Prostate-Specific Membrane Antigen (PSMA) Expression Predicts Need for Early Treatment in Prostate Cancer Patients Managed with Active Surveillance.

Metabolic dysregulation is an early event in carcinogenesis. Here, we examined the expression of enzymes involved in de novo lipogenesis (ATP-citrate lyase: ACLY), glucose uptake (Glucose Transporter 1: GLUT1), and folate-glutamate metabolism (Prostate-Specific Membrane Antigen: PSMA) as potential biomarkers of risk for early prostate cancer progression. Patients who were managed initially on active surveillance with a Gleason score of 6 or a low-volume Gleason score of 7 (3 + 4) were accrued from a prostate cancer diagnostic assessment program. Patients were asked to donate their baseline diagnostic biopsy tissues and permit access to their clinical data. PSMA, GLUT1, and ACLY expression were examined with immunohistochemistry (IHC) in baseline biopsies, quantitated by Histologic Score for expression in benign and malignant glands, and compared with patient time remaining on active surveillance (time-on-AS). All three markers showed trends for elevated expression in malignant compared to benign glands, which was statistically significant for ACLY. On univariate analysis, increased PSMA and GLUT1 expression in malignant glands was associated with shorter time-on-AS (HR: 5.06, [CI 95%: 1.83-13.94] and HR: 2.44, [CI 95%: 1.10-5.44], respectively). Malignant ACLY and benign gland PSMA and GLUT1 expression showed non-significant trends for such association. On multivariate analysis, overexpression of PSMA in malignant glands was an independent predictor of early PC progression (p = 0.006). This work suggests that the expression of metabolic enzymes determined by IHC on baseline diagnostic prostate biopsies may have value as biomarkers of risk for rapid PC progression. PSMA may be an independent predictor of risk for progression and should be investigated further in systematic studies.

Relative age effects in fitness testing in a general school sample: how relative are they?

When children or adolescents are grouped by age or year of birth, older individuals tend to outperform younger ones. These phenomena are known as relative age effects (RAEs). RAEs may result directly from differences in maturation, but may also be associated with psychological, pedagogic or other factors. In this article, we attempt to quantify RAEs in a simple fitness task and to identify the mechanisms operating. Data come from a 5-year study of 2278 individuals that included repeated administrations of the 20 m shuttle run. We use mixed-effect modelling to characterise change over time and then examine residuals from these models for evidence of an effect for age relative to peers or for season of birth. Age alone appears to account for RAEs in our sample, with no effects for age relative to peers or month of birth. Age grouping produces large disparities for girls under 12, moderate ones for boys of all ages and negligible ones for girls between 12 and 15. RAEs for this task and population appear to arise from simple age differences. Similar methods may be useful in determining whether other explanations of RAEs are necessary in other contexts. Evaluation processes that take age into account have the potential to mitigate RAEs in general settings.

When and for whom are relative age effects important? Evidence from a simple test of cardiorespiratory fitness.

OBJECTIVES: When individuals of different ages are combined into a single group and an ability that varies with age is measured, younger individuals are disadvantaged. This phenomenon is known as a relative age effect (RAE) and has been shown to be widespread in sport and education. METHODS: In this article, we examine RAEs in a large group of children tested repeatedly on the 20-m shuttle run, a common test of cardiorespiratory fitness. Following up on an earlier study that measured change with age, we add a growth curve model for change in variance, which makes it possible to derive RAEs for individuals of different ages and ability levels. RESULTS: Results show that a 1-year difference in age is associated with a change in performance of about 0.2 standard deviations. For 1-year age groups, this gives rise to ranking errors of 4 percentile ranks or less. We also show, however, that these relatively small ranking errors are capable of producing large age differences within groups identified as exceptional. Depending on the level of ability required for selection, children born in the first quarter of the year can be expected to outnumber those born in the last by 1.5 times, 2 times, or more. This finding is consistent with previously reported variation in RAEs at different performance levels. CONCLUSIONS: Results imply that RAEs are likely to be of relatively minor concern when people are graded or ranked but can produce substantial inequities and misclassifications when people with extremely high or extremely low ability levels undergo selection.

What Factors Increase Odds of Long-Stay Delayed Discharge in Alternate Level of Care Patients?

OBJECTIVE: The objective of this study was to determine the factors that increase the odds of long-stay delayed discharge in alternate level of care (ALC) patients using data collected from the Ontario Wait Time Information System (WTIS) database. DESIGN: Retrospective cohort study utilizing data from Niagara Health's WTIS database. WTIS includes individuals admitted to any of the Niagara Health sites that have been designated as ALC. SETTING AND PARTICIPANTS: Sample consisted of 16,429 ALC patients who received care in Niagara Health hospitals from September 2014 to September 2019 and were recorded in the WTIS database. METHODS: ALC designation of 30 or more days was used as the threshold for a long-stay delayed discharge. This study used binary logistic regression modeling to analyze sex, age, admission source, and discharge destination as well needs/barriers requirements to assess the likelihood of a long-stay delayed discharge among acute care (AC) and post-acute care (PAC) patients given the presence of each variable. Sample sizes calculations and receiver operating characteristic curves were used to verify the validity of the regression model. RESULTS: Overall, 10.2% of the sample were considered long-stay ALC patients. Both AC and PAC long-stay ALC patients were more likely to be male [OR = 1.23, (1.06-1.43); OR = 1.28, (1.03-1.60)] and have a discharge destination of a long-term care bed [OR = 28.68, (22.83-36.04); OR = 6.22, (4.75-8.15)]. AC patients had bariatric [OR = 7.16, (3.45-14.83)], behavioral [OR = 1.89, (1.22-2.91)], infection (isolation) [OR = 2.31, (1.63-3.28)], and feeding [OR = 6.38, (1.82-22.30)] barriers hindering discharge. PAC patients had no significant barriers hindering patient discharge. CONCLUSIONS AND IMPLICATIONS: Shifting the focus from ALC patient designation to short- vs long-stay ALC patients allowed this study to focus on the subset of patients that are disproportionately affecting delayed discharges. Understanding the importance of specialized patient requirements in addition to clinical factors can help hospitals become more prepared in preventing delayed discharges.

Risky Business: Factors That Increase Risk of Falls Among Older Adult In-Patients.

In hospitals, older patients are at increased risk of falling multiple times. This study incorporated an epidemiologic cross-sectional design consisting of 4,348 older patients (≥65-year-old). Eight hundred eighty five (20.4%) in-patients experienced multiple falls while remaining participants had one fall incident. A patient fall event was recorded with age, sex, incident date, type of fall, and location. Logistic regression assessed risk factors found in patients with multiple falls compared to those with one fall. Significant differences were observed in the proportion of multiple falls: in a bed with no rails, standing, walking, and using a wheel/Geri chair (p < .05). Overall, sex, type of fall, and location were significant in predicting multiple falls (p < .05). Male patients were at 16.1% greater risk of multiple falls, when compared to females (p < .05). A fall in complex care, mental health, or respirology were more likely to experience multiple falls (OR = 2.659, 3.620, 1.593 respectively), while season had no impact.

Gender, perceived competence and the enjoyment of physical education in children: a longitudinal examination.

BACKGROUND: The current study examined associations between gender, perceived athletic competence, and enjoyment of physical education (PE) class over time in a cohort of children enrolled in grade four (ages 9 or 10) at baseline (n = 2262). METHODS: We assessed each student 5 times over a period of 2 years. We used mixed effects modeling to examine change over time in enjoyment of PE. RESULTS: Enjoyment of PE declined among girls but remained constant among boys. Higher levels of perceived competence were associated with higher PE enjoyment. A 3-way interaction between gender, competence, and time revealed that PE enjoyment was lowest and declined most markedly among girls with low perceived athletic competence. Among boys with low competence, enjoyment remained at a consistently low level. CONCLUSIONS: Our results indicate that lower perceived athletic competence is associated with low enjoyment of PE, and, among girls, with declining enjoyment. Findings suggest that interventions in a PE context that target perceived competence should be considered in future work.

Association between body composition and conformity to the recommendations of Canada's Food Guide and the Dietary Approaches to Stop Hypertension (DASH) diet in peri-adolescence.

OBJECTIVE: The role of following the recommendations of Canada's Food Guide (CFG) and the Dietary Approaches to Stop Hypertension (DASH) diet on body composition in children is unknown. The present study assessed how conformity to the recommendations of these diets was associated with BMI, waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist girth (WG), hip girth (HG) and risk of overweight in peri-adolescents. DESIGN: CFG and DASH indices were derived from responses to a food questionnaire, with a higher index representing greater conformity to CFG and DASH diet recommendations. Body composition was assessed by trained research assistants. SETTING: Schools within the Niagara region (Ontario, Canada). SUBJECTS: Children (n 1570) aged 12.4 (sd 0.3) years. RESULTS: After adjustment for age to peak height velocity and total physical activity, a higher CFG index was associated with lower WHtR (b = -0.001, 95 % CI -0.002, -0.0004), WHR (b = -0.001, 95 % CI -0.002, -0.001) and WG (b = -0.18, 95 % CI -0.30, -0.07) in girls. No associations were observed in boys. In contrast, a higher DASH index was associated with decreased body composition measures in both genders. Specifically, the DASH index was negatively associated with BMI (girls: b = -0.07, 95 % CI -0.10, -0.04; boys: b = -0.05, 95 % CI -0.08, -0.02), WHtR (girls: b = -0.001, 95 % CI -0.002, -0.001; boys: b = -0.001, 95 % CI -0.002, -0.0004), WHR (girls: b = -0.001, 95 % CI -0.002, -0.001; boys: b = -0.001, 95 % CI -0.001, -0.00004), WG (girls: b = -0.24, 95 % CI -0.31, -0.16; boys: b = -0.15, 95 % CI -0.24, -0.07) and HG (girls: b = -0.15, 95 % CI -0.23, -0.07; boys: b = -0.12, 95 % CI -0.19, -0.04). A higher DASH index was also associated with lower odds of overweight in girls (OR = 0.70, 95 % CI 0.56, 0.87) and boys (OR = 0.76, 95 % CI 0.62, 0.93). CONCLUSIONS: The DASH diet may prevent overweight in peri-adolescents.

Contemporary nutrition-based interventions to reduce risk of infection among elderly long-term care residents: A scoping review.

BACKGROUND: Elderly long-term care residents (ELTCRs) face considerable burden of infection, especially evident during the COVID-19 pandemic. The nutritional status of the host can influence susceptibility to infection by altering immune system integrity, therefore, nutrition-based interventions may be a viable complement to existing infection prevention measures. OBJECTIVE: This scoping review sought to identify nutritional interventions and factors that have the strongest evidence to benefit ELTCRs, and thus best poised for rigorous clinical trial evaluation and subsequent implementation. METHODS: A database search of OVID-Medline, OVID-Embase, and Web of Science was performed from 2011 to 2021 to identify nutritional intervention studies which attribute to changes in infection in contemporary ELTCR settings. Articles were screened in duplicate and data extraction completed by a single reviewer, while a second reviewer verified the data which was fitted to identify evidence for nutritional interventions related to reducing rates of infection among ELTCRs. RESULTS: The search identified 1018 studies, of which 11 (nine clinical trials and two observational cohort studies) satisfied screening criteria. Interventions that significantly reduced risk of infection included whey protein (any infection), Black Chokeberry (urinary tract infection), and vitamin D (acute respiratory tract infection, skin and soft tissue infection). Both zinc and a dedicated meal-plan significantly improved lymphocyte parameters. Vitamin D deficiency was associated with the development of respiratory tract infections. Probiotic and soy-based protein interventions did not significantly affect risk of infection or lymphocyte parameters, respectively. CONCLUSION: The current scoping review was effective in identifying the use of nutrition-based interventions for infection prevention among ELTCRs. In this study, some nutrition-based interventions were observed to significantly influence the risk of infection among ELTCRs. Nutritional interventions such as vitamin D (preventing deficiency/insufficiency), Black Chokeberry juice, zinc gluconate, whey protein, and varied and nutrient dense meal plans may be suitable for future rigorous clinical trial evaluation.

Trajectories of cardiorespiratory fitness in children with and without developmental coordination disorder: a longitudinal analysis.

OBJECTIVE: To compare the longitudinal trajectories of cardiorespiratory fitness (CRF) in children with probable developmental coordination disorder (DCD) with those of typically developing children. SETTING: School-based study, conducted in a large region of Ontario, Canada. 75 out of a possible 92 schools (83%) consented to participate. PARTICIPANTS: A cohort of children, enrolled in grade 4 (mean 9 years 11 months; SD 0.05) at baseline (n=2278) were followed twice-yearly over a 2-year period. MEASURES: The short form of the Bruininks-Oseretsky test of motor proficiency was used to identify children with probable DCD and the Leger shuttle run to measure maximal oxygen uptake (VO(2)max). RESULTS: Mixed-effects modelling was used to estimate the change over time in predicted VO(2)max for both children with probable DCD and typically developing children. For all children, VO(2)max declined over time. Children (boys and girls) with probable DCD not only had lower VO(2)max at baseline compared with typically developing children, VO(2)max declined among these children at a much steeper rate. CONCLUSION: Although previous research has found children with DCD to have poor CRF compared with typically developing children, most of this work has relied on cross-sectional designs to examine group differences. The results of this study confirm that differences in CRF between children with and without probable DCD persist over time, highlighting the concern that DCD is a risk factor for poor cardiovascular health in children.

Sleep difficulties and obesity among preadolescents.

OBJECTIVE: To determine if sleep difficulties are associated with overweight/obesity status among preadolescents. METHODS: A total of 606 (288 males, 318 females) students, ages 11-13 years from southern Ontario, Canada, were included in this analysis. Overweight/obesity status was determined using age- and gender-specific criteria. Sleep difficulty status was determined if the parents reported children 'sometimes' or 'often' experiencing waking up at night, snoring or breathing loudly, and restlessness while sleeping. Logistic regression analysis was used to examine the association of childhood overweight status and sleep difficulties adjusting for age, gender, total physical activity score, total calories intake, maternal education level, and total hours of sleep. RESULTS: In this sample, 28% of children (76 boys and 95 girls) were identified as being overweight or obese. Relative to their normal-weight peers, overweight and obese individuals reported a higher prevalence of sleep difficulties (10.3% vs. 26.3%, p < 0.0001), reduced hours of sleep (9.4 vs. 9.2 hrs, p < 0.001), and a lower physical activity score (17.2 vs. 19.1, p < 0.01). Using a multiple logistic regression model, in comparison to children reporting none of the three sleep behaviour problems, the odds ratios (95% CI) of being overweight or obese for those having any one, two, or all three sleep behaviour problems were 1.04 (0.46-2.36), 1.35 (0.58-2.10), and 3.52 (1.42-8.74), respectively. CONCLUSIONS: The results suggest that the risk of overweight/obesity is associated with sleep difficulties among preadolescents. Further study is needed to determine the direction of this relationship.

Trajectories of relative weight and waist circumference among children with and without developmental coordination disorder.

BACKGROUND: Children with developmental coordination disorder have been found to be less likely to participate in physical activities and therefore may be at increased risk of overweight and obesity. We examined the longitudinal course of relative weight and waist circumference among school-aged children with and without possible developmental coordination disorder. METHODS: We received permission from 75 (83%) of 92 schools in southwestern Ontario, Canada, to enrol children in the fourth grade (ages 9 and 10 at baseline). Informed consent from the parents of 2278 (95.8%) of 2378 children in these schools was obtained at baseline. The main outcome measures were body mass index (BMI) and waist circumference. Children were followed up over two years, from the spring of 2005 to the spring of 2007. RESULTS: Over the course of the study, we identified 111 children (46 boys and 65 girls) who had possible developmental coordination disorder. These children had a higher mean BMI and waist circumference at baseline than did those without the disorder; these differences persisted or increased slightly over time. Children with possible developmental coordination disorder were also at persistently greater risk of overweight (odds ratio [OR] 3.44, 95% confidence interval [CI] 2.34-5.07) and obesity (OR 4.00, 95% CI 2.57-6.21) over the course of the study. INTERPRETATION: Our findings showed that children with possible developmental coordination disorder were at greater risk of overweight and obesity than children without the disorder. This risk did not diminish over the study period.

Developmental coordination disorder, sex, and activity deficit over time: a longitudinal analysis of participation trajectories in children with and without coordination difficulties.

AIM: Children with developmental coordination disorder (DCD) are known to participate in active play less than typically developing children. However, it is not known whether the activity deficit between children with and without DCD widens or diminishes over time. METHOD: Data were obtained from a large, prospective cohort study of children (baseline n=2278, total n=2470). Motor coordination was assessed for 2083 students using the short form of the Bruininks-Oseretsky Test of Motor Proficiency. Participation in organized and free-play activities was assessed using a participation questionnaire on five occasions over 3 years. Mixed-effects modelling was used to examine differences in participation over time between children with probable DCD (pDCD, n=111, 46 males, 65 females) and their typically developing peers (n=1972, 1016 males, 956 females). The mean age for the whole sample was 9 years 11 months (SD 5 mo) at assessment 1, 10 years 5 months (SD 5 mo) at assessment 2, 10 years 11 months (SD 5 mo) at assessment 3, 11 years 4 months (SD 4 mo) at assessment 4, and 11 years 11 months (SD 4 mo) at assessment 5. RESULTS: Children with pDCD reported less participation in organized and free-play activities than their typically developing peers, and these differences persisted over time. Among males, the gap in participation in free-play activities between those with DCD and typically developing children diminished substantially over time; among females, it increased slightly. INTERPRETATION: DCD is associated with a persistent activity deficit in children. Its effect on participation appears to be particularly serious among females but may diminish with time among males.

Arterial distensibility is reduced in overweight pre- and early pubescent children.

The objective of this study was to examine the differences in arterial distensibility between overweight/obese and normal weight pre- and early pubescent boys and girls. Arterial distensibility was measured in 65 children (43 normal weight and 22 overweight/obese) between the ages of 9 and 12 years. Weight classification was based on age and sex-specific body mass index (BMI) cut-offs and pubertal maturation by Tanner staging. Distensibility was determined using B-Mode echo-Doppler ultrasound to measure changes in the right common carotid artery (CCA) diameter, while carotid pulse pressure was measured at the left CCA by applanation tonometry. Accounting for age and sex (ANCOVA), CCA distensibility showed a significant difference (P < 0.05) between normal weight (0.79 +/- 0.21) and overweight children (0.61 +/- 0.21 mmHg(-1) x 10(-2)). Univariate analysis revealed that CCA distensibility was related to BMI, systolic blood pressure, brachial pulse pressure, and relative oxygen uptake (VO(2peak), milliliter per kilogram per minute). Multivariate analysis revealed that, when adjusting for brachial pulse pressure and relative VO(2peak), differences in CCA distensibility by BMI were no longer significant. This study demonstrates that attenuated arterial distensibility exists in overweight pre- and early pubescent children. As well, this study highlights the influential role of blood pressure and aerobic fitness on arterial distensibility.

Impact of a multifaceted and multidisciplinary intervention on pain, agitation and delirium management in a Canadian community intensive care unit: a quality improvement study protocol.

BACKGROUND: Pain and agitation are closely linked to the development of delirium, which affects 60%-87% of critically ill patients. Delirium is associated with increased mortality and morbidity. Clinical guidelines that suggest routine assessment, treatment and prevention of pain, agitation and delirium (PAD) is crucial to improving patient outcomes. However, the adoption of and adherence to PAD guidelines remain suboptimal, especially in community hospitals. The aim of this quality improvement study is to evaluate the impact of a multifaceted and multidisciplinary intervention on PAD management in a Canadian community intensive care unit (ICU). METHODS: This is a quality improvement, uncontrolled, before-and-after study of a multifaceted and multidisciplinary intervention targeting nurses (educational modules, visual reminders), family members (interviews, educational pamphlets and an educational video), physicians (multidisciplinary round script) and the multidisciplinary team as a whole (delirium poster). We will collect data every day for 6 weeks before implementing the intervention. Data collection will include clinical information and information on process of care. We will then implement the intervention. Four weeks after, we will collect data daily for 6 weeks to evaluate the effect of the intervention. On the basis of the volume of the ICU, we expect to enroll approximately 280 patients. We have obtained local ethics approval from the Hamilton Integrated Research Ethics Board (HiREB 18-040-C). INTERPRETATION: The results of this quality improvement study will provide information on adherence to PAD guidelines in a Canadian community ICU setting. They will also supply information on the feasibility of implementing multifaceted and multidisciplinary PAD interventions in community ICUs.

Screening for motor coordination challenges in children using teacher ratings of physical ability and activity.

We examined the effectiveness of a teacher-based rating scale called the teacher estimation of activity form (TEAF) to screen for developmental coordination disorder (DCD) in children. A random selection of 15 of 75 schools from the District School Board of Niagara in Ontario, Canada was chosen for this study. Every consented child in Grade 4 (n=502) was evaluated for probable DCD (pDCD) in school using the short form Bruininks-Oseretsky test of motor proficiency (BOTMP-SF). Each student also completed the children's self perceptions of adequacy in and predilection toward physical activity (CSAPPA) scale, participation questionnaire, and Léger 20-meter shuttle run, and had their height and weight measured. The 27 children (5.1%) who scored below the 5th percentile on BOTMP-SF were designated as pDCD cases and the 475 children who scored above the 5th percentile served as controls. Results showed that mean TEAF scores were significantly lower for pDCD children than controls (p<.001). Total TEAF scores ranging from 28 to 32 were preferred in maintaining good sensitivity (.74, 95% CI=.55-.87 to .85, 95% CI=.68-.94). The area under the ROC curve was .77 (95% CI, .68-.86) for the TEAF total score, and some individual items performed approximately as well as the full scale. The TEAF was positively correlated with measures of physical activity and fitness. The TEAF appears to be an effective tool in screening for DCD, particularly in a population setting. Considering the brevity of the TEAF and the discriminative power of individual items, this instrument would be effective in an abbreviated version.

Cardiovascular disease risk in adolescent smokers: evidence of a 'smoker lifestyle'.

This study assessed the prevalence of traditional cardiovascular disease risk factors in 119 adolescent smokers, compared to an age-matched sample of non-smokers. Participants were assessed for body mass index (BMI), relative body fat, systolic/diastolic/mean arterial blood pressure, total serum cholesterol, aerobic fitness, family (parents or siblings) smoking habits and history of cardiovascular disease. The results showed that BMI and relative body fat were significantly increased, while aerobic fitness was significantly decreased in smokers. Male smokers further demonstrated increased diastolic blood pressure and mean arterial pressure. Smokers also showed increased prevalence for family smoking habits and cardiovascular disease history. Prevalence rates for all other cardiovascular disease risk factors were increased in smokers, but the differences between groups did not reach statistical significance. It is concluded that the studied adolescent smokers demonstrated a higher risk for developing cardiovascular disease later in life, compared to their non-smoking counterparts.

The longitudinal relationship between generalized self-efficacy and physical activity in school-aged children.

Our understanding of the longitudinal relationship between generalized self-efficacy (GSE) and physical activity in children and youth is limited. The purpose of this study was to investigate the effect of GSE towards physical activity on sedentary behaviours and physical activity in school-aged children over time. A total of 2278 nine-year-old children (1120 girls and 1158 boys) were recruited at baseline and followed for seven waves of data collection from 2005 to 2008. All children completed questionnaires at each wave assessing their GSE (adequacy, predilection, and enjoyment), sedentary behaviours, free play, and organized activity. Mixed-effects models were used to estimate changes in physical activity and GSE within individuals over time, controlling for gender and motor ability. The results showed that participation in free play significantly increased over time, whereas organized activity significantly decreased over the same period. Children with high perceived adequacy and predilection had higher free play and organized activity participation relative to other children over time. However, the effect of perceived adequacy diminished over time, while the gaps between groups with different levels of predilection widened over time. While sedentary behaviours were lower over time in children with high predilection, these behaviours were consistently higher in children with high enjoyment. The differences in sedentary behaviours between groups increased over time for both predilection and enjoyment. This study highlights the importance of different components of GSE on physical activity participation. In addition, interventions targeting the enhancement of predilection may facilitate physical activity and reduce sedentary behaviours.

Comparison of anthropometry and parent-reported height and weight among nine year olds.

BACKGROUND: There is mounting evidence that the prevalence of overweight and obesity in children is reaching epidemic proportions in North America. We compared parent-report vs. measured BMI overweight and obesity prevalence estimates among 9 year olds using the 1996 NLSCY reports published by Willms et al. (2003) and anthropometric measurements from a regional population of public school children. METHODS: Body mass index (BMI) was calculated for 1,497 9-year-old children (males N = 734; females N = 763) from 75 public schools in the Niagara Region of Ontario, Canada. BMI from the 1996 NLSCY was based on parental reports of height and weight of 879 nine year olds. To define overweight and obese children, we used internationally accepted age- and gender-specific cut-offs as defined by Cole et al. (2000). RESULTS: The NLSCY overweight prevalence estimates of boys and girls may overestimate overweight boys and girls by 17% and 10%, respectively. Measured obesity prevalence estimates were similar to parent-reports. CONCLUSIONS: Our results suggest that parental reports of height and weight may inflate prevalence estimates of overweight children, but appear reasonably accurate for estimating obesity. Since prevalence of overweight and obesity are often combined to form a global estimate, reliance on parent-reported height and weight may overstate the magnitude of the problem.

Tracking cardiorespiratory fitness and physical activity in children with and without motor coordination problems.

OBJECTIVES: Previous research has shown children with Developmental Coordination Disorder (DCD) have lower cardiorespiratory fitness (CRF) than typically developing (TD) children. This has been hypothesized to be due to an activity deficit, whereby poor motor functioning discourages children from participating in physical activities, but this hypothesis has not been directly tested. In this study, we use longitudinal data to measure the extent to which physical activity explains differences in CRF between children with and without motor coordination deficits. DESIGN: Longitudinal observational study. METHODS: The study sample is an open cohort of children, numbering 2278 at baseline (age 9-10), that was followed for up to 5 years (to age 13-14). Motor skills were assessed once over the study period. Children scoring at or below the 5th percentile (n=103) on the Bruininks-Oseretsky Test of Motor Proficiency-Short Form were considered to have possible DCD (pDCD). CRF (estimated peak VO2) was estimated from performance on the Léger 20m shuttle run test, and physical activity was measured with the Participation Questionnaire. Both fitness and physical activity were measured up to 7 times over the study period. RESULTS: Children with pDCD had significantly lower CRF than their TD peers at each time point. CRF declined for both groups, but this decline was steeper for children with pDCD. Physical activity explained only a small part of the difference in CRF. CONCLUSIONS: The activity deficit did not contribute to the persistent and gradually widening gap in CRF between children with and without possible DCD. Possible reasons for this and future directions are discussed.

Longitudinal examination of objectively-measured physical activity and sedentary time among children with and without significant movement impairments.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) tend to be less active than typically-developing (TD) children. Current evidence, however, is based on cross-sectional and self-reported activity, and little is known about sedentary time among children with significant movement impairments such as DCD. The current study examines the longitudinal patterns of objectively measured physical activity and sedentary time in children with and without possible DCD (pDCD). METHODS: Data is from a longitudinal nested case-control study, with 103 participants (n=60 males ages=12 and 13 at baseline). Participants averaging ⩽16th percentile on the Movement Assessment Battery for Children were considered having significant movement impairments and pDCD (n=49). All participants wore accelerometers for seven days. RESULTS: There were significant main effects for time (Estimate=-23.98, p<.01) and gender (Estimate=59.86, p<.05) on total physical activity, and time spent being sedentary (Estimate=15.58, p<.05). Significant main effects for pDCD (Estimate=-5.38, p<.05) and gender (Estimate=26.89, p<.01), and time by gender interaction (Estimate=-7.50, p<.05) were found for moderate-to-vigorous physical activity (MVPA). Sedentary time did not differ between children with and without DCD. CONCLUSIONS: Results suggest children with pDCD engaged in less MVPA compared to TD children. Consistent patterns of MVPA over time, however, suggest that the divergence in MVPA occurs earlier in childhood. Further longitudinal research following a younger cohort is necessary to identify the specific point that differences in MVPA emerge.