Disparities in Accuracy of Maternal Perceptions of Obesity among Hispanic Children.

Maternal perceptions of their children's weight status may limit their readiness to foster healthy habits to prevent childhood obesity. We compared maternal perceptions as measured by verbal and visual scales of their children's weight status (CWS) with measured BMI/weight-for-age percentile among 75 Hispanic mothers with at least one child aged ≤10 years. Mothers were significantly more likely to underestimate their CWS compared to measured BMI, particularly during verbal appraisals. Although maternal perceptions (verbal and visual scales) were significantly associated with measured CWS, the strength of the association was moderate (Verbal r=0.45 (95%CI:0.30, 0.57); Visual r=0.34 (95%CI:0.18, 0.48)). In no case, did parents in this study identify their children as "obese." These results underscore the need for more precise understandings about parental perceptions in order to develop better modes of communication regarding health risks of obesity and ways to modify and control unhealthy behaviors related to body weight.

Global health education in general preventive medicine residencies.

Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health.

Which CAM modalities are worth considering?

This review-with a handy at-a-glance guide-examines 8 modalities, the level of evidence behind them, and the adverse effects you'll need to keep in mind.

Screening and brief intervention for risky alcohol use.

Alcohol screening and brief intervention are effective evidence-based methods recommended by multiple major medical societies. Primary care providers are uniquely positioned to recognize patients with alcohol use problems when they utilize screening in their practices. SBI has the potential to improve patients' overall health, reduce the risk of alcohol dependence, and prevent future alcohol-exposed pregnancies.

Childhood obesity prevention interventions in childcare settings: systematic review of randomized and nonrandomized controlled trials.

OBJECTIVE: Childcare settings are an opportune location for early intervention programs seeking to prevent childhood obesity. This article reports on a systematic review of controlled trials of obesity prevention interventions in childcare settings. DATA SOURCE: The review was limited to English language articles published in PubMed, Web of Science, and Education Resources Information Center (ERIC) between January 2000 and April 2012. INCLUSION CRITERIA: childhood obesity prevention interventions in childcare settings using controlled designs that reported adiposity and behavior outcomes. EXCLUSION CRITERIA: no interventions, non-childcare settings, clinical weight loss programs, non-English publications. DATA EXTRACTION: Publications were identified by key word search. Two authors reviewed eligible studies to extract study information and study results. DATA SYNTHESIS: Qualitative synthesis was conducted, including tabulation of information and a narrative summary. RESULTS: Fifteen studies met the eligibility criteria. Seven studies reported improvements in adiposity. Six of the 13 interventions with dietary components reported improved intake or eating behaviors. Eight of the 12 interventions with physical activity components reported improved activity levels or physical fitness. CONCLUSION: Evidence was mixed for all outcomes. Results should be interpreted cautiously given the high variability in study designs and interventions. Further research needs long-term follow-up, multistrategy interventions that include changes in the nutrition and physical activity environment, reporting of cost data, and consideration of sustainability.

Demographic and geographic variations in breast cancer mortality among U.S. Hispanics.

This paper examines demographic and geographic differences in breast cancer mortality (1999 to 2009) between U.S. Hispanic and non-Hispanic women from different racial groups. Data were publically available from the U.S. Centers for Disease Control and Prevention (CDC). Four racial groups are included: American Indian/Alaska Natives, Asian/Pacific Islanders, Blacks/African Americans, and Whites. Age-adjusted rates were obtained for women ages 35-64 and 65 years and older. Hispanic mortality was generally lower than non-Hispanic mortality regardless of age, race, Census Region, State, or county. The lone exception was Hispanic Asian/Pacific Islanders residing in Hawaii. Despite generally lower rates, there was considerable variation in Hispanic breast cancer mortality within the country. Poverty, percentage of renters, and educational attainment were important explanatory factors. Analytic epidemiologic studies might explain social, cultural, and other reasons for the observed geographic variations. Such studies, in turn, could support a stronger theoretical basis for public health policy.

Antibiotic use in acute upper respiratory tract infections.

Upper respiratory tract infections account for millions of visits to family physicians each year in the United States. Although warranted in some cases, antibiotics are greatly overused. This article outlines the guidelines and indications for appropriate antibiotic use for common upper respiratory infections. Early antibiotic treatment may be indicated in patients with acute otitis media, group A beta-hemolytic streptococcal pharyngitis, epiglottitis, or bronchitis caused by pertussis. Persistent cases of rhinosinusitis may necessitate the use of antibiotics if symptoms persist beyond a period of observation. Antibiotics should not be considered in patients with the common cold or laryngitis. Judicious, evidence-based use of antibiotics will help contain costs and prevent adverse effects and drug resistance.

Aging and disease prevention.

This article reviews evidence-based recommendations for geriatric prevention disciplines and topics including health behaviors (e.g., smoking cessation, physical activity), metabolic disorders, cardiovascular diseases, cancers, immunizations, depression, the promotion of independence,and polypharmacy. Recommendations for both the one-on-one, clinic-based setting and for community-wide initiatives are covered for each topic, as appropriate.