Associations between School-Behavior-Health Difficulties and Subsequent Injuries among Younger Adolescents: A Population-based Study.

Objective: School-behavior-health difficulties (SBHDs) may alter physical/mental capabilities and consequently increase injury risk during daily activities. This study assessed the associations of potential SBHDs and their cumulative number (SBHDcn) with various injury types among younger adolescents. Methods: The study population included 1,559 middle-school adolescents in France (10-18 years, 98% under 16,778 boys and 781 girls). They completed a questionnaire at school-year end collecting socioeconomic features (nationality, family structure, parents' education/occupation/income), school/out-of-school injuries during the school-year (dependent variables), and SBHDs starting before the school-year (low academic performance, alcohol/tobacco/cannabis/other-illicit-drugs use, physical/verbal violence, sexual abuse, perpetrated violence, poor social support, poor general health status, sleep difficulty, depressive symptoms, and suicide attempt). Data were analyzed using logistic regression models and Kaplan-Meier estimates. Results: Injuries were frequent during school-physical/sports-training (10.9%), other-school-training (4.7%), school-free-time (7.4%), out-of-school-sports-activity (16.5%), and traffic (2.2%). Single injury (one injury all injury types combined) and ≥2 injury types affected 23.3 and 7.9% of subjects, respectively. The proportion of adolescents without SBHDs decreased with age more quickly among those with each injury type than among those without injury. Various SBHDs were associated with most injury types, single injury, and ≥2 injury types (sex-age-adjusted odds/relative-risk ratios reaching 11, p < .001). A dose-effect association was found between SBHDcn 1-2/3-5/≥6 and both single injury and ≥2 injury types (sex-age adjusted relative risk ratios reaching 12.66, p < .001, vs. SBHDcn = 0). Socioeconomic features had a moderate confounding role in these associations. Conclusions: SBHDs strongly predict injuries among adolescents. Our findings may inform healthcare providers about their prominent role in detecting/reducing SBHDs and injuries.

Association of School Health Relationship Difficulties with Lack of Regular Physical Activity in Younger Adolescents: A Population Based Study.

Objective: Lack of regular physical activity (LPA) and the number of days/week with physical activity >60 minutes/day (Ndw) may be associated with school-health-relational difficulties (SHRDs) during the life-course. This study assessed their associations and the confounding role of socioeconomic features (nationality, family structure, parents' education/occupation/income) among younger adolescents. Methods: This cross-sectional population-based study included 1,559 middle-school adolescents from north-eastern France (10-18 years, 98% under 16 years, 778 boys and 781 girls). They completed over one-hour teaching period a questionnaire collecting last-12-month LPA and last-7-day Ndw (dependent variables), and risk factors including socioeconomic features, SHRDs (previous grade repetitions, last-12-month poor general health status/physical health/psychological health/social-relationships, depressive symptoms (and age at onset and duration from onset); cumulated number noted SHRDcn). Data were analyzed using logistic/linear regression models. Results: LPA was common (32.5%) and associated with all SHRDs (sex-age-adjusted odds ratio saOR reaching 1.99, p < .001) and depressive-symptoms duration (saOR 1.63 (p < .05) and 2.11 (p < .001) for 1-2 and ≥3 years, respectively, vs. no depressive symptoms). A dose-effect association was found between SHRDcn and LPA (24.0, 33.7, 45.6, and 53.5%; saOR 1.59, 2.58, and 3.43; for SHRDcn 1-2, 3-4, and ≥5 respectively, vs. SHRDcn = 0, p < .001). Ndw was similarly associated with all SHRDs and SHRDcn (sex-age-adjusted regression coefficient reaching -1.10 day/week, p < .001). These results were robust when controlling for socioeconomic features (18%

• Lack of physical activity (LPA) is strongly associated with school-health-relational difficulties (SHRDs) affecting most adolescents.• There are dose-effect associations between cumulative number of SHRDs and both LPA and number of days/week with physical activity >60 min/day (Ndw).• These links are robust when controlling for socioeconomic features which have a strong confounding role.• The risk of LPA and reduced Ndw increase with the duration of depressive symptoms from their onset.• Prevention to detect/reduce SHRDs may improve physical activity, especially for most at-risk adolescents.

Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

OBJECTIVE: Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. DESIGN: At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). SETTING: Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). SUBJECTS: Homeless adults with mental illness (n 2148). RESULTS: Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. CONCLUSIONS: Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

Anthropometric characteristics of hospitalised elderly women: a case-control study.

This study assessed the anthropometric status of 451 hospitalised female patients aged 70 or over, at their admission to hospital, in reference to 77 healthy women of the same age. The most frequent diseases were circulatory diseases (40.8%), mental disorders (29.9%), respiratory diseases (12.4%), endocrine and metabolic diseases (11.5%), osteomuscular diseases (8.4%), and traumatisms (6.9%). The differences were significantly high for mid-arm circumference (MAC), triceps skinfold thickness (TSF), weight, weight/height, and body mass index (BMI). The patients with cancers, blood diseases, mental disorders, respiratory disease, digestive diseases, or traumatisms had the lowest values. All the indicators correlated in a similarly negative way with age. The decreased TSF was more pronounced among subjects with respiratory diseases. Measurement of anthropometric indicators, TSF in particular, should be part of preventive measures aimed at reducing malnutrition and its consequences in a hospital setting.

Oxidant/antioxidant status, lipids and hormonal profile in overweight women with breast cancer.

This study was carried out to determine the relationships between leptin concentrations, lipid alterations, oxidant/ antioxidant status, in vitro LDL oxidizability and LDL-fatty acid composition in overweight breast cancer patients. Glucose, insulin, leptin, lipids, LDL-cholesteryl ester fatty acids, markers of oxidant status (MDA, Hydroperoxides, carbonyl proteins, conjugated dienes) and markers of antioxidant status (vitamins A, C, E, erythrocyte activities of the enzymes superoxide dismutase, SOD, catalase, glutathione peroxidase,GPx, and glutathione reductase, GR and the serum total antioxidant status, ORAC) were investigated in breast cancer patients and in control women. Our findings showed that insulin, leptin, triglyceride, cholesterol and LDL-C concentrations were increased in patients compared to controls. ORAC and vitamin C and E values were lower while plasma hydroperoxide, carbonyl protein and conjugated diene levels, SOD and GPx activities were higher than in controls. Alterations in LDL-fatty acid composition were associated with their enhanced oxidative susceptibility. There were significant positive correlations between leptin concentrations and LDL-C, hydroperoxides, carbonyl proteins, SOD activity, baseline conjugated diene levels and oxidation rate, and significant negative correlations between leptin and ORAC, lag time and LDL-PUFA in patients. In conclusion, breast cancer is associated with lipid alterations and enhanced oxidative stress linked to high leptin levels in overweight.

Effect of Ramadan fasting on anthropometric parameters and food consumption in 276 type 2 diabetic obese women.

AIM: To assess the effect of Ramadan fasting on body weight and food consumption in type 2 diabetic obese women. MATERIALS AND METHODS: A total of 276 outpatient women receiving oral antidiabetic drugs (OADs) (BMI = 34.63 +/- 3.29 kg/m(2)), aged 49 (+/-6 years), were selected. The study was carried out over three periods - before (T1: prefasting), during (T2: fasting), and after (T3: postfasting) Ramadan - in three towns located in the northwestern region of Algeria. During the course of 3 days, the daily food intake and anthropometric parameters weight, height, waist and hip circumferences, body mass index (BMI), and waist-hip ratio (WHR) were recorded. A one-way repeated measures ANOVA test was used to compare the groups. RESULTS: The main effect of fasting during Ramadan was a significant weight loss (-3.12 kg i.e. 3.70%; P < 0.01), a decrease in meal frequency (2.2 +/- 0.3 vs. 4.3 +/- 0.4) as well as in energy intake (1488 +/- 118 vs.1823 +/- 262 Kcal/d) and an important increase in dietary fat consumption (35.84 vs. 25.36%), especially the saturated one (231Kca/d i.e. 43.25%) of total fat, dietary cholesterol (392 +/- 121 vs. 221 +/- 73 mg/d), and polyunsaturated fatty acids (PUFA). Except in three cases, there were no frequent hypoglycaemic episodes observed among the participants. CONCLUSIONS: Fasting during the month of Ramadan causes weight loss and decrease in calorie intake, which is correlated with a decrease in meal frequency. However, more foods rich in fat and dietary cholesterol were consumed during this period. The latter could constitute a high risk for diabetics who are fasting, in particular when medication advice and/or health care control are insufficient or ignored.

Serum zinc and copper status in hospitalized vs. healthy elderly subjects.

OBJECTIVE: To assess serum zinc and copper concentrations of elderly hospitalized patients with a broad range of diseases and compare their levels to those of healthy community dwelling controls of similar age. METHODS: This case-control study compared serum zinc and copper levels of 668 hospitalized subjects, aged 70 or over, with 104 healthy controls of the same age and from the same geographical area. The study protocol, conducted by one physician on the day after the admission to the hospital, included a questionnaire on sociodemographic characteristics, a medical examination, and serum zinc and copper measured with flame atomic absorption spectrophotometry. Data were analysed using analysis of covariance, controlling for age and sex. RESULTS: The diseased subjects had markedly lower zinc concentrations than the control group. The frequency of low values (<0.70 mg/L) was high (20.2% vs. zero in controls, p < 0.001), and it differed among various disease categories: 35.7% for respiratory disease, 20%- 27% for cancer, infectious disease, trauma, blood diseases, and genitourinary diseases, and less than 20% for the other diseases. Low values for serum copper concentration (<0.80 mg/L) were rare in hospitalized subjects (1.4% vs. zero in controls). Whatever the disease category and number of diagnoses considered, the serum copper/zinc ratio was significantly (p < 0.001) higher in diseased than in healthy people. CONCLUSIONS: Elderly hospitalized patients are at elevated risk of low zinc but not copper values. The significantly lower values of serum zinc found in the hospitalized elderly compared to healthy elderly are likely to be related to disease rather than to aging per se. In addition to other classic anthropometric (BMI) and biological (serum proteins) nutritional parameters, copper/zinc ratio may be a useful marker of malnutrition.

Ramadan fasting induces modifications of certain serum components in obese women with type 2 diabetes.

OBJECTIVE: To examine the effect of fasting during Ramadan on certain serum components such as fasting serum glucose (FSG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TGs), high density lipoproteins (HDL-C), and low density lipoproteins (LDL-C) parameters in obese women patients with type 2 diabetes. METHODS: We conducted the study in Petit-Vichy Diabetology Center, Sidi-Bel-Abbes, Algeria from October 2003 to March 2004, on 60 obese outpatient women (BMI = 35.41 +/- 3.64 kg/m2), aged 51 +/- 10 years, who had diabetes for 5 +/- 2.5 years. The patients followed no specific diet, on medications, and presenting no degenerative complications. We carried out the study over 3 periods: before (pre-fasting), during (fasting), and after Ramadan month (post-fasting). RESULTS: Comparing Ramadan (fasting period) with non-Ramadan days (pre- and post-fasting periods), we observed significant decreases in FSG (16.72%, p<0.001), in HbA1c (11.3%, p<0.005), and in HDL-C (26.81%, p<0.001) rates, while TC (13.85%, p<0.001), TGs (16.9%, p<0.003), and the LDL-C (22.39%, p<0.0001) levels increased significantly. CONCLUSION: These findings show a beneficial effect of fasting during Ramadan on glucose homeostasis, however, we observed an unbalanced profile on lipids.

Lifestyle risk factors for chronic disease by family origin among children in multiethnic, low-income, urban neighborhoods.

OBJECTIVES: To describe the prevalence of lifestyle risk factors (LRF) for chronic disease by family origin (FO) among children in multiethnic, low-income, urban neighborhoods. DESIGN: Cross-sectional analysis. SETTING: 16 elementary schools located in disadvantaged, multiethnic neighborhoods in Montreal, Canada. PARTICIPANTS: 4659 schoolchildren aged 9-12 in grades 4-6. OUTCOME MEASURES: Smoking, level of physical activity, dietary habits, body mass index, sedentary behavior. METHODS: Subjects completed self-report questionnaires on sociodemographic characteristics and lifestyle behaviors; height and weight were measured in a standardized protocol. Fourteen FO groupings were identified based on language(s) spoken and countries of birth of both subjects and parents. We tested FO as an independent correlate of having 2 or more LRF, using the generalized estimating equations method. RESULTS: Relative to Canadian children, a higher proportion of Haitian, Portuguese, and other Central American/Caribbean children had 2 or more LRF, the proportion was similar among Cambodian, Vietnamese, Chinese, South American, East European, Arabic, Italian, and South Asian children, and lower among Salvadorean children. CONCLUSION: Prevention programs for youth should take differential distribution of LRF by ethnicity into account.