965-2004, giving active effects by economic progress and nutrition improvements to the physical growth of children and adolescents.
This paper examines Bryan Turner's view that medicine has replaced religion as the 'social guardian of morality.' It argues that Turner's failure to co-ordinate the theories of secularization and medicalization has prevented this hypothesis from being fully explored. A systematic and synthesized account of both medicalization and secularization is given, and used as the framework for a review of the history of Seventh-day Adventism-a sect that is both a product and an agent of the two processes. In conclusion it is suggested that medicalization may be conductive to sect development, and that secularization and medicalization are compatible models of social change.
An unusual confluence of historical factors may be responsible for nineteenth-century Sioux being able to sustain high statures despite enduring adverse conditions during the early reservation experience. An exceptionally long span of Dakota Sioux history was examined for secular trends using a cross-sectional design. Two primary sources were used: One anthropometric data set was collected in the late nineteenth century under the direction of Franz Boas, and another set was collected by James R. Walker in the early twentieth century. Collectively, the data represent the birth years between 1820 and 1880 for adult individuals 20 years old or older. Adult heights (n = 1197) were adjusted for aging effects and regressed on age, with each data set and each sex analyzed separately. Tests for differences between the adult means of age cohorts by decade of birth (1820-1880) were also carried out. Only one sample of adults showed any convincing secular trend (p < 0.05): surprisingly, a positive linear trend for Walker's sample of adult males. This sample was also the one sample of adults that showed significant differences between age cohorts. The failure to find any negative secular trend in this population of Amerindians is remarkable, given the drastic socioeconomic changes that occurred with the coming of the reservation period (ca. 1868). Comparisons with contemporary white Americans show that the Sioux remained consistently taller than whites well into the reservation period and that Sioux children (Prince 1989) continued to grow at highly favorable rates during this time of severe conditions. A possible explanation for these findings involves the relatively favorable level of subsistence support received by most of the Sioux from the US government, as stipulated by various treaties. Conservative estimates suggest that the Sioux may have been able to sustain net levels of per capita annual meat consumption that exceeded the US average for several years before 1893.
A retrospective sample survey of birth certificates from a Moscow maternity hospital over a 40-year period has revealed secular growth changes (involving mothers' stature, age at menarche, and four anthropometric traits in newborns) in two consecutive generations. Cohorts of mothers born in the period 1930-1949 showed high rates of acceleration. Age at menarche decreased in these cohorts at a rate of 12.5 months per 10 years, and a parallel gain in stature averaged 1.8 cm per 10 years; both rates were significantly higher than those for Western Europe. In later birth cohorts the acceleration in the maternal generation apparently ended. Anthropometric traits at birth (weight, body length, head and chest circumferences) show different patterns of secular changes from 1950 to 1990. According to multiple regression analysis, a temporal trend in the neonate body size might be mainly due to the parallel increase in mother's stature. The contribution of socioeconomic factors to the observed secular growth changes is discussed.
OBJECTIVE: To examine whether secular trends in risk factor levels and improvements in treatment can account for the observed decline in coronary heart disease mortality in the United States from 1980 to 1990 and to analyze the proportional contribution of these changes. DATA SOURCES: Literature review, US statistics, health surveys, and ongoing clinical trials. STUDY SELECTION: Data representative of the US situation nationwide reported in adequate detail. DATA EXTRACTION: A computer-simulation state-transition model of the US population between the ages of 35 and 84 years was developed to forecast coronary mortality. The input variables were estimated such that the combination of values led to an adequate agreement with reported coronary mortality figures. Subsequently, secular trends were modeled. DATA SYNTHESIS: Actual coronary mortality in 1990 was 34% (127,000 deaths) lower than would be predicted if risk factor levels, case-fatality rates, and event rates in those with and without coronary disease remained the same as in 1980. When secular changes in these factors were included in the model, predicted coronary mortality in 1990 was within 3% (10,000 deaths) of the observed mortality and explained 92% of the decline; only 25% of the decline was explained by primary prevention, while 29% was explained by secondary reduction in risk factors in patients with coronary disease and 43% by other improvements in treatment in patients with coronary disease. CONCLUSIONS: These results suggest that primary and secondary risk factor reductions explain about 50% of the striking decline in coronary mortality in the United States between 1980 and 1990 but that more than 70% of the overall decline in mortality has occurred among patients with coronary disease.
The report illustrates secular changes in the development of body height and mass in Lódź school children and youths in a period of time covering 65 years between 1930-1994. The lowest values of both traits were found in the early post-war period (1948-1949) increasing gradually until the end of the seventies. From that time the secular trend diminished successively, restraining completely in the last years (1992-1994). This seems to be connected with the economic crisis of the eighties in Poland, and the deep transformation of socio-economic relations in the last several years. According to the secular changeability values, the rate of that process in relation to younger groups of children increases considerably from the 12th year of life. The biggest changes (in centimeters and kilograms per decade) can be observed in the age of 15 and 16 years. Usually more distinctive variableness is apparent in boys than in girls.
What do contemporary controversies in healthcare reveal about secular values and the location of religion within an English medical centre? Using a socio-spatial methodology designed to break open ideological perspectives and normative values, we analyse the doctor-patient relationship, complementary and alternative medicine, and an issue that bridges the two, evidence-based medicine. In the physical, social and mental spaces of the medical centre we uncover the traces of religious activity and roles, and of alternative therapeutic regimes often informed by spiritual or religious systems. Furthermore, we disclose the heterogeneity of values that comprise the secular worldview of one group of contemporary general practitioners.
The following demarcates the sens of the human person in Orthodox-Catholic bioethics from the family of senses proper to secular bioethics and philosophy. The radically different sources of knowledge about the senses proper to each discipline suggest that the importation of philosophical and secular psychological distinctions and analyses into true Christianity's concern with the human person, is fundamentally misguided. This suggestion is confirmed by examination of the articles of Crosby, Glannon, Hoswepian, and Meador and Shuman.