Development and validation of a tool to assess knowledge of healthy lifestyles in early grade school children.

OBJECTIVE: Healthy habits during childhood has been of prime importance. We aimed to gather baseline information about health habits from children in kindergarten and first grade (typically ages 5-7). Our objectives were to validate the questionnaire in assessing health habits, as well as the electronic audience response system, iClicker (MPS, Gordonsville, VA), in this age group. RESULTS: The questionnaire completed by 75 kindergarteners and 66 first graders. For the first graders, questions involving healthy choices were answered correctly 78% of the time (range 8-94%) and had 84% agreement on repeat testing (range 64-93%). Questions on diabetes were answered correctly 79% of the time (range 65-94%) and had 85% agreement on repeat testing. Crohnbach's alpha was calculated to determine the reliability of the questionnaire: on the revised kindergarten questionnaire, this ranged from 0.79 to 0.81 on Day 1 and 0.84-0.97 on Day 5; for the first graders, this ranged 0.79-0.81 on Day 1 and 0.84-0.97 on Day 5. Both kindergarteners and first graders answered the simplest of the basic knowledge questions correctly > 80% of the time, with acceptable test-retest agreement. Additionally, these children demonstrated acceptable understanding of the use of the iClicker classroom response system.

Effect of animated movie in combating child sleep health problems.

OBJECTIVE: Sleep deprivation among teens is a major health issue. Only 15% of teens get 8.5 h of sleep on school nights. Sleep deprivation can lead to poor grades, sleepiness and moodiness. We undertook a study to assess the prevalence of sleep habit disturbance among elementary school students in South Texas with Hispanic ethnicity predominance. We also found how much a video based on sleep education had an impact on these children. METHOD: Once the Corpus Christi Independent School District (CCISD) approved the collection of baseline sleep data, questionnaires were administered using the Children's Sleep Habit Questionnaire (CSHQ.) These questionnaires were distributed prior to the viewing of the educational and animated movie KNIGHTS (Keep Nurturing and Inspiring Good Habits in Teen Sleep). Four months later, a random follow-up was performed and the children were requested to respond to the same CSHQ. RESULTS: 264 children from two elementary schools participated in this educational program. At baseline, 55.56% of the children had trouble sleeping. When the questionnaire was administered four months later, only 23.26% (p < 0.05) had trouble sleeping. Additionally, at baseline, approximately 60-70% children had some baseline bedtime resistance, anxiety dealing with sleep, issues with sleep duration and/or awakenings in the middle of the night. In the follow up questionnaire, results showed significant improvements in overall sleep habits, bedtime resistance, sleep anxiety and night awakenings amongst students (p < 0.05). However, no significant differences were seen in sleep duration and daytime sleepiness. CONCLUSION: Sleep deprivation and good sleep habits remain as a pervasive challenge among elementary school students. Administering an animated video about sleep education along with a provider-based education may be an effective tool for educating elementary school students and decreasing the prevalence of these sleep-related issues. Future prospective randomized studies are suggested.

Delayed recurrence of atypical pulmonary carcinoid cluster: a rare occurrence.

Carcinoid is one of the most common tumors of the gastrointestinal tract followed by the tracheobronchial tree. Bronchial carcinoid compromises 20% of total carcinoid and accounts for 1-5% of pulmonary malignancies. Carcinoid can be typical or atypical, with atypical carcinoid compromises 10% of the carcinoid tumors. Carcinoid usually presents as peripheral lung lesion or solitary endobronchial abnormality. Rarely it can present as multiple endobronchial lesion. We hereby present a rare case of an elderly gentleman who had undergone resection of right middle and lower lobe of lung for atypical carcinoid. Seven years later he presented with cough. CT scan of chest revealed right hilar mass. Flexible bronchoscopy revealed numerous endobronchial polypoid lesions in the tracheobronchial tree. Recurrent atypical carcinoid was then confirmed on biopsy.

Prolonged ventricular asystole: a rare adverse effect of hydrocodone use.

BACKGROUND: Prolonged ventricular asystole is a rare vagal reaction caused by hydrocodone use. Sinus bradycardia is a characteristic presentation of the vasovagal response; examples of other presentations include arrest or atrioventricular block. Physicians need to be aware of ventricular asystole due to vagally-mediated atrioventricular block caused by hydrocodone or other opiates. CASE REPORT: We present a case of prolonged ventricular asystole in a young patient due to a vasovagal reaction caused by the hydrocodone found in the hydrocodone/acetaminophen combination. CONCLUSIONS: Ventricular asystole can be a rare complication of hydrocodone found in hydrocodone/acetaminophen. Physicians need to be aware of this adverse effect, rather then resorting to expensive diagnostic interventions.