Patricia T. Alpert

Parental disconnect between perceived and actual weight status of children: a metasynthesis of the current research.

Purpose: Obesity is one of the most common chronic diseases in childhood. Many studies offer a variety of explanations for the alarming increase in childhood obesity; however, none discuss why an apparent disconnect exists in parental perceptions of their childs weight status. The purpose of this article was to review the current research literature on parental perceptions about their childrens weight. Data source: The articles included in this review were retrieved through a literature search using PubMed. Key words used to obtain relevant articles include childhood obesity, childhood overweight, and parental perception. Conclusions: Several studies looked at parental perceptions of childhood obesity generated from the United Kingdom, Australia, Italy, and the United States. Universally, parents were more likely to misperceive their childs weight. This was especially true for parents who were themselves overweight. Implications for practice: If parents do not recognize their child as at risk for overweight or overweight, they cannot intervene to diminish the risk factors for pediatric obesity and its related complications. More research is needed to identify why this phenomenon occurs. Only then can effective interventions be initiated.

The effect of modified jazz dance on balance, cognition, and mood in older adults

Purpose: The purpose of this pilot study was to evaluate the impact of jazz dance class instruction on balance, cognition, and mood (specifically depression) in 13 healthy, community‐dwelling, English‐speaking older women with a mean age of 68. Data sources: Data were collected using self‐report questionnaires (Folstein Mini Mental Status Examination [MMSE] and Geriatric Depression Scale [GDS]), and the sensory organization test (SOT) for balance measurements (using the NeuroCom Smart Balance Master) was performed at three time periods in the study: time 1: between week 1 and week 2 of jazz class (baseline), time 2: between week 8 and week 9 of jazz class (midpoint), and time 3: after week 15 of jazz class (final measurement). Conclusions: Differences in mean MMSE and GDS scores over time were not significant; however, SOT scores showed an increasing trend (p < .001). Data analysis using analysis of variance with repeated measures showed that balance measures improved throughout the duration of the study (F2,10 = 19.68, p < .001). Post hoc analyses using paired t tests with a Bonferroni correction indicated that significant increases in balance occurred from time 1 to time 2 and from time 2 to time 3. These preliminary pilot study findings suggest that jazz dance does not impact cognition or mood but may improve balance in older women. This finding may have significant implications for fall prevention in the postmenopausal population. Implications for practice: Because falls are a leading cause of morbidity and mortality in older adults of both genders, research is needed to evaluate both the impact of jazz dance on balance in older men and jazz dance as a fall prevention strategy in aging adults. Additionally, longitudinal research with a larger sample size is needed to test the effectiveness of jazz dance as a strategy for improving balance, cognition, and mood.

Postural balance in young adults: the role of visual, vestibular and somatosensory systems.

Purpose: The purpose of the study is to examine what sensory system predominates to maintain balance (e.g., visual, vestibular, and somatosensory) among people in their twenties and thirties. Data sources: A subset of individuals from a larger descriptive cross‐sectional study was assessed. A sample of 194 (males = 28%, females = 72%) young adults in the second and third decades of life had anthropometric measurements (height, weight, waist circumference, hip circumference, and leg length) taken and body mass index and waist‐to‐hip ratio were calculated. Balance was assessed using the NeuroCom Balance Master machine. Results: There was a significant difference among the three sensory systems for postural balance among the young population, F (2, 576) = 111.741, p < .001. Post hoc Bonferroni tests were maintained at the 0.05 level which showed significance for the visual system compared to vestibular and somatosensory system: visual (M = 93.7, SD = 2.07); vestibular (M = 90.4, SD = 2.74); and somatosensory (M = 90.0, SD = 3.13). Based on the results, the visual system is the predominant sensory system used by young adults to maintained optimal postural balance. Significance for Practice: There is very little known about balance of younger adults. If balance issues are identified early in adult life it is possible to prevent exacerbation of balance decline as one age. If nurse practitioners are aware of what dominant sensory systems for balance young adults use, perhaps strategies to preserve these can avoid falls as they age.

The Effect of a Senior Jazz Dance Class on Static Balance in Healthy Women Over 50 Years of Age: A Pilot Study

The purpose of this pilot study is to assess the impact of a senior jazz dance class on static balance for healthy women over 50 years of age using the NeuroCom Smart Balance Master System (Balance Master). A total of 12 healthy women aged 54—88 years completed a 15-week jazz dance class which they attended 1 time per week for 90 min per class. Balance data were collected using the Sensory Organization Test (SOT) at baseline (pre), at 7 weeks (mid), and after 15 weeks (post). An equilibrium score measuring postural sway was calculated for each of six different conditions. The composite equilibrium score (all six conditions integrated to 1 score) was used as an overall measure of balance. Repeated measures analyses of variance (ANOVAs) were used to compare the means of each participants SOT composite equilibrium score in addition to the equilibrium score for each individual condition (1—6) across the 3 time points (pre, mid, post). There was a statistically significant difference among the means, p < .0005. Pairwise (Bonferroni) post hoc analyses revealed the following statistically significant findings for SOT composite equilibrium scores for the pre (67.33 + 10.43), mid (75.25 + 6.97), and post (79.00 + 4.97) measurements: premid (p = .008); prepost (p < .0005); midpost (p = .033). In addition, correlational statistics were used to determine any relationship between SOT scores and age. Results indicated that administration of a 15-week jazz dance class 1 time per week was beneficial in improving static balance as measured by the Balance Master SOT.

The Effects of Vitamin D Deficiency and Insufficiency on the Endocrine and Paracrine Systems

Individuals are capable of producing vitamin D with proper exposure to sunlight. However, several factors can interfere with the effectiveness of this process. Most sunscreens filter out UVB light, thus inhibiting vitamin D production. Individuals with more darkly pigmented skin have greater difficulty producing vitamin D because melanin acts as an effective natural sunscreen, requiring longer sun exposure to produce an adequate daily allotment of vitamin D. Additionally, solely breastfed infants whose mothers suffered from vitamin D deficiency or insufficiency when pregnant have smaller reserves of the nutrient and are at greater risk of developing nutritional rickets. Vitamin D deficiency leads to rickets, osteomalacia, and osteoporosis. Long-term vitamin D insufficiency can lead to paracrine effects such as type 1 diabetes, cancer, and multiple sclerosis. This article reviews the current literature on vitamin D deficiency and insufficiency and their relation to different disease states. Potential areas for research are discussed.

New and Emerging Theories of Cardiovascular Disease: Infection and Elevated Iron

Heart disease is the leading cause of death in both men and women in industrialized countries. Despite the tremendous gains made in decreasing the number of deaths due to cardiovascular disease, it still is health care’s greatest challenge. Traditional risk factors account for only 50% of the incidence of cardiac disease. In fact, many individuals who develop heart disease have normal cholesterol and blood pressure levels. This suggests that other less well-studied risk factorsmay also play a role. The purpose of this report is to examine the role that recently suggested risk factors may play in the development of heart disease: coronary artery infection, specifically fromChlamydia pneumoniae, and elevated iron levels. Both initiate an inflammatory response, which might explain the elevated C-reactive protein levels frequently found in those who suffer from cardiac disease.

Practices of vitamin D recommendation in Las Vegas, Nevada.

Reports of vitamin D deficiency rickets, although rare in the United States, have increased over the past few years, including in children living in climates with abundant sunshine. The purpose of this study was to describe vitamin D recommendation practices among pediatric health care providers in Las Vegas, Nevada. Of the 155 providers surveyed, 52.3% did not recommend vitamin D for exclusively breastfed babies. Providers who were more likely to recommend supplementation were doctors of medicine, were female, specialized in pediatrics, were of Hispanic ethnicity, had previously practiced and trained in states less sunny than Nevada, had graduated from training 21 or more years previously, had taken histories of infants’ sun exposure, and had clinical experience with cases of rickets. Providers demonstrated a knowledge deficit for questions that dealt with preventive measures. J Hum Lact. 20(1):56-61.

Promising New Causal Explanations for Obesity and Obesity-Related Diseases

Current explanations for obesity center around a predisposition in genotype and phenotype, possibly triggered by an inflammatory process or event, and exacerbated by environmental and psychological factors. It is likely that a variety of physiologic factors may act in combination to produce clinical obesity. Leptin resistance may be an important neurochemical cause of obesity; elevated leptin levels have been correlated with weight gain over extended time periods. Genetic studies support the postulate that a gene originating with our cave-dwelling ancestors, critical to survival when food was scare, has evolved into a trigger for obesity and related diseases. A variety of biochemical markers are prevalent in obesity and obesity-linked disease states. C-reactive protein, interleukin-6, and others are elevated in obesity, supporting the hypothesis that inflammation plays a role in the condition. Tumor necrosis factor-α is overexpressed in obesity and diabetes, suggesting that it may be part of the link between the 2 conditions.

The Health Benefits of Dance

296/17/2095 Zerbe, K. (1995). The body betrayed: A deeper understanding of women, eating disorders and treatment. Carlsbad, CA.

Assessment and differential diagnosis of abdominal pain

Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. It is incumbent upon the primary care provider to have a thorough understanding of the many potential causes of abdominal pain, as well as a methodical, comprehensive, yet concise approach to its assessment.