Changes in body mass index and risk of adolescent psychopathology: a longitudinal cohort study.

BACKGROUND: Abnormal body mass index (BMI) has been associated with development of psychopathology. This association in children is well documented, for both overweight and underweight children. However, the association between change in BMI and the development of psychopathology has been less investigated. AIM: To investigate the association between change in BMI between childhood and adolescence and psychopathology in adolescence. METHODS: Data from the Growing Up in Ireland cohort were used. We investigated the '98 cohort (also known as the child cohort) at age 9/13. BMI, defined using internationally recognised definitions as underweight, healthy or overweight, was used as the exposure, and abnormal Strength and Difficulties Questionnaire scores were used as the outcome. Logistic regression was undertaken for the analysis. All analyses were adjusted for confounders. RESULTS: A change to overweight from healthy BMI was significantly associated with increased risk of psychopathology (adjusted OR 1.66; 95% CI 1.19-2.32). Both change from underweight to healthy (adjusted OR 0.12; 95% CI 0.03-0.43) or from overweight to healthy (adjusted OR 0.47; 95% CI 0.79-0.8) was associated with a significantly reduced risk of developing psychopathology. DISCUSSION: As a child's BMI returns to within the healthy range, their risk of adolescent psychopathology is reduced. Interventions to restore healthy BMI, in both underweight and overweight, children may reduce their risk of adolescent psychopathology.

Health-related quality-of-life measures for children.

Our purpose is to report the development and psychometric properties of a generic computer-delivered measure of health-related quality of life (HRQL) suitable for children aged 6 to 11 years, the Exeter HRQL scale (EHRQL). The theoretical model adopted is based on a definition of HRQL which assumes that HRQL is the result of discrepancies between an individual's actual self and ideal self. The EHRQL consists of 16 pictures, each of which is rated twice, first in terms of "like me" and second as "I would like to be". The difference between these scores is assumed to be indicative of HRQL. The EHRQL is delivered using a Macintosh Powerbook and takes approximately 20 min. Data are reported for 60 children with asthma (mean age = 8.93 years) and 69 healthy children (mean age = 7.49 years). In addition, children with asthma completed the Childhood Asthma Questionnaire (CAQ) and a measure of self-efficacy. For children with asthma, significant correlations were found between discrepancy scores and 3 of the 4 subscales of the CAQ. In addition, higher discrepancies were found for children with asthma compared with healthy children (p < 0.05). The EHRQL has acceptable internal reliability, and these data provide preliminary support for the theoretical assumption that HRQL reflects perceived discrepancies between an individual's actual self and ideal self. The measure also distinguished, as predicted, between children with asthma and healthy children. Methodological refinements to the EHRQL are suggested.

Quality of life in children following treatment for a malignant primary bone tumour around the knee.

Purpose. We report on the quality of life following treatment for a malignant primary bone tumour around the knee in skeletally immature children.Patients. Patients (n = 41; mean age = 18 years; range 8-28) had all experienced chemotherapy in a neo-adjuvant setting, surgical excision of the tumour and endoprosthetic replacement.Methods. Interviews were conducted separately with the child and mother and focused on mobility, body image and the impact of treatment on schooling, employment and plans for the future.Results. Mobility in the group was variable. Only 12% reported that they could run with any confidence. The proportion who were able to swim (49%) or ride a bike (46%) was higher. All had experienced major disruption in schooling (mean absence following diagnosis = 12 months). Eight had repeated a school year and 41% patients reported that their schoolwork was affected. As a result of their experience, eight (six females and two males) chose health-related employment. Concerns for the future were highest among males and those with manual jobs. Three patients were receiving psychiatric support, in relation to extreme concern about the risk of recurrence. All expressed satisfaction with treatment, and older patients believed that the prosthesis gave a better quality of life than amputation.Discussion. Our data suggest that outcome following limb-salvage surgery is variable. Education is disrupted. Even so, only two left school with no qualifications. Employment is most restricted among males with few qualifications who may benefit from sensitive vocational counselling.

Plant responses to elevational gradients of O(3) exposures in Virginia.

In Shenandoah National Park, O(3) monitoring data were characterized and attempts were made to relate O(3) concentration levels to visible foliar injury observed for five plant species surveyed. Foliar injury for three species increased with elevation. The 24-h monthly mean O(3) concentrations tended to increase with elevation; however, the number of elevated hourly occurrences did not. Although the frequency of high hourly O(3) concentrations did not consistently increase with elevation, O(3) exposures in the park may have been high enough to provoke an effect that may have been enhanced by vegetation sensitivities that differed as a function of altitude.

Screening loblolly pine seedling responses to SO2 and O3: analysis of families differing in resistance to fusiform rust disease.

Open pollinated families of loblolly pine differing in resistance to fusiform rust disease were screened in laboratory studies for responses to gaseous air pollutants. Twenty families were given acute exposures (2 fumigations for 4 h each) to SO(2) (0.4-1.0 ppm), O(3) (0.25 ppm), SO(2) (0.4-1.0 ppm) + O(3) (0.25 ppm) and control. Analyses of variance were performed to evaluate the treatment effects of these air pollutants on percent foliar injury, and to determine whether the families responded differentially to the air pollution treatments. Treatment effects were significant, with the combination treatment of SO(2) + O(3) producing a higher percentage of foliar injury than the controls; however, injury levels were very low and may not be of biological significance. Subsequently, twelve families were grown in two soil types for exposure to chronic levels of SO(2) (0.06 ppm), O(3) (0.07 ppm), SO(2) (0.06 ppm) + O(3) (0.07 ppm) and control. The families were then ranked for decreased primary shoot growth, shoot dry weight, root dry weight, total plant dry weight and root/shoot ratio after exposure to air pollution treatments. Air pollution treatments as a main effect were significant for only one of five growth parameters measured, that of primary shoot growth. The main effect of family, and the interaction of family and air pollution treatments, were significant for most growth parameters measured. In general, O(3) alone and in combination with SO(2) reduced growth more than SO(2) alone. Fumigation with O(3) reduced growth of two families in comparison with control groups, whereas SO(2) alone produced decreased growth in one family and stimulated growth in three families. Treatment with O(3) alone produced higher root/shoot ratios than fumigation with charcoal-filtered air in two families. Overall, families which were fast growers under control conditions maintained their ranking after exposure to air pollution. Families producing less growth in charcoal-filtered air also produced less growth under various air pollution regimes. Results indicated that these families exhibited a high degree of resistance to air pollution injury. Growth responses of seedlings may not reflect family differences in long-term productivity. No relationship was apparent between fusiform rust resistance and growth reductions due to air pollutants.