Summary Background The association between the gut microbiota and obesity in young children and adolescents is not fully studied. Objectives This study investigated the associations between the gut microbiota and body mass index (BMI) level (underweight, normal, overweight, obese) and lifestyles (diet type and exercise frequency), controlling for demographic and clinical factors among children aged 7–18 years. Methods A cohort study was conducted on 267 children aged 7–18 years from the American Gut Project. 16S rRNA sequences were analysed by QIIME 2™. Composition of gut microbiota and its associations with BMI level, weight change and lifestyles were analysed using linear decomposition model. Results Significant factors affecting the gut microbiota were BMI level (p = 0.009), exercise frequency (p = 0.003) and diet type (p = 0.01), controlling for age, sex and use of antibiotics and probiotics. More bacterial operational taxonomic units (OTUs) were associated with BMI level (120 OTUs) and diet type (122 OTUs) than exercise frequency (67 OTUs). Actinobacteria phylum had significantly depleted OTUs for BMI level, diet type and exercise frequency; Proteobacteria phylum had significantly enriched OTUs for higher BMI level and Firmicutes phylum had significantly enriched OTUs for more frequent exercise. Conclusions Significant associations were found between the gut microbiota composition and BMI level and lifestyles controlling for demographic and clinical factors in children aged 7–18 years.

For children with chronic conditions, well-being is closely related to how well their families function. Most prior research syntheses on family functioning and child well-being have focused on children with a single condition, thereby limiting the potential to aggregate and build on what is known across conditions. To address this challenge, research reports were reviewed and meta-analyses conducted of findings on the relationship between family functioning and child well-being across a range of chronic physical conditions. The sample was derived from a larger systematic review study that included 1,028 reports published between January 1, 2000 and March 31, 2014. The current review includes 53 studies in which a relationship between family functioning and child well-being was analyzed using one of four family measures: Family Adaptability and Cohesion Evaluation Scales, Family Environment Scale, Family Relationship Index, or Family Assessment Device. Most studies were cross-sectional and observational (n = 43, 81%). The most frequently studied conditions were diabetes, cancer, sickle cell disease, and asthma. In 37 studies, findings were sufficiently comparable to conduct meta-analyses. Significant correlations were identified between children's psychological health and seven of nine dimensions of family functioning. Significant correlations also were found between dimensions of family functioning and children's problem behaviors, social competence, quality of life, and, to a lesser extent, adherence and physical health. Of the family dimensions, cohesion and conflict were associated most strongly with child outcomes. Understanding the specific family variables, such as conflict, linked to varied child outcomes is key for intervention development. © 2016 Wiley Periodicals, Inc.

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This study investigated differences in osteoporosis knowledge, self-efficacy, and health beliefs among Chinese and American college students. Information obtained will be used in developing osteoporosis prevention programs for younger adults. Methods. Chinese (n = 409) and US (n = 408) college students completed the Osteoporosis Health Belief, Self-Efficacy, and Knowledge Tests. Results. Differences were seen in osteoporosis knowledge (M us = 14.52, M Chinese = 11.82), exercise knowledge (M us = 8.16, M Chinese = 9.04), calcium knowledge (M us = 8.47, M Chinese = 9.73), perceptions of exercise benefits (M us = 24.07, M Chinese = 21.09), calcium benefits (M us = 23.17, M Chinese = 18.36), exercise barriers (M us = 11.75, M Chinese = 14.96), calcium barriers (M us = 13.04, M Chinese = 15), and exercise self-efficacy (M us = 73.71, M Chinese = 63.81). Conclusion. US college students know more about osteoporosis and its risk factors; however, there are similarities in perception of risk between US and Chinese students. Chinese students perceive greater barriers to reducing their risk through exercise and dietary calcium intake.

Nurses can use the HBM-based intervention to enhance patients' health belief and self-efficacy towards the management of COPD, and subsequently benefit healthcare outcomes.

ObjectivesTo explore the association between the number of teeth and frailty among older Chinese adults using a nationally representative sample.DesignCross-sectional analysis was carried out using the 2014 wave data from the Chinese Longitudinal Healthy Longevity Survey, which used a targeted random-sampling design.SettingThis research was conducted in communities from nearly half of the counties and cities in 22 out of 31 provinces throughout China.ParticipantsOf the 6934 interviewees aged ≥65 years, the final analysis included 3635 older adults who had completed the 2014 wave survey on the variables included in the study.Primary and secondary outcome measuresOutcome variables included frailty, measured by the Frailty Index, and number of teeth. Covariates included demographic characteristics (ie, age, sex, co-residence, marital status, years of education and financial support), body mass index (BMI) and health behaviours (ie, smoking, drinking and exercise). A univariate logistic regression was used to test the factors associated with frailty. A multiple logistic regression model was used, using the frailty score as the dependent variable and the number of teeth together with significant covariates as the independent variables.ResultsThe prevalence of frailty was 27.68%. The mean number of teeth present was 9.23 (SD=10.03). The multiple logistic regression showed that older adults’ demographic variables, health behaviours, BMI, tooth number and chewing pain were significantly associated with frailty. After adjusting for the covariates, older adults with fewer teeth had significantly higher odds of frailty than those with 20 or more teeth (no teeth: OR=2.07, 95% CI 1.53 to 2.80; 1 to 10 teeth: OR=1.77, 95% CI 1.31 to 2.38), except for older adults with 11 to 20 teeth (OR=1.30, 95% CI 0.93 to 1.82).ConclusionsThe presence of fewer teeth is significantly associated with frailty status among older Chinese adults. Future studies are needed to explain the specific mechanisms underlying how oral health status is associated with frailty.

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Spirituality is associated with decreased pain and lower symptom burden and may serve as a protective factor against diminished overall QOL, specifically social, emotional, and functional domains in black patients with cancer pain. There is a need to develop spirituality-based interventions along with symptom management interventions to improve QOL for this population.