Perfil nutricional de pacientes ostomizados. Hospital General del segundo departamento de San Pedro Paraguay ­ Corea. 2022 / Nutritional profile of ostomized patients. General Hospital of the second department of San Pedro Paraguay ­ Korea. 2022

El perfil nutricional de los pacientes ostomizados adquiere especial atención debido a las condiciones que podrían predisponer a una malnutrición. El objetivo del estudio fue determinar el perfil nutricional de pacientes ostomizados que reciben atención ambulatoria en el Hospital General del Segundo Departamento de San Pedro-Paraguay - Corea, en el año 2022, se realizó un estudio observacional de corte transversal. Los datos obtenidos fueron cargados en una planilla electrónica Microsoft-Excel, para el análisis se utilizó estadística descriptiva. Para describir el estado nutricional de los pacientes se emplearon indicadores antropométricos y el Screening de Riesgo Nutricional (NRS-2002), aplicados mediante entrevista y evaluación clínica nutricional. El estudio tuvo una duración global de 9 meses, fueron incluidos 20 pacientes ostomizados atendidos en el Programa Nacional de Atención Integral al Paciente Ostomizado provisto por el Hospital General Paraguay-Corea que cumplieron con los criterios de inclusión. Se respetaron los principios éticos de investigación. El grupo etario más representativo fue el de 41 a 64 años o más, seguido del grupo etario de 20 a 40 años; mayor proporción de sexo masculino, procedencia rural. El tipo de ostomía más frecuente fue colostomía terminal seguido de colostomía laterales; enfermedad de base más frecuente fue el de tipo oncológico, seguida de obstrucción intestinal, trauma y por último fistulas y enfermedad diverticular. En conclusión, la apreciación global del estado nutricional evaluada mediante la herramienta NRS-2002 indicó que el perfil nutricional de los pacientes ostomizados presenta riesgo de malnutrición en todos los casos evaluados.

The nutritional profile of ostomized patients acquires special attention due to the conditions that could predispose to malnutrition. The objective of the study was to determine the nutritional profile of ostomized patients who receive outpatient care at the General Hospital of the Second Department of San Pedro-Paraguay Korea, in the year 2022, an observational study of a cross-section was conducted. The data obtained were loaded in an electronic form Microsoft-Excel, for the analysis was used descriptive statistics. To describe the nutritional status of patients, anthropometric indicators and nutritional risk screening (NRS-2002) were used, applied through nutritional clinical interview and evaluation. The study had a global duration of 9 months, 20 ostomized patients were included in the National Program for Comprehensive Care of the Ostomized Patient provided by the General Paraguay-Corea Hospital that complied with the inclusion criteria. Ethical research principles were respected. The most representative age group was 41 to 64 years or more, followed by the age group from 20 to 40 years; Greater proportion of male sex, rural origin. The most frequent type of ostomy was terminal colostomy followed by lateral colostomy; The most frequent base disease was the oncological type, followed by intestinal obstruction, trauma and finally fistulas and diverticular disease. In conclusion, the global appreciation of the nutritional status evaluated by the NRS-2002 tool indicated that the nutritional profile of ostomized patients has a risk of malnutrition in all cases evaluated.

Persistent confusion in nutrition and obesity research about the validity of classic nonparametric tests in the presence of heteroscedasticity: evidence of the problem and valid alternatives.

The use of classic nonparametric tests (cNPTs), such as the Kruskal-Wallis and Mann-Whitney U tests, in the presence of unequal variance for between-group comparisons of means and medians may lead to marked increases in the rate of falsely rejecting null hypotheses and decreases in statistical power. Yet, this practice remains prevalent in the scientific literature, including nutrition and obesity literature. Some nutrition and obesity studies use a cNPT in the presence of unequal variance (i.e., heteroscedasticity), sometimes because of the mistaken rationale that the test corrects for heteroscedasticity. Herein, we discuss misconceptions of using cNPTs in the presence of heteroscedasticity. We then discuss assumptions, purposes, and limitations of 3 common tests used to test for mean differences between multiple groups, including 2 parametric tests: Fisher's ANOVA and Welch's ANOVA; and 1 cNPT: the Kruskal-Wallis test. To document the impact of heteroscedasticity on the validity of these tests under conditions similar to those used in nutrition and obesity research, we conducted simple simulations and assessed type I error rates (i.e., false positives, defined as incorrectly rejecting the null hypothesis). We demonstrate that type I error rates for Fisher's ANOVA, which does not account for heteroscedasticity, and Kruskal-Wallis, which tests for differences in distributions rather than means, deviated from the expected significance level. Greater deviation from the expected type I error rate was observed as the heterogeneity increased, especially in the presence of an imbalanced sample size. We provide brief tutorial guidance for authors, editors, and reviewers to identify appropriate statistical tests when test assumptions are violated, with a particular focus on cNPTs.

Comparison of attention for malnutrition research on social media versus academia: Altmetric score analysis.

OBJECTIVES: In this study, we aimed to provide bibliometric and Altmetric overviews and visualization and to evaluate the correlation between traditional bibliometric and Altmetric analyses in the field of malnutrition. METHODS: Articles published in the past decade were identified by searching for the term "malnutrition" on the Web of Science indexing database and research platform. The top 50 cited articles were analyzed in terms of title, study type, topic of study, first author, publication year, citation number, keywords, organizations, average citations per year, journal H index, impact factor, and Altmetric attention score. Also, the top 50 Altmetric articles published in the past decade about malnutrition were provided on the website Altmetric.com. RESULTS: Among the top 50 cited articles, the most common study type, topic of study, publication year, and keyword were, respectively, original scientific paper (n = 26), definition-diagnosis of malnutrition (n = 17), 2010 (n = 13), and malnutrition (n = 18). The article titled "Maternal and child undernutrition and overweight in low-income and middle-income countries" in Lancet had the highest citation number, and the article "Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality" in Lancet had the highest Altmetric score. CONCLUSIONS: Evaluating academic publications with an Altmeric analysis in addition to a traditional bibliometric analysis is beneficial because Altmetric attention scores can give information about what the population wants to know about malnutrition and allows us to develop appropriate policies.

The characteristics and extent of food industry involvement in peer-reviewed research articles from 10 leading nutrition-related journals in 2018.

INTRODUCTION: There is emerging evidence that food industry involvement in nutrition research may bias research findings and/or research agendas. However, the extent of food industry involvement in nutrition research has not been systematically explored. This study aimed to identify the extent of food industry involvement in peer-reviewed articles from a sample of leading nutrition-related journals, and to examine the extent to which findings from research involving the food industry support industry interests. METHODS: All original research articles published in 2018 in the top 10 most-cited nutrition- and dietetics-related journals were analysed. We evaluated the proportion of articles that disclosed involvement from the food industry, including through author affiliations, funding sources, declarations of interest or other acknowledgments. Principal research findings from articles with food industry involvement, and a random sample of articles without food industry involvement, were categorised according to the extent to which they supported relevant food industry interests. RESULTS: 196/1,461 (13.4%) articles reported food industry involvement. The extent of food industry involvement varied by journal, with The Journal of Nutrition (28.3%) having the highest and Paediatric Obesity (3.8%) having the lowest proportion of industry involvement. Processed food manufacturers were involved in the most articles (77/196, 39.3%). Of articles with food industry involvement, 55.6% reported findings favourable to relevant food industry interests, compared to 9.7% of articles without food industry involvement. CONCLUSION: Food industry involvement in peer-reviewed research in leading nutrition-related journals is commonplace. In line with previous literature, this study has shown that a greater proportion of peer-reviewed studies involving the food industry have results that favour relevant food industry interests than peer-reviewed studies without food industry involvement. Given the potential competing interests of the food industry, it is important to explore mechanisms that can safeguard the integrity and public relevance of nutrition research.

A Tool to Explore Discrete-Time Data: The Time Series Response Analyser.

The analysis of time series data is common in nutrition and metabolism research for quantifying the physiological responses to various stimuli. The reduction of many data from a time series into a summary statistic(s) can help quantify and communicate the overall response in a more straightforward way and in line with a specific hypothesis. Nevertheless, many summary statistics have been selected by various researchers, and some approaches are still complex. The time-intensive nature of such calculations can be a burden for especially large data sets and may, therefore, introduce computational errors, which are difficult to recognize and correct. In this short commentary, the authors introduce a newly developed tool that automates many of the processes commonly used by researchers for discrete time series analysis, with particular emphasis on how the tool may be implemented within nutrition and exercise science research.

The fragility of statistically significant results from clinical nutrition randomized controlled trials.

BACKGROUND & AIMS: Recently, a parameter called "Fragility index" (FI) has been proposed, which measures how many events the statistical significance relies on. The lower the FI the more "fragile" the results, and thus more care should be taken when interpreting the results. Our aim in this study was to check FI of nutritional trials. METHODS: We conducted a systematic review of human clinical nutrition RCTs that report statistically significant dichotomous primary outcomes. We searched the EMBASE, MEDLINE, and Scopus databases. The FI of primary outcomes using the Fisher exact test was calculated and checked the correlations of FI with the number of randomised trials, the p-value of primary outcomes, the publication date, the journal impact factor and the number of patients lost to follow-up. RESULTS: The initial database search revealed 5790 articles, 37 of which were included in qualitative synthesis. The median (IQR) FI for all studies was 1 (1-3). 28 studies (75.7%) had an FI lower or equal to 2, and in 12 (32.43%) articles, the FI was lower than the number of patients lost to follow-up. No correlations were found between FI and the study characteristics (number of randomized patients, p value of primary outcome, event ratio in experimental group, event ratio in control group, publication date, journal impact factor, lost to follow-up). CONCLUSION: The results of RCTs in nutritional research often rely on a small number of events or patients. The number of patients lost to follow-up is frequently higher than the FI calculation. Formulating recommendations based on RCTs should be done with caution and FI may be used as auxiliary parameter when assessing the robustness of their findings.

Curriculum Changes and Trends 2010-2020: A Focused National Review Using the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II.

Medical school curricula have evolved from 2010 to 2020. Numerous pressures and influences affect medical school curricula, including those from external sources, academic medical institutions, clinical teaching faculty, and undergraduate medical students. Using data from the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II, the nature of curriculum change is illuminated. Most medical schools are undertaking curriculum change, both in small cycles of continuous quality improvement and through significant change to curricular structure and content. Four topic areas are explored: cost consciousness, guns and firearms, nutrition, and opioids and addiction medicine. The authors examine how these topic areas are taught and assessed, where in the curriculum they are located, and how much time is dedicated to them in relation to the curriculum as a whole. When examining instructional methods overall, notable findings include (1) the decrease of lecture, although lecture remains the most used instructional method, (2) the increase of collaborative instructional methods, (3) the decrease of laboratory, and (4) the prevalence of clinical instructional methods in academic levels 3 and 4. Regarding assessment methods overall, notable findings include (1) the recent change of the USMLE Step 1 examination to a pass/fail reporting system, (2) a modest increase in narrative assessment, (3) the decline of practical labs, and (4) the predominance of institutionally developed written/computer-based examinations and participation. Among instructional and assessment methods, the most used methods tend to cluster by academic level. It is critical that faculty development evolves alongside curricula. Continued diversity in the use of instructional and assessment methods is necessary to adequately prepare tomorrow's physicians. Future research into the life cycle of a curriculum, as well optional curriculum content, is warranted.

Quo vadis, Endocrinology and nutrition? / ¿Quo vadis, Endocrinología y Nutrición?

INTRODUCTION: In Spain, the system used to select a medical specialty is the MIR (internal resident physician) exam. The MIR selection number may reflect the interest in a given specialty. Our study objective was to confirm the increase in the selection number and to analyze possible factors influencing the decision. MATERIAL AND METHOD: To analyze change over time in the MIR number with which this specialty is chosen and to compare it with other related specialties, as well as the reasons why it is preferred using an anonymous survey to 108 MIRs of endocrinology. RESULTS: The average number of MIR for Endocrinology and Nutrition has gradually increased to 2336 in year 2018, a trend that coincides with an increase in the number of places offered but is more marked as compared to other medical specialties. Respondents weighed different factors when choosing specialty. When asked about the most positive aspects of the specialty, the highest rated was that day to day activity was "less intense". The most commonly mentioned negative aspect was the low number of techniques. When asked if the specialty had met their expectations, respondents gave an average score of 8.7, although the perceived prestige of the specialty scored only 6.7 points. CONCLUSIONS: There is an obvious deterioration of the MIR selection number of our specialty that it is not so marked in other specialties.

Best (but oft-forgotten) practices: missing data methods in randomized controlled nutrition trials.

Missing data ubiquitously occur in randomized controlled trials and may compromise the causal inference if inappropriately handled. Some problematic missing data methods such as complete case (CC) analysis and last-observation-carried-forward (LOCF) are unfortunately still common in nutrition trials. This situation is partially caused by investigator confusion on missing data assumptions for different methods. In this statistical guidance, we provide a brief introduction of missing data mechanisms and the unreasonable assumptions that underlie CC and LOCF and recommend 2 appropriate missing data methods: multiple imputation and full information maximum likelihood.

Nutrition education in the Australian New South Wales primary school curriculum: An exploration of time allocation, translation and attitudes in a sample of teachers.

ISSUE ADDRESSED: The dietary intakes of Australian children are not optimal, with few meeting recommended vegetable and fruit intake targets. Nutrition education in childhood is important for developing healthy eating patterns, with schools an ideal setting for a wide reach. The aims of this study were to examine nutrition education within the NSW primary school syllabus, explore how much time teachers spend teaching nutrition, what is taught, what materials are used, and to identify attitudes towards nutrition education. METHOD: An online survey consisting of 29 closed questions (with options for comments) was specifically developed for the purpose of this study. Teachers currently teaching at a NSW primary school were eligible to participate. RESULTS: A total of 33 NSW primary school teachers completed the survey. Results indicate that limited time is spent on teaching nutrition with some important nutrition education components currently missed, resources perceived to be inadequate and lack of time reported as the largest barrier to teaching nutrition. CONCLUSION: In order to improve the quality of nutrition education in NSW primary schools, several important topics need to be integrated into the curriculum, and time constraints of teachers should be taken into account. SO WHAT?: Findings from the current survey will inform the development of future nutrition education programs and resources with the aim of integrating nutrition education within the primary school curriculum.

Manual de Tratamento e Reabilitação Nutricional: 0 aos 14 anos / Manual for Treatment and Rehabilitation Nutrition - Volume I

A manutenção de um estado nutricional adequado é um direito humano fundamental, sendo também um pré-requisito para o desenvolvimento económico de um País. Em Moçambique, 43% das crianças menores de cinco anos de idade sofrem de desnutrição crónica, e 6% sofrem de desnutrição aguda.1 A desnutrição é um problema de saúde sério e aumenta os riscos de desenvolvimento de outras complicações, contribuindo para o aumento da mortalidade infanto-juvenil no nosso País. Dados recentes indicam que desnutrição é um fator que leva a aproximadamente um terço de 8 milhões de mortes em crianças menores de 5 anos (WHO 2013).

XVII Congreso SEINAP. El poder de una sustancia bien hecha en estudios nutricionales / XVII Congreso SEINAPThe power of well-done statistics in nutritional studies

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Participant and Household Characteristics Associated With Graduation From the Expanded Food and Nutrition Education Program.

OBJECTIVE: To examine empirically participant and household characteristics associated with Expanded Food and Nutrition Education Program (EFNEP) graduation and to determine whether they differ across 2 counties. DESIGN: Survey of EFNEP participants from 2011 to 2012. SETTING: Expanded Food and Nutrition Education Program sites serving limited-resource families in 1 rural and 1 urban/suburban county in Washington State. PARTICIPANTS: Expanded Food and Nutrition Education Program participants (urban/suburban: n = 647; rural: n = 569). MAIN OUTCOME MEASURE: Expanded Food and Nutrition Education Program completion/graduation. ANALYSIS: Multivariate logistic regression was used to examine associations of participant (ethnicity, race, age, education, pregnancy status, and nutrition knowledge/behavior at baseline) and household (number of people in the house, place of residence, and public assistance services) characteristics with EFNEP graduation. RESULTS: Associations were moderated by county. For the urban/suburban county, participants living with more people (after controlling for the total number of adults) were more likely to graduate. For the rural county, participants living with fewer total adults (after controlling for the total number in the house) and those with better food safety practices at baseline were more likely to graduate. CONCLUSIONS AND IMPLICATIONS: This study aids in understanding which participants are more or less likely to complete EFNEP successfully, and therefore can inform strategies aimed at increasing graduation rates.

Diseño y validación de un cuestionario para evaluar el nivel de conocimientos generales en nutrición en universitarios de ciencias de la salud / Design and validation of a questionnaire to assess the level of general knowledge in nutrition in college of health sciences

Fundamentos: El éxito de las actividades educativas destinadas a mejorar los hábitos alimentarios, requiere de instrumentos fiables que permitan evaluar el nivel de conocimientos de los participantes, antes y después de estas actividades. Métodos: Se realizó un estudio observacional, longitudinal y prospectivo. Participaron 158 estudiantes universitarios de Ciencias de la Salud de la Universidad de Vic-Universidad Central de Cataluña, en España. Se diseñó un cuestionario a partir de una revisión conceptual y por consenso entre un grupo de expertos. El instrumento fue validado mediante un pretest cognitivo, una prueba piloto test-retest y una aplicación final, analizando el comportamiento de sus propiedades psicométricas en cada aplicación. Resultados: Completaron el estudio 72 mujeres y 86 hombres, con una edad media de 20,857 años. Se obtuvo un instrumento de 27 preguntas distribuidas en cuatro bloques temáticos. La escala mostró una buena consistencia interna (alpha de Cronbach = 0,783) y una adecuada estabilidad (CCI de 0,763). Conclusiones: El instrumento diseñado permite evaluar con garantías el nivel de conocimientos generales en Alimentación y Nutrición de los estudiantes universitarios de Ciencias de la Salud que participaron en el proceso (AU)

Background: To the success of educational activities to improve the eating habits, it requires reliable instruments to evaluate the level of nutritional knowledge before and after these activities. Methods: An observational longitudinal prospective study was conducted. Some 158 students of Health Sciences in Vic University, in central Catalonia, Spain. A questionnaire was designed based on a conceptual review and agreed by an expert group. The instrument was validated by a cognitive test, a pilot test-retest and a final application, analyzing the psychometric properties on each occasion. Results: 158 Health Sciences students completed the study, 72 women and 86 men with a mean age of 20,857 years. An questionnaire of 27 questions divided into four thematic blocks was obtained. The scale showed good internal consistency in its version (Cronbach alpha = 0,783) and adequate stability (CCC = 0,763). Conclusions: The designed instrument can be accurately used to assess Health Science students’ nutritional knowledge (AU)

Intake of energy and nutrients; harmonization of Food Composition Databases

Food composition databases (FCDBs) provide detailed information about the nutritional composition of foods. The conversion of food consumption into nutrient intake need a Food composition database (FCDB) which lists the mean nutritional values for a given food portion. The limitations of FCDBs are sometimes little known by the users. Multicentre studies have raised several methodology challenges which allow to standardize nutritional assessments in different populations and geographical areas for food composition and nutrient intake. Differences between FCDBs include those attributed to technical matters, such as description of foods, calculation of energy and definition of nutrients, analytical methods, and principles for recipe calculation. Such differences need to be identified and eliminated before comparing data from different studies, especially when dietary data is related to a health outcome. There are ongoing efforts since 1984 to standardize FCDBs over the world (INFOODS, EPIC, EuroFIR, etc.). Food composition data can be gathered from different sources like private company analysis, universities, government laboratories and food industry. They can also be borrowed from scientific literature or even from the food labelling. There are different proposals to evaluate the quality of food composition data. For the development of a FCDB it is fundamental document in the most detailed way, each of the data values of the different components and nutrients of a food. The objective of AECOSAN (Agencia Española de Consumo Seguridad Alimentaria y Nutrición) and BEDCA (Base de Datos Española de Composición de Alimentos) association was the development and support of a reference FCDB in Spain according to the standards to be defined in Europe. BEDCA is currently the only FCDB developed in Spain with compiled and documented data following EuroFIR standards (AU)

La conversión de consumo de alimentos a ingesta de nutrientes necesita una base de datos de composición de alimentos (FCDB) que recoge los valores nutricionales medios de una porción dada de alimento. Las limitaciones de las FCDBs son, en ocasiones, poco conocidas por los usuarios. Los estudios multicéntricos han planteados varios retos metodológicos que permitan estandarizar la composición de alimentos y la ingesta de nutrientes para la evaluación nutricional en diferentes poblaciones y áreas geográficas. Las diferencias entre FCDBs incluyen las atribuibles a aspectos técnicos, como la descripción de los alimentos, cálculo de energía y definición de los nutrientes, métodos analíticos y principios para el cálculo de recetas. Estas diferencias necesitan ser identificadas y eliminadas antes de comparar los datos obtenidos de diferentes estudios, especialmente cuando dichos datos dietéticos se relacionan con resultados de salud. Desde 1984 se han realizado diversas iniciativas para estandarizar los FCDBs en el mundo (INFOOD, EPIC, EUROFIR, etc.). Los datos de composición de alimentos pueden ser obtenidos de diferentes fuentes como análisis de empresas privadas, universidades, laboratorios gubernamentales e industria alimentaria. También pueden tomarse prestados de la literatura científica o incluso del etiquetado nutricional. Existen diferentes propuestas para evaluar la calidad de los datos de composición de alimentos. Para el desarrollo de una FCDB es fundamental documentar, lo más detallado posible, cada uno de los valores de los diferentes componentes y nutrientes de un alimento. El objetivo de la AECOSAN y la asociación BEDCA fue el desarrollo y mantenimiento en España de una FCDB de acuerdo con los estándares definidos para Europa. BEDCA es actualmente la única FCDB desarrollada en España con datos compilados y documentados siguiendo los estándares de EuroFIR (AU)

[The iberoamerican scientific production in nutritional sciences: the indexation in PubMed and Google Scholar]. / La producción científica iberoamericana en ciencias de la nutrición: la indización en PubMed y Google Scholar.

OBJECTIVE: Analyze by bibliometric technique, the Iberoamerican scientific literature related to the nutritional sciences and retrieved on main search engines with free access through Internet (PubMed and Google Scholar). METHOD: Bibliometric analysis of scientific production recovered in the different selected search tools. The data were obtained by applying to each of them, a composed search equation according to the scheme: Population (neoplasms), Intervention (nutritional status), Outcome (quality of life). RESULTS: 789 references were reviewed, 604 of those were papers published in 277 journals, presenting 20 or more references: Supportive Care in Cancer 27 (4.47%; CI 95% 2.82-6.12) and Clinical Nutrition 20 (3.31%; CI 95% 1.88-4.74). Mean age of documents: 8.08 ± 6.40 (CI 95% 7.63-8.53), median 6 years (Burton Kleber Index), maximum 34 years and Price Index of 43.90%. The predominant geographical distribution among the authors was American, while the articles were written primarily in English. Dispersion of literature (Bradford Law): core (1st tertile), 22 journals (7.94%; CI 95% 4.76-11.13) with 202 articles published (33.44%; CI 95% 29.68-37.21). Statistics related to the impact factor of the core: mean 4.033 ± 4.022 and maximum 18,038 (Journal of Clinical Oncology). CONCLUSIONS: The studied thematic continues in force according to the current indicators, with a dominance of English as language of publication and United States filiation. The most referenced journals matching with high Impact publications on nutritional sciences and oncology. Highlighting the presence of an Iberoamerican journal (Nutrición Hospitalaria) with a clear international vocation.

Objetivo: Analizar mediante técnica bibliométrica, la literatura científica iberoamericana relacionada con las ciencias de la nutrición y recuperada en los principales buscadores de acceso gratuito a través de Internet (PubMed y Google Scholar). Método: Análisis bibliométrico de la producción científica recuperada de las diferentes herramientas de búsqueda seleccionadas. Los datos se obtuvieron, aplicando en cada buscador, una ecuación de búsqueda compuesta según el esquema: Población (neoplasms), Intervención (nutritional status), Resultado (quality of life). Resultados: Se revisaron 789 referencias de las que 604 eran artículos publicados en 277 revistas, presentando 20 o más referencias: Supportive Care in Cancer con 27 (4,47%; IC95% 2,82-6,12) y Clinical Nutrition con 20 (3,31%; IC95% 1,88-4,74). Edad media de los documentos: 8,08 ± 6,40 (IC95% 7,63-8,53), mediana 6 años (Índice de Burton Kleber), máximo 34 años e Índice de Price 43,90%. La distribución geográfica predominante entre los autores fue estadounidense, estando los artículos escritos principalmente en inglés. Dispersión de la literatura (Ley de Bradford): núcleo principal (1º tercil), 22 revistas (7,94%; IC95% 4,76- 11,13) 202 artículos publicados (33,44%; IC95% 29,68- 37,21). Estadísticos relacionados con el Factor de Impacto del núcleo: media 4,033 ± 4,022 y máximo 18,038 (Journal of Clinical Oncology). Conclusiones: La temática estudiada continúa vigente según los indicadores de actualidad, con un dominio del inglés como idioma de publicación y de la filiación estadounidense. Las revistas más referidas coinciden con publicaciones sobre ciencias de la nutrición y oncología de alto impacto. Destaca la presencia de una revista iberoamericana (Nutrición Hospitalaria) con clara vocación internacional.

La producción científica iberoamericana en ciencias de la nutrición: La indización en PubMed y Google Scholar / The Iberoamerican scientific production in nutritional sciences: the indexation in PubMed and Google Scholar

Objetivo: Analizar mediante técnica bibliométrica, la literatura científica iberoamericana relacionada con las ciencias de la nutrición y recuperada en los principales buscadores de acceso gratuito a través de Internet (PubMed y Google Scholar). Método: Análisis bibliométrico de la producción científica recuperada de las diferentes herramientas de búsqueda seleccionadas. Los datos se obtuvieron, aplicando en cada buscador, una ecuación de búsqueda compuesta según el esquema: Población (neoplasms), Intervención (nutritional status), Resultado (quality of life). Resultados: Se revisaron 789 referencias de las que 604 eran artículos publicados en 277 revistas, presentando 20 o más referencias: Supportive Care in Cancer con 27 (4,47%; IC95% 2,82-6,12) y Clinical Nutrition con 20 (3,31%; IC95% 1,88-4,74). Edad media de los documentos: 8,08 ± 6,40 (IC95% 7,63-8,53), mediana 6 años (Índice de Burton Kleber), máximo 34 años e Índice de Price 43,90%. La distribución geográfica predominante entre los autores fue estadounidense, estando los artículos escritos principalmente en inglés. Dispersión de la literatura (Ley de Bradford): núcleo principal (1º tercil), 22 revistas(7,94%; IC95% 4,7611,13) 202 artículos publicados (33,44%; IC95% 29,6837,21). Estadísticos relacionados con el Factor de Impacto del núcleo: media 4,033 ± 4,022 y máximo 18,038 (Journal of Clinical Oncology). Conclusiones: La temática estudiada continúa vigente según los indicadores de actualidad, con un dominio del inglés como idioma de publicación y de la filiación estadounidense. Las revistas más referidas coinciden con publicaciones sobre ciencias de la nutrición y oncología de alto impacto. Destaca la presencia de una revista iberoamericana (Nutrición Hospitalaria) con clara vocación internacional (AU)

Objective: Analyze by bibliometric technique, the Iberoamerican scientific literature related to the nutritional sciences and retrieved on main search engines with free access through Internet (PubMed and Google Scholar). Method: Bibliometric analysis of scientific production recovered in the different selected search tools. The data were obtained by applying to each of them, a composed search equation according to the scheme: Population (neoplasms), Intervention (nutritional status), Outcome (quality of life). Results: 789 references were reviewed, 604 of those were papers published in 277 journals, presenting 20 or more references: Supportive Care in Cancer 27 (4,47%; CI95% 2,82-6,12) and Clinical Nutrition 20 (3,31%; CI95% 1,88-4,74). Mean age of documents: 8,08 ± 6,40 (CI95% 7,63-8,53), median 6 years (Burton Kleber Index), maximum 34 years and Price Index of 43.90%. The predominant geographical distribution among the authors was American, while the articles were written primarily in English. Dispersion of literature (Bradford Law): core (1st tertile), 22 journals (7,94%; CI95% 4,76-11,13) with 202 articles published (33,44%; CI95% 29,68-37,21). Statistics related to the impact factor of the core: mean 4,033± 4,022 and maximum 18,038 (Journal of Clinical Oncology). Conclusions: The studied thematic continues in force according to the current indicators, with a dominance of English as language of publication and United States filiation. The most referenced journals matching with high Impact publications on nutritional sciences and oncology. Highlighting the presence of an Iberoamerican journal (Nutrición Hospitalaria) with a clear international vocation (AU)

Racial and ethnic differences in subspecialty service use by children with autism.

OBJECTIVE: To describe racial differences in use of specialty care among children with autism spectrum disorder. METHODS: We identified patients ages 2 to 21 years with an International Classification of Diseases, Ninth Revision code of autism (299.0) seen from 2000 to 2011 at a major academic health center by using a research patient data repository and determined rates of specialty provider visits and procedures by race. We then used logistic regression to determine the associations of rates of subspecialty visits and procedures with race and ethnicity, controlling for gender, age, and payer type. RESULTS: We identified 3615 patients (2935 white, 243 Hispanic, 188 African American, and 249 other). The most striking differences were in use of gastroenterology (GI)/nutrition services. Nonwhite children were less likely to use GI/nutrition specialty providers (African American, odds ratio = 0.32 [95th percentile confidence interval: 0.18-0.55]; Hispanic, 0.32 [0.20-0.51]; other, 0.56 [0.34-0.92]) as well as neurology (African American, 0.52 [0.33-0.83]; Hispanic, 0.40 [0.27-0.59]) and psychiatry/psychology (African American, 0.44 [0.27-0.72]; Hispanic, 0.60 [0.41-0.88]; other, 0.62 [0.38-0.99]). Nonwhite children were less likely to have had GI studies: colonoscopy (African American, 0.23 [0.10-0.53]; Hispanic, 0.26 [0.14-0.50]), endoscopy (African American, 0.31 [0.16-0.58]; Hispanic, 0.27 [0.16-0.46]; other, 0.53 [0.31-0.90]), and stool studies (African American, 0.49 [0.30-0.91]). Hispanic children had lower rates of neurologic and other testing: EEG (Hispanic, 0.53 [0.35-0.78]), brain MRI (African American, 0.37 [0.22-0.63]; Hispanic, 0.62 [0.42-0.90]), sleep study (Hispanic, 0.18 [0.04-0.76]), and neuropsychiatric testing (Hispanic, 0.55 [0.32-0.96]). CONCLUSIONS: We found racial and ethnic differences among children diagnosed with autism in use of care and procedures. Possible explanations for these findings include differences in presentation, referral rates, or referral follow through.