Intermittent Fasting and Metabolic Health.

Given the ongoing strain that the obesity epidemic has placed on public health outcomes, new and effective approaches to weight control are needed. One approach to improving weight and metabolic outcomes is intermittent fasting, which consists of multiple different timing schedules for temporary food avoidance, including alternate-day fasting, other similar full-day fasting patterns, and time-restricted feeding (where the day's food is consumed over a 6-h period, allowing for 18 h of fasting). These feeding schedules have favorable metabolic effects by intermittently inducing the metabolism of fatty acids to ketones. The regimens overall lead to a decrease in weight and have been linked to improvements in dyslipidemia and blood pressure. While more research is needed on longer-term outcomes and this approach should be avoided in particular health conditions, intermittent fasting should be considered as an option for individuals who have a pattern of unhealthy weight gain using standard eating patterns.

Relation of total bilirubin and QT interval prolongation (from the Third National Health and Nutrition Examination Survey).

OBJECTIVE: The association of bilirubin with cardiovascular disease (CVD) is controversial. We sought to explore the association of total bilirubin (TB) levels with QT interval in a multiracial cohort. METHODS: A total of 6,627 participants (59.0 ± 13.3 years; 52.6% women, 49.7% Non-Hispanic Whites) without CVD from the Third National Health and Nutrition Examination Survey were included in this analysis. QT was automatically measured from digital 12-lead electrocardiogram in a central reading center. A multivariable logistic regression model was used to examine the cross-sectional association between tertiles of TB and prolonged QT interval (≥450 ms in men and ≥460 ms in women). RESULTS: The prevalence of prolonged QT was higher among those with higher levels of TB (prolonged QT prevalence was 4.7%, 6.8%, and 7.0% across TB lower (0-0.4 mg/dl), middle (0.5-1.6 mg/dl), and higher (0.70-4.30 mg/dl) tertiles, respectively). In a model adjusted for potential confounders, participants within the highest TB tertile had significantly greater odds of the prolonged QT interval (Odds ratios [95% confidence interval] 1.53 [1.16-2.02]) compared to those with bilirubin levels in the first tertile. Each 0.29 mg/dl increase in TB levels was associated with a 12% (p-value <.0001) increase in the prevalence of prolonged QT interval. This association was stronger in men than in women (interaction p-value = .04). CONCLUSION: Elevated bilirubin levels are associated with a prolonged QT interval. This finding extends our current knowledge on the relationship between serum bilirubin and CVD by demonstrating a link between higher TB and abnormal cardiac repolarization.

Detection of beta-thalassaemia trait: a study of fifty families.

BACKGROUND: This study was carried out to detect beta-thalassaemia trait in the siblings of beta thalassaemia major children by Hemoglobin (Hb) electrophoresis. METHODS: Subjects were divided into two groups. Group 1 was the patients group comprising 100-subjects siblings of beta-thalassaemia major children and Group 2 was the control group with 25-subjects. RESULTS: It was observed that 58% of the siblings of beta-thalassaemia major children had beta-thalassaemia trait. Even in the control group 2 subjects had beta thalassaemia trait, which shows that thalassaemia gene is very common in Hazara division of Pakistan.

Bilateral rhegmatogenous retinal detachments with unilateral vitreous base avulsion as the presenting signs of child abuse.

PURPOSE: To describe a 7-year-old boy with bilateral rhegmatogenous retinal detachments and unilateral vitreous base avulsion as the presenting signs of child abuse. METHOD: Case report. RESULTS: Examination demonstrated no external signs of trauma or ocular findings typically found in battered child syndrome; however, findings of rhegmatogenous retinal detachments and vitreous base avulsion raised the suspicion of child abuse, which was confirmed with further history. A scleral buckle procedure and pars plana vitrectomy with silicone oil tamponade were performed in the right eye followed by a similar procedure in the left eye 1 week later. CONCLUSION: Vitreous base avulsion and rhegmatogenous retinal detachments may be the only presenting signs of child abuse.

Resolving conflict creatively: evaluating the developmental effects of a school-based violence prevention program in neighborhood and classroom context.

This study evaluated the short-term impact of a school-based violence prevention initiative on developmental processes thought to place children at risk for future aggression and violence and examined the influence of classroom and neighborhood contexts on the effectiveness of the violence prevention initiative. Two waves of developmental data (fall and spring) were analyzed from the 1st year of the evaluation of the Resolving Conflict Creatively Program (RCCP), which includes 5053 children from grades two to six from 11 elementary schools in New York City. Three distinct profiles of exposure to the intervention were derived from Management Information System (MIS) data on between classroom differences in teacher Training and Coaching in RCCP, Classroom Instruction in RCCP, and percentages of students who are Peer Mediators. Developmental processes that place children at risk were found to increase over the course of the school year. Children whose teachers had a moderate amount of training and coaching from RCCP and who taught many lessons showed significantly slower growth in aggression-related processes, and less of a decrease in competence-related processes, compared to children whose teachers taught few or no lessons. Contrary to expectation, children whose teachers had a higher level of training and coaching in the RCCP but taught few lessons showed significantly faster growth over time in aggressive cognitions and behaviors. The impact of the intervention on children's social cognitions (but not on their interpersonal behaviors) varied by context. Specifically the positive effect of High Lessons was dampened for children in high-risk classrooms and neighborhoods. Implications for future research on developmental psychopathology in context and for the design of preventive interventions are discussed.

The Evaluation of the Resolving Conflict Creatively Program: an overview.

The Resolving Conflict Creatively Program (RCCP) is a comprehensive, school-based program in conflict resolution and intercultural understanding implemented in more than 110 New York City public schools. The National Center for Children in Poverty is currently conducting an evaluation of the program in grades 1-6, although the program itself is implemented in grades K-12. The following components are included: teacher training, classroom instruction and staff development, the program curriculum, administrators' training, peer mediation, parent training, and a targeted intervention for high-risk youth. The program evolved out of practice-based theory. Researchers and practitioners have collaborated on and designed an evaluation that illustrates how the practice-based theory is consistent with and can be put into operation using developmental and ecological theories of the etiology of violence-related behaviors in middle childhood. The target population for this study is approximately 9,600 children, 5-12 years of age, in 15 elementary schools in New York City. The evaluation is being conducted over two years with two data-collection points in each year. A cross-sequential design is being used to examine the short- and intermediate-term utility with children at different ages/developmental stages. The relative effect of the beginning program can be compared to more comprehensive models. A total of 8,233 students responded to the baseline survey. The study population is largely Hispanic (41%) and African American (37%). Preliminary analyses indicate that baseline means of such constructs as aggressive fantasies, hostile attributional biases, and conduct problems increase with grade level. Ten years of practice-based experience and one year of a two-year quantitative evaluation have taught several important lessons about school-based program implementation and the evaluation of such programs. The scope and longevity of the RCCP and the empirically rigorous evaluation now under way will make a significant contribution to the field of violence prevention and field-based program evaluation.

Multifocal musculoskeletal cystic tuberculosis without systemic manifestations.

A case of multifocal cystic tuberculosis is presented, affecting the clavicle and the iliac bones with considerable soft tissue involvement. It was found in a 34-year-old male, an immigrant from Yemen. The extensive cystic nature of both lesions and the lack of systemic manifestations despite multifocal disease are unusual.

Comparison of four methods of assessing visual acuity in young children.

The purpose of this study was to determine which of four tests, the Acuity Cards, the Dot Visual Acuity test, the Broken Wheel test, or the American Optical (AO) pictures, might be most useful for clinical assessment of visual acuity in 2- and 3-year-olds. Data related to clinical utility including success rates, required test times, reliability, and acuity norms were collected. High success rates and short test times support use of the Acuity Cards for 2-year-olds. For testing 3-year-olds a measure of recognition acuity, the Broken Wheel test, may be most useful.