24.8.10
Nafiu OO, Burke C, Lee J, et al. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics. 2010 Aug;126(2):e306-10. Epub 2010 Jul 5. (Original) PMID: 20603254
METHODS: Children who were aged 6 to 18 years and undergoing elective noncardiac surgeries were the subjects of this study. Trained research assistants collected clinical and anthropometric data from all patients. We calculated Pearson correlation coefficients between NC and other indices of obesity. We then determined by receiver operating characteristic analyses the optimal NC cutoff for identifying children with high BMI.
RESULTS: Among 1102 children, 52% were male. NC was significantly correlated with age, BMI, and waist circumference in both boys and girls, although the correlation was stronger in older children. Optimal NC cutoff indicative of high BMI in boys ranged from 28.5 to 39.0 cm. Corresponding values in girls ranged from 27.0 to 34.6 cm.
CONCLUSIONS: NC is significantly correlated with indices of adiposity and can reliably identify children with high BMI. NC is a simple technique that has good interrater reliability and could be used to screen for overweight and obesity in children.
16.8.10
Guideline Title Evidence-based clinical practice guideline on linear growth measurement of children.
Evidence-based clinical practice guideline on linear growth measurement of children.
Foote JM, Brady LH, Burke AL, Cook JS, Dutcher ME, Gradoville KM, Groos JA, Kinkade KM, Meeks RA, Mohr PJ, Schultheis DS, Walker BS. Evidence-based clinical practice guideline on linear growth measurement of children. Des Moines (IA): Blank Children's Hospital; 2009. 29 p. [128 references]
Guia elaborada para ayudar a los profesionales de la salud en la aplicación de conocimientos basados en pruebas para el proceso de medir el crecimiento lineal en los lactantes, niños y adolescentes que utilizan instrumentos y técnicas estandarizadas que son exactos y fiables.
Un equipo multidisciplinario de profesionales de la salud con distintas capacidades y perspectivas se organizó para desarrollar la guía de práctica clínica. El equipo estuvo integrado por enfermeras, pediatras y médicos de cabecera enfermera pediátrica y neonatal especialistas en enfermería clínica, enfermería educadores, un supervisor de enfermería, una enfermera investigadora, un endocrinólogo pediátrico, un pediatra de atención primaria, y un nutricionista pediátrico. El investigador enfermera tenía experiencia en los procesos de la práctica basada en la evidencia y sirvió como un experto en procesos. Los miembros del equipo eran todos los modelos de papel respetado y líderes dentro de sus propias disciplinas que compartían un interés en la evaluación del crecimiento y la práctica basada en la evidencia. En conjunto, representaban los puntos de vista de la práctica, la investigación, la educación, y las partes interesadas administrativas, así como usuarios previstos directriz. El equipo se reunió una vez al mes durante un periodo de un año, con los miembros del equipo con las asignaciones entre las reuniones.
5.8.10
Guide to Clinical Preventive Services, 2009 Recommendations of the U.S. Preventive Services Task Force
Recommendations of the U.S. Preventive Services Task Force
Resumen de las recomendaciones de la USPSTF con fecha del 2009. En http://www.ahrq.gov/clinic/pocketgd09/pocketgd09.pdf se puede bajar las recomedaciones.
Interesante también el manual de procedimientos de la institución descargable en http://www.ahrq.gov/clinic/uspstf08/methods/procmanual.htm
Por último su escala de grado de la recomendación se puede bajar en http://www.ahrq.gov/clinic/uspstf/grades.htm
4.8.10
Effects of a Brief Intervention for Reducing Violence and Alcohol Misuse Among Adolescents: A Randomized Controlled Trial [Original Contribution] Walton, M. A., Chermack, S. T., Shope, J. T., Bingham, C. R., Zimmerman, M. A., Blow, F. C., Cunningham,
Objective To determine the efficacy of brief interventions addressing violence and alcohol use among adolescents presenting to an urban ED.
Design, Setting, and Participants Between September 2006 and September 2009, 3338 patients aged 14 to 18 years presenting to a level I ED in Flint, Michigan, between 12 pm and 11 pm 7 days a week completed a computerized survey (43.5% male; 55.9% African American). Adolescents reporting past-year alcohol use and aggression were enrolled in a randomized controlled trial (SafERteens).
Intervention All patients underwent a computerized baseline assessment and were randomized to a control group that received a brochure (n = 235) or a 35-minute brief intervention delivered by either a computer (n = 237) or therapist (n = 254) in the ED, with follow-up assessments at 3 and 6 months. Combining motivational interviewing with skills training, the brief intervention for violence and alcohol included review of goals, tailored feedback, decisional balance exercise, role plays, and referrals.
Main Outcome Measures Self-report measures included peer aggression and violence, violence consequences, alcohol use, binge drinking, and alcohol consequences.
Results About 25% (n = 829) of screened patients had positive results for both alcohol and violence; 726 were randomized. Compared with controls, participants in the therapist intervention showed self-reported reductions in the occurrence of peer aggression (therapist, –34.3%; control, –16.4%; relative risk [RR], 0.74; 95% confidence interval [CI], 0.61-0.90), experience of peer violence (therapist, –10.4%; control, +4.7%; RR, 0.70; 95% CI, 0.52-0.95), and violence consequences (therapist, –30.4%; control, –13.0%; RR, 0.76; 95% CI, 0.64-0.90) at 3 months. At 6 months, participants in the therapist intervention showed self-reported reductions in alcohol consequences (therapist, –32.2%; control, –17.7%; odds ratio, 0.56; 95% CI, 0.34-0.91) compared with controls; participants in the computer intervention also showed self-reported reductions in alcohol consequences (computer, –29.1%; control, –17.7%; odds ratio, 0.57; 95% CI, 0.34-0.95).
Conclusion Among adolescents identified in the ED with self-reported alcohol use and aggression, a brief intervention resulted in a decrease in the prevalence of self-reported aggression and alcohol consequences.
Trial Registration clinicaltrials.gov Identifier: NCT00251212
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Un Saludo
Jose Galbe