- Email: [email protected]
Sports for all or physical activity for all?
5
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results from 13 perinatal studies. J AIDS 1995; 8: 506-10. Shaffer N, Brown T, Roongpisuthipong A, et al. Maternal viral load and perinatal HIV transmission. Presented at the Third International Conference on AIDS in Asia and the Pacific. Sept 17-21, 1995. Abstract A801. Mastro TD, de Vincenzi I. Probabilities of sexual HIV-1 transmission. AIDS 1996; 10 (suppl A): S75-S82. Robertson D, Sharp P, McCutchan, Hahn B. Recombination in HIV-1. Nature 1995; 374: 124-26. Kanki PJ, Travers KU, M’Boup S, et al. Heterosexual spread of HIV-2 and HIV-1. Lancet 1994; 343: 943-46. Marlink R, Kanki P, Thiav I, et al. Reduced rate of disease development after HIV-2 infection as compared with HIV-1. Science
1994; 265: 1587-90.
Sports for all
or
physical activity for all?
See page 1789 The findings of Steptoe and Butler’s epidemiological study in this week’s issue, combined with results from randomised trials in small samples,’ provide strong support for the notion that physical activity is an important influence on psychological health in adolescents. These benefits are experienced during youth, so adolescents do not have to wait decades for all the health benefits of physical activity, as is the case with cardiovascular disease prevention. Expectations of such immediate psychological benefits should motivate teenagers to be more physically active and adults to support programmes that accomplish this aim. Young people can obtain the psychological and physical health benefits through various activities. The emphasis in this Olympic year is on sports. Many young people receive substantial amounts of activity through sports, but a major limitation is the high dropout rate during adolescence. By the adult years few participate in sports. Young people should choose physical activities they enjoy, which can include bicycling, skating, jogging, dancing, aerobics classes, and many other non-sport activities. Even with all these choices, substantial proportions of adolescents in the USAand UK3 do not meet recommended physical activity levels. Societal factors may contribute to inadequate physical activity among some adolescents. Requirements for physical education typically decrease in the latter years of high school. Although physical education alone cannot be expected to provide young people with sufficient physical activity,4 decreased requirements and lack of facilities have negative impacts on youth. Reductions in funding for parks and recreation programmes make it more difficult for youth to be active. Many of the programmes and facilities available are for elite sports, which exclude the vast majority of adolescents. Added to these difficulties is the burgeoning of opportunities for sedentary recreation. Much of the research on correlates of, and interventions to promote, physical activity in adolescents has focused on psychological and social factors.5 Several programmes that teach adolescents how to change their physical activity habits are effective, but most of the effects are weak and short-lived .5 Educational programmes aimed at changing individual activity levels are expected to be more effective in an environment that is rich in facilities and programmes. If this is true, the highest priority approach is altering policies to make physical activity more convenient. In the meantime, steps can be taken to promote physical activity in adolescents. Improving physical education is the
best documented intervention approach for youth5,6-and a particularly effective public health one because it can affect a very large proportion of young people. The emphasis should not be on competition in organised youth sports, but on participation rates. Facilities should be provided locally since not everybody can afford transport costs. Options include opening schools to serve as evening fitness centres. Improving bicycle trails and parks would also encourage physical activity. And because of the important influences that parents have on their children’s physical activity,5 educating parents on how to ensure that their adolescents keep active is needed as a supplementary effort. J F Sallis Department
of
Psychology,
San
Diego
State
University,
San
Diego,
California, USA 1 2 3 4
5
6
Calfas KJ, Taylor WC. Effect of physical activity on psychological variables in adolescents. Pediatr Exerc Sci 1994; 6: 406-23. Pate RR, Long BJ, Heath G. Descriptive epidemiology of physical activity in adolescents. Pediatr Exerc Sci 1994; 6: 434-47. Sports Council and Health Education Authority. Allied Dunbar National Fitness Survey. London: Belmont Press, 1993. Simons-Morton BG, Taylor WC, Snider SA, et al. Observed levels of elementary and middle school children’s physical activity during physical education classes. Prev Med 1994; 23: 437-41. Sallis JF, Simons-Morton BG, Stone EJ, et al. Determinants of physical activity and interventions in youth. Med Sci Sports Exerc 1992; 24: S248-57. Leupker RV, Perry CL, McKinlay SM, et al. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovasular Health (CATCH). JAMA 1996; 275: 768-76.
Familial Mediterranean fever: underlying defect clearer, but diagnostic problems
persist Familial Mediterranean fever (FMF, recurrent hereditary polyserositis) remains an under-recognised cause of transient symptoms-usually localised to serosal surfaces, including peritoneum, pleura, and synovia-associated with febrile episodes. Between attacks, the affected individual, usually, but not always, genetically related to a high-risk group (Jewish, Armenian, Turkish, and some Arabs), is symptom-free. Although subject to controversy, a recessive mode of inheritance has seemed probable since the initial description in 1908. A recent twin-study involving 21 dizygotic and monozygotic twin sets (identified from 1943 Israeli FMF patients) confirms this mode of inheritance;’ full concordance was present in all 10 monozygotic twin sets but in only three out of 11 dizygotes. However, in a survey (also conducted in Israel) involving 3000 affected individuals, although recessive inheritance was usual, results from two families (one Ashkenazi and the other of Georgian Iraqi origin) could be explained only by autosomal dominant transmission,FMF occurring in four consecutive generations. Recent results clearly indicate that in both Armenians and non-Ashkenazi Jews the responsible gene is linked to the a-globulin complex on the short arm (p) of chromosome 16.’-5 Proximity to the microsatellite markers in D16S283 and D16S291 is considered, by the researchers, to allow a preclinical diagnostic test in "most pedigrees with affected individuals".’5 Whereas the biochemical basis for FMF remains unclear (although chromosomal location of the gene should assist
1779
6 7
8 9
results from 13 perinatal studies. J AIDS 1995; 8: 506-10. Shaffer N, Brown T, Roongpisuthipong A, et al. Maternal viral load and perinatal HIV transmission. Presented at the Third International Conference on AIDS in Asia and the Pacific. Sept 17-21, 1995. Abstract A801. Mastro TD, de Vincenzi I. Probabilities of sexual HIV-1 transmission. AIDS 1996; 10 (suppl A): S75-S82. Robertson D, Sharp P, McCutchan, Hahn B. Recombination in HIV-1. Nature 1995; 374: 124-26. Kanki PJ, Travers KU, M’Boup S, et al. Heterosexual spread of HIV-2 and HIV-1. Lancet 1994; 343: 943-46. Marlink R, Kanki P, Thiav I, et al. Reduced rate of disease development after HIV-2 infection as compared with HIV-1. Science
1994; 265: 1587-90.
Sports for all
or
physical activity for all?
See page 1789 The findings of Steptoe and Butler’s epidemiological study in this week’s issue, combined with results from randomised trials in small samples,’ provide strong support for the notion that physical activity is an important influence on psychological health in adolescents. These benefits are experienced during youth, so adolescents do not have to wait decades for all the health benefits of physical activity, as is the case with cardiovascular disease prevention. Expectations of such immediate psychological benefits should motivate teenagers to be more physically active and adults to support programmes that accomplish this aim. Young people can obtain the psychological and physical health benefits through various activities. The emphasis in this Olympic year is on sports. Many young people receive substantial amounts of activity through sports, but a major limitation is the high dropout rate during adolescence. By the adult years few participate in sports. Young people should choose physical activities they enjoy, which can include bicycling, skating, jogging, dancing, aerobics classes, and many other non-sport activities. Even with all these choices, substantial proportions of adolescents in the USAand UK3 do not meet recommended physical activity levels. Societal factors may contribute to inadequate physical activity among some adolescents. Requirements for physical education typically decrease in the latter years of high school. Although physical education alone cannot be expected to provide young people with sufficient physical activity,4 decreased requirements and lack of facilities have negative impacts on youth. Reductions in funding for parks and recreation programmes make it more difficult for youth to be active. Many of the programmes and facilities available are for elite sports, which exclude the vast majority of adolescents. Added to these difficulties is the burgeoning of opportunities for sedentary recreation. Much of the research on correlates of, and interventions to promote, physical activity in adolescents has focused on psychological and social factors.5 Several programmes that teach adolescents how to change their physical activity habits are effective, but most of the effects are weak and short-lived .5 Educational programmes aimed at changing individual activity levels are expected to be more effective in an environment that is rich in facilities and programmes. If this is true, the highest priority approach is altering policies to make physical activity more convenient. In the meantime, steps can be taken to promote physical activity in adolescents. Improving physical education is the
best documented intervention approach for youth5,6-and a particularly effective public health one because it can affect a very large proportion of young people. The emphasis should not be on competition in organised youth sports, but on participation rates. Facilities should be provided locally since not everybody can afford transport costs. Options include opening schools to serve as evening fitness centres. Improving bicycle trails and parks would also encourage physical activity. And because of the important influences that parents have on their children’s physical activity,5 educating parents on how to ensure that their adolescents keep active is needed as a supplementary effort. J F Sallis Department
of
Psychology,
San
Diego
State
University,
San
Diego,
California, USA 1 2 3 4
5
6
Calfas KJ, Taylor WC. Effect of physical activity on psychological variables in adolescents. Pediatr Exerc Sci 1994; 6: 406-23. Pate RR, Long BJ, Heath G. Descriptive epidemiology of physical activity in adolescents. Pediatr Exerc Sci 1994; 6: 434-47. Sports Council and Health Education Authority. Allied Dunbar National Fitness Survey. London: Belmont Press, 1993. Simons-Morton BG, Taylor WC, Snider SA, et al. Observed levels of elementary and middle school children’s physical activity during physical education classes. Prev Med 1994; 23: 437-41. Sallis JF, Simons-Morton BG, Stone EJ, et al. Determinants of physical activity and interventions in youth. Med Sci Sports Exerc 1992; 24: S248-57. Leupker RV, Perry CL, McKinlay SM, et al. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovasular Health (CATCH). JAMA 1996; 275: 768-76.
Familial Mediterranean fever: underlying defect clearer, but diagnostic problems
persist Familial Mediterranean fever (FMF, recurrent hereditary polyserositis) remains an under-recognised cause of transient symptoms-usually localised to serosal surfaces, including peritoneum, pleura, and synovia-associated with febrile episodes. Between attacks, the affected individual, usually, but not always, genetically related to a high-risk group (Jewish, Armenian, Turkish, and some Arabs), is symptom-free. Although subject to controversy, a recessive mode of inheritance has seemed probable since the initial description in 1908. A recent twin-study involving 21 dizygotic and monozygotic twin sets (identified from 1943 Israeli FMF patients) confirms this mode of inheritance;’ full concordance was present in all 10 monozygotic twin sets but in only three out of 11 dizygotes. However, in a survey (also conducted in Israel) involving 3000 affected individuals, although recessive inheritance was usual, results from two families (one Ashkenazi and the other of Georgian Iraqi origin) could be explained only by autosomal dominant transmission,FMF occurring in four consecutive generations. Recent results clearly indicate that in both Armenians and non-Ashkenazi Jews the responsible gene is linked to the a-globulin complex on the short arm (p) of chromosome 16.’-5 Proximity to the microsatellite markers in D16S283 and D16S291 is considered, by the researchers, to allow a preclinical diagnostic test in "most pedigrees with affected individuals".’5 Whereas the biochemical basis for FMF remains unclear (although chromosomal location of the gene should assist
1779