Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting

The prevalence of childhood obesity is increasing worldwide with long‐term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects. Evaluation of interventions could provide more practically relevant information when considered in the context of the setting in which the intervention was delivered. This systematic review has evaluated diet and physical activity interventions aimed at reducing obesity in children, from birth to 5 years old, by intervention setting. A systematic review of the literature, consistent with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, was performed. Three electronic databases were searched from 2010 up to December 2020 for randomised controlled trials aiming to prevent or treat childhood obesity in children up to 5 years old. The studies were stratified according to the setting in which the intervention was conducted. Twenty‐eight studies were identified and included interventions in childcare/school (n = 11), home (n = 5), community (n = 5), hospital (n = 4), e‐health (n = 2) and mixed (n = 1) settings. Thirteen (46%) interventions led to improvements in childhood obesity measures, including body mass index z‐score and body fat percentage, 12 of which included both parental/family‐based interventions in conjunction with modifying the child''s diet and physical activity behaviours. Home‐based interventions were identified as the most effective setting as four out of five studies reported significant changes in the child''s weight outcomes. Interventions conducted in the home setting and those which included parents/families were effective in preventing childhood obesity. These findings should be considered when developing optimal strategies for the prevention of childhood obesity.     

Eine Wirkung des Progesterons auf die Atmung

Zusammenfassung An vier männlichen Versuchspersonen und einer Frau in der Menopause wurde eine steigernde Wirkung des Corpus-luteum-Hormons auf die Atmung beschrieben. Die aus anderen Gründen von Döring und Loeschcke ²⁰ vorgelegte Anschauung, daß das Progesteron der führende Faktor bei den Atmungsveränderungen der Frau während Schwangerschaft und lutealer Phase des normalen Zyklus ist, wird dadurch bestätigt.Mit 7 Textabbildungen. Hermann Rein zum 50. Geburtstag gewidmet.Herrn Prof. Dr. H. Martius, Göttingen und Herrn Prof. Dr. C. Kaufmann, Marburg, danken wir für die liebenswürdige Unterstützung unserer Arbeit.     

Dental care utilization: a study of 50- to 75-year-olds in Southern Sweden

This study investigates dental care utilization in an adult population in Southern Sweden in relation to dental and social conditions, attitudes to costs, and perceived need to obtain dental services. The study was based on responses to a questionnaire sent in 1998 to a random sample, 1974 persons, aged 50-75 years. The response rate was 66%. A significantly higher probability of dental care utilization less than once a year was found for men, for those with few remaining teeth, and for those with removable dentures. A higher probability of dental care utilization less than once a year was found for those who stated perceived need to obtain dental care with no possibility because of the cost and for those who stated that the cost had influenced their attendance for dental care. The results showed that there were differences for sex and dental conditions in dental care utilization and that dental care utilization was related to attitudes towards costs of dental care.     

When people with dementia are perceived as witches. Consequences for patients and nurse education in South Africa

Aims and Objectives

To explore and describe the link between culture and dementia care with the focus on the influence of the belief in dementia as witchcraft and people with dementia as witches.

Background

In South Africa, especially in townships and rural areas, dementia is often perceived as connected to witchcraft rather than to disease. Persons labelled as witches—mostly older women—may be bullied, ostracised, beaten, stoned, burned, even killed.

Method

One strand of findings from a larger international study is presented with in‐depth qualitative interviews of one close family member and seven nurses caring for patients with severe dementia in nursing homes in Tshwane in South Africa. A hermeneutic analytic approach was used.

Results

Two main themes are found, namely “Belief in witchcraft causing fear of persons with dementia” and “Need of knowledge and education.” Fear of and violence towards people with dementia are based on the belief that they are witches. Some of the nurses had also held this belief until they started working with patients with dementia. There is a great need for education both among healthcare workers and the populace.

Discussion

The “witch” belief prevents seeking professional help. As nursing homes tend to be private and expensive, professional dementia care is virtually unattainable for the poor. Dementia needs a more prominent place in nursing curricula. Nurses as educators need to know the local culture and language to be accepted in the various communities. They need to visit families affected by dementia, give awareness talks in churches, schools and clinics and facilitate support groups for carers of people with dementia in the local language.

Conclusion

Improved nurses’ education in gerontology and geriatric care is needed. Trained specialist nurses may work as mediators and help eradicate the witchcraft beliefs connected to severe dementia.     

Novel Nickel Contact Dermatitis in a Patient Taking Isotretinoin

There are many reports about contact dermatitis to nickel and side effects of isotretinoin, but the development of contact dermatitis to a previously tolerated allergen while taking isotretinoin is not well described. We report the case of a 19‐year‐old man who developed a new nickel allergy during isotretinoin treatment. We theorize that thinning of the stratum corneum by this medication allows for greater antigen presentation and thus sensitization to contact allergens.