Influences of Parenting Education on Development of Obesity Among Young Children.

OBJECTIVE: This project aimed to prevent obesity in high-risk infants using community health workers.ßto provide mothers with culturally appropriate nutrition and health education. METHODS: This randomized controlled trial enrolled mothers prenatally and infants at birth. Mothers were Spanish-speaking WIC participants with obesity. Trained, Spanish-fluent, community health workers visited homes of intervention mothers to encourage breastfeeding, and promote delayed introduction of solid foods, adequate sleep, limited screen time, and active play. A blinded research assistant collected data at the home. Outcomes were weight-for-length and BMI-z scores, obesity at age 3.ßyears and percent time obese during follow-up. Data were analyzed using multiple variable regression. RESULTS: Of 177 children enrolled at birth, 108 were followed to age 30...36.ßmonths. At the final visit, 24% of children were obese. Obese status at age 3.ßdid not differ between intervention and control (P.ß=.ß.32). Using BMI-z at the final visit, we observed a significant interaction between education and breastfeeding (P.ß=.ß.01). Time spent while obese from birth until age 30...36.ßmonths, by multiple variable analysis, did not show significant differences between intervention and control, but breastfed children experienced significantly less time obese than formula fed (P.ß=.ß.03). Formula-fed children in the control group, spent 29.8% of time obese, while breastfed infants in the intervention group spent 11.9% of time obese. CONCLUSIONS: The educational intervention did not prevent obesity at age 3.ßyears. However, time spent obese from birth to age 3.ßyears was best in breastfed children living in homes regularly visited by community health workers.

High-sensitivity troponin T in preterm infants with a hemodynamically significant patent ductus arteriosus.

OBJECTIVE: To investigate if a hemodynamically significant patent ductus arteriosus (hsPDA) leads to elevated high-sensitivity troponin T (hsTnT) and NTproBNP levels in serum. STUDY DESIGN: Infants <34 weeks and <1500 g were prospectively enrolled, except those with major congenital or chromosomal anomalies. An echocardiogram (ECHO) was performed and hsTnT and NTproBNP were measured within 5 days of life and repeated after treatment of hsPDA. Clinical, ECHO, and hsTnT data were analyzed using Student t-test, two proportion z-test, and regression analysis. RESULTS: Seventy infants were enrolled. Infants in the hsPDA group had lower gestation and birth weight. Mean hsTnT and NTproBNP levels in the hsPDA group were higher compared to the group without an hsPDA, with levels being 251.54 vs 161.6 pg/ml, p < 0.01 for hsTnT and 18181.02 vs 3149.23 pg/ml, p < 0.001 for NTproBNP. CONCLUSION: HsPDA leads to increased hsTnT and NTproBNP levels in preterm infants without affecting cardiac function.

Transcutaneous bilirubin estimation in extremely low birth weight infants receiving phototherapy: a prospective observational study.

BACKGROUND: Measurement of transcutaneous bilirubin (TcB) is a quick, reliable and painless method to guide management of hyperbilirubinemia. Studies in term and late preterm infants have found that TcB measurements from covered areas (TcB-C) during phototherapy (PHT) co-relate well with serum bilirubin levels. Limited data exists in extremely low birth weight (ELBW) infants. METHODS: In this prospective observational study, an opaque patch was placed on the back of an ELBW infant prior to initiation of PHT. TcB-C and TcB-E (TcB from exposed area) levels were measured at birth and at 24-h intervals for 5 days. Total serum bilirubin (TSB) levels were also measured within 30 min of obtaining TcB levels. A Wilcoxon signed rank test was used for data analysis. A mixed effect model was used to adjust for repeated measurements over time. The p value < 0.05 was considered significant. RESULTS: A total of 19 infants were enrolled in the study, with a mean gestational age of 26 ± 2 weeks and mean weight 827 ± 127 g. The difference between TcB-C and TSB was 2.68 ± 2.41 mg/dl (mean ± SD, p <  0.001). In contrast, the difference between TcB-E and TSB was - 0.51 ± 1.74 mg/dl (p = 0.02). TcB-C consistently overestimates TSB, while TcB-E consistently underestimates TSB. CONCLUSIONS: During PHT exposure, TcB-C does not correlate with TSB values in ELBW infants. TcB-C levels cannot be used as a surrogate for TSB measurement in ELBW infants.

Technology Courage: Implications for Faculty Development.

This article was migrated. The article was marked as recommended. Purpose: From a decade of technology-focused faculty development, the authors recognized that academic physicians adopt educational technology at varying rates and with variable confidence. This work is an exploration of the phenomenon of technology courage and how the concept can inform faculty development. Method: Qualitative methods of interpretative phenomenological analysis (IPA) were used. Faculty interviews were transcribed using Google Docs voice typing. Data were analyzed, themes developed, and supportive narratives were identified using IPA methodology. Results: Two themes emerged. The theme of Willingness includes willingness to try, explore, or risk learning a new technology; and willingness to persist in the face of fear or anxiety. The theme of Benefit Evaluation relates to motivators for technology courage, i.e., assessing benefit to self and learners before learning and using a new technology. Conclusions: From a theme analysis, a definition of technology courage has emerged: willingness to try and to persist when using a new technology because of perceived benefit to self and/or others. The authors discuss how further research of the construct might be guided by theoretical frameworks of grit, self-efficacy, teacher identity, and generational learning differences. Recommendations are offered on how the construct of technology courage can be valuable for technology-focused faculty development.

Online faculty development for creating E-learning materials.

BACKGROUND: Faculty who want to develop e-learning materials face pedagogical challenges of transforming instruction for the online environment, especially as many have never experienced online learning themselves. They face technical challenges of learning new software and time challenges of not all being able to be in the same place at the same time to learn these new skills. The objective of the Any Day Any Place Teaching (ADAPT) faculty development program was to create an online experience in which faculty could learn to produce e-learning materials. METHODS: The ADAPT curriculum included units on instructional design, copyright principles and peer review, all for the online environment, and units on specific software tools. Participants experienced asynchronous and synchronous methods, including a learning management system, PC-based videoconferencing, online discussions, desktop sharing, an online toolbox and optional face-to-face labs. Project outcomes were e-learning materials developed and participants' evaluations of the experience. Likert scale responses for five instructional units (quantitative) were analyzed for distance from neutral using one-sample t-tests. Interview data (qualitative) were analyzed with assurance of data trustworthiness and thematic analysis techniques. RESULTS: Participants were 27 interprofessional faculty. They evaluated the program instruction as easy to access, engaging and logically presented. They reported increased confidence in new skills and increased awareness of copyright issues, yet continued to have time management challenges and remained uncomfortable about peer review. They produced 22 new instructional materials. DISCUSSION: Online faculty development methods are helpful for faculty learning to create e-learning materials. Recommendations are made to increase the success of such a faculty development program.

Hand force of men and women over 65 years of age as measured by maximum pinch and grip force.

This cross-sectional study aimed to assess the impact of age and gender on 4 measures of grip and pinch force of well elderly community dwellers and to provide normative values. The hypotheses were that age and gender affect pinch and grip force and that these 2 factors might interact. Hand strength of 224 seniors 65-92 years old was tested. Grip and pinch force decreased in successively older age groups past 65 years. Men's grip force exceeded that of women in all age groups. Men's hand-force decline was steeper than that of women over successive age groups, suggesting that gender differences in force decreased with age. Trends were the same for all 4 types of grip- and pinch-force measurement but were most clearly visible in grip and key-pinch force. Norms were provided for seniors age 65-85+ years in 5-yr increments.