Parenting Practices Are Associated With Out-of-School Physical Activity in US Adolescents in 2014.

INTRODUCTION: Lack of physical activity (PA) is associated with obesity, diabetes, hypertension, cardiovascular diseases, and cancer. Parenting practices influence PA in young children. However, there is little evidence available for adolescents. We examined whether parenting practices were associated with out-of-school PA (OSPA) in US adolescents. METHODS: This cross-sectional 2019 study analyzed data from the 2014 FLASHE study, a web-based, quota-sampled survey of parent-adolescent dyads. Inclusion required survey completion and parents to live with their teen (ages 12-17 y old). Physically limited adolescents were excluded. Dyads were stratified by teen age. Exposures included parental modeling, monitoring, facilitation, restriction, guided choice, and pressure. The outcomes of interest were OSPA Youth Activity Profile scores. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using adjusted logistic regressions. RESULTS: A total of 1109 dyads were included. Guided choice increased odds of OSPA for 15- to 17-year-olds (OR = 2.12; 95% CI, 1.17-3.84). Facilitation increased odds of OSPA for 12- to 14-year-olds (OR = 2.21; 95% CI, 1.13-4.33). Monitoring decreased odds of OSPA for 15- to 17-year-olds (OR = 0.34; 95% CI, 0.20-0.57) and 12- to 14-year-olds (OR = 0.45; 95% CI, 0.27-0.74). Friend support increased odds of OSPA in 15- to 17-year-olds (OR = 4.03; 95% CI, 2.29-7.08) and 12- to 14-year-olds (OR = 3.05; 95% CI 1.69-5.51). CONCLUSION: Future interventions should prioritize (1) shared decision making for older teens, (2) access to PA opportunities for younger adolescents, and (3) promoting peer PA and friend support for everyone.

Association Between Insurance Status and Chondrosarcoma Stage at Diagnosis in the United States: Implications for Detection and Outcomes.

INTRODUCTION: Chondrosarcoma is a common primary bone tumor, and survival is highly influenced by stage at diagnosis. Early detection is paramount to improve outcomes. The aim of this study is to analyze the association between insurance status and stage of chondrosarcoma at the time of diagnosis. METHODS: A comparative cross-sectional study was conducted using the Surveillance, Epidemiology and End Results database. Patients with a diagnosis of chondrosarcoma between 2007 and 2016 were included. Exposure variable was insurance status and the outcome chondrosarcoma staging at the time of diagnosis. Control variables included tumor grade, age, sex, race, ethnicity, marital status, place of residence, and primary site. Both unadjusted and adjusted (multiple logistic regression) odds ratios (ORs) and 95% confidence intervals (CIs) were computed to estimate the association between insurance status and stage. RESULTS: An effective sample of 2,187 patients was included for analysis. In total, 1824 (83%) patients had health insurance (nonspecified), 277 (13%) had Medicaid, and the remaining 86 (4%) had no insurance. Regarding stage at diagnosis, 1,213 (55%) had localized disease, whereas 974 (45%) had a later stage at presentation. Before adjustment, the odds of being diagnosed at an advanced (regional/distant) stage were 55% higher in patients without insurance (unadjusted OR 1.55; 95% CI 1.003 to 2.39). After adjusting for potential confounders, the odds increased (adjusted OR 1.94; 95% CI 1.12 to 3.32). Variables with a significant association with a later stage at diagnosis included older age ( P < 0.001), male sex ( P < 0.001), pelvic location ( P < 0.001), and high grade ( P < 0.001). CONCLUSION: Being uninsured in the United States increased the odds of a late-stage diagnosis of chondrosarcoma by 94% when compared with insured patients. Lack of medical insurance presumably leads to diminished access to necessary diagnostic testing, which results in a more advanced stage at diagnosis and ultimately a worse prognosis. Efforts are required to remediate healthcare access disparities. LEVEL OF EVIDENCE: Level III.

Association between Knowledge of Zika Transmission and Preventative Measures among Latinas of Childbearing Age in Farm-Working Communities in South Florida.

Zika infection, an otherwise usually mild disease, is of serious public health concern due to the potential teratogenic effects of the virus. The incidence of Zika infection is difficult to document since it is mostly asymptomatic and detection of those carrying Zika is usually not possible. Currently, there is no vaccine for Zika; therefore, use of personal preventative measures is the only method of avoiding transmission. The aim of this study was to evaluate the association between knowledge of Zika transmission and the use of preventive measures among Latinas of childbearing age who lived in or near farm-working communities in South Florida. A secondary data analysis was performed on a cross-sectional study, sampling 100 Latina women aged 18⁻50 years. Sixty-nine percent demonstrated a high degree of knowledge of Zika transmission, and 68% were categorized as taking good preventative measures. Women with high knowledge were 5.86 times more likely to take good preventative measures than those with no knowledge (p-value = 0.05). Knowledge was associated with more preventative measures. Therefore, it is essential to further investigate this relationship in order to develop effective public health interventions for this population.

Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care.

BACKGROUND AND OBJECTIVES: Kangaroo mother care (KMC) is a multifaceted intervention for preterm and low birth weight infants and their parents. Short- and mid-term benefits of KMC on survival, neurodevelopment, breastfeeding, and the quality of mother-infant bonding were documented in a randomized controlled trial (RCT) conducted in Colombia from 1993 to 1996. The aim of the present study was to evaluate the persistence of these results in young adulthood. METHODS: From 2012 to 2014, a total of 494 (69%) of the 716 participants of the original RCT known to be alive were identified; 441 (62% of the participants in the original RCT) were re-enrolled, and results for the 264 participants weighing ≤1800 g at birth were analyzed. The KMC and control groups were compared for health status and neurologic, cognitive, and social functioning with the use of neuroimaging, neurophysiological, and behavioral tests. RESULTS: The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group. CONCLUSIONS: This study indicates that KMC had significant, long-lasting social and behavioral protective effects 20 years after the intervention. Coverage with this efficient and scientifically based health care intervention should be extended to the 18 million infants born each year who are candidates for the method.

Manejo preventivo del dolor postoperatorio con ketoprofeno IV y efecto ahorrador de narcoticos / Preventive management of postoperative pain with ketoprofen IV and reduction effect of narcotics

Objetivo: Existen bases teóricas que sugieren que las propiedades antiinflamatorias y analgésicas del ketoprofen, administrado durante la cirugia, y en forma regular durante el postoperatorio, pueden disminuir los requerimientos de analgésicos opioides en el control del dolor postoperatorio. El objetivo de este estudio fue el evaluar el impacto del ketoprofen en el manejo del dolor postoperatorio con morfina, administrado informa de Analgesia Controlada por el Paciente (PCA). Diseño; Estudio clínico, triplemente enmascarado, controlado con placebo, randomizado. Lugar: Hospital San Ignacio, un centro académico de tercer nivel en el cual el Departamento de anestesia ha establecido la Clínica del Dolor y desarrolla un Programa de Control Postoperatorio del Dolor. Pacientes: Sujetos entre 15 y 60 años de edad, admitidos en el Hospital San Ignacio para cirugía electiva ortopédica, ginecológica y abdominal, con riesgo operatorio bajo (ASA I-II), elegibles para PCA de acuerdo con los Criterios Estándar del Departamento de Anestesiologia. Criterios de Exclusión: embarazo lactancia, contraindicaciones para las medicaciones del estudio, alteraciones mentales, problemas del SNC o neuropatía periférica que pudiera alterar la percepción del dolor o la documentación de su severidad. Se incluyeron 198 pacientes, 2 fueron no elegibles luego de la aleatorización y fueron excluidos del análisis. Los 196 restantes fueron analizados. Intervenciones: Los candidatos fueron identificados durante la evaluación preanestésica, e invitados a participar. La inclusión definitiva se hizo durante la cirugía si en la misma no se presentaban eventos notables y su duración era menor de 4 horas. Los pacientes fueron asignados aleatoriamente a los tratamientos experimentales y Jrecibieron ketoprofen o placebo 20 minutos antes del final de la cirugía y posteriormente, cada 8 horas durante 24 horas. Una vez recuperados de la anestesia, el dolor fue evaluado cada 10 minutos por los primeros 120 minutos, luego a las 2 horas y después, cada 4 horas, como mínimo. Se utilizó una Escala Visual Análoga de O a 10 Cuando el paciente reportaba dolor de intensidad > 4/10 un bolo iv de 2,5 mg de morfina fue administrador se repitió cada 10 minutos hasta que el dolor se encontraba < 5/10. Posteriormente, hasta 0,6 mg cada 10 minutos podían ser auto-administrados por el paciente utilizando el dispositivo de PCA...