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1.
Objectives:  The Broselow pediatric emergency weight estimation tape is an accurate method of estimating children's weights based on height–weight correlations and determining standardized medication dosages and equipment sizes using color-coded zones. The study objective was to determine the accuracy of the Broselow tape in the Indian pediatric population.
Methods:  The authors conducted a 6-week prospective cross-sectional study of 548 children at a government pediatric hospital in Chennai, India, in three weight-based groups: <10 kg ( n =  175), 10–18 kg ( n =  197), and >18 kg ( n =  176). Measured weight was compared to Broselow-predicted weight, and the percentage difference was calculated. Accuracy was defined as agreement on Broselow color-coded zones, as well as agreement within 10% between the measured and Broselow-predicted weights. A cross-validated correction factor was also derived.
Results:  The mean percentage differences were −2.4, −11.3, and −12.9% for each weight-based group. The Broselow color-coded zone agreement was 70.8% in children weighing less than 10 kg, but only 56.3% in the 10- to 18-kg group and 37.5% in the >18-kg group. Agreement within 10% was 52.6% for the <10-kg group, but only 44.7% for the 10- to 18-kg group and 33.5% for the >18-kg group. Application of a 10% weight-correction factor improved the percentages to 77.1% for the 10- to 18-kg group and 63.0% for the >18-kg group.
Conclusions:  The Broselow tape overestimates weight by more than 10% in Indian children >10 kg. Weight overestimation increases the risk of medical errors due to incorrect dosing or equipment selection. Applying a 10% weight-correction factor may be advisable.  相似文献   

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PURPOSE.  To test the feasibility and impact of an individually tailored educational intervention to promote healthy weight in Chinese American children (ages 8–10).
DESIGN.  A pre- and post-test study ( N  = 57) using standardized instruments to measure children's usual food choices, knowledge of nutrition and physical activity needs, and time spent engaging in physical and sedentary activities.
RESULTS.  We found improvement after the intervention in all three areas.
PRACTICE IMPLICATIONS.  Healthcare providers need to provide parents and children with specific recommendations regarding children's weight statuses, dietary intake, and levels of activity.  相似文献   

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Title.  Chronic sorrow in parents of children with type 1 diabetes.
Aim.  This paper reports on a study exploring parents' longer-term experiences of having a child with type 1 diabetes.
Background.  Parents of children with type 1 diabetes may experience a grief reaction at diagnosis similar to that normally associated with bereavement, but little is known about their long-term emotional adaptation. Chronic sorrow, a sustained but intermittent grief reaction, is identified in adults with diabetes but has not previously been explored in relation to parents.
Methodology.  In-depth interviews were conducted in 2007 with a convenience sample of 17 parents of children with type 1 diabetes 7–10 years after diagnosis. Data were explored within a theoretical framework of grief, loss, adaptation, and change.
Findings.  Parents had adapted to the needs of diabetes management but most had not 'come to terms' with the diagnosis. They experienced a resurgence of grief at critical times during their child's development and some, particularly mothers, became upset during their interviews, even though these took place 7–10 years after their child's diagnosis. Mothers elaborated more on their emotions than fathers, but continuing feelings associated with grief, such as anger and guilt, were expressed by both fathers and mothers.
Conclusion.  Greater understanding of parents' long-term emotional responses and recognition that grief may never resolve in these parents may enable healthcare professionals to provide appropriate and timely support at critical times.  相似文献   

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PURPOSE.  The purpose of this focused ethnographic study was to explore the quality of life (QOL) of school-age heart-transplant recipients.
DESIGN AND METHODS.  Semistructured interviews were conducted with 11 parent–child dyads. Data were analyzed using content analysis and constant comparison.
RESULTS.  Participants identified key factors impacting the children's QOL including: participation in normal activities, normalcy, staying healthy, sources of strength and support, and struggles (parents' perspectives) and doing what kids do, being with family and friends, and being a heart transplant kid (children's perspectives).
PRACTICE IMPLICATIONS.  Interventions focusing on the key factors identified by participants may impact the QOL of school-age heart-transplant recipients.  相似文献   

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ABSTRACT Objectives: The aim of this study was to compare the risk factors in women who delivered an infant of low birth weight (LBW, <2,500 g) versus women who delivered an infant weighing >2,500 g in a large metropolitan county (Bexar) in South Texas.
Design: An exploratory case comparison design was used to identify factors related to LBW outcomes in women receiving prenatal care.
Sample: The cases were obtained from community hospitals. A stratified random sample was selected from a population of 38,064 infant births, of which 2,910 were identified as LBW. The final sample size was N =321 (<2,500 g, n =151; ≥2,500 g, n =170).
Measurements: Dependent variable of infant birth weight; independent variables of maternal age, maternal race/ethnicity, education, smoking, prior pregnancy history, timing of and number of prenatal visits, prepregnancy body mass index and weight gain during pregnancy, and past medical history and medical problems during pregnancy.
Results: Independent variables found to be predictive of LBW in this study included maternal race/ethnicity, timing of first prenatal visit, number of prenatal visits, prior pregnancy history, and maternal weight gain.
Conclusions: This study confirmed previous findings that African American women are at a higher risk for LBW deliveries and demonstrated that Anglo and Hispanic women have similar rates of LBW deliveries.  相似文献   

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BACKGROUND: The relationship between length of storage of red blood cell (RBC) units and biochemical changes has been well studied, but little is known about the progression of cellular immunomodulative properties in blood recipients. This study aims to quantify in vitro T-cell activation and cytokine release by white blood cells, after incubation with supernatants from leukoreduced RBCs.
STUDY DESIGN AND METHODS: Whole blood cultures were incubated with supernatant from five leukoreduced RBC units stored for 1, 6, 10, 15, 24, and 42 days. Supernatant-induced T-cell activation was evaluated by quantifying CD25 expression. Supernatant-induced cytokine production was determined by measuring interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α levels.
RESULTS: No cytokines were detected in RBC supernatants even after 42 days of storage. However, IL-6 levels in whole blood culture increased significantly when incubated with supernatant from RBC units stored for 1, 6, and 15 days, by factors of 1.7 ± 0.3, 1.7 ± 0.3, and 1.4 ± 0.3, respectively. TNF-α levels were significantly decreased on Days 24 and 42 of storage by factors of 0.50 ± 0.42 and 0.33 ± 0.21, respectively. IL-10 levels were significantly increased on Days 1 and 42 of storage by factors of 2.3 ± 1.3 and 3.2 ± 2.8, respectively. After an initial increase in IL-6 and TNF-α production, there was a significant linear decrease in their levels measured from units stored for longer times. No significant changes in CD25 expression were observed over time.
CONCLUSION: Although no cytokines were measured in the supernatants from leukoreduced RBCs, these supernatants exhibited variable immunomodulatory effects related to their length of storage.  相似文献   

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Background:  Involving school nurses in weight gain prevention activities in already overweight children may be a means to address childhood obesity prevention.
Objective:  To describe and evaluate a treatment method aimed for implementation in school care centres.
Methods:  Twenty families (20 overweight children aged 7 years) were interviewed at baseline with standardized questionnaires, received simple dietary and lifestyle advice. Weight was measured and advice/support by school nurses was available monthly during the 1-year period. A follow-up was made after 1 year. Changes in wellbeing, life style and body mass index (BMI) z -score were recorded and analysed. Experiences from parents and nurses were also examined.
Results:  A good (91%) or fair (54%) adherence to dietary advice was found in children who decreased or maintained their z -score respectively. Mean BMI z -score reduced [−0.16 (p = 0.03)] during the intervention period. Generally, parents and school nurses were satisfied with the programme, helping them to set limits and be more self-confident in their role as 'health adviser' respectively.
Conclusions:  Overweight progression in younger children is possible to modify by increased awareness of the problem, of their food habits and lifestyle practices. Providing school nurses with the knowledge to address the problem and working in collaboration with dieticians and a healthcare team can be an effective means to prevent further weight gain in overweight school-age children. Possibility of stigmatization was expressed thus efforts will need to be made to carry out such a programme to preserve the children's integrity and run activities in a discrete manner in the school environment.  相似文献   

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