WHAT'S KNOWN ON THIS SUBJECT:The number of overweight and obese children has dramatically increased in recent decades. To combat this trend, information on possible gender-related differences in risk factors of overweight and obesity is critical.
WHAT THIS STUDY ADDS:This study examines associations of gender and physiologic and behavior measurements with potential cardiovascular risk. Lunch consumption and screen time were associated with weight; however, other associations with weight differ by gender. This information can be used to tailor future interventions.
abstractBACKGROUND: Previous studies have demonstrated gender-related differences in body composition, physical activity, and diet. This observational study assesses gender variance in independent predictors for obesity to determine targeted areas for intervention.
METHODS:Data from 1714 sixth-grade students enrolled in Project Healthy Schools were compared by using health behaviors and physiologic markers (lipids, random glucose, blood pressure, and resting and recovery heart rates). Students were stratified by gender and obesity (BMI $95th percentile by age and gender). Physiologic markers and behaviors were compared by using x 2 analysis. Univariate associations with P , .10 were included in a stepwise logistic regression model to determine independent predictors for obesity by gender.
Introduction: Adverse events are common in medical training and practice, which can lead to distress among providers. One method of coping with distress is debriefing, which has been shown to improve participants' ability to manage their grief and has been associated with lower rates of burnout. Methods: We designed this 2-hour workshop to provide senior residents with the knowledge and skills to lead debriefing sessions within their teams. In this curriculum, we have included a workshop facilitator's guide, didactic information reviewing the components of effective debriefing, a video of a sample debriefing, two videos demonstrating potential debriefing challenges, small-group practice cases, a debriefing pocket card resource, and pre-and postworkshop survey evaluations. Results: Twenty second-year pediatric and medicine-pediatric residents were included in the pilot study of this workshop. They reported an average of 2.2 (SD = 2.4) distressing events in the preceding month. None of the residents had received previous training in debriefing, and only 10% had previously led a debriefing session. Pre-and postintervention surveys demonstrated significant increases in resident comfort in and likelihood of leading a debriefing session, as well as in recognition of personal distress. Discussion: This workshop serves as one model to enhance training and education regarding debriefing in residency training programs. The issue of distress is not unique to residents, and although this training was initially designed for that population, it could easily be adapted to reach a broader audience of medical trainees and providers.
IntroductionHepatopulmonary syndrome is a clinical syndrome that can affect patients of all ages with liver disease and is more common in children with biliary atresia. Contrast echocardiography is the test of choice to diagnose the presence of intrapulmonary vascular dilatation. The established treatment for hepatopulmonary syndrome is liver transplantation.Case presentationWe present the case of an 8-month-old Caucasian baby boy with a history of biliary atresia, polysplenia, and interrupted inferior vena cava who presented with hypoxemia and cyanosis that progressed rapidly. A chest computed tomography angiogram revealed significant dilatation of the pulmonary vasculature, prompting further evaluation and diagnosis of hepatopulmonary syndrome with contrast echocardiography. He was maintained on a milrinone infusion while awaiting liver transplantation. His hypoxemia improved slowly following liver transplantation, requiring tracheostomy and prolonged ventilator dependence.ConclusionsHepatopulmonary syndrome should be included in the differential for progressive hypoxemia in children with liver disease, particularly those with biliary atresia. Imaging with chest computed tomography angiogram and contrast echocardiography should be considered in cases of unexplained refractory hypoxemia.
The traditional methods of teaching as well as multimedia teaching and to suggest other useful teaching methods that can be attempted in imparting knowledge to the students. Basically teaching must include two major components sending and receiving information. Ultimately, a teacher tries his best to impart knowledge as the way he understood it. So, any communication methods that serve this purpose without destroying the objective could be considered as innovative methods of teaching. The use of innovative methods in educational institutions has the potential not only to improve education, but also to empower people, strengthen governance and galvanize the effort to achieve the human development goal for the country.
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