Abstract: Aims: Patients with Cystic Fibrosis (CF) have increased risk of malnutrition. Early detection of nutritional deterioration enables prompt intervention and correction. The aims of this project were to define the nutritional status of CF patients in Iran and New Zealand, compare and contrast the McDonald Nutritional Risk Screening (NRS) tool with the Australasian Guidelines for Nutrition in Cystic Fibrosis, and validate these results with each patient’s evaluation by their CF clinical team.

Methods:Children with CF (2 - 18 years) were assessed during routine outpatient visits over one year. Anthropometric measurements were obtained. Both tools were applied and the results compared to their clinical evaluation (as gold standard) with calculation of specificity and sensitivity.

Results:Under-nutrition was seen more frequent in the 33 Iranian children than in the 36 New Zealand (NZ) patients (39% versus 0%, p=0.0001), whereas over-nutrition was more prevalent in NZ children (9% versus 17%, p=0.05). At the first visit, both guidelines were able to recognize 77% and 61% of under-nourished Iranian patients, respectively. The mean sensitivity and specificity for all visits for the McDonald tool were 83% & 73% (Iran) and 65% & 86% (NZ). Sensitivity and specificity for the Australasian guidelines were 79% & 79% (Iran) and 70% & 90% (NZ).

Conclusions: Both tools successfully recognised patients at risk of malnutrition. The McDonald tool had comparable sensitivity and specificity to that described previously, especially in Iranian patients. This tool may be helpful in recognizing at risk CF patients, particularlyin developing countries with fewer resources.

Keywords: Cystic Fibrosis, Malnutrition, Nutritional Risk Screening (NRS), NRS tools, over-nutrition.

Abstract: Introduction: Parents have a significant impact on child nutrition and the child's eating habits in long-term behavior. This study aims to examine the effects of mothers' attitudes on the eating behaviors of children and the determination of their nutritional status.

Method: Children's eating habits and mothers' eating attitudes were examined in 417 children with face-to-face interviews using the Child Feeding Questionnaire (CFQ). The participants' anthropometric characteristics were determined, and body mass indexes (kg/m2) were calculated. AnthroPlus software was used to determine the children’s BMI-for-age Z-scores. BeBiS nutrition information system was used to assess children’s food intake.

Results: The mothers' median BMI was above the overweight threshold. The lowest CFQ score was for perceived child weight, and the maximum score was for food restriction. Significant differences were found in mothers ages, mothers' BMIs, children's WAZ and BAZ scores, and BMIs, weight (p<0.001), perceived parent weight scores (p=0.04), and pressure to eat (p=0.04). Families should be conscious about nutrition for the protection and promotion of children's health.

Keywords:  Eating behavior, children, mother, anthropometry, nutritional status.

Abstract: This study examined the qualitative motor performance characteristics of 35 preadolescent obese children (18 female, 17 male) in the Midwest of the United States. An available sample of children ages six to 13 were classified as obese based on a BMI score of 30 or greater. The Test of Gross Motor Development-2 (TGMD-2)was used to assess all subjects. This test measures the qualitative motor ability of children using two subtest categories of fundamental motor skills including locomotors (running, hopping, skipping, jumping, leaping and galloping) as well as object control skills (throwing, catching, kicking, bouncing a ball, rolling a ball and striking). All participants received a raw score, standardized score, sum of standards and gross motor quotient score. All scores were compared to national norms established by the authors of the TGMD-2. The results indicated that the group norms of the obese children were significantly below the mean scores of the national average for all measures including locomotor standard scores (M=3.80, SD=2.44, p<0.001) and object-control standard scores(M=4.43, SD=2.89, p<0.001)and the gross motor development quotient (M=64.69, SD=15.05, p<0.001).The researchers concluded that the significantly lower motor performance scores of obese children may lead this population to participate less in health enhancing movement opportunities as they grow into adolescence and adulthood. The authors noted that the TGMD-2 is designed for children ages 3-10 and has a significant ceiling effect for older children. A younger population may reveal more robust conclusions in further study. Additionally, further study is recommended to determine whether programs aimed at lowering obesity levels in children can have an impact on qualitative fundamental motor skill performance.

Keywords: Kinesiology, obesity, pedagogy, Body Mass Index, BMI, assessment, health, physical education, motor performance, motor skills.

Abstract: Objective: To assess the relative prognostic value of 11 variables including, omega-3, perceived stress, cortisol and sleep duration, in predicting adolescent depression.

Design, Setting and Participants: A cross-sectional study of 444 healthy adolescents aged 16-18 years, from 10 schools within the Northern Sydney and Central Coast regions of New South Wales, Australia. Participants provided blood and saliva samples and completed questionnaires. Statistical classification methods were used to model the relationships between the predictors and depression.

Main Outcome Measures: relative predictive value of each variable in correctly classifying depression.

Results: 6% of boys and 9% of girls were categorised as experiencing severe to extremely severe depression. 4% of boys and 10% of girls were categorised as experiencing severe to extremely severe stress. The mean AM:PM cortisol for boys, 22±101, was higher than that of girls, 11±10. The average omega-3 index for boys, 10.5±3.7, was also higher than that of girls, 7.7±2.6. The average sleep duration of 7.8±1.1 hrs showed no gender differences.

The best classification model identified perceived stress as the most significant predictor of depression followed by BMI and omega-3 index. Cortisol ratio was a significant discriminator for boys but not girls. When stress was excluded, shorter sleep duration became a significant discriminator in both boys and girls with waist to hip ratio providing further discrimination in girls only.

Conclusion: The strongest predictor of depression in adolescents was perceived stress followed by higher BMI and lower omega-3 levels. These findings provide a rational basis for establishing program priorities for the prevention and treatment of adolescent depression.

Keywords: Child, depression, adolescent, omega-3, sleep, BMI, cortisol.