No abstract

This study examined the associations between severity of stunting, plasma protein concentrations and morbidity of 104 Nepali boys, aged 10±14 years, living in contrasting environments. Boys from a remote village were compared with three similarly aged urban groups: poor squatters, homeless street children, and middle-class schoolchildren. All but the middle-class group were stunted, particularly village boys whose mean height-for-age z-score (22´97, SD 0´82) indicates severe growth retardation. Stunting was significantly associated with increased plasma levels of the acute-phase protein a 1 -antichymotrypsin itself inversely related to plasma levels of albumin. Plasma ACT levels of village children (mean 1´52 g/l, SD 0´43) were three to four times higher than those of squatters and homeless street children, and five times higher than those of middle-class boys. Despite being the most severely stunted and having the most abnormal plasma protein values, village children reported the lowest burden of disease, a contradiction which may reflect exposure to sub-clinical infections or habituation to illness and low expectation of treatment. This study draws attention to the strikingly high levels of ACT and of stunting in the rural sample, and cautions on the use of uncorroborated morbidity reports across different epidemiological and socio-ecological environments. Possible mechanisms to explain the impact of illness and inflammation on growth faltering are discussed.

The article presents a description and critique of a large range of anthropological methods used in research with children in Nepal. It highlights the importance of a comparative, multidisciplinary and emic perspective. The value of empirical biological research methods, their potential for triangulation with social methods and validity for policy and programming are discussed. Data collected on physical and psychological well-being of children facilitate a comparison of homeless street children with other rural and urban control groups. The nature of researcher-informant relationships is crucial to the quality of information gleaned from traditional methods of demographic survey and observation.

Flex heart rate (HR, beats per minute) has assumed increasing importance in studies of energy expenditure and physical activity. Flex HR is defined as the mean of maximum rest and minimum exercise HR recorded during a standard test. This report examines methodological and substantive issues regarding the measurement and interpretation of population variation in flex HR values. Flex HR was determined for 80 Nepali 10–14‐year‐old boys living in contrasting physical and socioeconomic environments (31 village boys, 24 urban middle‐class schoolboys, and 25 homeless street boys). The three populations exhibited significant differences in flex HR, with villagers averaging lower values than school or homeless boys (91, 100, and 103 bpm, respectively, P < 0.0001). They also differed in mean resting HR (P < 0.0002), but not in the percentage increase of flex over resting HR. To evaluate reliability, flex HR measurements were repeated on 14 school boys after a 3‐month interval. Mean initial and repeat values were not significantly different, but discrepancies were large for individual subjects (−15 to +24 bpm). This suggests that flex HR is reliable at the population level, but not necessarily stable for individuals over time. The range of factors contributing to variation in flex HR between and within populations have implications for the use of HR monitoring to estimate levels of physical activity. © 1996 Wiley‐Liss, Inc.

Homeless children live and work independently of their families on the streets in many cities of the developing world. A survey was undertaken to compare the family backgrounds and current lifestyles of 329 six to seventeen year old Nepali boys is contrasting environments. A representative sample of 130 homeless boys is compared with three other groups of 54 rural, 62 urban squatter and 83 urban privileged school - children. Structured questionnaires and iterviews revealed considerable variation in the family background of the homeless and control populations. Homeless children belong to a variety of caste and ethnic backgrounds, with 49% of individuals being high caste. Data on family structure showed that 52% of homeless boys had both parents at home, 23% had step-parents, and only 8% were parent-less. In contrast, very few rural and urban controls (0-2%) had step-parents. For the homeless, family structure, particularly the presence of step-parents, influenced the age of first leaving home, reasons given for migration, and frequencies of home visits. The majority of homeless children visited their families at least once a year. Success on the streets, as indicated by daily earnings, is variable and influenced both by age and income-generating activity. The lifestyles and relationships of homeless boys are discussed.