José Pedro Novalbos Ruiz

La percepción del sobrepeso y la obesidad infantil por parte de los progenitores

Fundamento: Con frecuencia los padres no perciben la sobrecarga ponderal de sus hijos. El objetivo de este trabajo es estudiar con que frecuencia se produce este hecho y si esta percepcion se asocia a diferencias en habitos alimentarios, actividad fisica y sedentarismo de sus hijos. Metodos: Estudio transversal de 1.620 ninos de 3 a 16 anos seleccionados en un muestreo por conglomerados (2008-2010). 454 presentaron sobrecarga ponderal. Se estudiaron sus caracteristicas antropometricas, habitos alimentarios, actividad fisica (adaptacion cuestionarios Cindi/Maraton) y sedentarismo. Analizamos las diferencias con ninos con normopeso, sobrecarga ponderal percibida y no percibida (chi2 y Anova). Resultados: Los padres percibieron el 34,7% del sobrepeso y un 72,3% de obesidad en sus hijos varones, y un 10,8% y 53,8% respectivamente en las hijas. Los padres y madres obesos identifican un 54,5% y el 57,7% de los casos de sobrecarga ponderal de varones, frente al 23,8% y 27,8% en ninas. La percepcion del exceso de peso se asocio a la cualificacion profesional del padre (47%) y a la de ser ama de casa en las mujeers (40%). La percepcion coincidio con mayor cumplimiento de recomendaciones de actividad fisica en los hijos (67,5 vs. 77,3%) e hijas (47,5% vs 55,6%) mas jovenes, menor sedentarismo en estas (42,6% vs. 38,9%), y discretas diferencias por sexo y edad en los habitos alimentarios. Conclusiones: Un porcentaje significativo de casos con sobrecarga ponderal infantil no es percibida por sus padres debiendose estudiar sus causas y por que esta percepcion parental no determina diferencias en alimentacion, actividad fisica y sedentarismo de sus hijos.

Validación del test para la identificación de trastornos por uso de alcohol en población universitaria: AUDIT y AUDIT-C

The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbachs Alpha, the Kappa index, Spearmans correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbachs alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbachs Alpha, the Kappa index, Spearmans correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbachs alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD. Language: es

Accidentalidad e incidencia de accidentes biológicos de riesgo en estudiantes de enfermería

Fundamento Estudiar la incidencia y carac-teristicas de los accidentes biologicos de los estudiantes de enfermeria durante sus practicas hospitalarias. Material y metodo Estudio retrospectivo en cinco centros mediante dos cuestionarios, uno sobre la duracion de las practicas y accidentalidad, y otro sobre caracteristicas, precauciones y actuacion postexposicion. Resultados De 397 alumnos, presentaron accidentes el 70,5%, la accidentalidad fue del 64% (intervalo de confianza del 95%, 59-68). El 15% fueron accidentes con riesgo biologico, predominando pinchazos (39%) y salpicaduras (32,5%); cabe destacar que un 49,2% de los accidentes se produjeron recogiendo el material, asi como debido a la ausencia de proteccion individual en el 58%. Uno de cada 8 accidentes presento riesgo biologico. Conclusiones La accidentalidad fue muy elevada, con importantes deficiencias en la seguridad.

Perfil antropométrico y prevalencia de sobrepeso de los escolares de Ubrique. Cádiz

FUNDAMENTO: La obesidad del adulto es un importante factor de riesgo de diversas enfermedades cronicas, y parece ligada a la obesidad en la infancia. Por ello identificar a ninos con riesgo de obesidad, podria ser una medida adecuada de prevencion de estas enfermedades en el adulto. El objetivo de nuestro estudio fue conocer el perfil antropometrico y la prevalencia de sobrepeso de una poblacion escolar de un nucleo rural de Cadiz con un importante caracter industrial. METODO: Se realizo un estudio transversal donde se estudio una muestra representativa de 493 escolares de ambos sexos entre 4 y 14 anos de edad, en los que se realizaron mediciones de la talla, peso, perimetro braquial, pliegue cutaneo tricipital, y se calculo el IMC. Los resultados se compararon con una poblacion espanola de referencia. Como medida de sobrepeso se utilizo el IMC > o = 25 Kg/m². RESULTADOS: La talla, el peso, el perimetro braquial y el pliegue cutaneo tricipital y el IMC, presentaron valores algo superiores a la poblacion de referencia, especialmente en las edades mayores. La Prevalencia de sobrepeso fue de 4.05%, con un mayor numero de casos a partir de los 12 anos y sin que se apreciaran diferencias por sexos. CONCLUSIONES: Los escolares presentaron un patron antropometrico ligeramente superior a la poblacion de referencia, y una baja prevalencia de sobrepeso. Estos resultados estan en linea con los publicados por los autores sobre la alimentacion de esta poblacion.

Effects of lipid-based nutrient supplements v. micronutrient powders on nutritional and developmental outcomes among Peruvian infants

OBJECTIVE To determine the effects of lipid-based nutrient supplements (LNS) on childrens Hb, linear growth and development, compared with supplementation with micronutrient powder (MNP). DESIGN The study was a two-arm parallel-group randomized controlled trial, where participants received either LNS or MNP for daily consumption during 6 months. Supplements were delivered by staff at government-run health centres. Hb, anthropometric, motor development, language development and problem-solving indicators were measured by trained research assistants when children were 12 months of age. SETTING The study was conducted in five rural districts in the Province of Ambo in the Department of Huánuco, Peru. SUBJECTS We enrolled 6-month-old children (n 422) at nineteen health centres. RESULTS Children who received LNS had a higher mean Hb concentration and lower odds of anaemia than those who received MNP. No significant differences in height-for-age, weight-for-height or weight-for-age Z-score, or stunting and underweight prevalence, were observed. Provision of LNS was associated with a higher pre-verbal language (gestures) score, but such effect lost significance after adjustment for covariates. Children in the LNS group had higher problem-solving task scores and increased odds of achieving this cognitive task than children in the MNP group. No significant differences were observed on receptive language or gross motor development. CONCLUSIONS LNS between 6 and 12 months of age increased Hb concentration, reduced anaemia and improved cognitive development in children, but showed no effects on anthropometric indicators, motor or language development.

Relevancia del soporte nutricional especializado en las declaraciones de voluntades anticipadas. Experiencia de un centro hospitalario de especialidades

Introduction: The Statement of Advance Directives (SAD) is a written document that contains the preferences for health care and treatments desired to receive when the capacity to express is lost. Objective: To study the content of SAD registered in the office of Register of Advance Directives of the Hospital Universitario Puerta del Mar regarding Specialized Nutritional Support (SNS) and hydration in the period from November 2013 to December 2015. Method:Cross-sectional study on the content of the SAD written in the form of Decree 59/2012. Nine relevant variables related with SNS-H are studied in the DVA. Results: 414 SAD are analysed, 60% of which belong to women. The average age is 55.2 years. 41.7% of the SAD was registered by self-motivation. 84.78% do not wish to receive parenteral nutrition, 91.06% reject feeding through gastrostomy intubation, and 89.37% do not want to receive the nasogastric intubation. Hydration is rejected by 71.25%. The three possible options of SNS depend on the age of the declarant with statistical significance (p < 0.001), but not so for hydration. Both SNE and hydration are significantly associated with the reasons for the registration of Advance Directives (p < 0.001). Conclusions: Age is the main factor that determines the choice of accepting or rejecting SNS. By contrast, the choice of hydration is not conditioned by age. The reasons that drive respondents to register DVA is another determinant in the choice of whether to receive or not SNE and hydration.