Total energy expenditure among children with motor, intellectual, visual, and hearing disabilities: a doubly labeled water method.

OBJECTIVE: Few studies have evaluated the total energy expenditure (TEE) of children with disabilities using the doubly labeled water (DLW) method; however, none have compared it by disability type. Furthermore, no large-scale studies have focused on the severity of motor disability (MD). We aimed to compare TEE in children with disabilities by disability type. METHODS: In a cross-sectional study design, TEE was measured using the DLW method, anthropometry, and weighted food records. The following comparisons were made: (1) TEEs among four disability types and (2) TEEs of three subgroups classified by MD based on the Gross Motor Function Classification System (GMFCS). RESULTS: In total, 256 children (138 boys; ages 6-15 years) were studied. The comparison between the four disability types for boys in all age categories revealed that TEE (kJ/d) was lowest in MD, followed by intellectual disability (ID), visual disability, and hearing disability (HD), in that order. TEE/fat-free mass (FFM) (kJ/FFMkg/d) was also lowest in MD and highest in HD. TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were also lowest in MD and highest in HD in girls. For both boys and girls, TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were higher in the MD subtype GMFCS I-II than in GMFCS III-IV and GMFCS V. CONCLUSIONS: TEE differed, depending on the disability type, and was the lowest in MD and highest in HD for both boys and girls. Analysis by GMFCS classification revealed that greater severity of motor dysfunction resulted in lower TEE.

Serum albumin levels and their correlates among individuals with motor disorders at five institutions in Japan.

BACKGROUND/OBJECTIVES: The level of serum albumin is an index of nourishment care and management. However, the distribution and correlates of serum albumin levels among individuals with motor disorders have not been reported until now. Therefore, we examined the distribution and correlates of serum albumin levels among individuals with motor disorders. SUBJECTS/METHODS: A cross-sectional study on 249 individuals with motor disabilities (144 men, mean age: 51.4 years; 105 women, mean age: 51.4 years) was conducted at five institutions in Ibaraki Prefecture, Japan in 2008. The results were compared with data from the National Health and Nutrition Survey. RESULTS: The mean serum albumin levels were 4.0 ± 0.4 g/dL for men and 3.8 ± 0.5 g/dL for women. Overall, 17 (11.8%) men and 25 (23.8%) women had hypoalbuminemia (serum albumin level ≤ 3.5 g/dL); these proportions were greater than those among healthy Japanese adults (≤ 1%). Low serum albumin level was related with female sex, older age, low calf circumference, low relative daily energy intake, low hemoglobin (Hb), low blood platelet count, low high-density lipoprotein cholesterol (HDL-C), low HbA1c, and high C-reactive protein (CRP) levels. The strongest correlates, based on standardized betas, were Hb (0.321), CRP (-0.279), and HDL-C (0.279) levels. CONCLUSIONS: These results indicate that the prevalence of hypoalbuminemia is higher in individuals with motor disabilities than in healthy individuals and that inflammation is a strong negative correlate of serum albumin levels. Therefore, inflammation should be examined for the assessment of hypoalbuminemia among institutionalized individuals with motor disabilities.

Evaluation of the plasticization of ion-selective electrode membranes by pulsed NMR analyses.

The potentiometric polymeric membranes for ion-selective electrodes were evaluated by analyses of the proton spin-spin relaxation times T2 with pulsed NMR. The T2 measurements were performed using the Hahn-Echo, Solid-Echo and CPMG pulse sequences. The T2 values and fractions F of each component were obtained by analyses of the FID signals measured with the Hahn-Echo pulse sequence. The softer potentiometric polymeric membrane possessed the main fraction F(L), providing a relatively longer T(2L) value. A linear relationship existed between the weight ratio of the membrane solvent and ln T(2L) (or ln total T2×F). This analysis method could quantify the degree of hardness or softness of the potentiometric polymeric membranes with the differences in the membrane solvent weight. The normalized derivative spectra were acquired from the transverse magnetization M(t) data measured by using the Solid-Echo and CPMG pulse sequences. In the normalized derivative spectra of the potentiometric polymeric membranes, most PVC peaks in the short time region shifted to a larger area of long time regions by plasticization, and the softer potentiometric polymeric membrane incorporating more membrane solvent exhibited a relaxation peak in the relatively longer time region. Thus, the normalized derivative spectra were effective in elucidating the compatibility of the PVC with the membrane solvent.

[Parent-child relationships and mindfulness].

Psychological approaches such as mindfulness-based stress reduction or mindfulness-based cognitive therapy could be effective for relieving a wide range of psychosocial stresses or frictions between parents and children. Several interventional approaches based on mindfulness have been shown to be useful for improving parent-child relationships not only among healthy families but also among those with difficult psychopathologies. Particularly in the relationships of parents with their children with developmental disorders such as autism or attention-deficit/hyperactivity disorders, these approaches may play an important role in that the motivations of both parents and children could be enhanced because they can actually feel that their mental condition improves through meaningful parent-child interactions that they experience in their daily lives. These approaches are also expected to improve communications between mothers and children through the development of a finely honed sensitivity. One practical example is shown for the mental growth of children by the mindfulness-based dietary education and the secondary effects of this education on the parents. We can also apply these effective methods to the improvement of general interpersonal relationships.