Eating habits associated with nutritional deviation in elementary school students / Hábitos alimentares associados ao desvionutricional em estudantes de educação básica

The objective of this study was to identify and analyze the index of nutritional deviation in primary schoolchildrenfrom a city in the state of Rio Grande do Sul, Brazil, to promote healthy eating. A questionnaire and anthropometricevaluation of 540 students were carried out. Body Mass Index (BMI) was measured according to the parameters of theWorld Health Organization (WHO). The results indicated that 67.9% of the students were of adequate weight and 32%had nutritional diversion: underweight (6.6%); overweight (14.4%); or obesity (10.9%). School H showed the highestpercentage of students with deviated nutritional status (43.2%): 9.2% were obese, 21.7% were overweight, and 12.3%were underweight. However, when comparing the schools by year of study, the 8th-grade classroom A of school G showedthe greatest nutritional diversion (55%). High nutritional diversion provides evidence of a health risk, since they consumelow amount of fruits and vegetables and have high consumption of foods which have high caloric values

O objetivo do estudo foi identificar e analisar o índice de desvio nutricional em estudantes de educação básica, de ummunicípio do Rio Grande do Sul (RS), na perspectiva de promoção da alimentação saudável. Realizou-se um questionárioe avaliação antropométrica de 540 estudantes. Foi identificado Índice de Massa Corporal (IMC) de acordo com osparâmetros da Organização Mundial de Saúde (OMS). Os resultados indicaram que 67,9% dos estudantes apresentarampeso adequado e 32% tem desvio nutricional, entre baixo peso (6,6%), sobrepeso (14,4%) ou obesidade (10,9%). A escolaH foi a que apresentou um maior percentual de estudantes com desvio do estado nutricional (43,2%), sendo 9,2% comobesidade, 21,7% com sobrepeso e 12,3% com baixo peso. Porém, ao comparar as turmas, foi o 8º ano A da escola G queteve maior desvio nutricional, com 55%. O elevado desvio nutricional evidenciou risco para a saúde, visto que consomembaixa quantidade de frutas e verduras e elevado consumo de alimentos de alto valor calórico

Eating habits associated with nutritional deviation in elementary school students / Hábitos alimentares associados ao desvionutricional em estudantes de educação básica

The objective of this study was to identify and analyze the index of nutritional deviation in primary schoolchildrenfrom a city in the state of Rio Grande do Sul, Brazil, to promote healthy eating. A questionnaire and anthropometricevaluation of 540 students were carried out. Body Mass Index (BMI) was measured according to the parameters of theWorld Health Organization (WHO). The results indicated that 67.9% of the students were of adequate weight and 32%had nutritional diversion: underweight (6.6%); overweight (14.4%); or obesity (10.9%). School H showed the highestpercentage of students with deviated nutritional status (43.2%): 9.2% were obese, 21.7% were overweight, and 12.3%were underweight. However, when comparing the schools by year of study, the 8th-grade classroom A of school G showedthe greatest nutritional diversion (55%). High nutritional diversion provides evidence of a health risk, since they consumelow amount of fruits and vegetables and have high consumption of foods which have high caloric values(AU)

O objetivo do estudo foi identificar e analisar o índice de desvio nutricional em estudantes de educação básica, de ummunicípio do Rio Grande do Sul (RS), na perspectiva de promoção da alimentação saudável. Realizou-se um questionárioe avaliação antropométrica de 540 estudantes. Foi identificado Índice de Massa Corporal (IMC) de acordo com osparâmetros da Organização Mundial de Saúde (OMS). Os resultados indicaram que 67,9% dos estudantes apresentarampeso adequado e 32% tem desvio nutricional, entre baixo peso (6,6%), sobrepeso (14,4%) ou obesidade (10,9%). A escolaH foi a que apresentou um maior percentual de estudantes com desvio do estado nutricional (43,2%), sendo 9,2% comobesidade, 21,7% com sobrepeso e 12,3% com baixo peso. Porém, ao comparar as turmas, foi o 8º ano A da escola G queteve maior desvio nutricional, com 55%. O elevado desvio nutricional evidenciou risco para a saúde, visto que consomembaixa quantidade de frutas e verduras e elevado consumo de alimentos de alto valor calórico(AU)

Unplanned pediatric intensive care unit readmissions: a single-center experience.

PURPOSE: The purpose of the study was to compare patients readmitted to the pediatric intensive care unit (PICU) unexpectedly within 48 hours (early), more than 48 hours from transfer (late), or not readmitted during the same hospitalization. MATERIALS AND METHODS: A retrospective study (2007-2009) was performed at a tertiary care pediatric academic hospital. Readmitted at-risk patients were grouped by timing of readmission, and a sample of nonreadmitted patients was randomly selected. Early readmissions were compared to late readmissions and to nonreadmissions. RESULTS: Of 3805 eligible patients, 3.9% had an unplanned PICU readmission with almost half occurring within 48 hours. Median times to readmission were 21.5 hours (early) and 7 days (late). Compared with late readmissions, early readmissions were more often admitted from and transferred to a surgical service, transferred on a weekend, and readmitted with the same primary diagnosis. Compared with nonreadmitted patients, independent risk factors for early readmission were admission source and respiratory support at PICU transfer. Readmitted patients had longer total PICU and hospital lengths of stay than nonreadmitted patients. Late readmissions had a higher mortality than early readmissions. CONCLUSIONS: Patients requiring an unplanned PICU readmission had worse outcomes than those without a readmission. Future studies should focus on identifying modifiable risk factors for targeted interventions.

The immune response: targets for the treatment of severe sepsis.

The clinical process of severe sepsis is characterized by extreme inflammation interlinked with potent stimulation of the coagulation cascade often followed by a state of relative immune paralysis. In this paper, we will review many of the potential therapies directed at various steps along the inflammatory cascade from modulation of inflammatory mediators eliciting the immune response, alteration of the host's immune response in both a stimulatory and depressive manner, and taming the overexuberant coagulation response triggered by the fierce coagulation-inflammation cycle. Finally, we will discuss further opportunities for research to improve our ability to design effective therapies.

Should physicians have facial piercings?

OBJECTIVE: The objective of this study was to assess attitudes of patrons and medical school faculty about physicians with nontraditional facial piercings. We also examined whether a piercing affected the perceived competency and trustworthiness of physicians. DESIGN: Survey. SETTING: Teaching hospital in the southeastern United States. PARTICIPANTS: Emergency department patrons and medical school faculty physicians. INTERVENTIONS: First, patrons were shown photographs of models with a nontraditional piercing and asked about the appropriateness for a physician or medical student. In the second phase, patrons blinded to the purpose of the study were shown identical photographs of physician models with or without piercings and asked about competency and trustworthiness. The third phase was an assessment of attitudes of faculty regarding piercings. MEASUREMENTS AND MAIN RESULTS: Nose and lip piercings were felt to be appropriate for a physician by 24% and 22% of patrons, respectively. Perceived competency and trustworthiness of models with these types of piercings were also negatively affected. An earring in a male was felt to be appropriate by 35% of patrons, but an earring on male models did not negatively affect perceived competency or trustworthiness. Nose and eyebrow piercings were felt to be appropriate by only 7% and 5% of faculty physicians and working with a physician or student with a nose or eyebrow piercing would bother 58% and 59% of faculty, respectively. An ear piercing in a male was felt to be appropriate by 20% of faculty, and 25% stated it would bother them to work with a male physician or student with an ear piercing. CONCLUSIONS: Many patrons and physicians feel that some types of nontraditional piercings are inappropriate attire for physicians, and some piercings negatively affect perceived competency and trustworthiness. Health care providers should understand that attire may affect a patient's opinion about their abilities and possibly erode confidence in them as a clinician.

Chronic pain in the ED.

There has been increasing awareness concerning the problem of acute pain in ED patients. There has, however, been little attention devoted to chronic pain in ED patients. Our purpose was to determine the extent and severity of chronic pain in adult ED patients. Adult noncritical patients were interviewed to determine if they had chronic pain. The Chronic Pain Grade scale was used to grade the severity of the pain. Four hundred seventy-six patients were enrolled. One hundred ninety-three (40.6%) had chronic pain. Sixty-five (13.7%) identified their chronic pain as the reason for the ED visit. The spine and abdomen were the most common sites of chronic pain. Those with chronic pain were more likely to be unemployed (relative risk [RR], 1.77; 95% confidence interval [CI], 1.34-2.34), disabled (RR, 3.24; 95% CI, 1.95-5.40), and have had four or more ED visits in the past year (RR, 2.47; 95% CI, 1.76-3.47). A total of 32.1% had class 3 pain (high disability, moderately limiting) and 58.0% had class 4 pain (high disability, severely limiting). Many noncritical ED patients have chronic pain. They are high users of ED services and most have not been seen in a pain clinic. Further studies are indicated to further delineate the demographics of this population and determine which patients would best be served in other healthcare settings. In an effort to improve care, ED physicians should be educated in diagnosing and treating chronic pain.