Home About us Contact
|
Home About us Contact | ||
|
|
||
Anthropometry
Selected AbstractsThe prevalence of lipodystrophy in an ambulant HIV-infected population: it all depends on the definitionHIV MEDICINE, Issue 3 2001VM Carter Objectives This study's objective was to determine the prevalence of body shape changes and metabolic abnormalities in an ambulant population with HIV infection. Three different definitions of lipodystrophy were used to assess these changes. Patients' anthropometric measures and dual-energy X-ray absorptiometry (DEXA) scans were compared in order to estimate fat distribution in this population. We sought to evaluate potential predictors for lipodystrophy according to each of the three definitions. Methods We performed a cross-sectional study in the outpatient clinic of a tertiary referral hospital in Melbourne, Australia. We enrolled a total of 167 HIV-infected ambulatory patients over 3 months in mid-1998. Data on 159 males, 149 of whom were receiving triple combination antiretroviral therapy, were evaluated. Anthropometric measures, clinical examination, self-report of body shape changes, biochemical measures and DEXA scan were used to assess lipodystrophy and risk factors for cardiovascular disease. Patients described body shape changes in the face, trunk, arms and legs. Laboratory parameters measured included fasting triglyceride (TG), cholesterol, high-density lipoproteins (HDL), glucose, insulin, CD4 cell count and plasma HIV RNA. Current and past antiretroviral therapies were ascertained. Results According to one proposed Australian national definition of lipodystrophy (LDNC), the prevalence of lipodystrophy in this population was 65%. This definition included an objective assessment with major and minor criteria. Patient-defined lipodystrophy (LDP), which involved a subjective assessment of thinning arms and legs and central adiposity, occurred in 19%. Patient-defined lipoatrophy (LAP), which involved a subjective assessment of thinning arms and legs without central adiposity, occurred in 21.3%. No change in body habitus was noted by 37% of the cohort. Hypercholesterolaemia was recorded in 44%, hypertriglyceridaemia in 52% and elevated insulin levels in 23%. Anthropometry was predictive of the per cent total body fat recorded by DEXA scan, but produced consistently lower values. In multivariate analysis, LDP and LAP were significantly associated with stavudine (d4T) use, while LAP was also associated with zidovudine (ZDV) treatment. There were no treatment associations with LDNC. Protease inhibitor (PI) exposure was associated with metabolic changes but not patient perceived body shape changes, while d4T and ZDV exposure was associated with increased triglycerides and reduced peripheral fat stores. Conclusions The prevalence of body shape changes in a single population varied depending on the definition applied. The LDNC definition overestimated body shape abnormalities in comparison with patient perception. LAP was associated with significantly lower fat stores measured by anthropometry and DEXA scan than those identified under the LDNC definition. In contrast to LDNC, LAP was associated with d4T exposure, nucleoside reverse transcriptase inhibitor (NRTI) and ZDV duration of use, but not PI use. Until a consensus definition for lipodystrophy is developed, including agreement on objective measurement and thresholds for abnormality, careful description of the individual components of the syndrome is required to enable cohort comparisons so that predictors of the syndrome can be assessed more accurately and outcome studies made feasible. [source] Anthropometry of fetal vasculature in the chorionic plateJOURNAL OF ANATOMY, Issue 6 2007Z. Gordon Abstract Normal fetal development is dependent on adequate placental blood perfusion. The functional role of the placenta takes place mainly in the capillary system; however, ultrasound imaging of fetal blood flow is commonly performed on the umbilical artery, or on its first branches over the chorionic plate. The objective of this study was to evaluate the structural organization of the feto-placental vasculature of the chorionic plate. Casting of the placental vasculature was performed on 15 full-term placentas using a dental polymer mixed with colored ink. Observations of the cast models revealed that the branching architecture of the chorionic vessel is a combination of dichotomous and monopodial patterns, where the first two to three generations are always of a dichotomous nature. Analysis of the daughter-to-mother diameter ratios in the chorionic vessels provided a maximum in the range of 0.6,0.8 for the dichotomous branches, whereas in monopodial branches it was in the range of 0.1,0.3. Similar to previous studies, this study reveals that the vasculature architecture is mostly monopodial for the marginal cord insertion and mostly dichotomous for the central insertion. The more marginal the umbilical cord insertion is on the chorionic plate, the more monopodial branching patterns are created to compensate the dichotomous pattern deficiency to perfuse peripheral placental territories. [source] Specific insulin sensitivity and leptin responses to a nutritional treatment of obesity via a combination of energy restriction and fatty fish intakeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2008I. Abete Abstract Background, Nutritional strategies to treat obesity often influence neuroendocrine factors related to body weight control. The present study aimed to investigate whether the inclusion of three fatty fish servings per week within a hypocaloric diet may have specific healthy effects on insulin and leptin functions. Methods, Thirty-two subjects (body mass index = 31.6 ± 3.5 kg m,2) aged 36 ± 7 years, were assigned to a control or fish-based energy-restricted diet over an 8-week period. Anthropometry, body composition, lipid profile, leptin and insulin values were measured at the start and at the end of the dietary intervention. Results, Both experimental diets resulted in a similar mean weight loss (control = 5.3 ± 2.6% versus fish-based = 5.5 ± 2.5%; P = 0.783). A significant reduction in insulin resistance, as determined by the homeostatic model assessment index (HOMA-IR = insulin × glucose/22.5), was observed after the fish-based intervention. The change in circulating leptin was higher in the fish-based diet compared to the control group. Sixteen percent of the variability in the change of adjusted-leptin could be explained (P = 0.034) by the HOMA index change and the type of diet. Conclusions, Three servings a week of fatty fish included in an energy-restricted diet appears to be a valid strategy for specifically improving insulin sensitivity and leptin levels in obese subjects, which could involve a better body weight regulation after a nutritional intervention period. [source] The efficacy of dietetic intervention in patients with chronic obstructive pulmonary diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2008L. Bottle Background:, Clinical trials have shown that pulmonary rehabilitation can improve the functional status and quality of life of chronic obstructive pulmonary disease (COPD) patients (Lacasse, 2006) but there is no research examining the efficacy of group dietetic intervention during standard 8 week rehabilitation courses. Current input is usually limited to a 1 h nutrition education session. This pilot study aimed to investigate whether patients receiving additional dietetic intervention during pulmonary rehabilitation significantly increased their general nutritional knowledge, thereby facilitating improvements in dietary intake and nutritional status. Methods:, Patients were recruited from two courses of pulmonary rehabilitation and randomly allocated to a control group or an intervention group. Anthropometry (height, weight, body mass index, mid arm circumference and triceps skinfold), 3 day food diaries and nutritional knowledge questionnaires covered guidelines, food groups, choosing healthy options and diet and COPD were completed at baseline and at the end of 8 weeks. In week 2 both groups received the same nutrition education session which covered healthy eating during periods of stability as well as advice on coping with loss of appetite and reduced intake during illness and exacerbations. The intervention group was followed up during weeks 4, 6 and 7 when further anthropometric measurements were taken and additional dietary advice was provided, which addressed issues raised by individual patients. Information from food diaries was converted to nutrients using Windiets dietary analysis software. Statistical analyses were carried out using SPSS (v14) and included Mann,Whitney U non parametric tests, paired t -tests and Spearman correlations used for comparisons over time and between groups. For analysis purposes patients were classified as normal weight (NW) and overweight (OW). Approval was obtained from the appropriate Ethics Committee. Results:, Changes reported were not statistically significant (P > 0.05). Complete data sets were obtained for six control (NW = 2, OW = 4) and five intervention (NW = 1, OW = 4) patients. Nutritional knowledge increased in the control group by 5% compared to 3% in the intervention group. Control NW patients increased their energy intake resulting in a mean weight gain of 0.5 kg (SD 3.3). OW control group patients increased their energy intake by 12.4% (16.9) with a mean weight gain of 0.2 kg (2.5). All control patients increased their intake of in total fat, saturated fatty acids (SFA), sugars and sodium. Conversely there was a decrease in energy intake in the intervention group of 14.4% (17.8) and a mean weight loss of 1.5 kg (1.2) (three out of four overweight patients lost weight). Improvements in diet were shown with reduced intakes of total fat, SFA, sugars and sodium. The NW patient in the intervention group regained weight that had previously been lost. These changes did not correlate with changes in nutritional knowledge. Discussion:, An increase in nutritional knowledge was expected to facilitate appropriate changes in dietary intake and nutritional status. Despite the lack of correlation between dietary knowledge and intake, beneficial outcomes were none-the-less observed in the intervention group. The trend for weight gain in OW control group patients, and weight loss in OW intervention group patients contrasted with results seen by Slinde et al. (2002) where the control OW patients lost weight, and OW intervention patients gained weight. It is possible that in the current study, patients in the intervention group were motivated to lose weight with repeated exposure to the dietitian, rather than an increase in nutritional knowledge. Significant anthropometrical changes were unlikely to be observed in 8 weeks, and further follow up may be necessary to establish sufficient evidence for the most efficacious level of dietetic intervention. The small sample sizes, especially with regard to weight sub groups, limits the conclusions which can be drawn. Further research is recommended, using a larger sample size, in order to make recommendations for dietetic best practice. Conclusion:, The results of this study did not show statistical significance and the association between nutritional knowledge and improved nutritional outcomes remains unclear. However, the findings may have clinical significance since they appear to show that additional dietetic intervention may benefit the nutritional status of patients with COPD attending pulmonary rehabilitation. References, Lacasse, Y., Goldstein, R., et al. (2006) Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 4, CD003793. Slinde, F., Gronberg, A.M., et al. (2002) Individual dietary intervention in patients with COPD during multidisciplinary rehabilitation. Respir. Med. 96, 330,336. [source] Methods for measuring abdominal obesity in the prediction of severe acute pancreatitis, and their correlation with abdominal fat areas assessed by computed tomographyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010A. Duarte-Rojo Aliment Pharmacol Ther 2010; 32: 244,253 Summary Background, Obesity increases the risk for severe acute pancreatitis, although abdominal obesity may be a better prognostic marker. Aim, To determine if a single anthropometric parameter best predicts severe acute pancreatitis and correlates with intra-abdominal fat. Methods, Ninety-nine patients with acute pancreatitis were studied prospectively. Anthropometry included body mass index (BMI) and girths (umbilical/minimum waist, iliac/trochanter hip, thigh). Several waist-to-hip/waist-to-thigh ratios (WHR/WTR) were constructed. A CT-scan with calculation of cross-sectional abdominal fat areas was obtained in 37 cases. Results, Severe acute pancreatitis occurred in 25 patients. Waist circumference (WC), WHR and WTR , all using the umbilical reference , most accurately predicted severe acute pancreatitis. Only umbilical WC was retained in multivariate analysis: the risk for severe acute pancreatitis increased 16% with every 1 cm (OR 1.16, 95%CI: 1.1,1.3). Abdominal obesity caused a 6-fold increase in risk. Umbilical WC correlated best with subcutaneous fat area (r = 0.791, P < 0.001), whereas WHR with intra-abdominal (r = 0.594, P < 0.001). Conclusions, Abdominal obesity according to umbilical WC is a better predictor for development of severe acute pancreatitis than BMI, minimum WC, WHR and WTR. The protocol for anthropometry must be standardized as it may affect results. Both subcutaneous and intra-abdominal fat appears to affect the likelihood of a severe outcome. [source] Total body bone measurements: A cross-sectional study in children with acute lymphoblastic leukemia during and following completion of therapyPEDIATRIC BLOOD & CANCER, Issue 1 2009Kara M. Kelly MD Abstract Background Abnormalities in bone mineral density (BMD) occur in children treated for acute lymphoblastic leukemia (ALL). However, BMD estimates have been performed using varied instruments, reference data, and interpretations. This exploratory cross sectional study to evaluate bone mass in children with ALL, uses an algorithm that serially adjusts for variables known to affect pediatric bone measures by dual energy X-ray absorptiometry (DXA), based on models developed in 1,218 healthy children and adolescents. Procedure Anthropometry, DXA scans, and factors with possible influence on bone mass were evaluated in 21 ALL patients receiving chemotherapy and 20 in the follow-up phase. Main outcome was treatment group differences in Z -scores for total body bone mineral content (BMC), bone area (Area), and areal BMD (aBMD). Results Mean Z -scores for the entire study population for BMC, Area, and aBMD were significantly less than zero. Among possible contributing factors, only calcium intake was a significant co-variate. Comparison between treatment groups showed that least-square mean Z -scores for patients on-therapy for at least 12 months were significantly lower than those off therapy for at least 12 months (P: 0.0008,0.044), except for BMC at last step of the algorithm (adjusted for sex, age, ethnicity, height, weight, and bone area). Conclusions Evaluation of total body DXA by this algorithm is consistent with better general bone status in those off-therapy. However, in this small exploratory study, the lack of significant difference between Z -scores for fully adjusted BMC in on- versus off-therapy groups suggests possible risk of low peak bone mass. Additional longitudinal evaluation is warranted. Pediatr Blood Cancer 2009;52:33,38. © 2008 Wiley-Liss, Inc. [source] Anthropometry and Breast Cancer Risk in Nigerian WomenTHE BREAST JOURNAL, Issue 5 2006FWACS, Michael N. Okobia MBBS Abstract: The recent upsurge in global obesity and the recognition of the role of metabolic syndrome and other correlates of obesity in the etiology of breast cancer and other chronic diseases has created the impetus for renewed interest in the role of anthropometric measures in breast cancer risk. This case-control study was designed to evaluate the role of anthropometric variables in breast cancer susceptibility in an indigenous sub-Saharan African population drawn from midwestern and southeastern Nigeria, a population grossly underreported in the global epidemiologic literature. Study participants were 250 women with breast cancer who were receiving treatment in the surgical outpatient clinics and surgical wards of four university teaching hospitals located in midwestern and southeastern Nigeria, while the controls were 250 age-matched women without breast cancer or other malignant diseases being treated for other surgical diseases in the same institutions between September 2002 and April 2004. Waist:hip ratio (WHR) was associated with a significant 2.5-fold increased risk of premenopausal breast cancer (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.48,4.41] and a 2-fold increased risk of postmenopausal breast cancer (OR = 2.00, 95% CI 1.04,2.53). Increasing height conferred a modestly nonsignificant increased risk of premenopausal breast cancer (OR = 1.59, 95% CI 0.98,2.58). The study showed that WHR is a significant predictor of breast cancer risk in Nigerian women and measures to sustain increased physical activity and ensure healthy dietary practices are recommended to reduce the burden of obesity in the population. [source] Intra-individual variability in infancy: Structure, stability, and nutritional correlatesDEVELOPMENTAL PSYCHOBIOLOGY, Issue 3 2008Theodore D. Wachs Abstract Intra-individual variability (IIV) refers to relatively stable differences between individuals in the degree to which they show behavioral fluctuations over relatively short time periods. Using temperament as a conceptual framework the structure, stability, and biological roots of IIV were assessed over the first year of life. Biological roots were defined by maternal and infant nutrition. The sample was 249 Peruvian neonates, followed from the second trimester of pregnancy through the first 12 months of life. Maternal anthropometry, diet, iron status, and fetal growth were assessed prenatally. Neonatal anthropometry and iron status were assessed at birth. Degree of exclusive breastfeeding was assessed at 3 and 6 months, infant anthropometry was assessed at 3, 6, and 12 months, infant dietary intake was assessed at 6 and 12 months and infant iron status was tested at 12 months. Individual differences in IIV at 3, 6, and 12 months were derived from a residual standard deviation score based on infant behaviors measured using the Louisville Temperament Assessment Procedure. Principal components analysis indicated that individual differences in IIV were defined by two components at 3, 6, and 12 months. There was modest stability between IIV components assessed at 3 and 12 months. Reduced levels of IIV at 3 months were predicted by higher maternal weight and higher fetal weight gains in the first and second trimesters of pregnancy. Higher levels of IIV at 3 months were predicted by higher levels of maternal hemoglobin during pregnancy and higher levels of neonatal ferritin. © 2008 Wiley Periodicals, Inc. Dev Psychobiol 50: 217,231, 2008. [source] Endothelial markers in chronic heart failure: training normalizes exercise-induced vWF releaseEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 9 2004L. W. E. Sabelis Abstract Background, Chronic heart failure (CHF) is characterized by endothelial dysfunction. Vascular endothelium is important for control of haemostasis and vasoregulation. The aim of the present study was to investigate plasma levels of several endothelial markers and the exercise-induced changes on these plasma levels in CHF patients. Subsequently, the effect of a 6-month training programme on these markers is described. Materials and methods, Twenty-nine male CHF patients (NYHA II/III, age 60 ± 8 year, body mass index 26·7 ± 2·3 kg m,2, left ventricular ejection fraction 26·3,7·2%; mean ± SD) participated. Patients were randomly assigned to a training or control group. Training (26 weeks; combined strength and endurance exercises) was four sessions/week: two sessions supervised and two sessions at home. Before and after intervention, anthropometry, endothelial markers (haemostasis and vasoregulation), maximal workload and peak oxygen uptake were assessed. Results, Physical training positively affected maximal workload. Plasma levels of endothelial markers were not affected by physical training and not related to exercise tolerance. After training, stimulated (maximal exercise) plasma von Willebrand Factor (vWF) release was present, whereas at baseline this release was absent. Conclusion, Physical training led to normalization of the stimulated plasma vWF release. Plasma levels of other endothelial markers were not affected by physical training either at rest or under stimulated (maximal exercise) conditions. [source] The prevalence of lipodystrophy in an ambulant HIV-infected population: it all depends on the definitionHIV MEDICINE, Issue 3 2001VM Carter Objectives This study's objective was to determine the prevalence of body shape changes and metabolic abnormalities in an ambulant population with HIV infection. Three different definitions of lipodystrophy were used to assess these changes. Patients' anthropometric measures and dual-energy X-ray absorptiometry (DEXA) scans were compared in order to estimate fat distribution in this population. We sought to evaluate potential predictors for lipodystrophy according to each of the three definitions. Methods We performed a cross-sectional study in the outpatient clinic of a tertiary referral hospital in Melbourne, Australia. We enrolled a total of 167 HIV-infected ambulatory patients over 3 months in mid-1998. Data on 159 males, 149 of whom were receiving triple combination antiretroviral therapy, were evaluated. Anthropometric measures, clinical examination, self-report of body shape changes, biochemical measures and DEXA scan were used to assess lipodystrophy and risk factors for cardiovascular disease. Patients described body shape changes in the face, trunk, arms and legs. Laboratory parameters measured included fasting triglyceride (TG), cholesterol, high-density lipoproteins (HDL), glucose, insulin, CD4 cell count and plasma HIV RNA. Current and past antiretroviral therapies were ascertained. Results According to one proposed Australian national definition of lipodystrophy (LDNC), the prevalence of lipodystrophy in this population was 65%. This definition included an objective assessment with major and minor criteria. Patient-defined lipodystrophy (LDP), which involved a subjective assessment of thinning arms and legs and central adiposity, occurred in 19%. Patient-defined lipoatrophy (LAP), which involved a subjective assessment of thinning arms and legs without central adiposity, occurred in 21.3%. No change in body habitus was noted by 37% of the cohort. Hypercholesterolaemia was recorded in 44%, hypertriglyceridaemia in 52% and elevated insulin levels in 23%. Anthropometry was predictive of the per cent total body fat recorded by DEXA scan, but produced consistently lower values. In multivariate analysis, LDP and LAP were significantly associated with stavudine (d4T) use, while LAP was also associated with zidovudine (ZDV) treatment. There were no treatment associations with LDNC. Protease inhibitor (PI) exposure was associated with metabolic changes but not patient perceived body shape changes, while d4T and ZDV exposure was associated with increased triglycerides and reduced peripheral fat stores. Conclusions The prevalence of body shape changes in a single population varied depending on the definition applied. The LDNC definition overestimated body shape abnormalities in comparison with patient perception. LAP was associated with significantly lower fat stores measured by anthropometry and DEXA scan than those identified under the LDNC definition. In contrast to LDNC, LAP was associated with d4T exposure, nucleoside reverse transcriptase inhibitor (NRTI) and ZDV duration of use, but not PI use. Until a consensus definition for lipodystrophy is developed, including agreement on objective measurement and thresholds for abnormality, careful description of the individual components of the syndrome is required to enable cohort comparisons so that predictors of the syndrome can be assessed more accurately and outcome studies made feasible. [source] Young child feeding practices and child nutritional status in rural GhanaINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 4 2007Christina A. Nti Abstract A study was conducted in the Manya Krobo district of Ghana with the objective of studying young child feeding practices and child nutrition situation in the area. The study was a cross-sectional survey involving 400 mothers with young children between 0 and 18 months. A combination of methods, including structured interviews using questionnaire, dietary assessment and anthropometry, was used to collect data for the study. The data obtained were analysed using spss version 10 in Windows. Means and standard deviations were generated for continuous variables and frequency distribution for categorical variables. The results revealed that although breastfeeding rates were high (97%), complementary feeding practices were less than ideal with as many as 14% of the children being introduced to complementary foods below the age of 3 months. The nutritional quality of complementary foods were poor and the prevalence of stunting among the children was high (20%). For adequate complementary feeding and improved child nutrition in this population, nutrition education intervention programmes aimed at improving nutrient intake among young children, through improved diet diversity and increased use of local foods rich in iron and other nutrients, need to be undertaken. [source] Effect of caregiver feeding behaviours on child nutritional status in rural GhanaINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2007Christina A. Nti Abstract A six-month observational study involving 100 mothers with infants between the ages of 6 and 12 months was conducted in the Manya Krobo district of Ghana. The objective was to assess the role of caregiver feeding behaviours on child nutritional status using a modified positive deviance approach. Each child was in the study for 6 months, during which they were observed at home once a month. On each visit, data were collected on the child anthropometry, child meal frequency, diet diversity, responsiveness of caregiver during feeding, child's appetite and feeding atmosphere as well as caregiver hygienic practices related to feeding. Using weight-for-age (WAZ) and length-for-age (LAZ) scores, the children were classified as positive or negative deviant children. The study revealed significant differences between the two groups of children in terms of caregiver feeding behaviours. Positive deviant children had significantly higher meal frequencies (3.1 ± 0.4 vs. 2.4 ± 0.6, P = 0.001), diet diversity scores (6.3 ± 0.6 vs. 3.7 ± 1.1, P = 0.001), were fed under better hygienic conditions (7.2 ± 0.9 vs. 4.2 ± 1.1, P = 0.001) and were much more interested in food during feeding (85.8% vs. 59.3%). Caregiver responsiveness during feeding was also significantly higher among the positive deviant group (6.5 ± 0.8 vs. 4.5 ± 0.9, P = 0.001). This study has demonstrated the tremendous effect of caregiver feeding behaviours on child nutritional outcomes and provides a scientific basis for introducing care during feeding as a component of intervention to improve child nutritional status in Ghana. [source] More Broken Bones: A 4-Year Double Cohort Study of Young Girls With and Without Distal Forearm FracturesJOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2000A. Goulding Abstract Predictors of childhood fractures have not been investigated previously. This study was undertaken to determine whether a previous history of forearm fracture, low bone mineral density (BMD; both areal bone mineral density [aBMD, g/cm2] and volumetric bone mineral apparent density [BMAD, g/cm3]), or anthropometry, influence fracture risk in young girls. At baseline, two cohorts of girls, aged 3,15 years, were evaluated: 100 had recently broken a forearm (group 1) and 100 were fracture free (group 2). Four years later we restudied 170 of these girls (82 from group l and 88 from group 2). We now report the relationships of previous fracture history, baseline BMD (measured by dual-energy X-ray absorptiometry), baseline weight, and height to risk of new fracture. More new fractures occurred in group l (37 fractures in 24 girls) than in group 2 (8 fractures in 7 girls; p = 0.0007). The independent predictors for occurrence of a new fracture at any skeletal site in a multivariate model adjusting for age, weight, total body aBMD, and fracture history were previous fracture (hazard ratio [HR], 3.28; 95% CI, 1.41-7.64); age (HR per l-year increase, 0.91; 95% CI, 0.84-0.99); total body aBMD (HR per l SD decrease, 1.92; 95% CI, 1.31-2.81); and body weight (HR per l SD increase, 1.49; 95% CI, 1.06-2.08). Girls with two risk factors together had substantially greater fracture risk: previous fracture and low spinal BMAD (HR, 9.4; 95% CI, 2.8-32.0), previous fracture and high body weight (HR, 10.2; 95% CI, 2.8-37.6), or previous fracture and low total body aBMD (HR, 13.0; 95% CI, 3.9-43.1). We conclude that previous forearm fracture, low total body aBMD, low spinal BMAD, and high body weight each increase risk of new fractures within 4 years in young girls. Interventions to reduce the risk of fractures, particularly forearm fractures, in girls warrant further study. [source] Nutritional status and patient characteristics for hospitalised older patients with chronic obstructive pulmonary diseaseJOURNAL OF CLINICAL NURSING, Issue 13 2008Sigrid Odencrants MSc Aim. The aim of the study was to describe and compare nutritional status and social and medical characteristics among older patients with chronic obstructive pulmonary disease admitted to an acute care hospital ward for respiratory medicine. Background. Chronic obstructive pulmonary disease is a condition associated with risk of developing malnutrition. A body mass index <20 is predictive of hospitalisation for acute exacerbations of chronic obstructive pulmonary disease. Knowledge about patient characteristics is crucial for the identification of malnourished patients and the development of nursing care for these patients. Design. Quantitative descriptive study. Methods. Thirty-three hospitalised women and 17 men with a mean age of 75·7 years (SD 6·9) were consecutively included. A very severe case of chronic obstructive pulmonary disease was indicated in 28 out of 39 patients who underwent a lung function test. Data were collected with measurement of nutritional status using Mini Nutritional Assessment, anthropometry and lung function. Results. Nearly half of the patients (48%) were identified as malnourished, an equal part as at risk for malnutrition and two patients as well nourished. The mean Mini Nutritional Assessment score of 17·2 (SD 3·99) for all patients was near the Mini Nutritional Assessment cut-off score (i.e. 17) for malnutrition. Patients identified as malnourished had a mean body mass index of 18·9 and those at risk for malnutrition had a mean of 23·4. It was more common for those identified as malnourished to live singly, to not live in own property and to be dependent on daily community service. Seven patients identified as malnourished died during the data collection period. Conclusions. This study provides important knowledge about further risks of impaired nutritional status among older patients with chronic obstructive pulmonary disease. Relevance to clinical practice. This knowledge can provide registered nurses with the necessary knowledge to make them aware of certain patients needing particular kinds of attention. [source] Cause and effect relationship of malnutrition with idiopathic chronic pancreatitis: Prospective case,control studyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2008Shallu Midha Abstract Background and Aim:, Patients with chronic pancreatitis are often malnourished. The role of malnutrition in the pathogenesis of chronic pancreatitis is unclear. The aim of the present article was to study prospectively the cause and effect relationship of malnutrition with idiopathic chronic pancreatitis in a case,control study. Methods:, Consecutive patients with chronic pancreatitis underwent anthropometry, nutritional and dietary assessments. For dietary assessment, food frequency questionnaire and 24-hour dietary recall methods were used. Primary outcome measure was cause and effect relationship of malnutrition with idiopathic chronic pancreatitis. Results:, Of 201 patients with chronic pancreatitis, 120 had idiopathic chronic pancreatitis (mean age 29.60 years, 74 males) who formed the study group. None of the patients consumed cassava. The nutritional status and dietary intake of the patients before the onset of chronic pancreatitis were comparable with those of controls with 20.6% of patients and 22.5% of controls being malnourished (body mass index [BMI] < 18.5). After the onset of chronic pancreatitis, 56.5% of patients lost weight and significantly more patients became malnourished compared with controls (45.8% vs 22.5%; P < 0.001). The causes of weight loss were diabetes, higher calories from proteins, and pseudocyst. Conclusion:, Malnutrition was not a cause of idiopathic chronic pancreatitis and weight loss occurred as an effect of chronic pancreatitis. Cassava was not found to be a cause of idiopathic chronic pancreatitis. [source] Non-alcoholic fatty liver syndrome: A hepatic consequence of common metabolic diseasesJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2003FRANCESCO ANGELICO Abstract Background and Aims: The association of liver steatosis with a number of common metabolic conditions has been suggested. The aim of the present study was to evaluate the clinical features of subjects with different severities of steatosis. Methods: The present study was performed in 282 consecutive patients with ,bright liver' at ultrasonography and in 58 subjects without steatosis. They had no history of alcohol abuse and negative tests for the presence of hepatitis B and C virus. Patients underwent clinical examination, anthropometry, laboratory tests and routine liver ultrasonography. Steatosis was graded as absent, mild, moderate and severe. Results: A progressive increase in the prevalence of obesity (P < 0.001), type 2 diabetes (P < 0.001), alanine aminotransferase (ALT) elevation (P < 0.001) and hypertriglyceridemia (P < 0.001), and a decrease of hypercholesterolemia (P < 0.05) was observed from the control group to the groups with mild, moderate and severe steatosis. More than half the subjects with liver steatosis had insulin resistance metabolic syndrome. Obesity, diabetes and hypertriglyceridemia were more common by 5.3-fold, 4.0-fold, and 6.7-fold, respectively, in subjects with severe steatosis, as compared to controls. Prevalence of obesity, diabetes and hyperlipidemia was significantly higher in subjects with fatty liver and ALT elevation. Conclusion: Fatty liver can be considered as the hepatic consequence of common metabolic diseases. © 2003 Blackwell Publishing Asia Pty Ltd [source] Risk of malnutrition in a sample of acute and long-stay NHS Fife in-patients: an auditJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2008C. H. S. Ruxton Abstract Background, Hospital malnutrition (undernutrition) continues to attract concern. The implementation of standards for food and fluids in Scotland provided the stimulus for an audit of current practices in NHS Fife hospitals in order to provide baseline data with which to evaluate progress. Methods, One hundred and fifty in-patients were recruited from wards likely to yield those with a high risk of malnutrition. Using patient records and anthropometry, data were collected on weight, weight change, body mass index (BMI), mid-upper-arm circumference (MUAC), dietetic referral, therapeutic diets and patients' perceptions of nutritional status. Malnutrition was estimated by comparing BMI, weight change and MUAC with the Malnutrition Universal Screening Tool (MUST) and standards published by the Scottish Intercollegiate Guidelines Network (SIGN). Results, Depending upon the standard used, the minimum risk of malnutrition varied from 14 to 25%. The prevalence was lower than that reported previously, although methods were not directly comparable. Obesity was also evident with 42% of patients having a BMI > 25. Mean weight change from admission to audit was +0.4 kg, with a wide range (,11 kg to +13 kg). Most patients identified as malnourished were referred to the dietitian or given nutritional support. Conclusions, Fewer patients were at risk of malnutrition than expected. However, improving the provision of food and fluids remains a priority in Fife as malnutrition and eating problems can occur across the entire BMI spectrum. [source] Investigation into the nutritional status, dietary intake and smoking habits of patients with chronic obstructive pulmonary diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2004W. J. Cochrane Abstract Background and aims Weight loss and reduced fat-free mass are prevalent amongst patients with chronic obstructive pulmonary disease (COPD). However, the causes of this weight loss are not clear. The aims of this study are to investigate the factors affecting body weight and dietary intake in a group of outpatients with COPD, and to investigate any differences between adequately nourished and malnourished patients. Methods In 103 stable outpatients, nutritional status was assessed using Body Mass Index (BMI) and upper arm anthropometry. Lung function, smoking status, exercise tolerance, dietary intake, dietary problems and health-related quality of life were assessed. Patients were classed as either adequately nourished or malnourished. Results Twenty-three per cent of subjects were classed as malnourished. The malnourished subjects had lower lung function measurements, suffered more dietary problems and had lower nutritional intake compared with the adequately nourished subjects. They also had poorer fatigue scores. In linear regression analysis, the factors that had the most effect on BMI were a low transfer factor, presence of early satiety, and being a current smoker. Conclusion Important differences were found between adequately nourished and malnourished subjects. These differences move us closer to understanding how best to screen and treat this group of patients. [source] Percutaneous endoscopic gastrostomy feeding in haemodialysis out-patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2000H. A. Sayce Introduction Malnutrition is highly prevalent in haemodialysis (HD) patients and plays a major role in influencing outcome. Although use of home enteral feeding is expanding rapidly in the UK, it is a method of nutritional support which remains under-utilized in HD out-patients. We report our experience and outcomes in a series of eight cases. Methods Home gastrostomy feeding was initiated in eight malnourished HD out-patients, administered either continuously overnight or as daily bolus feeds. Nutritional parameters were monitored weekly by the renal dietitian and included dry weight, upper-arm anthropometry and serum albumin. The number and duration of hospitalizations during the period of feeding were recorded. Results After 3 months of feeding, median dry weight increased from 43.0 to 48.3 kg (P = 0.012), mid-upper arm circumference increased from 20.2 to 24.8 cm (P = 0.018), triceps skinfold thickness increased from 7.3 to 11.3 mm (P = 0.046), mid-upper arm muscle circumference increased from 17.7 to 19.8 cm (P = 0.027) and serum albumin increased from 29.5 to 36.5 g L,1 (P = 0.011). Few complications were encountered and hospital admission rates were low. Conclusion Home gastrostomy feeding, with appropriate monitoring and support, is an effective method of improving and maintaining nutritional status in this vulnerable group. [source] Circulating and synovial levels of IGF-I, cytokines, physical function and anthropometry differ in women awaiting total knee arthroplasty when compared to menJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005Sonia M. C. Pagura Abstract Purpose: Determine if gender differences in osteoarthritis relate to cytokine and growth factor levels. Methods: Cross-sectional comparison of serum and synovial concentrations of cytokines (IL-1,,, TNF-,, IL-6), growth factors (IGF-I, TGF-,, IRAP), physical performance and perceived function in total knee arthroplasty candidates (TKAC) (n = 17) and healthy controls (n = 21) was done. Results: Serum IGF-I values were reduced in female (TKAC 137.6 ± 7.2; Controls 160.2 ± 26.2) but not male TKAC (TKAC 182.6 ± 18.4; Controls 184.0 ± 18.4) (p < 0.05). Serum and synovial levels of cytokines and growth factors did not differ significantly by group or gender. Physical performance testing (SPW, TUG) revealed significant group and gender differences (p = 0.001) with women demonstrating greater functional impairment. Discussion: A systemic, not local component to OA pathophysiology may exist for female TKAC. Male TKAC were less impaired, and their IGF-I levels differ little from Control values. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Methods for measuring abdominal obesity in the prediction of severe acute pancreatitis, and their correlation with abdominal fat areas assessed by computed tomographyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010A. Duarte-Rojo Aliment Pharmacol Ther 2010; 32: 244,253 Summary Background, Obesity increases the risk for severe acute pancreatitis, although abdominal obesity may be a better prognostic marker. Aim, To determine if a single anthropometric parameter best predicts severe acute pancreatitis and correlates with intra-abdominal fat. Methods, Ninety-nine patients with acute pancreatitis were studied prospectively. Anthropometry included body mass index (BMI) and girths (umbilical/minimum waist, iliac/trochanter hip, thigh). Several waist-to-hip/waist-to-thigh ratios (WHR/WTR) were constructed. A CT-scan with calculation of cross-sectional abdominal fat areas was obtained in 37 cases. Results, Severe acute pancreatitis occurred in 25 patients. Waist circumference (WC), WHR and WTR , all using the umbilical reference , most accurately predicted severe acute pancreatitis. Only umbilical WC was retained in multivariate analysis: the risk for severe acute pancreatitis increased 16% with every 1 cm (OR 1.16, 95%CI: 1.1,1.3). Abdominal obesity caused a 6-fold increase in risk. Umbilical WC correlated best with subcutaneous fat area (r = 0.791, P < 0.001), whereas WHR with intra-abdominal (r = 0.594, P < 0.001). Conclusions, Abdominal obesity according to umbilical WC is a better predictor for development of severe acute pancreatitis than BMI, minimum WC, WHR and WTR. The protocol for anthropometry must be standardized as it may affect results. Both subcutaneous and intra-abdominal fat appears to affect the likelihood of a severe outcome. [source] The use of exclusive enteral nutrition for induction of remission in children with Crohn's disease demonstrates that disease phenotype does not influence clinical remissionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009E. BUCHANAN Summary Background, Exclusive enteral nutrition (EEN) achieves variable remission rates in patients with Crohn's disease (CD). Aim, To describe our experience of treating CD with an 8-week course of primary EEN and to study factors affecting treatment outcome. Methods, All CD patients treated with EEN in our centre between 2004 and 2007 were included in the study. Remission was determined by a combination of clinical parameters. Disease phenotype was assigned using published classifications. Inflammatory markers and anthropometry (Z -scores) were calculated before and after treatment. Results, A total of 114 children were treated (four were excluded). Median age at diagnosis was 11.6 years. Fifty-seven (51.8%) were fed orally whilst 53 (48.2%) were fed by tube. Eighty-eight (80%) achieved remission with consequent reductions in erythrocyte sedimentation rate and C-reactive protein (P < 0.001). Patients in remission had comparative improvements in weight (,1.04 cf. ,0.40) and BMI Z -scores (,0.98 cf. ,0.03) by the end of treatment (P < 0.001). Individuals with isolated terminal ileal disease (n = 4) had lower remission rates than other locations (P = 0.02). No other significant differences in remission rates for any other disease locations were found. Conclusions, Exclusive enteral nutrition induces clinical remission, normalization of inflammatory markers and improves weight/BMI Z -scores in most patients. This study demonstrates that disease phenotype should not influence clinicians when commencing patients on EEN. [source] Preterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural NepalMATERNAL & CHILD NUTRITION, Issue 3 2007Christine P. Stewart Abstract Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age , 25 years who gave birth to a singleton liveborn infant who was measured within 72 h of delivery were included (n = 1393). There was no difference in the risk of low birthweight (OR = 0.96; 95% CI = 0.90,1.02) or small for gestational age (OR = 1.01; 95% CI = 0.94,1.08) per year of increasing maternal age among primiparae. Young maternal age did not affect the anthropometry or gestational age of the offspring of parity 1 women. Each year of increasing maternal age among primiparae was associated with increases in birth length (0.07 cm; 95% CI = ,0.01 to 0.16), head (0.05 cm; 95% CI = 0.01,0.09) and chest circumference (0.07 cm; 95% CI = 0.01,0.12), but not weight (9.0 g; 95% CI = ,2.1 to 21.8) of their offspring. Young maternal age was associated with an increased risk of preterm delivery among primiparae (OR = 2.07; 95% CI = 1.26,3.38) that occurred at an age cut-off of ,18 years relative to those 19,25 years. Thus, we conclude that young maternal age (,18 years) increased the risk of preterm delivery, but not intrauterine growth retardation, for the first but not second liveborn infant. [source] Anténor Firmin: Haitian Pioneer of AnthropologyAMERICAN ANTHROPOLOGIST, Issue 3 2000Carolyn Fluehr-Lobban Anténor Firmin published De I'Égalité des Races Humaines in 1885 in Paris as a response both to Arthur de Gobineau's racist tome L'lnégalité des Races (1853-55) and to the racialist anthropology of the nineteenth century. This pioneering work of anthropology has been translated for the first time into English by Assclin Charles as The Equality of the Human Races (Firmin [1885]2000). In 662 pages of the original text, Firmin systematically critiqued the anthropometry and craniometry that dominated the anthropology of his day, while he envisioned a broad, synthetic discipline that would follow once this narrow approach to the study of man was abandoned. He challenged virtually every extant racial myth and laid a basis for the understanding of human variation as adaptation to climate and environment. Contrary to the polygenist doctrines of the infertility of interracial matings, Firmin extolled the value of racial mixture, especially in the vigorous New World hybrid populations. He developed a critical view of racial classifications and of race that foreshadowed much later social constructions of race. In the book he also articulated early Pan-Africanist ideas as well as an analytical framework for what would become postcolonial studies. The Equality of the Human Races is a text that lies historically at the foundations of the birth of the discipline of anthropology, yet it is unknown to the field. It is a pioneering work in critical anthropology that awaits recognition 115 years after it was first published. [Anténor Firmin, history of racism, antiracism, historical texts, Haitian anthropologist, critical anthropology, nineteenth-century pioneer] [source] Savage bodies, civilized pleasures: M. V. Portman and the AndamaneseAMERICAN ETHNOLOGIST, Issue 2 2009SATADRU SEN ABSTRACT In this article, I examine the deployment of ethnographic and photographic techniques in British colonialism in the Andaman Islands. Focusing on the work of Maurice Portman, who was "officer in charge of the Andamanese" between 1879 and 1900, I examine the mechanisms by which savagery was constructed in a marginal and newly pacified colony where the indigenous population was assumed by Britons to be dying but not quite dead. I argue that in this ideological and political setting, the colonizer's assertions of control and delinquent fantasies of losing control came together in the aesthetics and measurements of the eroticized aboriginal body. [Andaman Islands, South Asia, M. V. Portman, photography, anthropometry, colonialism, savagery] [source] Diet quality and anthropometry between different sailboarding stylesNUTRITION & DIETETICS, Issue 1 2010Ioannis DOUMTSIOS Abstract Aim:, To identify diet quality and basic anthropometric characteristics of sailboarders. Methods:, The study was conducted in 91 sailboarders, who were divided in two groups according to muscle recruitment during sailing; those performing wave or freestyle surfing formed the WF group (n = 46) and those performing slalom or formula the SF group (n = 45), as the first includes more lower-body muscle recruitment. Diet and anthropometry were evaluated during training days and compared between the two study groups. Results:, The WFs demonstrated lower % body fat (21%), circumferences, skinfolds, body mass index (23.9 kg/m2) and fat mass index (5.1 kg/m2) compared with the SFs (body fat 25.2%, body mass index 26.1 kg/m2 and fat mass index 6.6 kg/m2). Dietary intake was similar and both groups presented a negative energy balance, high cholesterol intake and adequacy in the intake of most micronutrients except for vitamin E of the WF group. The windsurfers achieved a low healthy eating index (54.3 and 58.1 for WF and SF respectively), indicative of a diet in need of improvement and reported the post-training consumption of beer and fast food. Conclusion:, Overall findings suggest the need for dietary counselling in windsurfers, as glycogen depletion is crucial in sailboarding, where one athlete consists of the total boat crew thus, glycogen depletion leading to insufficient energy for technical movements while sailing, has direct effect on the result of the race. [source] Auricular anthropometry of Hong Kong Chinese babiesORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 1 2004T.F. Fok Structured Abstract Authors , Fok TF, Hon KL, So HK, Wong E, Ng PC, Lee AKY, Chang A Objectives , To provide a database of the auricular measurements of Chinese infants born in Hong Kong. Design , Prospective cross-sectional study. Setting and Sample Population , A total of 2384 healthy singleton, born consecutively at the Prince of Wales Hospital and the Union Hospital from October 1998 to September 2000, were included in the study. The range of gestation was 33,42 weeks. Measurements and Results , Measurements included ear width (EW), ear length (EL) and ear position (EP). The data show generally higher values for males in the parameters measured. When compared with previously published data for Caucasian and Jordanian term babies, Chinese babies have shorter EL. The ears were within normal position in nearly all our infants. Conclusion , The human ear appears to grow in a remarkably constant fashion. This study establishes the first set of gestational age,specific standard of the ear parameters for Chinese new-borns, potentially enabling early syndromal diagnosis. There are significant inter-racial differences in these ear parameters. [source] Impact of Diabetes on QT Dynamicity in Patients With and Without Myocardial Infarction: The KORA Family Heart StudyPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2007WOLFGANG LIEB M.D. Introduction: Patients with diabetes mellitus (DM) have an unfavorable prognosis after myocardial infarction (MI), partially due to a higher risk of sudden cardiac death (SCD). QT dynamicity is an independent predictor of SCD in post-MI patients. However, the effects of diabetes on QT dynamicity in patients with MI have not been described. Methods: We studied 468 survivors of MI (67 with DM) from the population-based MONICA registry (KORA Family Heart Study), Augsburg, Germany, by standardized questionnaire, anthropometry, electrocardiogram (ECG), 30-minute-Holter-ECG-recordings and echocardiography. In addition, 422 siblings without prior MI (22 with DM) were studied by the same protocol. Results: Among post-MI patients, the QT/RR slope was significantly steeper in diabetics than in nondiabetics (0.096 ± 0.057 vs 0.077 ± 0.045; P = 0.002). Likewise, among siblings without MI, the QT/RR slope was steeper in diabetics than in nondiabetics (0.104 ± 0.053 vs 0.080 ± 0.042; P = 0.008). The association of DM with steeper QT/RR slope remained significant in multivariate models in post-MI patients (,: ,0.14; P = 0.004) as well as in individuals without MI (,: ,0.10; P = 0.047). Conclusions: In a large population of survivors of MI and unaffected siblings, patients and siblings presenting with DM exhibited an abnormal QT rate-dependence, compared with individuals without DM in both groups. Thus, diabetes itself may be a major determinant of ventricular arrhythmias, independently of a previous MI. These observations might in part explain the higher incidence of sudden cardiac death and ventricular arrhythmias in patients with DM. [source] Association between maternal seafood consumption before pregnancy and fetal growth: evidence for an association in overweight women.PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2009The EDEN mother-child cohort Summary Studies in countries with high seafood consumption have shown a benefit on fetal growth and child development. The objective of our study was to determine the association between seafood consumption in French pregnant women and fetal growth. Pregnant women included in the EDEN mother-child cohort study completed two food frequency questionnaires on their usual diet in the year before and during the last 3 months of pregnancy (n = 1805). Fetal circumferences were measured by ultrasound and anthropometry at birth. Variables were compared across tertiles of the mother's seafood consumption using multiple linear regression to adjust for confounding variables. Analyses were stratified by maternal overweight status because of an interaction between maternal seafood consumption and her body mass index (P < 0.01). There was no association between seafood intake and fetal growth in the whole sample of women. For overweight women (n = 464), higher consumption of seafood before pregnancy was associated with higher fetal biparietal and abdominal circumferences and anthropometric measures. From the lowest to the highest tertiles, mean birthweight was 167 g higher (P = 0.002). No significant association was found with consumption at the end of pregnancy. In conclusion, high seafood consumption before pregnancy is positively associated with fetal growth in overweight women. [source] ALSPAC,The Avon Longitudinal Study of Parents and ChildrenPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2001Golding ALSPAC (The Avon Longitudinal Study of Parents and Children, formerly the Avon Longitudinal Study of Pregnancy and Childhood) was specifically designed to determine ways in which the individual's genotype combines with environmental pressures to influence health and development. To date, there are comprehensive data on approximately 10 000 children and their parents, from early pregnancy until the children are aged between 8 and 9. The study aims to continue to collect detailed data on the children as they go through puberty noting, in particular, changes in anthropometry, attitudes and behaviour, fitness and other cardiovascular risk factors, bone mineralisation, allergic symptoms and mental health. The study started early during pregnancy and collected very detailed data from the mother and her partner before the child was born. This not only provided accurate data on concurrent features, especially medication, symptoms, diet and lifestyle, attitudes and behaviour, social and environmental features, but was unbiased by parental knowledge of any problems that the child might develop. From the time of the child's birth many different aspects of the child's environment have been monitored and a wide range of phenotypic data collected. By virtue of being based in one geographic area, linkage to medical and educational records is relatively simple, and hands-on assessments of children and parents using local facilities has the advantage of high quality control. The comprehensiveness of the ALSPAC approach with a total population sample unselected by disease status, and the availability of parental genotypes, provides an adequate sample for statistical analysis and for avoiding spurious results. The study has an open policy in regard to collaboration within strict confidentiality rules. [source] | |||||||||||||||||||||||||||||||