What vitamins and minerals should be given to breastfed and bottle-fed infants?

Breastfed and formula-fed infants should receive intramuscular vitamin K soon after birth to prevent classic hemorrhagic disease of the newborn (strength of recommendation [SOR]: A, systematic review of controlled trials). Routine iron supplementation for all term, healthy, breastfed infants is not proven to be safe or necessary. Formula-fed infants should be consuming formula that contains 10 to 12 mg/L of iron (SOR: A, 2 small randomized controlled trials)

Does a high-fiber diet prevent colon cancer in at-risk patients?

There is no direct evidence of an effect of dietary fiber on colon cancer incidence. A diet high in fiber has not been shown to be effective in the short-term (2- to 4-year) prevention of recurrent colon polyps (strength of recommendation [SOR]=A, based on consistent randomized clinical trials). Furthermore, epidemiological evidence is inconsistent in demonstrating an association between dietary fiber consumption and the occurrence of colon cancer (SOR=C)

Training a New Librarian in the What, How, Where, and Why of Health Sciences Collection Management

Collection management for the health sciences, particularly clinical medicine, is an increasingly complex job which, anecdotally, is usually given to experienced librarians. Health sciences libraries tend to delegate collections responsibilities to one librarian who holds all of the institutional collections knowledge. Replacing these people as they retire or move on can be difficult unless new librarians become trained in collections work. At the Michigan State University Libraries, recent search committee experience revealed that an entrylevel health sciences collections position attracted fewer applicants than entry‐level health sciences positions for instruction, liaison, or educational technology. This may reflect the focus of library school curricula as even applicants for the collections position generally had very little relevant exposure to the subject in library school or internships. Health sciences librarianship in general can involve a lot of on‐the‐job training, but supervisors hiring new librarians for collections may find themselves starting from scratch. This poster will demonstrate a detailed training program developed to teach a newly graduated librarian how to develop and manage an extensive clinical medicine collection at a large university library serving medical schools. The step‐wise approach focuses on learning by doing, moving from the specific to general principles rather than the other way around. Decision making for selection of materials is approached from multiple angles: institutional analysis, subject analysis, and publisher and vendor knowledge. The new librarian will provide insight into which parts of the training were most helpful

Do statins reduce the risk of stroke?

HMG Co-A reductase inhibitors (statins) are effective for primary prevention of ischemic stroke in people who have a history of occlusive artery disease, coronary artery disease, or diabetes without history of cerebrovascular disease (strength of recommendation [SOR]: A, based on 1 randomized controlled trial [RCT]). Statins reduce the risk of ischemic stroke in hypertensive patients with multiple cardiovascular risk factors and nonfasting total cholesterol <250 mg/dL (SOR: A, based on RCT). Statins also reduce the risk of ischemic stroke for patients with coronary disease or equivalents (such as diabetes or peripheral artery disease), including patients who have a normal fasting lipid profile (SOR: A, based on RCT). For patients with ischemic stroke who have coronary disease, statins prevent recurrent ischemic stroke; evidence is conflicting about whether this benefit is proportional to initial cholesterol levels (SOR: A, systematic review). Statins do not prevent hemorrhagic stroke (SOR: A, based on RCTs)

Which complementary therapies can help patients with PMS?

Chasteberry tree and calcium have demonstrated efficacy and safety in treating symptoms of premenstrual syndrome (PMS) (strength of recommendation [SOR]: A, randomized controlled trials [RCTs]). Pyridoxine and saffron may be effective, but high doses of pyridoxine can cause neuropathy (SOR: B, RCT and meta-analysis of lower-quality studies). Insufficient evidence exists to recommend magnesium. St. John's wort and evening primrose oil aren't effective for managing PMS (SOR: B, inconsistent or limited quality patient- oriented evidence). No evidence was found to support black cohosh or vitamin E

When is it OK for children to start drinking fruit juice?

Children should be at least 6 months of age (strength of recommendation [SOR]: C, expert opinion) and parents should provide only 100% fruit juice in a cup (not a bottle). Intake should be limited to 4 to 6 oz a day until 12 months of age (SOR: C, expert opinion). It's important to reiterate to parents that breastfeeding is the preferred source of infant nutrition for the first 6 (preferably 12) months of life (SOR: A, systematic reviews)

What is the clinical workup for failure to thrive?

The clinical evaluation of failure to thrive (FTT) includes a thorough history and physical examination; observation of parent-child interactions; observation and documentation of the child's feeding patterns; and a home visit by an appropriately trained health care professional (Strength of Recommendation [SOR]: C). Further diagnostic testing should be performed as indicated by positive findings from the history and physical exam or if the child's weight has not improved at follow-up (SOR: C)

Air Pollution and Odor in Communities Near Industrial Swine Operations

BackgroundOdors can affect health and quality of life. Industrialized animal agriculture creates odorant compounds that are components of a mixture of agents that could trigger symptoms reported by neighbors of livestock operations.ObjectiveWe quantified swine odor episodes reported by neighbors and the relationships of these episodes with environmental measurements.MethodsBetween September 2003 and September 2005, 101 nonsmoking volunteers living within 1.5 mi of industrial swine operations in 16 neighborhoods in eastern North Carolina completed twice-daily odor diaries for approximately 2 weeks. Meteorological conditions, hydrogen sulfide, and particulate matter ≤ 10 μm in aerodynamic diameter (PM10) were monitored in each neighborhood. We used mixed models to partition odor variance within and between people and between neighborhoods, and to quantify relationships between environmental factors and odor.ResultsParticipants reported 1,655 episodes of swine odor. In nine neighborhoods, odor was reported on more than half of study-days. Odor ratings were related to temperature, PM10, and semivolatile PM10 in standard but not mixed models. In mixed models, odor increased 0.15 ± 0.05 units (mean ± SE) for a 1-ppb increase in H2S, and 0.45 ± 0.14 units for a 10-μg/m3 increase in PM10 at wind speeds > 6.75 miles per hour. The odds of reporting a change in daily activities due to odor increased 62% for each unit increase in average odor during the prior 12 hr (t-value = 7.17).ConclusionsThis study indicates that malodor from swine operations is commonly present in these communities and that the odors reported by neighbors are related to objective environmental measurements and interruption of activities of daily life

Trajectories and predictors of response in youth anxiety CBT:Integrative data analysis

OBJECTIVE: Integrative data analysis was used to combine existing data from nine trials of cognitive-behavioral therapy (CBT) for anxious youth (N = 832) and identify trajectories of symptom change and predictors of trajectories.METHOD: Youth- and parent-reported anxiety symptoms were combined using item-response theory models. Growth mixture modeling assessed for trajectories of treatment response across pre-, mid-, and posttreatment and 1-year follow-up. Pretreatment client demographic and clinical traits and treatment modality (individual- and family-based CBT) were examined as predictors of trajectory classes.RESULTS: Growth mixture modeling supported three trajectory classes based on parent-reported symptoms: steady responders, rapid responders, and delayed improvement. A 4-class model was supported for youth-reported symptoms: steady responders, rapid responders, delayed improvement, and low-symptom responders. Delayed improvement classes were predicted by higher number of diagnoses (parent and youth report). Receiving family CBT predicted membership in the delayed improvement class compared to all other classes and membership in the steady responder class compared with rapid responders (youth report). Rapid responders were predicted by older age (parent report) and higher number of diagnoses (parent report). Low-symptom responders were more likely to be male (youth report).CONCLUSIONS: Integrative data analysis identified distinct patterns of symptom change. Diagnostic complexity, age, gender, and treatment modality differentiated response classes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).</p