Longitudinal correlates of the persistence of irregular eating from age 5 to 14 years.

AIM: To report the stability of parent-perceived child irregular eating from 6 months to 14 years of age and to investigate a predictive model inclusive of child and parent factors. METHODS: Of the 7223 singleton children in a birth cohort, 5122 children were re-interviewed at 5 years and 4554 for the 14-year analysis. Information was obtained from structured interviews including questions answered by parents of the child at birth, 6 months, 5 years and 14 years; and by teenagers at age 14 years and from physical measures of the child. The mother's perception that the child was an irregular eater at age 14 years was the major outcome variable of interest. RESULTS: Approximately 40% of irregular eaters at age 5 will still be irregular eaters at age 14 years. This was not related to maternal education or socio-economic class. Significant at multivariate analysis were infant feeding problems and the children's ability to regulate their sleep and mood. Significant maternal factors were greater age, not feeling positive about the baby and persistent maternal anxiety during the child's early years. CONCLUSION: Irregular eating behaviour displays considerable continuity from childhood to mid-adolescence. Independent contributions to this behavioural phenotype include child biological and psychological factors and maternal anxiety during the child's early years.

Predictors of maternal misclassifications of their offspring's weight status: a longitudinal study.

BACKGROUND: Very little is known about the factors influencing parental misclassifications of a child's weight status. The aim of this study is to examine the predictors of maternal misclassifications of their adolescent offspring's weight status. METHODS: A mother-child linked analysis was carried out using 14-year follow-up data from a population-based prospective birth cohort of 2650 children (52% males) who were participants in the Mater-University Study of Pregnancy in Brisbane (Australia) in 1981. Offspring's observed height and weight and maternal perception of offspring weight were reported when they were 14 years old and predictors were prospectively recorded either at first clinical visit of mothers or at 5 or 14 years follow-up. Maternal misclassifications were defined combining observed body mass index (BMI) categories and maternal perceptions of their offspring's weight status. RESULTS: We found that maternal misclassification of child's weight status was common and included misclassifications both to higher and lower weight categories. Forty percent of mothers of overweight children misclassified their child as normal or underweight, more so in males than females. Fifteen percent of mothers of normal weight children misclassified their child as underweight, again more so in males than females. The main independent predictors of maternal misclassifications of child weight status were gender, child dissatisfaction with appearance, shape, size and weight, dieting to lose weight, general health status, maternal BMI and family meals. Gender, child dissatisfaction, dieting and maternal overweight were especially associated with misclassifications of overweight children. CONCLUSIONS: This study identified a number of maternal, child and family factors associated with maternal misclassifications of child weight status. Although relevant for clinical practice, further study is needed, however, to evaluate the benefits and harms of promoting increasing parental and child awareness of the child's weight status at a population level.

Eating disorders and oral health: a review of the literature.

This article is a review of the recent literature pertaining to the oral sequelae of eating disorders (EDs). Dentists are recognized as being some of the first health care professionals to whom a previously undiagnosed eating disorder patient (EDP) may present. However, despite the prevalence (up to 4 per cent) of such conditions in teenage girls and young adult females, there is relatively little published in the recent literature regarding the oral sequelae of EDs. This compares unfavourably with the attention given recently in the dental literature to conditions such as diabetes mellitus, which have a similar prevalence in the adult population. The incidence of EDs is increasing and it would be expected that dentists who treat patients in the affected age groups would encounter more individuals exhibiting EDs. Most of the reports in the literature concentrate on the obvious clinical features of dental destruction (perimolysis), parotid swelling and biochemical abnormalities particularly related to salivary and pancreatic amylase. However, there is no consistency in explanation of the oral phenomena and epiphenomena seen in EDs. Many EDPs are nutritionally challenged; there is a relative lack of information pertaining to non-dental, oral lesions associated with nutritional deficiencies.

Predictors of low bone density in young adolescent females with anorexia nervosa and other dieting disorders.

OBJECTIVE: To compare the bone density of adolescent patients with anorexia nervosa with adolescent patients with other dieting disorders and to evaluate risk factors for low bone density in these patients. METHOD: Sixty-nine consecutive female patients referred to an adolescent eating disorders clinic were studied by interview, blood sampling, body composition, and lumbar spine bone density measurement using dual energy X-ray absorptiometry. RESULTS: Although patients with anorexia nervosa were more malnourished, their bone density was similar to other dieting patients. Patients were divided into a low and normal bone density group irrespective of psychiatric diagnosis. Patients with low bone density had dieted for longer, had lower lean body mass, more often had not achieved menarche, and had longer duration of secondary amenorrhea and lower estrogen levels. DISCUSSION: Irrespective of clinical diagnosis, adolescents with dieting disorders have increased risk of low bone density when malnutrition commences early in puberty and is associated with reduced lean body mass and impaired ovarian function.

Kinetic analysis of the effect of poliovirus receptor on viral uncoating: the receptor as a catalyst.

We examined the role of soluble poliovirus receptor on the transition of native poliovirus (160S or N particle) to an infectious intermediate (135S or A particle). The viral receptor behaves as a classic transition state theory catalyst, facilitating the N-to-A conversion by lowering the activation energy for the process by 50 kcal/mol. In contrast to earlier studies which demonstrated that capsid-binding drugs inhibit thermally mediated N-to-A conversion through entropic stabilization alone, capsid-binding drugs are shown to inhibit receptor-mediated N-to-A conversion through a combination of enthalpic and entropic effects.

Posttraumatic stress disorder and emotional problems in children following motor vehicle accidents: an extended case series.

OBJECTIVE: The prevalence of posttraumatic stress disorder (PTSD) and general psychopathology in children following motor vehicle accidents (MVA) was investigated. METHOD: Twenty-six subjects aged 8-13 years presenting to an emergency department following an MVA were assessed 3 months after the accident using a standard clinical psychiatric assessment, a structured research interview and self- and parent-report questionnaires. RESULTS: A higher prevalence of psychopathology was seen in the sample compared with community controls. Self-report of PTSD symptoms revealed 22% subjects in the moderate or severe PTSD range and 35% of mild severity. There was significant concordance between self-report PTSD scores and a clinical diagnosis of PTSD. Perception of threat and the internalising subscale on the Child Behaviour Checklist were significantly correlated with PTSD scores. CONCLUSIONS: PTSD and other symptoms of emotional distress are common following MVAs. The clinical and public health implications are discussed, and areas for further research highlighted.

Two distinct binding affinities of poliovirus for its cellular receptor.

To study the kinetics and equilibrium of poliovirus binding to the poliovirus receptor, we used surface plasmon resonance to examine the interaction of a soluble form of the receptor with poliovirus. Soluble receptor purified from mammalian cells is able to bind poliovirus, neutralize viral infectivity, and induce structural changes in the virus particle. Binding studies revealed that there are two binding sites for the receptor on the poliovirus type 1 capsid, with affinity constants at 20 degrees C of K(D)(1) = 0.67 microm and K(D)(2) = 0.11 microm. The relative abundance of the two binding sites varies with temperature. At 20 degrees C, the K(D)(2) site constitutes approximately 46% of the total binding sites on the sensor chip, and its relative abundance decreased with decreasing temperature such that at 5 degrees C, the relative abundance of the K(D)(2) site is only 12% of the total binding sites. Absolute levels of the K(D)(1) site remained relatively constant at all temperatures tested. The two binding sites may correspond to docking sites for domain 1 of the receptor on the viral capsid, as predicted by a model of the poliovirus-receptor complex. Alternatively, the binding sites may be a consequence of structural breathing, or could result from receptor-induced conformational changes in the virus.

Defects in nuclear and cytoskeletal morphology and mitochondrial localization in spermatozoa of mice lacking nectin-2, a component of cell-cell adherens junctions.

Nectin-2 is a cell adhesion molecule encoded by a member of the poliovirus receptor gene family. This family consists of human, monkey, rat, and murine genes that are members of the immunoglobulin gene superfamily. Nectin-2 is a component of cell-cell adherens junctions and interacts with l-afadin, an F-actin-binding protein. Disruption of both alleles of the murine nectin-2 gene resulted in morphologically aberrant spermatozoa with defects in nuclear and cytoskeletal morphology and mitochondrial localization. Homozygous null males are sterile, while homozygous null females, as well as heterozygous males and females, are fertile. The production by nectin-2(-/-) mice of normal numbers of spermatozoa containing wild-type levels of DNA suggests that Nectin-2 functions at a late stage of germ cell development. Consistent with such a role, Nectin-2 is expressed in the testes only during the later stages of spermatogenesis. The structural defects observed in spermatozoa of nectin-2(-/-) mice suggest a role for this protein in organization and reorganization of the cytoskeleton during spermiogenesis.

Detection and importance of laxative use in adolescents with anorexia nervosa.

OBJECTIVE: The frequency of laxative use in adolescents with anorexia nervosa is poorly described. This study of adolescents with anorexia nervosa examined self-report and biochemical screening methods for the detection of laxative use, the pattern of laxative use in this population over time, and the associated medical complications and psychopathology. METHOD: Forty-three consecutive patients with anorexia nervosa were studied. Initial assessment encompassed psychiatric history, medical examination, and administration of the Eating Disorders Examination, Child Behavior Checklist, and Youth Self-Report. Biochemical investigations, including random urinary laxative screening, were performed at assessment and follow-up. RESULTS: The frequency of laxative use from self-report alone was 12%; combined with urine screening it was 19%. The frequency of laxative use increased to 32% with prospective follow-up. Medical complications were associated with laxative use at follow-up. Laxative use was associated with longer duration of disease and with higher scores on the Eating Disorders Examination subscale Eating Concern. CONCLUSIONS: Laxative use is common among adolescents with anorexia nervosa, and the risk of associated medical complications increases over time. Biochemical screening will improve detection of laxative use. Longer duration of illness and greater Eating Concern scores are associated with increased risk of laxative use, and monitoring patients at increased risk is important.

Fetal growth and subsequent mental health problems in children aged 4 to 13 years.

To test the hypothesis that children with suboptimal fetal growth have significantly poorer mental health outcomes than those with optimal growth, a population random sample survey of children aged 4 to 16 years in Western Australia in 1993 was conducted. The Child Behavior Checklist (Achenbach 1991a) and the Teacher Report Form (Achenbach 1991b) were used to define mental health morbidity. Survey data for 1775 children aged 4 to 13 years were available for linkage with original birth information. The percentage of expected birthweight (PEBW) was used as the measure of fetal growth. Children below the 2nd centile of PEBW who had achieved only 57% to 72% of their expected birthweight given their gestation at delivery were at significant risk of a mental health morbidity (OR 2.9, 95% CI 1.18, 7.12). In addition, they were more likely to be rated as academically impaired (OR 6.0, 95% CI 2.25, 16.06) and to have poor general health (OR 5.1, 95% CI 1.69, 15.52).

Three-dimensional structure of poliovirus receptor bound to poliovirus.

Poliovirus initiates infection by binding to its cellular receptor (Pvr). We have studied this interaction by using cryoelectron microscopy to determine the structure, at 21-A resolution, of poliovirus complexed with a soluble form of its receptor (sPvr). This density map aided construction of a homology-based model of sPvr and, in conjunction with the known crystal structure of the virus, allowed delineation of the binding site. The virion does not change significantly in structure on binding sPvr in short incubations at 4 degrees C. We infer that the binding configuration visualized represents the initial interaction that is followed by structural changes in the virion as infection proceeds. sPvr is segmented into three well-defined Ig-like domains. The two domains closest to the virion (domains 1 and 2) are aligned and rigidly connected, whereas domain 3 diverges at an angle of approximately 60 degrees. Two nodules of density on domain 2 are identified as glycosylation sites. Domain 1 penetrates the "canyon" that surrounds the 5-fold protrusion on the capsid surface, and its binding site involves all three major capsid proteins. The inferred pattern of virus-sPvr interactions accounts for most mutations that affect the binding of Pvr to poliovirus.

Post-disaster service provision following proactive identification of children with emotional distress and depression.

OBJECTIVE: Proactive, school-based psychological testing for emotional distress and depression was employed 6 months after a bushfire disaster. The service provision aim was to provide children with the greatest emotional distress the relatively limited therapeutic resources available in the post-disaster environment. Specific hypotheses were tested: that the prevalence of emotional distress and depression would be elevated 6 months post disaster; that emotional distress would be correlated with traumatic events; and that depression would be related to experiences of loss. METHOD: Six months after a bushfire disaster grade 4, 5, and 6 students (n = 601) participated in screening using a test battery measuring emotional distress, depressive symptoms and trait anxiety. RESULTS: Twelve percent (n = 72) of children experienced severe emotional distress 6 months after the bushfire. Rates of depression were similar to rates in non-traumatised child community samples. Multivariate analysis suggested that emotional distress was significantly associated with trait anxiety, evacuation experience, the perception that parents may have died during the bushfire, and depressive symptoms. Depressive symptoms were associated with total distress score, trait anxiety and perception of threat to the parents. CONCLUSIONS: Substantial mental health morbidity was identified 6 months after a bushfire disaster. The usefulness of post-disaster service provision influenced by proactive screening is discussed and reasons for further research highlighted.

Effects of copper deficiency and experimental diabetes on tissue antioxidant enzyme levels in rats.

Male weanling rats were fed diets containing either adequate (6.2 mg/kg) or deficient (0.82 mg/kg) quantities of copper for 35 days. Six rats from each group (n = 12) were then injected with streptozotocin to induce diabetes. Rats were killed after a further 16 days and tissues removed for the analysis of the copper level and antioxidant enzyme activities. Diabetes resulted in increased cardiac catalase, glutathione S-transferase (GST), copper-zinc superoxide dismutase and manganese superoxide dismutase activities. Renal catalase levels were decreased in diabetes, while glucose-6-phosphate dehydrogenase activity (G6PDH) was increased. Diabetes significantly decreased the activities of hepatic GST and G6PDH. The combination of diabetes and copper deficiency resulted in increased levels of hepatic GST, glutathione peroxidase and glutathione reductase. Hepatic and renal tissue copper levels were also increased in diabetes, apparently improving copper status in the copper-deficient rats. Alterations of antioxidant enzyme activities in diabetes were suggestive of increased oxidant stress, especially in cardiac tissue.