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Revista Panamericana de Salud Pública
ORIGINAL RESEARCH INVESTIGACIÓN ORIGINAL
Physical activity and overweight among adolescents on the Texas-Mexico border
La actividad física y el sobrepeso en adolescentes que viven en la frontera mexicanoestadounidense
Adriana PérezI, II, *; Belinda M. ReiningerII, III; María Isabel Aguirre FloresIV; Maureen SandersonII, V; Robert E. RobertsVI
IThe University of Texas Health Science Center at Houston, School of Public Health, Division of Biostatistics, Brownsville, Texas, United States of America
IIHispanic Health Research Center, Brownsville, Texas, United States of America
IIIThe University of Texas Health Science Center at Houston, School of Public Health, Division of Health Promotion and Behavioral Sciences, Brownsville, Texas, United States of America
IVSecretaría de Educación de Tamaulipas, Ciudad Victoria, Tamaulipas, México
VThe University of Texas Health Science Center at Houston, School of Public Health, Division of Epidemiology, Brownsville, Texas, United States of America
VIThe University of Texas Health Science Center at Houston, School of Public Health, Division of Health Promotion and Behavioral Sciences, Houston, Texas, United States of America
OBJECTIVE: To investigate differences in associations between physical activity and over-weight for students in two adjacent areas on the border between Mexico and the United States of America: students in the city of Matamoros, Mexico, and Mexican-American students in the Lower Rio Grande Valley (LRGV) area of southern Texas. Since the extremely high prevalence of overweight among Mexican-American adolescents is well-recognized, we wanted to determine whether overweight has become a problem among Mexican adolescents as well.
METHODS: Students from 6 schools (n = 653), representing 11% of the ninth-grade students in Matamoros during 2002–2003, and students from 13 high schools (n = 4 736), representing 22% of the ninth-grade students in the LRGV during 2000-2001, completed questionnaires. Polytomous logistic regression was performed to estimate the risk of being at risk for overweight (> 85th percentile to < 95th percentile of body mass index (BMI) for age and sex) and the risk of being overweight (> 95th percentile of BMI-for-age and sex) versus normal weight that were associated with measures of physical activity. For simplicity, the classification of normal weight also included underweight.
RESULTS: A higher percentage of adolescents in the LRGV were at risk of overweight (17%) in comparison with adolescents from Matamoros (15%). The percentages of LRGV and Matamoros adolescents who were overweight were identical (17%). LRGV adolescent boys (OR = 0.87, 95% CI = 0.77-0.98) who participated in team sports were less likely to be at or above the 85th percentile of BMI-for-age and sex. Although of borderline significance, Matamoros and LRGV adolescent boys who participated in physical education classes were less likely to be at risk for overweight. Among neither the Matamoros students nor the LRGV students were any of the various other physical activity categories or levels associated with being at risk for overweight or being overweight.
CONCLUSIONS: Nearly one-third of the students in both Matamoros and the LRGV are at risk for overweight or are overweight. Implementation of interventions on healthful dietary choices and participation in physical education classes and sports teams are essential for reducing the extremely high prevalence of overweight among students on both sides of the Texas/Mexico border.
Key words: Overweight, obesity, physical fitness, adolescent, Mexican Americans, Mexico, Texas.
OBJETIVO: Investigar si hay diferencias en las asociaciones entre la actividad física y el sobrepeso observadas en estudiantes de dos zonas colindantes en la frontera mexicanoestadounidense: estudiantes de la ciudad de Matamoros, México, y estudiantes mexicanoestadounidenses del valle a lo largo de la desembocadura del Río Bravo (VRB) en la parte sur del estado de Texas. Dada la consabida prevalencia extremadamente alta de sobrepeso en adolescentes mexicanoestadounidenses, los autores queríamos determinar si el sobrepeso también se ha convertido en un problema entre adolescentes mexicanos.
MÉTODOS: Estudiantes de 6 escuelas (n = 653), que comprenden 11% de los estudiantes de noveno grado en Matamoros durante 2002–2003, y estudiantes de 13 bachilleratos (n = 4 736), que comprenden 22% de los estudiantes de noveno grado del VRB durante 2000–2001, contestaron cuestionarios. Se llevó a cabo una regresión logística politómica a fin de calcular el riesgo de estar en riesgo de tener sobrepeso (> 85.º percentil a <95.º percentil de índice de masa corporal (IMC) para la edad y el sexo) y el riesgo de tener sobrepeso (> 95.º percentil de índice de masa corporal (IMC) para la edad y el sexo), frente a un peso normal, que se asociaban con distintos grados de actividad física. En aras de la sencillez, en la clasificación del peso normal también se abarcó la insuficiencia de peso.
RESULTADOS: Un mayor porcentaje de adolescentes estaban en riesgo de sufrir sobrepeso en el VRB (17%) que en Matamoros (15%). Los porcentajes de adolescentes de VRB y de Matamoros que tenían sobrepeso fueron idénticos (17%). Los varones adolescentes en el VRB (razón de posibilidades [RP] = 0,87; IC95% = 0,77 a 0,98) que participaron en deportes en equipo tuvieron una menor probabilidad de estar en riesgo de tener sobrepeso. No se encontraron asociaciones entre ningunas de las demás categorías de actividad física por un lado, y estar en riesgo de sufrir sobrepeso o tener sobrepeso por el otro, ni en estudiantes de Matamoros ni en los del VRB.
CONCLUSIONES: Casi una tercera parte de los estudiantes tanto en Matamoros como en el VRB está en riesgo de tener sobrepeso o tiene sobrepeso. La puesta en práctica de intervenciones para fomentar hábitos alimentarios sanos y la participación en clases de educación física y en deportes en equipo es una medida esencial para reducir la prevalencia extremadamente alta de sobrepeso observada en estudiantes a ambos lados de la frontera entre México y Estados Unidos.
Palabras clave: Obesidad, peso corporal, acondicionamiento físico, adolescente, Americanos Mexicanos, México, Texas.
Health risk behaviors established during childhood create behavioral patterns that extend into adulthood and contribute to leading causes of morbidity and mortality (1). For example, low levels of physical activity established in childhood have been shown to contribute to overweight and obesity among adults (2). In recent years an extremely high prevalence of being at risk of overweight or being overweight among adolescents has been reported in the United States of America and in other nations (2–4). Food consumption (particularly of calorie-dense foods) and lack of physical activity have been associated with obesity, coronary artery disease, and type 2 diabetes (5–8).
Objective 22-6 of the Healthy People 2010 publication (9) establishes guidelines for moderate physical activity among adolescents in the United States, and the 2005 Dietary Guidelines for Americans (10) provides consistent recommendations for children and adolescents. Healthy People 2010 (9) suggests that adolescents engage in moderate physical activity for at least 30 minutes per day on five or more days per week, and in vigorous physical activity that promotes cardio-respiratory fitness for at least 20 minutes per day three or more days per week. Based on United States national data from the Youth Risk Behavior Survey, the prevalence of moderate physical activity among ninth-grade schoolchildren of all ethnicities was 28.3% for males and 22.3% for females (1). The prevalences of moderate physical activity were lower among Hispanic adolescent boys (23.3%) and girls (20.6%) (1). A similar pattern was seen for the prevalence of vigorous physical activity, where male (73.1%) and female (63.6%) ninth-grade schoolchildren of all ethnicities had higher prevalences than did Hispanic males (66.7%) and females (51.8%) (1). Limited information has been found concerning the prevalence of physical activity in Mexico. Hernández et al. (11, 12) reported 1.8 hours per day (± 1.3 hours per day standard deviation) as the average of moderate and vigorous physical activity combined among schoolchildren 9– 16 years old in Mexico City.
Our study investigated patterns of specific risk behaviors among Mexican-American and Mexican youths by gender. The objective of the research was to determine whether an association exists between physical activity and overweight among ninth-grade students in the city of Matamoros, Tamaulipas, Mexico, which is in northeastern Mexico, on the border with the United States. Additionally, we wanted to compare the results from Matamoros with the results for Mexican-American youth living directly across the border in the Lower Rio Grande Valley (LRGV) area of the state of Texas. A strength of this comparison is that most of the students in the LRGV area are of Mexican descent and live in close proximity to Matamoros, thus minimizing cultural and acculturation differences between the two areas. Since the extremely high prevalence of overweight among Mexican-American adolescents is well-recognized, we wanted to determine whether over-weight has become a problem among Mexican adolescents as well.
Lower Rio Grande Valley survey and participants
During the 2000–2001 school year the Lower Rio Grande Valley Youth Risk Behavior Survey (LRGV-YRBS) was conducted. The primary objective of the LRGV-YRBS was to determine health risk behaviors that contribute to adolescent morbidity and mortality in the four southernmost counties of Texas (Cameron, Hidalgo, Starr, and Willacy). (This LRGV-YRBS survey was not part of the national YRBS done in the United States.) A full description of the LRGV-YRBS study design, participants, and sample has been provided previously (13, 14), so only a brief summary will be given here. Specifically, this survey measured behaviors related to (1) unintentional injuries and violence, (2) tobacco use, (3) drug and alcohol use, (4) sexual behaviors, (5) diet and physical activity, (6) sleep and work patterns, (7) suicidal thoughts, (8) suicidal behaviors, (9) depression, and (10) anxiety. The LRGV-YRBS questions on unintentional injuries, violence, tobacco use, drug and alcohol use, sexual behaviors, diet, and physical activity were based on the national YRBS (1), which was conducted by the Centers for Disease Control and Prevention (CDC) of the United States.
In the 2000–2001 school year there were over 21 500 ninth-graders enrolled in the 40 public high schools in the LRGV area. A sample of 18 public high schools with ninth-grade school-children representative of the LRGV population was selected using a stratified multistage probabilistic sampling design, but 5 of the schools refused to participate. The resulting sample included 5 118 respondents from 13 public high schools, representing 24% of the ninth-grade students. For this study we restricted our analysis to 4 736 students (22% of the ninth-grade students) who reported they were Mexican-American and who did not have missing values on sex, age, and the adjustment variables of student marital status and family standard of living. This study was approved by the University of Texas Health Science Center at Houston's Committee for the Protection of Human Subjects. Passive parental permission was obtained by the school districts prior to conducting the survey. Under the supervision of a moderator, the students answered the self-administered survey questionnaire during regularly scheduled classes. Students had the opportunity to refuse participation, or they could have been absent the day of the survey, which may have contributed to the overall response rate of 67%. Self-reported height and weight, from two of the survey questions, were used to compute body mass index (BMI).
Matamoros survey, participants, and measurement of height and weight
For the Matamoros survey, we forward-translated the English-language LRGV-YRBS questionnaire into Spanish and then back-translated it into English in order to ensure that the Spanish and English versions of the questionnaire were comparable. The Spanish questionnaire was also adapted using the Mexican cultural idiom. The Secretariat of Education of the state of Tamaulipas (Secretaría de Educación de Tamaulipas) added questions on family support, school support and empowerment, religiosity, and housing arrangements. A pilot study was conducted in two schools, and minor modifications were made to improve the readability of the instrument. This instrument is available upon request from the authors.
Matamoros is located across the Rio Grande River from the sister city of Brownsville (Cameron County), Texas. During the 2002–2003 school year there were a total of 28 public and private high schools in Matamoros, with 5 762 students in the ninth grade (tercero de secundaria in the Mexican school system). The Secretariat of Education of Tamaulipas provided the sampling frame used to select a representative sample of ninth-grade students. Unlike the LRGV-YRBS, the sampling frame included both public schools and private schools.
The Matamoros high schools were stratified using the total number of ninth-grade classes in each school: those with 10 or more ninth-grade classes, and those with fewer than 10 ninth-grade classes. The sampling design implemented for this cross-sectional survey was a two-stage stratified cluster design. The sample size required for this survey was estimated using as main outcomes of interest the prevalence of violent behavior and drug use among students. These behaviors, estimated to have a prevalence of 10%, were chosen because they were expected to have the lowest prevalence of risky behaviors. Thus, if the sample size was sufficient to detect differences in these risky behaviors, it would be sufficient to detect differences in all risky behaviors. Assuming a type I error level of 0.05% and a precision level of 25% from the true population value, we required a minimum of 623 students.
Using an estimated participation rate of 68%, we randomly selected six high schools that had fewer than 10 ninth-grade classes and two high schools that had 10 or more ninth-grade classes. Seeking to obtain similar weights across strata of classes, we selected all ninth-grade classes from the high schools with fewer than 10 ninth-grade classes. Two high schools with fewer than 10 ninth-grade classes refused to participate. The final sample included 669 respondents, from 6 of the 28 high schools, representing 12% of ninth-grade students in Matamoros during 2002–2003. For this manuscript we restricted our analysis to 653 students (11%) who did not have missing values on age and the adjustment variables of student marital status and family standard of living.
The consent form for participation in this study was approved by the Committee for the Protection of Human Subjects at the University of Texas Health Science Center at Houston. The form required the active consent of a parent or guardian. Students who did not receive parental authorization or who forgot to bring the signed consent form to school were given other written activities (e.g., crossword puzzles) to do while the students who had consent completed the survey. Under the guidance of a trained moderator the students answered the self-administered questionnaire during a regularly scheduled class. The overall response rate was 58%.
Using a standard protocol, trained project staff measured the height and weight of each student, in a predesignated area in each school. The adolescents removed any heavy clothes and their shoes before being measured. Height was measured to the nearest 0.1 cm with the portable PE-AIM-101 stadiometer unit (Perspective Enterprises, Portage, Michigan, United States). Weight was measured to the nearest 0.1 kg with the portable BWB-800S digital scale with a remote display (Tanita, Arlington Heights, Illinois, United States) calibrated to 250 lb (113 kg) before each series of measurements. Project staff wrote both measures directly on the student questionnaires.
For quality control we randomly selected 7% of the students to remeasure. The Lin concordance correlation coefficient for agreement (15, 16) was 0.976 for height and 0.993 for weight. The Pearson correlation coefficient, a measure of precision, was 0.977 for height and 0.994 for weight. The bias correction factor, a measure of accuracy, was 0.998 for height and 0.999 for weight. For all survey respondents in Matamoros, body mass index (BMI) was calculated using the standard equation of weight in kilograms divided by the square of the height in meters.
Lower Rio Grande Valley and Matamoros BMI classification and questions about personal life situation, physical activity, and attempted weight control
Using the current United States BMI-for-age and sex growth charts (http://www.cdc.gov/growthcharts/), the adolescents in the LRGV and in Matamoros were classified as normal weight (< 85th percentile), at risk of overweight (> 85th percentile to < 95th percentile), or overweight (> 95th percentile). For simplicity, our classification of normal weight included underweight.
Two questions on personal life situation were examined. Students' marital status was asked as "Some people get married before they turn 18. Which of the following best describes you?". We used the following categories of response: (1) single, never married; (2) living with a partner or significant other, but not married; (3) married; and (4) separated, divorced, or widowed. The family's standard of living was asked as "What best describes your family's standard of living? Economically, would you say your family is. . .". We used the following categories of response: (1) very well-off, (2) living very comfortably or just getting along, and (3) nearly poor or poor.
Five measures of physical activity were examined and dichotomized as physically active or inactive. The criteria for active were: (1) vigorous-intensity physical activity in three or more sessions per week, lasting at least 20 minutes each; (2) moderate-intensity physical activity in five or more sessions per week, lasting at least 30 minutes each; (3) strength training in three or more sessions per week; (4) enrollment in physical education classes; and (5) participation on one or more sports teams.
One question was used to assess television viewing: "On an average school day, how many hours do you watch TV?". We dichotomized it as three or more hours per day during an average school day versus less than three hours per day.
Six measures of attempted weight control were examined with a time frame of "during the past 30 days." The six questions used for assessment were: (1) "Did you exercise to lose weight or to keep from gaining weight? (yes/no)"; (2) "Did you eat less food, fewer calories, or foods low in fat to lose weight or to keep from gaining weight? (yes/no)"; (3) "Did you go without eating for 24 hours or more (also called fasting) to lose weight or to keep from gaining weight? (yes/no)"; (4) "Did you take any diet pills, powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight? (Do not include meal replacement products such as Slim·Fast) (yes/no)"; (5) "Did you vomit or take laxatives to lose weight or to keep from gaining weight? (yes/no)"; and (6) "Which of the following are you trying to do about your weight? (lose weight, gain weight, stay the same weight, or I am not trying to do anything about my weight)".
Data management and statistical analysis for the Lower Rio Grande Valley and for Matamoros
The LRGV students completed Scantron forms, which were scanned for data entry. The Matamoros questionnaires were scanned using Snap version 6.0 software (17). Verification and inconsistencies were assessed using SAS version 9.1 software (18). We computed probabilistic sampling weights to account for differential inclusion probabilities in the cluster sampling at the school level. Sampling weights were the inverse of the selection probability for the sampling ratio at each stage of selection. In the LRGV, ratio adjustment for ninth-grade students enrolled in all public high schools was implemented using the total school enrollment. In Matamoros, nonresponse adjustment and ratio adjustment for ninth-grade students enrolled in all public and private high schools were implemented using the sampling frame provided. The nonresponse adjustment accounted for students who refused to complete the questionnaire and students who were absent the day of the survey. The ratio adjustment was done to ensure that the gender composition of the samples was the same as that of the total school enrollment in the LRGV and Matamoros. Sample design characteristics, including the clustering of students within schools and stratification of the sample, were accounted for using the sampling weights. Weighted percentages, means, standard errors, and test statistics were calculated using SUDAAN version 9.0.0 software (19). Polytomous logistic regression analyses were performed to estimate the risk of at risk for overweight (> 85th percentile to < 95th percentile of BMI-for-age and sex) and to estimate the risk of overweight (> 95th percentile of BMI-for-age and sex) versus normal weight. The exposures that were investigated included physical activity, watching television, and attempted weight control. We reported associations for girls and boys separately. All estimates were adjusted for the students' perceptions of their family standard of living and for the students' marital status. The proportional odds ratio assumptions (20) held for these data in the LRGV and Matamoros. For this reason, only one set of odds ratios is presented in our results. For example, this model assumes that the odds of being at risk of overweight compared to being normal weight is proportional to the odds of being overweight compared to being at risk for overweight or being normal weight for a particular independent variable.
Table 1 presents the demographic characteristics, BMI classification, types and levels of physical activity, number of hours of television watched, and attempts to lose weight among students in Matamoros and in the LRGV. The median age of the adolescents in Matamoros was 14 years, and it was 15 years in the LRGV. There were statistically significant differences between LRGV girls and LRGV boys in marital status (P = 0.002). In the LRGV, we observed a greater proportion of adolescents who were married; living with a partner or significant other but not married; or separated, divorced, or widowed than was true in Matamoros. There was no significant difference in marital status between the Matamoros girls and the Matamoros boys. There were statistically significant differences in the family's standard of living between girls and boys in both Matamoros (P = 0.0174) and the LRGV (P = 0.01).
The LRGV boys were more likely to be at or above the 85th percentile of BMIfor-age than were the LRGV girls (P = 0.002) (Table 1). The difference between Matamoros girls and Matamoros boys was not significant (P = 0.072) (Table 1). The overall prevalence of at risk for overweight was 15% in the Matamoros students and 17% in the LRGV students. The overall prevalence of overweight was 17% in both the Matamoros students and the LRGV students.
Of the Matamoros students, 97.7% were classified as active in one or more of the physical activity measures, compared with 85.4% of the LRGV students (Table 1). Just over 7% of the Matamoros students and just over 9% of the LRGV students were classified as active on all five measures of physical activity. In both Matamoros and the LRGV, of any of the measures of physical activity, students were the least likely to engage in moderate intensity physical activity. In both Matamoros and the LRGV, adolescent boys were more likely to engage in four measures of physical activity (vigorous, moderate, strength training, and sports-team participation) than were the girls (P < 0.025 for all).
Fifty-seven percent of the students in Matamoros and 50% of the students in the LRGV watched television three or more hours per day during an average school day (Table 1). About 46% of the students in Matamoros and 64% of the students in the LRGV had exercised to lose weight or to keep from gaining weight during the 30 days preceding the survey. During the preceding 30 days, the LRGV girls were significantly more likely than were the LRGV boys to have done the following to try to control their weight: (1) exercised to lose weight or to keep from gaining weight (P = 0.011); (2) eaten less food, fewer calories, or foods low in fat (P < 0.001); (3) gone without eating for 24 hours or more (P = 0.001); (4) taken diet pills, powders, or liquids without a doctor's advice (P = 0.036); and (5) vomited or taken laxatives (P = 0.001). The LRGV girls were significantly more likely than were the LRGV boys to try to lose weight, while the LRGV boys were more likely than were the LRGV girls to try to gain weight (P = 0.002). This gender difference on trying to lose weight or to gain weight was not significant among the Matamoros students.
Table 2 presents the adjusted odds ratios (ORs), with 95% confidence intervals (CIs), from polytomous logistic regression for being at risk of over-weight (> 85th percentile to < 95th percentile BMI-for-age and sex) and being overweight (> 95th percentile of BMIfor-age and sex) versus normal weight that were associated with measures of physical activity, watching television, and attempted weight control. Adolescent boys in the LRGV who participated in sport teams were less likely (OR = 0.87; 95% CI = 0.77–0.98) to be at or above the 85th percentile of BMIfor-age. Although of borderline significance, adolescent boys in the LRGV (OR = 0.80; 95% CI = 0.63–1.02) and in Matamoros (OR = 0.40; 95% CI = 0.15– 1.08) were also less likely to be at or above the 85th percentile of BMI-forage if they participated in physical education classes. None of the remaining physical activity measures was associated with being at risk for overweight or with being overweight among Matamoros students.
In comparison with normal-weight girls, adolescent girls in both Matamoros and the LRGV who were at risk for overweight or overweight were more likely to try to lose weight by exercising, eating less food, or taking diet pills, powder, or liquids without a doctor's advice during the 30 days preceding the survey (Table 2). Adolescent girls in the LRGV who were at risk for overweight or were over-weight consistently reported that they were less likely to try to gain weight (OR = 0.10; 95% CI = 0.03–0.38).
On the other hand, adolescent boys in Matamoros who were at risk for overweight or were overweight were more likely than normal-weight boys to exercise and to eat less food in order to lose weight during the 30 days preceding the survey (Table 2). Adolescent boys in the LRGV who were at risk for overweight or were overweight were more likely to perform all five of the measures for attempted weight control. These same boys consistently reported that they were less likely to try to gain weight (OR = 0.29; 95% CI = 0.15–0.58) and more likely to try to lose weight (OR = 6.40; 95% CI = 4.10–9.98). Watching television three or more hours per day on average on a school day was not statistically associated with being at risk for overweight or overweight among the girls and boys in either Matamoros or the LRGV.
This is the first study to describe overweight, physical activity, watching television, and attempted weight control among adolescents in the city of Matamoros. In addition, we compared the results from Matamoros with those from the LRGV area across the border from Matamoros. Nearly one-third of the students in Matamoros and in the LRGV are at risk for overweight or are overweight; the prevalence of at risk for overweight and overweight was based on United States criteria (21).
Using nationwide data for Mexico collected in 2000 with measured heights and weights and applying the same CDC criteria that we did in our study, del Río-Navarro et al. (22) found that 18.3% of 14-year-old Mexican girls and 12.5% of 14-year-old Mexican boys were at risk for over-weight. When restricting the analysis to the northern region of Mexico (where Matamoros is located), the prevalence of at risk for overweight among children 10–17 years old was 17.2% for girls and 14.9% for boys (22). In comparison with their counterparts in northern Mexico overall (23), the ninth-grade girls in Matamoros had a lower prevalence of at risk for over-weight (15.0%), and the ninth-grade boys had a similar prevalence of at risk for overweight (14.5%).
In the LRGV the prevalence of over-weight among girls (11%) and among boys (23%) was lower than previously reported for Hispanic adolescents in Texas (24). For eighth-grade students in Texas in 2000–2002, Hoelscher et al. (24) reported a prevalence of over-weight of 16% among Hispanic girls and of 33% among Hispanic boys. A possible explanation for the lower estimates of overweight found in the LRGV compared to the Hoelscher et al. (23) findings for Texas overall may have been the self-reported heights and weights for LRGV students; in the Hoelscher et al. (23) study the students' height and weight were measured directly. Another explanation for the lower estimates of overweight found in the LRGV may be the small size of the LRGV sampling frame (21 500 students) versus that of the Hoelscher et al. (23) study (288 584 students).
The prevalence of overweight in the Matamoros girls (13.6%) and in the Matamoros boys (20.8%) is consistent with previously reported data (22, 24). In particular, for the northern region of Mexico, del Río-Navarro et al. (22) reported an overweight prevalence of 13.0% for girls and 14.7% for boys 10–17 years of age.
It is not surprising that physical education enrollment was similar for boys and girls in Matamoros and higher than it was for the LRGV students, given that the Mexican school curriculum requires a minimum of two class sessions during the school week, for at least 45 minutes each. The Matamoros boys were more likely to participate in physical activities than were the Matamoros girls. However, the Matamoros girls had a lower prevalence of overweight, which may be due to the girls' higher prevalence of attempting to maintain ideal weight through dieting. Our findings indicate that current physical activities do not decrease the likelihood of being at risk of overweight or of overweight. In the LRGV and in Matamoros the prevalences of having participated in vigorous and moderate physical activities were similar to those for Hispanic and ninth-grade schoolchildren in the United States. Dietary education, in combination with physical activity intervention programs, has shown promising results for school-based approaches to reducing overweight among youth (25–29).
Our data do not support some previous studies (30–33) where a substantial amount of time watching television was found to be a risk factor for at risk for overweight among adolescents. Our results are consistent with a meta-analysis of United States studies (34) that found that the relationship between TV viewing and body fatness among adolescents is likely to be too small to be of clinical relevance (34). Our results are also consistent with data from adolescents in Mexico City (11).
There are limitations to the approach that we used in this study. First, the use of cross-sectional data did not allow us to evaluate increasing or decreasing trends in this region; surveillance efforts are required to evaluate possible increasing rates of overweight. Studies indicate that it is likely that overweight adolescents remain overweight as they enter adulthood (11), and adulthood overweight has been shown to be associated with markedly increased risks of cardiovascular disease and type 2 diabetes (11, 35, 36). Current data from Mexican adolescents indicate that overweight could be the basis for a growing problem of adult chronic disease (22).
A second limitation was that we conducted the survey in Matamoros during the 2002–2003 school year, two years after the survey done in the LRGV. In spite of this, the results should be comparable. Because of the lack of interventions during these two years, we did not expect any significant changes in the behavior of school-children in Matamoros. Similarly, we did not expect any significant bias in this population on the prevalence of overweight, physical activities, watching television, or measures attempting to control weight due to the lack of interventions during these two years. In addition, the data from Matamoros allowed us to adjust for nonresponse, which was not possible with the LRGV data.
Our biggest limitation was the different methods for collecting information on heights and weights in the LRGV and Matamoros. However, self-reported and direct measures of heights and weights have been found to be highly correlated (37).
In summary, we determined that overweight has become as big a problem among the Mexican adolescents as among the Mexican-American adolescents. The challenge of overcoming the extremely high prevalence of over-weight or of being at risk for over-weight among adolescents in the Texas/Mexico border region is immense. Interventions focusing on diet, diet education, and physical activities need to be implemented, along with evaluations of these intervention. These measures are essential for reducing the extremely high prevalence of over-weight among students in this region.
Acknowledgments. This research was supported by a grant from the United States National Institutes of Health National Center on Minority Health and Health Disparities (NIH CMHD P20MD000170-019001). The authors would like to thank the principals, coordinators, teachers, and other staff in the public and private schools in Matamoros for their support of this study. The authors also thank the students from the associate degree program in nursing at the University of Texas at Brownsville; the staff from Healthy Communities of Brownsville, Inc.; the staff from The University of Texas Health Science Center at Houston School of Public Health Brownsville Regional Campus; and volunteers and staff members from the Secretaría de Educación de Tamaulipas.
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10. United States of America, Department of Health and Human Services. Physical activity. In: U.S., DHHS. 2005 dietary guidelines for Americans. Available from: http://www.healthierus.gov/dietaryguidelines/ [Web site]. Accessed 5 May 2005.
11. Hernández B, Gortmaker SL, Colditz GA, Peterson KE, Laird NM, Parra-Cabrera S. Association of obesity with physical activity, television programs and other forms of video viewing among children in Mexico City. Int J Obes Relat Metab Disord. 1999;23:845–54.
12. Hernández B, Gortmaker SL, Laird NM, Colditz GA, Parra-Cabrera S, Peterson KE. Validez y reproducibilidad de un cuestionario de actividad e inactividad física para escolares de la ciudad de México. Salud Publica Mex. 2000;42:315–23.
13. Roberts RE, Lee ES, Hernandez M, Solari AC. Symptoms of insomnia among adolescents in the lower Rio Grande Valley of Texas. Sleep. 2004;27:751–60.
14. Sanderson M, Coker AL, Roberts RE, Tortolero SR, Reininger BM. Acculturation, ethnic identity, and dating violence among Latino ninth-grade students. Prev Med. 2004;39: 373–83.
15. Lin LI-K. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989;45:255–68.
16. Lin LI-K. Correction to "A concordance correlation coefficient to evaluate reproducibility" (1989 V45 p255–268). Biometrics. 2000;56: 324–5.
17. Snap. Survey Software. Mercator, Professional Edition [computer program]. Version 6. Boston: Research Group Ltd.; 2003.
18. SAS Institute Inc. SAS [computer program]. Version 9.1. Cary: SAS Institute Inc.; 2005.
19. Research Triangle Institute. SUDAAN Software for the Statistical Analysis of Correlated Data [computer program]. Version 9.0.0. Research Triangle Park: RTI; 2005.
20. Agresti A. Categorical data analysis. New York: John Wiley & Sons; 1990.
21. United States of America, National Center for Health Statistics. 2000 CDC growth charts: Available from: http://www.cdc.gov/growthcharts/ [Web site] Accessed 5 May 2005.
22. Del Río-Navarro BE, Velázquez-Monroy O, Sánchez-Castillo CP, Lara-Esqueda A, Berber A, Fanghänel G, et al. The high prevalence of overweight and obesity in Mexican children. Obes Res. 2004;12:215–23.
23. Sánchez-Castillo CP, Pichardo-Ontiveros E, López P. Epidemiología de la obesidad. Gac Med Mex. 2004;140 Suppl 2:S3–20.
24. Hoelscher DM, Day RS, Lee ES, Frankowski RF, Kelder SH, Ward JL, et al. Measuring the prevalence of overweight in Texas school-children. Am J Public Health. 2004;94:1002–8.
25. Campbell K, Waters E, O'Meara S, Summer-bell C. Interventions for preventing obesity in childhood. A systematic review. Obes Rev. 2001;2:149–57.
26. Caballero B. Obesity prevention in children: opportunities and challenges. Int J Obes Relat Metab Disord. 2004;28 Suppl 3:S90–S95.
27. Coleman KJ, Tiller CL, Sanchez J, Heath EM, Sy O, Milliken G, et al. Prevention of the epidemic increase in child risk of overweight in low-income schools: the El Paso Coordinated Approach to Child Health. Arch Pediatr Adolesc Med. 2005;159:217–24.
28. Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, et al. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch Pediatr Adolesc Med. 1999;153:409–18.
29. Jago R, Baranowski T. Non-curricular approaches for increasing physical activity in youth: a review. Prev Med. 2004;39:157–63.
30. Dietz WH, Jr., Gortmaker SL. Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics. 1985;75:807–12.
31. Francis LA, Lee Y, Birch LL. Parental weight status and girls' television viewing, snacking, and body mass indexes. Obes Res. 2003;11: 143–51.
32. Gordon-Larsen P, Adair LS, Popkin BM. Ethnic differences in physical activity and inactivity patterns and overweight status. Obes Res. 2002;10:141–9.
33. Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986–1990. Arch Pediatr Adolesc Med. 1996;150:356–62.
34. Marshall SJ, Biddle SJ, Gorely T, Cameron N, Murdey I. Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. Int J Obes Relat Metab Disord. 2004;28:1238–46.
35. Goran MI, Ball GD, Cruz ML. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab. 2003;88:1417–27.
36. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113:475–82.
37. Strauss RS. Comparison of measured and self-reported weight and height in a cross-sectional sample of young adolescents. Int J Obes Relat Metab Disord. 1999;23:904–8.
Manuscript received 1 June 2005. Accepted for publication 15 August 2005.
* Send correspondence to: Adriana Pérez, 80 Fort Brown, SPH Building, Room N2.200, Brownsville, Texas 78520, United States of America; telephone: 956-882-5160; fax: 956-882-5153; e-mail: adriana.perez@utb.edu
Organización Panamericana de la Salud Washington - Washington - United States
E-mail: contacto_rpsp@paho.org


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Note these dates in your calendars and come out to meet your Parent Council!!
Generally the third Monday of the month, 6:30pm in the Staff Lounge at 679 Prestwick Circle.
Special Guests: Music and Phys. Ed.
Summer flew this year in a way that was bolder and faster than ever in our house! Hard to imagine it will be our daughters last year at MTS this year! Wasn't it just Kindergarten Orientation? That being said, you and your child/ren may have moved on from our school and group, and if that is the case, please respond to this message to be removed from the mailing list.
Hello McKenzie Towne School Families!
It was so nice to see you all out at our Annual Muffin Mixer this week! I am glad to have the first week of school under our belt, those mornings are never easy the first week.
I wanted to send out a quick reminder that our first Parent Council Meeting will be this Monday, September 11th, at McKenzie Towne School in the teachers Lounge at 6:30 pm sharp. There are some exciting opportunities to support your child's learning this year, and this is a great meeting to learn about those and meet your 2018 parent council.
We hope you can make it out, and I look forward to serving as your Key Communicator for another school year. Here's to another year of late night, poorly edited shout outs from MTSPA!
Plants that were left behind!!
Veggie Fundraiser Pick Up Tomorrow from 3-5pm At MTS!!
Veggie Fundraiser Pick Up Tomorrow from 3-5pm At MTS!! Don't forget to come to the school to pick up your order!!! See you there!
Very Important Council Meeting This Monday!
Why is parent council amazing? Is it the feeling of community you get at the meetings? Is it the insider knowledge you take away from the administrative and teaching teams? Is it having a voice that truly makes a difference in your child's education? YES!! Simply put, it is all of these things and more!
Please come out to parent council this Monday, more than ever, our group needs your involvement. Meet us in the teacher's lounge at 630 pm, May 29th.
We hope you can make it out this Monday, April 23, to our next parent council meeting!
Just a few reminders, MTS pride wear orders are due tomorrow, Friday April 21st. Plant orders are coming soon, so if you ordered some amazing veggies, remember to mark May 25th on your calendar for pick up.
We still have a partnership with Allstate, Cobs and Mabel's Labels. All great ways to support Mckenzie Towne School and the excellent programs and services we get the pleasure of offering the students.


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Home 1gridPREPS 2018-19 athletic season: Overland's new softball field highlights Cherry Creek district changes
Z PM edition - LOCAL
2018-19 athletic season: Overland's new softball field highlights Cherry Creek district changes
AURORA | Softball will be played on the Overland High School campus for the first time in the upcoming 2018 fall season.
Given that the school opened in 1978, that's a really long time to wait for a first pitch.
But the Trailblazers — who have played on various diamonds across the street from the school in Utah Park since softball became a Colorado High School Activities Association sanctioned sport in 1987 — have a sparkling new field on the corner of South Peoria Street and East Jewell Avenue.
"It's been a long time coming; our girls have deserved a field that we can call their own for many years," third-year Overland athletic director Ryan Knorr said.
"We are incredibly happy with what the district has done to help us get here…At no point did anybody balk at the idea that our girls deserve a field."
The Overland softball field is really the only large athletic facilities improvement for the Cherry Creek School District as a whole ahead of the 2018-19 prep season, which begins with practice Aug. 6 in a variety of sports.
Knorr said discussions had taken place in the last few years between Overland and the City of Aurora to enhance the field at adjacent Utah Park — which is part of a long-standing Intergovernmental Agreement (IGA) between the two entities — but a consensus developed to build a field on school grounds.
The practice football and lacrosse field on the northwest corner of the campus became the logical site for the softball field and construction began in the spring.
The project was headed by Doug Blue, the district's longtime manager of grounds and irrigation.
Work ramped up in May just before school let out, continued through the summer and needs just a few more finishing touches, such as bleachers and the installation of a scoreboard that Knorr feels will bring the whole project together. The field also has an enclosed hitting cage next to it that Utah Park did not.
Overland's first game on the new field is currently scheduled for Aug. 18, but that may change as Knorr attempts to put together more of an opening ceremony.
"I'm extremely excited for the Overland community and for the girls softball players to have a place to call their own," CCSD athletic director Larry Bull said.
Last year, CCSD finished a similar project for the Cherry Creek softball team at the Village Greens Park near the school's campus. The district has an IGA with the City of Greenwood Village as well.
Though softball is now finished at Utah Park, it remains very much a part of Overland's athletic base. The baseball team continues to use the recently refurbished Tony Schenbeck Field, while the boys and girls swim teams and boys and girls tennis squads also use the facilities at the park.
Other than the Overland softball field and new bleachers for Eaglecrest in "The Nest," the theme for CCSD athletically is continuity.
Bull is pleased to have the same group of high school athletic directors in Steve Carpenter (Cherokee Trail), Vince Orlando (Eaglecrest), Wesly Smock (Grandview), Knorr (Overland) and John Thompson (Smoky Hill) plus Jason Wilkins (Cherry Creek), while the activities directors at each school also stayed the same.
That should allow the district to pick up the momentum it had last season when athletes and teams won a slew of Class 5A state team and individual championships.
There are a few differences Bull noted, including the new calendar (on which athletic practices begin Aug. 6, while school doesn't begin until Aug. 13) and a new superintendent, as Scott Siegfried — a great supporter of athletics — has replaced Bull's brother, Harry.
One exciting change comes in football, where the Colorado High School Activities Association's latest realignment plan has brought district teams into the same conference again after a two-year hiatus.
The new Metro East Conference again mirrors the Centennial League with district teams Cherokee Trail, Cherry Creek, Eaglecrest, Grandview and Overland joined by Arapahoe.
Smoky Hill — now under the direction of highly successful veteran Colorado coach Tom Thenell — is part of the 10-team Metro 10 conference.
"I think getting the league rivalries back in the district is very exciting," Bull said.
"There's a lot of excitement about the upcoming season around here."
2018-19 prep athletic season
CCSD athletic improvements
Cherry Creek School District
Cherry Creek schools
Doug Blue
Jason Wilkins
Larry Bull
new softball field
Overland High School
Overland softball
Ryan Knorr
Steve Carpenter
Vince Orlando
Wesly Smock
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Top rated barely coherent movies that are also overemphasizing
Check out today's highest ranked barely coherent and overemphasizing movies! Looking for the greatest movies of all times? Here is the list of the best movies that are barely coherent and overemphasizing, based on the crowd's interest and popular searches from the country. Maimovie provides context-aware recommendation based on extensive data gathered and analyzed by AI.
1 Uncut Gems (2019)
A charismatic New York City jeweler always on the lookout for the next big score makes a series of high-stakes bets that could lead to the windfall of a lifetime. Howard must perform a precarious high-wire act, balancing business, family, and encroaching adversaries on all sides in his relentless pursuit of the ultimate win.
2019-08-30 | Crime / Thriller
Adam Sandler, Julia Fox
redeemable quality
breakneck pace
extremely uncomfortable
2 The Last Airbender (2010)
The story follows the adventures of Aang, a young successor to a long line of Avatars, who must put his childhood ways aside and stop the Fire Nation from enslaving the Water, Earth and Air nations.
Noah Ringer, Dev Patel
choppy editing
quite disappointing
downright laughable
3 Star Wars: Episode I - The Phantom Menace (1999)
Anakin Skywalker, a young slave strong with the Force, is discovered on Tatooine. Meanwhile, the evil Sith have returned, enacting their plot for revenge against the Jedi.
1999-05-19 | Adventure / Action
Liam Neeson, Ewan McGregor
less than impressive
bit disappointing
comedown
4 The Da Vinci Code (2006)
A murder in Paris' Louvre Museum and cryptic clues in some of Leonardo da Vinci's most famous paintings lead to the discovery of a religious mystery. For 2,000 years a secret society closely guards information that — should it come to light — could rock the very foundations of Christianity.
2006-05-17 | Thriller / Mystery
Tom Hanks, Audrey Tautou
completely hooked
religious zealot
faithful adaptation
5 The Iron Lady (2011)
2011-12-30 | History / Drama
Meryl Streep, Anthony Stewart Head
political view
brief glimpse
6 The Blair Witch Project (1999)
In October of 1994 three student filmmakers disappeared in the woods near Burkittsville, Maryland, while shooting a documentary. A year later their footage was found.
1999-07-14 | Horror / Mystery
Heather Donahue, Michael C. Williams
irrational acting
genuinely chill
7 The Hitchhiker's Guide to the Galaxy (2005)
Mere seconds before the Earth is to be demolished by an alien construction crew, Arthur Dent is swept off the planet by his friend Ford Prefect, a researcher penning a new edition of "The Hitchhiker's Guide to the Galaxy."
2005-04-28 | Adventure / Comedy
Martin Freeman, Zooey Deschanel
moderately entertaining
rapid fire dialogue
8 Star Wars: The Last Jedi (2017)
Rey develops her newly discovered abilities with the guidance of Luke Skywalker, who is unsettled by the strength of her powers. Meanwhile, the Resistance prepares to do battle with the First Order.
2017-12-13 | Science Fiction / Action
Mark Hamill, Carrie Fisher
geeking out
conclusive ending
9 The Other Guys (2010)
Unlike their heroic counterparts on the force, desk-bound NYPD detectives Gamble and Hoitz garner no headlines as they work day to day. When a seemingly minor case turns out to be a big deal, the two cops get the opportunity to finally prove to their comrades that they have the right stuff.
2010-08-06 | Action / Comedy
Will Ferrell, Derek Jeter
comedic flairs
quite a few laughs
comic gem
10 Star Wars: The Force Awakens (2015)
Thirty years after defeating the Galactic Empire, Han Solo and his allies face a new threat from the evil Kylo Ren and his army of Stormtroopers.
Harrison Ford, Mark Hamill
triangular plot
relatively new
Related movies to barely coherent & overemphasizing by Maimovie
Top rated barely coherent movies on Netflix
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Top rated barely coherent movies on Amazon Prime Video
Top rated barely coherent movies on Shudder
Top rated barely coherent movies on Acorn TV
Top rated barely coherent movies on Hulu
What are recommended movies of Top rated barely coherent movies that are also overemphasizing?
The recommended movies of Top rated barely coherent movies that are also overemphasizing are Uncut Gems, The Last Airbender, Star Wars: Episode I - The Phantom Menace, The Da Vinci Code, The Iron Lady, The Blair Witch Project, The Hitchhiker's Guide to the Galaxy, Star Wars: The Last Jedi, The Other Guys, Star Wars: The Force Awakens.
How did people review the movies in Top rated barely coherent movies that are also overemphasizing list?
According to the review analysis on Maimovie, movies in Top rated barely coherent movies that are also overemphasizing list are rated as constant flow, non-existent character development, redeemable quality, grated voice, stilted dialogue, ticked off, unprofessionally produced, infuriated, zero character development, eagerly waited.


For those unfamiliar with supermarkets in Spain, there are few these days that are good and most verge on repugnant (Mercadona.) One of the ones that has historically been the mecca of all bargain dwellers was Lidl although in recent years something happened and, if you look carefully, you can actually find quite tasty items hidden in the folds of their junk food, soda, and mass-produced bread.
I speak mainly of their wine section in this regard. While typically full of bottles that aren't fit to bathe a stray cat with, every so often they pull out some random wine that is of merit. How they came in to possession of said wine should probably go without mention, but for the crafty shopper, they are there to find.
And this brings us to Domaine de Pignan from Châteauneuf-du-Pape for 12€. For those who haven't followed the general upward trend of Châteauneuf wines/prices, good bottles typically start at about 20€ if not 30€ thus a wine for 12€ seems immediately suspect.
Long story short, it's a damned fine wine. Jancis Robinson even gave it 17 points a couple of years ago. In that review she stated that it would be prime to drink from 2014-2020. As we are here in 2015, I would have to say, well-called as the initial bottle I bought was great and indeed felt it could stand even a bit longer.
Brisk red fruit, very much alive and vibrant, ruby/brown in color with only mild rim variation. Slightly oxidative and vegetal in the nose with a touch of chalkiness and pronounced freshly-cut rosemary. Even in the mouth, red fruit stays prevalent with cherry and young plum notes that carry in to the finish. Could easily stand another 2-3 years.


Play new game Crazy-jump.io for free online at our website Iogamescom.com. As other games on our website, you can play this game in your browser, your mobile and enjoy it for free as well. As you know, it is a funny io game. In this game, you will get an opportunity to smash. You will use your mouse to direct your gummy person and then left click to jump up and smash down. Your task here is to try to kill your enemies as more as possible. Please run, jump, and smash your way to victory in this elegant and engaging arena battler. Your strategy in this game is to try and attack opponents closer to the edge of a cliff in order to knock them out of the game permanently. This game is simple but it is very funny and interesting. I hope that you will like this game and come back here to play more game. Have fun playing this game called Crazy-jump.io!
You will use your mouse to control your character.


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Since 1999, Fox-Miles & Associates, Inc. Licensed Insolvency Trustee has been helping Edmonton-area residents (including clients from Hinton and Sherwood Park) through financial difficulties. Call us today at 780-444-3939 to make an appointment.


A Predicamen is a horror story by Edgar Allan Poe.
The main character in A Predicament is a woman who is the protagonist. The conflict in this story was Person vs. Fate. I think it is this because the antagonist is time. She can't run away all she can do is wait for her fate. In the beginning of the story there is a exposition. This is where the background of the characters is explained in the beginning of the story. In this story there is definitely symbolism. Also there is an allegory. ...one step remained. One step! One little, little step! Upon one such little step is the great staircase of human life how vast a sum of human happiness or misery depends! I thought of myself, then of Pompey, and then of the mysterious and inexplicable destiny which surrounds us I thought of my many false steps which have been taken and may be taken again." This shows the symbolism between taking step on a staircase and taking steps in life.


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Famous trout streams too hot, too low
Victor Whitman,Times Herald-Record
Roscoe — Trout Town is quickly becoming drought town.
The Beaverkill and the Willowemoc, world famous trout-fishing streams and the lifeblood of this north Sullivan County fishing haven, are off-limits for fishing.
The problem: The streams are too low and too hot.
Anglers are being encouraged to pack up their tackle and move to no-name streams in other parts of Sullivan.
Legally, you can still fish at Junction Pool and the scores of famous holes where the sport of fly-fishing was practically invented, but you'll get sour looks from locals and anglers who consider it unethical.
Two months of dry and hot weather have drained the streams to a trickle in places and heated the water to 72 degrees. On Monday evening, the water warmed to 78 degrees. Overly warm water contains less oxygen, putting stress on the fish. Fish cannot be caught and released safely when the water temperature tops 70.
"They can't deal with the heat," said Bob Angyal, a senior biologist at the Department of Environmental Conservation.
The DEC is recommending that anglers move to the headwaters, where water is cooler.
And rainfall is way down. Historically, Sullivan gets slightly more than 8 inches of rain in May and June. As of yesterday, just 2.2 inches have fallen in the past six weeks.
It's quite a turnaround since April, when these same streams flooded their banks in one of the most destructive floods in county history.
"It's pretty rough right now," said Bob Rumpf, a licensed professional fly-fishing guide who also works at Catskill Flies, one of three fly-fishing stores in Roscoe. "What we really need is some rain."
The Beaverkill and the Willowemoc (known collectively as the Beamoc) normally can be fished until early July. Spring — with its cool, high waters — represents the heart of the season. This unseasonably hot and dry weather has cut the season by a month. The streams have been off-limits for a week.
"We have made it through the meat and potatoes of the season," said Ken Tutalo, a licensed professional guide and owner of the Baxter House, a 100-year-old converted farmhouse that caters to fly-fishermen.
"Historically, the rivers aren't year-round fisheries — It's better to leave the rivers and fish somewhere else."
Still, the Beamoc means big business in Roscoe, where the short Main Street draws life from the narrow fishing window.
As it stands, fishing remains good on the Neversink in eastern Sullivan County and on the East and West branches of the Delaware, which is roughly a half-hour by car to the west of Roscoe. What you lose, says New Jersey fly-fisherman Jim Martin, is that special feeling of casting a lonely line on a stream that you've seen on television or read about in books.
"For the most part, they have more name recognition," he said. "There's the romance of it."
Keys to the story
The Beaverkill and Willowemoc are world famous in fly-fishing lore.
About 20,000 anglers fish the Beaverkill, Little Beaverkill, Mongaup Creek and Willowemoc each year.
Fishing is a multimillion-dollar business in Roscoe, where the Beaverkill and Willowemoc meet at the famed Junction Pool.
Under the best conditions, the water flows about 250 cubic feet per second and the water temperature is less than 60 degrees. Yesterday morning, the Beaverkill had a flow of 108 cubic feet per second and a temperature of 72 degrees. The Willowemoc had a flow of 79 cubic feet per second and a temperature of 72 degrees. Under those conditions, trout won't typically survive after release.


Greater Des Moines was awarded four 2015 Iowa Tourism Awards, including Outstanding Marketing Collaboration, Outstanding Individual Leader and two Outstanding Niche Marketing Initiative awards.
The Iowa Tourism Conference brought together nearly 300 industry representatives in Ottumwa last week for educational sessions and networking. The Iowa Tourism Awards are the highest honor given for tourism in Iowa.


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Along with personal training I also focus on nutrition. Although the personal training qualifications do include an element of nutrition I found that it left too many grey areas so I decided to develop my knowledge in nutrition in order to pass on to my clients.
This method is about educating you to make the right food choices rather than a strict meal plan for you to follow leaving you more in control of the food that you eat.
This is how it works. For one week I ask you to write a food diary listing everything that you have eaten and drank, your mood and hunger levels. There is also a detailed questionnaire for you to fill in regarding you health, lifestyle and anything else that could be related your diet.
At the end of the week I will write a report advising you on your food choices and what changes you should make based on the types of food that you are eating, micro and macronutrients and portion sizes, your Basel metabolic rate, Daily energy expenditure and the amount of calories that you are needed in order to lose weight.
This can be done as a one off or on a weekly basis. For the weekly food diary I am able to go through your meal plans for the week, i'm available to call to advise on food choices when eating out and make recommendations on a weekly basis. A full report on your food diary will be produced each week in order to help and educate you to choose the right foods.
I will be on hand via text, phone or email as your nutrition advisor to make realistic goals and changes with an understanding approach to your dietary needs, lifestyle and goals.
This service is the same as the food diary analysis but instead of doing everything via email, and phone it is done on a face to face basis. I will travel to your home and we will go through all the paperwork together.
Each week we will then meet to go through your food diary and then I will produce a report based on our meeting and listing targets for the following week.
Every Thursday, 7PM at Ullesthorpe Village Hall.
This is a unique weight loss class to get you on track with your eating habits. This is aimed at people who are not looking for a quick fix but instead are looking for long term sustainable weight loss by giving you the knowledge and tools to be in control of your own diet.
The first week you will be given a welcome pack with all the tools that you need to get you started. I also teach you how to write a food diary and ask you to do this for the next week. We will do weights and measurements which will allow you to have some 1:1 time to discuss anything that you do not wish to share with the group.
Each week there will be a new topic of discussion as well as sharing food diaries, weigh ins, measurements and time to discuss any questions you may have about weight loss. I also provide, recipe ideas, exercise programmes and fact sheets to keep you on track with your goals.
This is not just about the group session there is also a closed Facebook group where you can ask questions throughout the week and discuss things with me and other members of the group. This is a very useful tool and has proved to be very successful.


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Women with IBS experience worse quality of life than men, new research shows
Double work and a high embarrassment factor can lead to the quality of life being affected more among women than men by irritable bowel syndrome (IBS), a very common gastrointestinal disease. Even with the same level of physical pain and other symptoms, women's perceived quality of life is worse than the mens, according to new research.
"Even if the similarities are larger than the differences, there is a pattern of differences between men and women with IBS," confirms Ida Björkman, Licensed Nurse and researcher in person-centered care at Sahlgrenska Academy.
Between 10 and 15 percent of the population meets the diagnosis criteria for IBS, a condition with an irritable bowel and varying degrees of pain, abdominal swelling, gas, diarrhea and constipation.
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However, many refrain from seeking care. In some cases, because the symptoms are not so severe, but also because sufferers do not like to talk about the problems.
Gas and swelling
"You have gas, your stomach swells, you don't know what to wear and think 'I look so fat'. All of this affects women's quality of life more than the men's," says Ida Björkman
Her dissertation is based on studies of more than 500 IBS patients with medium to severe symptoms, which sometimes also lead to sickness absence from work. In the follow-up interview studies, it clearly came forth that men and women are affected in slightly different ways.
"The gastrointestinal symptoms are associated with many taboos, which were harder for the women to handle; the men had a more relaxed attitude to their symptoms," says Ida Björkman.
"We also already know that stress worsens IBS. The men described work and family finances as stress factors while the women felt that they did double work and had a second shift of household work when they came home from work. This negative stress can affect the stomach in both sexes and the problems worsen," she continues.
Health diary
Ida Björkman describes the IBS sufferers as a patient group with an extremely good grasp of what they eat and do not eat, and they always have a coin in their pocket to quickly be able to go to public toilets if necessary.
The healthcare services can also play an important role for developing everyday strategies in her opinion. In one of the partial studies, a small patient group was visited twice by a nurse for person-centered support, with a follow-up visit or phone call, and kept a special health diary on their own. More studies are needed to evaluate the set-up, but the direction is clear:
"A partnership needs to be established between care provider and patient, and each individual life situation needs to be addressed. It takes more time than a regular consultation of 20 minutes, but if it reduces the suffering and means that the patients do not need as much care later on, it's a good investment," says Ida Björkman.
Posted in: Men's Health News | Medical Research News | Women's Health News
Tags: C Syndrome, Constipation, Consultation, Diarrhea, Gastrointestinal Disease, Healthcare, IBS-C, Irritable Bowel Syndrome, Pain, Research, Stomach, Stress
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The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
Gastroenterology
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Why is my account on hold?!
'Why am I on hold?!' is a common concern among students, and it's often flagged when they attempt to use one of the services provided by the university.
Aurora Banner is undergoing a major upgrade that will improve the user experience, including capabilities for automation, usability, mobility and integration.
The University of Manitoba has embarked on a journey to refresh our Aurora Banner experience and develop a new foundation that will support new capabilities for automation, usability, mobility and integration.
There are a couple of changes to the rules around the Registration Revision period, and fee payments that you should be aware of.


In 1952 Paul Jodoin, the son of a family of growers in Rougemont settled on an orchard in Saint-Damase, an orchard which still belongs to the company today.
Over time, Paul and Monique (Lavoie), his wife, continued to expand their activities by buying orchard after orchard in the same region. In 1961, the couple built a refrigerated warehouse on the orchard in St.-Jean- Baptist. In 1974 the company Vergers Paul Jodoin Inc. officially came into existence. Paul Jodoin had been the operator and administrator since its founding until 1987.
It was in November 1987 that the three Jodoin brothers Pierre, François, and Sylvain bought all the shares in the company from their father. All of them had worked in the family business from five to ten years before taking possession in 1987.
To date, the company Vergers Paul Jodoin is still owned by the three Jodoin brothers. Today, the company has over 600 acres of land, a large cold storage and controlled atmosphere, a packaging and conditioner with modern electronic controller, a processing plant for juice and other products. The company hires sixty full-time staff and hundreds at the peak time in September.
To begin, all apples are picked by hand to give you the juiciest and best apples All apples are then washed and brushed. Only the most delicious apples are specially selected and sent to the pressing stage. After pressing only once, the juice is pasteurized and shortly maintained in an aseptic tank ready for bottling. Once all the recipes are ready, we proceed to the bottling stage. In a single day, we fill the bottles with juice that is from freshly pressed apples along with several other varieties of fresh juice. It is also at this stage that we conduct the analysis and control of the product quality. Each production is analyzed to ensure impeccable quality. That is the secret to making pure juice with no added sugar, a juice that gives you the full flavor of the apple in Quebec.


Chris Hawkins: Male vocalist, guitarist. Chris provides all the male leads.
Betty Giacobazzi: Female vocalist, keyboardist.
They can have a complete sound as a two-some. Chris and Betty are very entertaining and put on a good show.
Three-Piece Band "To Be Renamed"
Phyllis Staker: Female lead vocalist, guitarist, bass pedals and harmonica.
Extremely talented and fun to watch. She provides an entertaining atmosphere and her talents are extraordinary. She adds a fantastic sound. Note that Phyllis and Karen also perform as a two-piece band.
Karen Sperlin: Vocalist, female drummer.
Karen's talents are exceptional. She is quite an entertainer. With the addition of Karen to the group, there is even a more unique sound. Note that Karen and Phyllis also perform as a two-piece band.
This group is very versatile. We can mix and match the number in the band to accommodate a small or large room. You can choose which band would work for you by looking at the size of the room and audience. Whether we perform as a two-three-or four-piece band, we can customize our selection of music to your needs. We have performed at numerous events including: festivals, private parties, clubs, special events and more. Our musical selections include: Oldies, Standards, Gospel, Country Comedy and Rock 'N Roll. We take special requests and take pride in putting on a good show.


Partitioned views allow the data in a large table to be split into smaller member tables. The data is partitioned between the member tables based on ranges of data values in one of the columns. The data ranges for each member table are defined in a CHECK constraint specified on the partitioning column. A view that uses UNION ALL to combine selects of all the member tables into a single result set is then defined. When SELECT statements referencing the view specify a search condition on the partition column, the query optimizer uses the CHECK constraint definitions to determine which member table contains the rows.
The application that populates May1998sales must make sure that all rows have 5 in the OrderMonth column and that the order date specifies a date in May 1998. This is enforced by the constraints defined on the table.
For example, the following SELECT statement queries for information about specific months.
The SQL Server query optimizer recognizes that the search condition in this SELECT statement references only rows in the May1998Sales and Jun1998Sales tables. Therefore, it limits its search to those tables.
To perform updates on a partitioned view, the partitioning column must be a part of the primary key of the base table. If a view is not updatable, you can create an INSTEAD OF trigger on the view that allows updates. You should design error handling into the trigger to make sure that no duplicate rows are inserted. For an example of an INSTEAD OF trigger designed on a view, see Designing INSTEAD OF Triggers.
CHECK constraints are not needed for the partitioned view to return the correct results. However, if the CHECK constraints have not been defined, the query optimizer must search all the tables instead of only those that cover the search condition on the partitioning column. Without the CHECK constraints, the view operates like any other view with UNION ALL. The query optimizer cannot make any assumptions about the values stored in different tables and it cannot skip searching the tables that participate in the view definition.
If all the member tables referenced by a partitioned view are on the same server, the view is a local partitioned view. If the member tables are on multiple servers, the view is a distributed partitioned view. Distributed partitioned views can be used to spread the database processing load of a system across a group of servers. For more information, see Federated Database Servers.
The definition of the partitioned view for current results can be changed to add the newest period and drop the oldest period.
The definition of the partitioned view for past results can be changed to add the period just dropped from the current results view. The past results view can also be updated to remove and archive the oldest period it covers.
When you insert data into the partitioned views, the sp_executesql system stored procedure can be used to create INSERT statements with execution plans that have a significant chance of being reused in systems with many concurrent users.
Removed the statement that local partitioned views are included only for backward compatibility and are in the process of being deprecated.


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Q: Upgrading PHP on MacOS Sierra I'm trying to update my php to the current version on my MacOS Sierra.

*

*When I type in vi ~/.bash-profile, all I get is a series of "~". How exactly do I update the PATH?

*sudo vi /usr/local/php5/php.d/99-liip-developer.ini gives me a ton of text, and when I try to run the next command (sudo cat /Library/Server/Web/Config/php/local.ini >> /usr/local/php5/php.d/99-liip-developer.ini) I get permission denied. How do I go about this?

A: To answer your questions:

*

*If you are not familiar with the vi editor, you probably want to use another text editor. On OS X for example (this should open TextEdit normally...):$ open ~/.bash_profileIf that does not give you TextEdit, you
can also do:$ open -a TextEdit ~/.bash_profile

*If your user doesn't have sudo permissions, you need to login as root or as a user who does have super user privileges. That would be the only way you can change that file.

redpajama_set_name: RedPajamaStackExchange


Hi, How have you been? As you have noticed recently I've posted less often than I used to. Sorry I have been unwell and struggling to get back to a stage where I can function. So atm, I'm trying to post every Wed 🙂 But I would like to know if you'll like me to post more often? If so, how often?