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Energy intake, not energy output, is a determinant of body size in infants.

BACKGROUND: It has been proposed that the primary determinants of body weight at 1 y of age are genetic background, as represented by parental obesity, and low total energy expenditure. OBJECTIVE: The objective was to determine the relative contributions of genetic background and energy intake and expenditure as determinants of body weight at 1 y of age. DESIGN: Forty infants of obese and 38 infants of lean mothers, half boys and half girls, were assessed at 3 mo of age for 10 risk factors for obesity: sex, risk group (obese or nonobese mothers), maternal and paternal body mass index, body weight, feeding mode (breast, bottle, or both), 3-d energy intake, nutritive sucking behavior during a test meal, total energy expenditure, sleeping energy expenditure, and interactions among them. RESULTS: The only difference between risk groups at baseline was that the high-risk group sucked more vigorously during the test meal. Four measures accounted for 62% of the variability in weight at 12 mo: 3-mo weight (41%, P = 0.0001), nutritive sucking behavior (9%, P = 0.0002), 3-d food intake (8%, P = 0.0002), and male sex (3%, P = 0.05). Food intake and sucking behavior at 3 mo accounted for similar amounts of variability in weight-for-length, body fat, fat-free mass, and skinfold thickness at 12 mo. Contrary to expectations, neither total nor sleeping energy expenditure at 3 mo nor maternal obesity contributed to measures of body size at 12 mo. CONCLUSIONS: Energy intake contributes significantly to measures of body weight and composition at 1 y of age; parental obesity and energy expenditure do not.

Adult↗

Assisted suicide of a selfish gene.

Medea (M) factors and the hybrid incompatibility factor (H) are involved in two incompatibility systems in flour beetles that were previously thought to be independent. M factors are a novel class of selfish genes that act by maternal lethality to nonself. The H factor causes the death of hybrids with a paternally derived H gene and previously uncharacterized maternal cofactors. We now find that M factors exhibit their selfish behavior only in the absence of the H factor. Furthermore, we show that the previously uncharacterized maternal cofactors required for H-associated hybrid inviability are identical to M factors. We propose that incompatibility between H strains and M strains is due to suppression by the H factor of the self-rescuing activity of the lethal M genes. This interaction has the effect of converting M elements from selfish into self-destructive or "suicidal" genes. M factors are globally widespread, but are conspicuously absent from India, the only country where the H factor is known to occur. Such a mechanism could prevent the spread of selfish M elements by establishing an absolute barrier to hybridization in the boundary between M and non-M zones.

Animals↗

Male-male competition and parental care in collared flycatchers (Ficedula albicollis): an experiment controlling for differences in territory quality.

Females are known to benefit from mate choice in several different ways but the relationship between these benefits has received little attention. The quality of resources provided by males, such as nest sites, and paternal care are often assumed to covary positively However, because the location of the nest affects the cost of parental care, these two benefits from mate choice can easily be confounded. To investigate the provisioning ability of successful competitors while controlling for differences in territory quality we removed early-settled pairs of collared flycatchers (Ficedula albicollis) and allowed replacement by later-arriving males or floaters (i.e.'poor competitors'). A control group of early-settled males (i.e. 'good competitors') had their females removed. Females paired to good competitors enjoyed a significantly higher reproductive success and tended to receive more parental assistance from their mates compared with females mated to poor competitors. Thus, some males seem able not only to compete successfully over resources but also to feed their offspring at a relatively higher rate. An alternative explanation, that poor competitors invested less in offspring quality in response to a lower share of paternity, could be rejected. The rate of extra-pair paternity did not differ between the two treatment groups. Our results suggest that male- male competition can sometimes facilitate female choice of superior care-givers. Thus, a female's benefit from choosing a competitive male may not be restricted to the quality of the resource he defends but can also include superior paternal care.

Animals↗

The hospital inpatient stay: the experience of first-time parents.

The experience of hospital inpatient stays at childbirth was studied in a longitudinal study of the experiences of 96 first-time parents during the transition to parenthood. For women, the prospect of birth was a major worry during pregnancy. Negative expectations proved in general to be justified by events, with many women reporting predominantly bad memories of the experience. Satisfaction with the hospital inpatient stay is also considered: a major source of dissatisfaction was inadequate help with breast feeding, which produced many difficulties. Middle class mothers were in general more dissatisfied with their hospital stay, as were women who had Caesarean births. Relationships were found between antenatal class attendances and the likelihood of a normal delivery and reported pain during childbirth. The role and experience of fathers was also considered. Most expected to be at the birth from an early stage in pregnancy; more than two-thirds were present for the delivery and half or more at the labour. Their experience at this time was more positive than that of their partners. But during the hospital stay, this role was much more marginal. The results are discussed in terms of their implications for antenatal preparation, breast feeding and paternal involvement.

Adult↗

Dangerous behavior in a demented patient. Preserving autonomy in a patient with diminished competence.

When a cognitively-impaired elderly man nearly caused a serious fire at home through his inappropriate use of a gas oven, the incident raised questions about his capacity to live alone. Although he clearly wanted to preserve his independence, the health care team felt obligated to assure his safety. The following discussion of dangerous behavior in a demented elderly man elicits and portrays these conflicting values, and highlights the physician's obligations in such ethically and legally complex situations.

Activities of Daily Living↗

Health promotion--caring concern or slick salesmanship?

There is an increasing tendency for administrators and government to expect both the health services and the education service to 'show results' for the investment of public money in them. One response to this has been the growing commitment to 'health promotion', where measurable objectives may be set in terms of desired behaviour (stopping smoking, breast self-examination, child immunisation etc) and where evaluation can be made on the evidence of statistical improvement. Health workers use the term 'promotion' in a variety of ways which seem to be as confusing to them as they are to their clients --the general public. Since successful promotion is likely to depend on the 'hard sell' (and since the methodology and aims of this may be incompatible with those of health education) this paper looks at some of the questions which the customer might wish to ask the salesman before deciding whether or not to buy.

Australia↗

Age, parasuicide and problem drinking.

The contribution from genetic loading in a series of male parasuicidal patients with early onset alcohol problem was found to be of less importance than the nurturance factor of separation from father during childhood. Behavioural patterns in this younger onset group were significantly more antisocial than those in the older onset group.

Adult↗

Factors predicting safe-sex talk and condom use in early sexual relationships.

This study explored some of the antecedents and consequences of young adults' beliefs about safe-sex communication in their early couple relationships. The sample consisted of 237 unmarried, heterosexual Australian university students, 16 to 19 years of age, approximately evenly divided between virgins and those with sexual experience. Drawing on a model of couple sexual communication as the product of prior experiences with communication, assertion, and conflict resolution in the family of origin, we examined links between these variables and respondents' attitudes and practices of safe-sex discussion and condom use with their dating partners. The results showed that women and nonvirgin men had more positive attitudes toward safe-sex communication than male virgins had. Difficulties with self-assertion outside of the sexual context and mothers' and fathers' use of avoidance as a conflict resolution strategy were negatively correlated with willingness to discuss safe sex, whereas mothers' more frequent safe-sex education was a positive predictor. The results of a hierarchical multiple regression analysis indicated that assertion, paternal conflict avoidance, and male gender were independent predictors of reluctance to negotiate for safer sex. At a behavioral level, positive attitudes to safe-sex discussion predicted having talked about AIDS and condoms with a dating partner as well as actual condom use by the subsample of daters who had experienced sexual intercourse. Implications for improving family and couple communication and for sex education were considered.

Adolescent↗

Ethics in health promotion: freedom or determinism?

Nurses' beliefs about human nature will influence their interactions with clients. Health promotion can be approached from the point of view of the individual or of society as a whole. This article examines how nurses can promote the health of their clients.

Choice Behavior↗

A model of (often mixed) stereotype content: competence and warmth respectively follow from perceived status and competition.

Stereotype research emphasizes systematic processes over seemingly arbitrary contents, but content also may prove systematic. On the basis of stereotypes' intergroup functions, the stereotype content model hypothesizes that (a) 2 primary dimensions are competence and warmth, (b) frequent mixed clusters combine high warmth with low competence (paternalistic) or high competence with low warmth (envious), and (c) distinct emotions (pity, envy, admiration, contempt) differentiate the 4 competence-warmth combinations. Stereotypically, (d) status predicts high competence, and competition predicts low warmth. Nine varied samples rated gender, ethnicity, race, class, age, and disability out-groups. Contrary to antipathy models, 2 dimensions mattered, and many stereotypes were mixed, either pitying (low competence, high warmth subordinates) or envying (high competence, low warmth competitors). Stereotypically, status predicted competence, and competition predicted low warmth.

Adult↗

Resident smoking in long-term care facilities--policies and ethics.

OBJECTIVE: To characterize smoking behavior, facility policies related smoking, and administrators' views of smoking-related problems in Veterans Affairs nursing home care units nationwide. METHODS: An anonymous mail survey of long-term care facilities was administered to 106 nursing home supervisors at VA Medical Centers with nursing home care units. The response rate was 82%. RESULTS: Administrators from 106 VA nursing home units reported smoking rates ranging from 5% to 80% of long-term care residents, with an average of 22%. Half of the nursing homes had indoor smoking areas. Frequent complaints from nonsmokers about passive smoke exposure were reported in 23% of the nursing homes. The nursing administrators reported that patient safety was their greatest concern. Seventy- eight percent ranked health effects to the smokers themselves a "major concern," while 70% put health effects to exposed nonsmokers in that category. Smoking in the nursing home was described as a "right" by 59% of respondents and a "privilege" by 67%. Some individuals reported that smoking was both a right and a privilege. CONCLUSION: Smoking is relatively common among VA long-term care patients. The promotion of personal autonomy and individual resident rights stressed in the Omnibus Budget Reconciliation Act of 1987 may conflict with administrative concerns about the safety of nursing home smokers and those around them.

Aged↗

Issues concerning patient advocacy: personal experiences.

Issues concerning patient advocacy and nursing advocacy are explored in relation to the nurse's role and the UKCC code of conduct. The author's personal experiences of being an advocate are described. Potential conflict between the nurse's role and doctor's role in relation to advocacy is identified. The best person to take on the role of patient advocate is discussed.

Agonistic Behavior↗