Extended composite index of anthropometric failure in Argentinean preschool and school children.

OBJECTIVE: The Composite Index of Anthropometric Failure (CIAF) can only be applied to children under 5 years of age and does not contemplate obesity. The aim of this study was to propose an Extended CIAF (ECIAF) that combines the characterization of malnutrition due to undernutrition and excess weight, and apply it in six Argentine provinces. DESIGN: ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess. SETTING: Cross-sectional study conducted in Buenos Aires, Catamarca, Chubut, Jujuy, Mendoza and Misiones (Argentina). PARTICIPANTS: 10 879 children of both sexes aged between 3 and 13·99. RESULTS: ECIAF in preschool children (3 to 4·99 years) was 15·1 %. The highest prevalence was registered in Mendoza (16·7 %) and the lowest in Misiones (12·0 %). In school children (5 to 13·99 years) ECIAF was 28·6 %. Mendoza also recorded the highest rate (30·7 %), while Catamarca and Chubut had the lowest values (27·0 %). In the whole sample, about 25 % of the malnutrition was caused by undernutrition and 75 % by excess weight. CONCLUSIONS: The ECIAF summarizes anthropometric failure by both deficiency and excess weight and it highlights that a quarter of the malnutrition in the Argentine population was caused by undernutrition, although there are differences between Provinces (P < 0·05). ECIAF estimates are higher than those of CIAF or under-nutrition.

Growth of school children in different urban environments in Argentina.

BACKGROUND: Nutritional transition has been described in various countries, each showing inherent characteristics. Furthermore, different patterns also appear within the same country. AIM: To compare the nutritional status of schoolchildren, of both sexes, living in two Argentine cities with different urban and environment characteristics, from the perspective of nutritional transition. SUBJECTS AND METHODS: The sample comprised 5355 children (6-13 years) living in Puerto Madryn (Chubut) and General Alvear (Mendoza), Argentina. Weight and height were transformed into Z-scores according to NHANES I- II; underweight, stunting and wasting defined by - 2 SD and overweight and obesity calculated according the cut-off proposed by IOTF. Prevalences of nutritional status were estimated. RESULTS: Comparison of the two cities revealed significant χ² values for the indicators of nutritional status analysed. Puerto Madryn had higher prevalences of overweight and obesity. General Alvear exhibited higher stunting and underweight values. CONCLUSIONS: The cities studied are in different stages of nutritional transition. Puerto Madryn is undergoing growing industrialization and urbanization and thus exhibits characteristics typical of an 'obesogenic' environment. General Alvear, a less complex urban centre, where some cultural patterns related to an agrarian way of life appear to have been retained, is situated at a less advanced stage.

Craniometric variation and the settlement of the Americas: testing hypotheses by means of R-matrix and matrix correlation analyses.

New archaeological findings and the incorporation of new South American skull samples have raised fundamental questions for the classical theories of the Americas' settlement. The aim of this study was to estimate craniometric variability among several Asian and Native American populations in order to test goodness of fit of the data to different models of ancient population entries and dispersions into the New World. Our data set includes Howells' variables recorded on East Asian, North American, and South American natives (except for Na-Dene speakers). Five Fuego-Patagonian samples and one Paleoamerican sample were also included. A multivariate extension of the R-matrix method for quantitative traits was used to obtain Fst values, which were considered estimations of intergroup variation. Three main models for the peopling of the New World were represented in hypothetical design matrices. Matrix permutation tests were performed to quantify the fit of the observed data with 1) geographical separation of the samples and 2) three ways of settlement, which were the Three Migration Model (TMM), the Single Wave Migration model (SWM), and the Two Components Settlement Model (TCS). R-matrix results showed high levels of heterogeneity among Native Americans. Matrix permutation analyses suggested that the model involving high Amerindian heterogeneity and two different morphological patterns or components (derived "Mongoloid" vs. generalized "non-Mongoloid") explains better the variation observed, even when the effects of geographical separation are removed. Whether these patterns arose as a result of two separate migration events or by local evolution from Paleoamericans to Amerindians remains unresolved.

The settlement of Patagonia: a matrix correlation study.

Matrix correlation represents an innovative methodology to evaluate the explanatory power of several hypotheses by measuring their correspondence with observed morphological variation. In this paper, we view the origins of Patagonians from a matrix correlation approach. Personal and published data on nonmetric cranial traits were used to estimate a biological distance matrix involving five major groups from Patagonia and two from the northwest and northeast regions of Argentina. To evaluate correspondence with other important factors, we used a geographic distance matrix and four design matrices, representing several patterns of settlement and differentiation. Biological distance was found to be strongly associated with spatial separation; the correlation between geography and nonmetric cranial distances was highly significant. When geographic distance is held constant, correlation between a model representing high levels of heterogeneity between the samples and morphological (nonmetric) variation becomes highly significant.

Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women.

This study examined the long-term effectiveness of a postpartum smoking relapse prevention intervention by evaluating the smoking status and smoking cessation self-efficacy of original study participants at 12 months following delivery. Two hundred and thirty-eight women who had participated in a randomized clinical trial, a nurse-delivered relapse prevention intervention, were visited in their homes. Data were collected on smoking status, self-efficacy, mental health, alcohol use, breast feeding, social support, smoking in the social environment, and sociodemographics. Smoking status was verified with measures of carbon monoxide in expired air. The 12-month continuous smoking abstinence rate was 21.0% in the treatment group and 18.5% in the control group; odds ratio (OR) = 1.17, 95% confidence interval (CI) = 0.62-2.22. One half (50.4%) of the control group and 41.2% of the treatment group reported smoking daily at 12 months; OR = 1.45, 95% CI = 0.87-2.43. The treatment group attained higher self-efficacy. Four variables were associated with relapse to daily smoking; breast feeding and mental health had protective effects, while partners who smoked and greater amount smoked prior to pregnancy had adverse effects.

Preventing smoking relapse in postpartum women.

BACKGROUND: Although many women quit smoking during pregnancy, the majority resume smoking shortly after giving birth. OBJECTIVES: To test a program to prevent smoking relapse in the postpartum period by comparing the rates of continuous smoking abstinence, daily smoking, and smoking cessation self-efficacy in treatment and control groups. METHODS: In a randomized clinical trial, nurses provided face-to-face, in-hospital counseling sessions at birth, followed by telephone counseling. The target population included women who quit smoking during pregnancy and who gave birth at one of five hospitals. The 254 participating women were interviewed 6 months after delivery and assessed biochemically to determine smoking status. RESULTS: The 6-month continuous smoking abstinence rate was 38% in the treatment group and 27% in the control group (odds ratio [OR] = 1.63, 95% confidence interval [CI] .96 - 2.78). Significantly more control (48%) than treatment (34%) group participants reported smoking daily (OR = 1.80, 95% CI = 1.08 - 2.99). Smoking cessation self-efficacy did not vary significantly between the groups. CONCLUSIONS: Smoking cessation interventions focusing on the prenatal period have failed to achieve long-term abstinence. Interventions can be strengthened if they are extended into the postpartum period.

Nursing's metaparadigm concepts: disimpacting the debates.

Theoretical advances in nursing have been complicated by polarization and extreme positions regarding nursing's approach to its main metaparadigm concepts: person, health, environment and nursing. In this paper, the authors deconstruct some of the central arguments that are used to further this polarization. Using a critical interpretive approach, they explain some of the logical implications imposed by various extreme positions for the larger project of nursing's health and social mandate, and consider the effects of such polarization. On the basis of an appreciation of the serious difficulties inherent in certain philosophical and theoretical positions currently evident within nursing's literature, the authors argue for a less extreme and more integrated reference point for nursing's theory and practice.

Effect of gonadal activity on the cranial dimorphism of the rat.

Weanling rats of both sexes were submitted to either castration, or castration together with periodic injections of testicular extract to males or of ovarian extract to females. Control and experimental animals were sampled at 63 days of age. Cranial differentiation between sexes was estimated by Mahalanobis D2 distances. The controls showed a significant sexual cranial difference. Orchidectomy decreased cranial differences and this effect was compensated by injections of testicular extract. On the other hand, oophorectomy increased cranial differences, which were diminished by injections of ovarian extract. Sexual cranial dimorphism in the normal rat seems to be the result of a counteracting effect between testicular and ovarian hormonal secretions.

Variations in sexual dimorphism in the skulls of rats subjected to malnutrition, castration, and treatment with gonadal hormones.

Two groups of weanling rats were subjected to malnutrition, one with periodic injections of testosterone (males) and the other with estradiol (females). Two other groups (castrated males or castrated females) received normal feedings. In control animals, the relative weights (mg/gm body weight) of testes, seminal vesicles, and ovaries were greater than in malnourished rats. However, relative weights of those organs in hormone-treated, malnourished animals were greater than in those subjected to malnutrition alone and still greater than in controls. Normal sexual cranial dimorphism (SCD) was decreased 16% by male castration, 23% by malnutrition, and 83% by estradiol treatment in malnourished females. On the other hand, normal SCD was increased 20% by female castration and more than 200% by testosterone treatment in malnourished males. All monosexual comparisons corroborated the bisexual range of distances found. Testicular but not ovarian secretions seemed to influence sexual cranial dimorphism. Malnutrition delayed SCD because of a deficiency of testosterone level in stressed males. It is suggested that estradiol in females may counteract sexual cranial development and that its inhibitory effect may be additive to the testosterone deficit evoked by malnutrition.

Effects of protein-calorie malnutrition during suckling and post-weaning periods on discontinuous cranial traits in rats.

The influences of protein-calorie malnutrition (PCM), and sex during lactation and post-lactation on the frequencies of 25 discontinuous cranial traits (DCT), were investigated in Holtzman rats. Significant differences were observed in about 20% of the traits. Those traits were: the interfrontal fusion, the posterior incurvation of the palatine border, the double maxillary foramen, the double posterior palatine foramen, and the double frontal foramen. Total PCM was the nutritional factor which showed the greatest influence on the variability of the DCTs. It was followed, in decreasing order, by the PCM imposed during post-lactation and lactation. Sex had more influence than early PCM but less than late PCM. It is concluded that despite their apparent stability, a substantial number of DCTs were altered by both biological (like sex) and environmental factors (like nutritional deficiencies) imposed at different stages of postnatal development.

Effect of age, sex and nutrition on discontinuous traits of rat skull.

The effect of biological (age and sex) and environmental factors (protein-calorie malnutrition and protein deficit) on 24 discontinuous cranial traits was investigated in Holtzman rats. The traits affected were (a) the interfrontal fusion, by age and nutrition; (b) the double posterior palatine foramen, by sex and nutrition, and (c) the double maxillary foramen, by nutrition. It is concluded that most of the traits studied were fairly stable. Nevertheless, it must be pointed out that taxonomic studies based on discontinuous cranial traits should be interpreted with care due to the influence of environmental and biological factors on the phenotypic expression of some of them.