Linking parent perceptions of children's weight to early coronary risk factors: results from the CARDIAC Project.

INTRODUCTION: Obesity is a public health threat because of the increasing prevalence in childhood and its causal relationship to the leading cause of death in America, heart disease. Detecting early signs of cardiovascular disease (CVD) risk factors in children and appropriately intervening to reverse the unhealthy trajectory associated with childhood obesity is of great importance. The objective of this study is to observe parental perception of their child's body mass index (BMI) and find associations between inaccurately estimated children and CVD risk factors. METHODS: This study analyzed the association between 147 rural fifth grade students' lipid profiles and parents' self-reported survey who participated in the 2008-2011 Coronary Artery Risk Detection in Appalachian Communities study. RESULTS: After controlling for covariates, underestimated children were more likely to have higher log-transformed triglyceride and systolic blood pressure values and overestimated children were more likely to have lower systolic blood pressure. CONCLUSIONS: Underestimating a child's BMI is associated with coronary risk-related factors, while overestimating a child's BMI is associate with a protective CVD marker. A follow-up study examining the development of CVD risk factors in children of parents who inaccurately estimate their BMI would help clarify this relationship. Knowledge of how parental perceptions directly influence higher lipid levels in children could have an impact on public health efforts in the fight against childhood obesity in rural environments.

The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction.

BACKGROUND AND PURPOSE: Assessing disability is important, and numerous interviewer-assisted and self-report questionnaires are used to accomplish this task. These questionnaires can be classified as being generic, condition or disease specific, or patient specific. The purpose of this study was to determine test-retest reliability, construct validity, and sensitivity to change of the Patient-Specific Functional Scale (PSFS) when applied to patients with knee dysfunction. SUBJECTS: Subjects were 38 physician-referred patients with knee dysfunction. METHODS: The PSFS and the Medical Outcomes Study 36-Item Short-Form Health Survey were administered at a patient's initial visit and following 2 to 3 weeks of treatment. An assessment of global change was also made by the patient and clinician at follow-up. These measures allowed the assessment of construct validity and sensitivity to change. To obtain an estimate of reliability, the PSFS was also administered within 72 hours of the initial assessment. RESULTS: Test-retest reliability and sensitivity to change were excellent (intraclass correlation coefficient [type 2,1] R = .84 and Pearson's r = .78, respectively). Validity was also confirmed. CONCLUSION AND DISCUSSION: Previous investigation on persons with low back pain suggested that the PSFS has promising measurement properties. The results of this study provide further evidence supporting the reliability, validity, and efficiency of the PSFS. Further investigation is needed to determine the extent to which the PSFS can be applied across a variety of conditions and age groups.

Giardiasis in ringed seals from the western arctic.

Sixteen beluga whales (Delphinapterus leucas) and fifteen ringed seals (Phoca hispida) from the western arctic region of Canada were examined for giardiasis and cryptosporidiosis. Intestinal contents from the rectum and colon were collected from animals slaughtered by Inuit hunters. A fluorescent monoclonal antibody identified Giardia sp. cysts in three of 15 (20%) seals. Thus, ringed seals are implicated as a potential reservoir for this zoonosis in the arctic.

Prevalence and etiology of respiratory distress in infants of diabetic mothers: predictive value of fetal lung maturation tests.

The purpose of this study was to investigate the prevalence of respiratory distress syndrome attributable to surfactant deficiency in infants of diabetic mothers tested for fetal lung maturation. Three tests were assessed: (1) lecithin/sphingomyelin ratio, (2) phosphatidylglycerol concentration, and (3) optical density at 650 nm. From January 1987 through June 1989, 526 diabetic gestations were delivered within 5 days of fetal lung maturation testing. Surfactant-deficient respiratory distress syndrome was present in five infants (0.95%); all were less than 34 weeks' gestational age. Other causes of respiratory distress were transient tachypnea of the newborn (n = 5), hypertrophic cardiomyopathy (n = 4), pneumonia (n = 2), polycythemia (n = 1), and meconium aspiration syndrome (n = 1). The use of standard maturity values of lecithin/sphingomyelin ratio greater than or equal to 2.0, phosphatidylglycerol greater than 2% to 5%, and optical density at 650 nm greater than or equal to 0.150 were evaluated. Each test had a 100% sensitivity in identifying surfactant-deficient respiratory distress syndrome and a 100% negative predictive value in identifying the absence of disease. All three tests had a low positive predictive value: 15% for lecithin/sphingomyelin ratio, 9% for phosphatidylglycerol, and 3% for optical density at 650 nm. We concluded that most cases of respiratory distress in the infants of diabetic mothers were unrelated to surfactant deficiency. The standard maturity values used in fetal lung maturation tests were valid in the diabetic gestation. The optical density at 650 nm was useful as a first-line test to predict the absence of surfactant-deficient respiratory distress syndrome.