Which variables influence compliance with physical activity recommendations in young children?

Introducción: Existen recomendaciones europeas de actividad física para la infancia. El principal objetivo de estudio era determinar los factores que podrían influir en el cumplimiento de las recomendaciones europeas de actividad física en la primera infancia. Métodos: Se incluyó a 136 niños (2-8 años), clasificados según su estado de peso medido con puntajes Z del IMC siguiendo los estándares de la Organización Mundial de la Salud. Se midió la actividad física durante 5 días consecutivos con acelerómetros y la ingesta diaria. Resultados: Una mayor actividad física se asoció con un menor estado de peso (B = −1,55; IC 95%: −2,02 a −1,08; p < 0,001), menor edad (B = −1,33; IC 95%: −1,72 a −0,93; p < 0,001) y mayor gasto energético (B = 0,02; IC 95%: 0,02 a 0,03; p < 0,001). El total de la muestra tuvo una actividad física ligera (media = 589 cpm/día). Los niños con sobrepeso y obesidad pasaron menos tiempo en actividad física moderada-vigorosa (p = 0,005) y más tiempo en actividad física sedentaria (p = 0,005) que los del grupo normopeso. Todos los grupos pasaron entre 90 y 130 min diarios en actividades sedentarias, con una media que supone un 15,5% del tiempo de actividad (eliminando las horas de sueño). El cumplimiento de las recomendaciones europeas depende del sexo (p = 0,010) y del estado de peso (p = 0,038). Conclusión: Los preescolares pasaron más de 100 min diarios en tiempo sedentario. Las recomendaciones europeas de actividad física moderada-vigorosa diarias se cumplieron por la mayoría de la muestra. Sin embargo, este cumplimiento dependía del sexo y del menor estado de peso.Introduction: There are established European guidelines for physical activity in childhood. The main goal of our study was to determine the factors that may influence compliance with European recommendations for physical activity in young children. Methods: We included 136 children (aged 2-8 years) classified by weight status, calculated based on the body mass index z-score using the growth standards of the World Health Organization. We measured physical activity over 5 consecutive days with accelerometers and recorded the food intake. Results: A greater level of physical activity was associated with a lower weight status category (B = −1.55; 95% CI: −2.02 to −1.08; P < .001), lower age (B = −1.33; 95% CI: −1.72 to −0.93; P < .001) and greater energy expenditure (B = 0.02; 95% CI: 0.02 to 0.03; P < .001). The overall physical activity in the sample was light (mean = 589 cpm/day). Children with overweight and obesity spent less time engaged in moderate to vigorous physical activity (P = .005) and more time engaged in sedentary activities (P = .005) compared to children with normal weight. All groups spent between 90 and 130 minutes a day in sedentary activities, with a mean time spent that amounted to 15.5% of their time (excluding time spent sleeping). The adherence to European recommendations varied in association with sex (P = .010) and weight status (P = .038). Conclusion: Young children spent more than 100 minutes a day engaged in sedentary activities. Most of the sample met the European recommendations for daily moderate to vigorous physical activity. However, the degree of adherence depended on sex and weight status

Highest Plasma Phenylalanine Levels in (Very) Premature Infants on Intravenous Feeding; A Need for Concern

Objective. To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age. Study Design. This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula), or partial or fully intravenous feeding], gestational age in weeks (<32, 32–37, ≥37), gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] ≥95th percentile. Associations were analysed using multivariate models [linear (means difference) and logistic regression (adjusted odds ratios)]. Results. Higher phenylalanine values were associated with lower gestational age (p<0.001) and with intravenous feeding (p<0.001). Conclusion. The degree of prematurity and intravenous feeding influenced the plasma concentration of phenylalanine in the newborn. Caution should be taken in [phenylalanine] for newborns with intravenous feeding, monitoring them carefully. Very preterm infants given the recommended amount of amino acids should also be strictly monitored. These findings should be taken into consideration and call for adapting the amounts to the needs of the infant

Factors associated with moderate neonatal hyperthyrotropinemia

Background Maternal iodine deficiency is related to high neonatal thyroid-stimulating hormone (TSH) values, with the threshold of 5 mIU/L recommended as an indicator of iodine nutrition status. The objective of this study was to analyse possible risk factors for increased TSH that could distort its validity as a marker of iodine status. The clinical relevance of this research question is that if the factors associated with iodine deficiency are known, iodine supplementation can be introduced in risk groups, both during pregnancy and in newborns. Methods A case-control study was carried out in a sample of 46,622 newborns in 2002–2015 in Spain. Of these, 45,326 had a neonatal TSH value ≥5 mIU/L. The main variable was having TSH ≥5 mIU/L and the secondary variables were: sex, gestational age, day of sample extraction and maternal origin. Associated factors were analysed through a logistic regression model, calculating the odds ratio (OR). Results The factors associated with this outcome were: male sex (OR = 1.34, 95% CI: 1.20–1.50, p<0.001), originating from an Asian/Oceanic country (OR = 0.80, 95% CI: 0.54–1.20, p = 0.536) or Europe (OR = 0.80, 95% CI: 0.66–0.96, p = 0.285) (including Spain, OR = 1) [p<0.001 for America (OR = 0.54, 95% CI: 0.44–0.68) and p = 0.025 for Africa (OR = 0.78, 95% CI: 0.62–0.97)] and fewer days from birth to sampling (OR = 0.80, 95% CI: 0.77–0.82, p<0.001). Conclusions The risk of high neonatal TSH without congenital hypothyroidism is higher in males, decreases with a greater number of days from birth to extraction, and is dependent on maternal ethnicity but not on gestational age

Determinación de grasa corporal en niños españoles de 2 a 7 años mediante diferentes fórmulas de plicometría y el índice cintura-talla

Introduction: It seems relevant to analyze the body composition in the early childhood. However, there is not an agreed in the protocol to assess body composition in this age range/group. Objective: To determine the most useful equation to estimate the body fat percentage that preschool children contain and the utility of the waist-to-height ratio to determine abdominal obesity. Methods: We measured (weight, height, waist circumference and skinfolds) 285 children aged 2 to 7 years old. BMI Z-Score, waist-to-height ratio and body fat percentage were estimated by Brook and Lukaski, Siri, Goran, Slaughter, Deurenberg, Huang, Dezenberg and Hoffman equations. Results: It was found that 26% combined overweight and obesity, with similar distribution in both sexes. Results: The body fat obtained with the Hoffman equation (15.6-31.9%) showed the highest correlation with children BMI Z-Score. Waist-to-height ratio also presented a good relationship with children weight status. There were not significant differences between gender and body fat percentage or waist-to-height ratio. Conclusions: The Hoffman equation and waist-to-height ratio could be adequate to estimate body fat percentage and abdominal obesity respectively in Spanish preschool children from medium-low socioeconomic status.Introducción: parece relevante analizar la composición corporal en la primera infancia. Sin embargo, en este rango de edad no existe un protocolo consensuado para determinar la composición corporal. Objetivo: determinar la fórmula más útil para estimar el porcentaje de grasa corporal contenido en niños preescolares y la utilidad del índice cintura-talla para determinar la obesidad abdominal. Métodos: medimos (peso, talla, circunferencia abdominal y pliegues cutáneos) a 285 niños de 2 a 7 años. Se estimaron el Z-Score de IMC, el índice cintura-talla y el porcentaje de grasa corporal mediante las fórmulas de Brook y Lukaski, Siri, Goran, Slaughter, Deurenberg, Huang, Dezenberg y Hoffman. Resultados: se halló un 26% de prevalencia combinada de sobrepeso y obesidad, con distribución similar entre sexos. El porcentaje de grasa corporal obtenido con la fórmula de Hoffman (15,6-31,9%) mostró la mayor correlación con el Z-Score del IMC. El índice cintura-talla también presentó una buena relación con el estado nutricional de los niños. No hubo diferencias significativas entre el sexo y el porcentaje de grasa corporal o el índice cintura-talla. Conclusiones: la fórmula de Hoffman y el índice cintura-talla podrían ser adecuados para estimar el porcentaje de grasa corporal y la obesidad abdominal respectivamente, en preescolares españoles de nivel socioeconómico medio-bajo

Impact of prematurity and immigration on neonatal screening for sickle cell disease

Background: Others have described a relationship between hemoglobin A levels and gestational age, gender and ethnicity. However, studies are needed to determine normal cut-off points considering these factors. To address this issue we designed a study to determine the percentiles of normality of neonatal hemoglobin A levels taking these factors into account. Methods: This cross-sectional study involved 16,025 samples for sickle cell disease screening in the province of Alicante, Spain, which has a high immigration rate. The primary variable was hemoglobin A, and the secondary variables were gender, gestational age (preterm and full term) and maternal origin (Spain, the rest of Europe, North Africa, Sub-Saharan Africa, Latin America and Asia). Percentiles of normality (1 and 99) were obtained by origin, gender and gestational age using quantile regression models and bootstrap samples. The association between these percentiles of normality and altered levels (≥1%) of hemoglobin E was analyzed. We obtained the percentiles of normality (1 and 99) for each maternal origin, gender and gestational age. Results: Of a total of 88 possible E carriers, 65 had above-normal hemoglobin A levels (74%). The levels of normality for hemoglobin A varied greatly according to the maternal origin and gestational age. Conclusion: With the levels of normality that we established it is possible to discard samples with unrecorded blood transfusions. Our methodology could be applied to other diseases in the neonatal screening

Valores de actividad física en niños de dos a siete años, medidos mediante actimetría durante cinco días consecutivos las 24 horas diarias

Introduction: interpretation of accelerometer-derived physical activity in preschool children is confounded by differences in cut-off points. Aim: the purpose of this study was to analyze physical activity in 2-to-7-year-old children to establish reference values for daily activity. Methods: observational study in children aged 2-7 years, without chronic diseases and whose parents provided informed consent. The main variable was physical activity, measured continuously over 120 hours (three workdays and two weekend days) by accelerometer. Secondary variables were weight status (body mass index [BMI] Z-score) and gender. The relationship between the main variable and secondary variables was determined through the t-test, ANOVA and the Pearson correlation coefficient. A multivariate model was used to obtain the standard deviation (SD) of all possible combinations of values, constructing percentiles of normality (x ± SD and x ± 2·SD). Results: one hundred and thirty-six children (35% of municipality children) were included in the study (54.4% of them were girls). Their weight status distribution was: 25 underweight (18.4%), 54 normal weight (39.7%), 12 risk of overweight (8.8%), 22 overweight (16.2%) and 23 obese (16.8%). The median age was 5.7 years and the mean physical activity was 592 counts/minute. The boys undertook more physical activity (p = 0.031) and the underweight and normal-weight children undertook more physical activity than the overweight and obese children (p = 0.012). There were no significant differences according to age. The multivariate analysis showed significant differences (p < 0.001) according to gender and weight status. In boys, physical activity decreased as weight status increased. In contrast, the girls in the extreme BMI groups obtained higher levels of physical activity. Conclusion: overweight and obese preschool children had lower levels of physical activity than normal weight children. Physical activity levels were higher in boys.Introducción: la interpretación de la actividad física medida mediante actimetría en preescolares es confusa debido a los diferentes puntos de corte. Objetivo: el objetivo de este estudio fue analizar la actividad física en niños de dos a siete años para establecer valores de actividad física diaria. Método: estudio observacional en niños de dos a siete años, sin enfermedades crónicas y cuyos padres hubieran firmado el consentimiento informado. La variable principal fue la actividad física, medida durante 120 horas ininterrumpidas (tres días laborables y dos días festivos) mediante actímetros. Las variables secundarias fueron el estado de peso (puntaje z de índice de masa corporal [IMC]) y el sexo. La relación entre la variable principal y las variables secundarias fue determinada mediante el test-t, ANOVA y el coeficiente de correlación de Pearson. Se utilizó un modelo multivariable para obtener estándares de desviación en todas las posibles combinaciones de valores, construyendo percentiles de normalidad (x ± DE y x ± 2·DE). Resultados: participaron en el estudio 136 niños (35% de los niños del municipio); el 54,4% fueron chicas. La distribución de estado de peso fue: 25 niños con bajo peso (18,4%), 54 normopeso (39,7%), 12 en riesgo de sobrepeso (8,8%), 22 con sobrepeso (16,2%) y 23 con obesidad (16,8%). La media de edad fue 5,7 años y de actividad física, 592 cuentas/minuto. Los chicos realizaron mayor actividad física (p = 0,031) y los niños con bajo peso y normopeso realizaron mayor actividad física que los niños con sobrepeso y obesidad (p = 0,012). No hubo diferencias significativas respecto a la edad. El análisis multivariable mostró diferencias significativas (p < 0,001) respecto al sexo y el estado de peso. En los niños, la actividad física decreció cuando aumentó el peso. Por el contrario, las niñas en grupos de IMC extremos obtuvieron mayores niveles de actividad física. Conclusión: los preescolares en situación de sobrepeso y obesidad presentaron niveles menores de actividad física que los niños normopeso. Los niveles de actividad física fueron mayores en los chicos

Effects of Watching Cartoons During an Echocardiography on Infants and Preschool Children. A Prospective Randomized Study

Echocardiography is currently the main diagnostic technique in pediatric cardiology, but sometimes it is difficult to use in very young children, as a complete and accurate study depends on the patient’s and family’s cooperation. Children’s behavior is one of the main problems for this procedure, and interventions like sedative medication have been used to facilitate its performance. The aim of this study was to analyze the effects of TV entertainment in infants and preschool children during echocardiography. We designed an experimental study in children with a heart murmur. An examination room was prepared with a TV on the ceiling, giving the children an unobstructed view during the echocardiography procedure. Fifty-eight patients were randomized into two groups: TV intervention vs. usual care (consisting of other distraction measures). The primary outcome was echocardiography time, but we also assessed blood pressure, quality of technique, child behavior, and parents’ stress level. The TV group showed a statistically significant reduction in duration of the echocardiography and systolic and diastolic blood pressure, as well as better quality of technique and child behavior. Consequently, we recommend the use of a TV as a simple and useful distraction method for improving echocardiography in young children

Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica

Background and Aims: Diagnostic delay (DD) is especially relevant in children with inflammatory bowel disease, leading to potential complications. We examined the intervals and factors for DD in the pediatric population of Spain. Methods: We conducted a multicentric prospective study, including 149 pediatric inflammatory bowel disease patients, obtaining clinical, anthropometric, and biochemical data. Time to diagnosis (TD) was divided into several intervals to identify those where the DD was longer and find the variables that prolonged those intervals. Missed opportunities for diagnosis (MODs) were also identified. Results: Overall TD was 4.4 months (interquartile range [IQR] 2.6–10.4), being significantly higher in Crohn’s disease (CD) than in ulcerative colitis (UC) (6.3 [IQR 3.3–12.3] vs. 3 [IQR 1.6–5.6] months, p = 0.0001). Time from the visit to the first physician until referral to a pediatric gastroenterologist was the main contributor to TD (2.4 months [IQR 1.03–7.17] in CD vs. 0.83 months [IQR 0.30–2.50] in UC, p = 0.0001). One hundred and ten patients (78.3%) visited more than one physician (29.9% to 4 or more), and 16.3% visited the same physician more than six times before being assessed by the pediatric gastroenterologist. The number of MODs was significantly higher in CD than that in UC patients: 4 MODs (IQR 2–7) vs. 2 MODs ([IQR 1–5], p = 0.003). Referral by pediatricians from hospital care allowed earlier IBD diagnosis (odds ratio 3.2 [95% confidence interval 1.1–8.9], p = 0.025). Conclusions: TD and DD were significantly higher in CD than those in UC. IBD patients (especially those with CD) undergo a large number of medical visits until the final diagnosis.Jiménez Treviño S, Pujol Muncunill G, Martín-Masot R, Rodríguez Martínez A, Segarra Cantón O, Peña Quintana L, Armas Ramos H, Eizaguirre Arocena FJ, Barrio Torres J, García Burriel JI, Ortigosa Castillo L, Donat Aliaga E, Crujeiras Martínez V, Barros García P, Botija Arcos G, Bartolomé Porro JM, Juste Ruiz M, Ochoa Sangrador C, García Casales Z, Galicia Poblet G, Oliver Goicolea P, Lorenzo Garrido H, García Romero R, La Orden Izquierdo E, Pérez Solis D, Navas-López VM, Díaz Martin JJ and Martín de Carpi J (2020) Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica. Front. Pediatr. 8:584278. doi: 10.3389/fped.2020.58427

Docencia en Derecho y Proceso: hacia un aprendizaje de calidad en la Universidad

Presentación / Esther Pillado González (pp. 11-13). -- La adaptación de la asignatura derecho procesal penal al grado en la Universidad Carlos III de Madrid: un proceso aún inconcluso / Juan Manuel Alcoceba Gil (pp. 17-26). -- Role playing, cooperación competitiva y method case en la docencia-aprendizaje del Derecho Procesal / Cristina Alonso Salgado (pp. 27-35). -- Esquemas y materiales básicos para explicar en el grado en derecho el sistema de impugnación de actos jurídicos de las administraciones públicas en España / Roberto O. Bustillo Bolado (pp. 37-40). -- Nuevas herramientas y técnicas para la docencia del derecho / Juan Cámara Ruiz (pp. 41-51). -- Novas técnicas na docência em direito / Marco Carvalho Gonçalves (pp. 53-60). -- Experiência de lecionação em Direito em cursos não jurídicos – a lecionação da UC de Direito das Crianças e Jovens ao Mestrado em Intervenção Psicossocial com Crianças, Jovens e Famílias do Instituto de Educação / Cristina M. A. Dias (pp. 61-67). -- Los programas universitarios para mayores: la docencia en Derecho en la Universidad de Vigo / Teresa Estévez Abeleira (pp. 69-79). -- El aprendizaje activo del Derecho Procesal / María Dolores Fernández Fustes (81-92). -- El aprendizaje como método de adquirir los conocimientos / Raquel López Jiménez (pp. 93-101). -- Alumnado con necesidades especiales en el grado en derecho: el reto de la normalización e inclusión / Ángel M. Mariño de Andrés y M. Teresa Martínez Táboas (pp. 103-110). -- Docencia y proceso penal: intentando experimentar el proceso / Sabela Oubiña Barbolla (pp. 111-127). -- La integración de las redes sociales en la enseñanza del Derecho Penal / Natalia Pérez Rivas (pp. 129-135). -- Análisis y prospectiva de una plataforma e-learning en ciencias jurídicas / Amparo Rodríguez Damián, Margarita Pino Juste, Arturo Casar Sarasola y Manuel Pérez Cota (pp. 137-149). -- La evaluación de competencias en las materias “prácticas externas” del Máster Universitario en Abogacía: problemas y retos / Mónica Siota Álvarez (pp. 151-164). -- La enseñanza del derecho procesal a través del método del caso / Helena Soleto Muñoz (pp. 165-178). -- A aprendizagem activa do Direito Processual – reflexão sobre velhos hábitos e novas práticas / Lurdes Varregoso Mesquita (pp. 179-189). -- Acão executiva e metodologia aplicada – demonstração de caso / Lurdes Varregoso Mesquita, Diana Leiras (pp. 191-201). -- Derecho Constitucional y género / Almudena Bergareche Gros (pp. 205-216). -- Aproximación al fenómeno de la violencia de género a través de las novelas como recurso didáctico / María Castro Corredoira (pp. 217-227). -- La formación en género en derecho penal: el cine como recurso didáctico / Natalia Pérez Rivas, Fernando Vázquez-Portomeñe Seijas (pp. 229-240). -- Cuestiones controvertidas de la docencia en el ámbito del derecho constitucional: la perspectiva de género y el principio de transversalidad / Pablo Riquelme Vázquez (pp. 241-253). -- Storytelling y cine extranjero en la explicación del sistema de justicia penal español / Cristina Alonso Salgado (pp. 257-263). -- Direito e Cinema. Breve reflexão a partir da experiência da docência ao 1.º ano do curso de Direito / Maria Clara Calheiros (pp. 265-273). -- El cine como opción pedagógica en la enseñanza del derecho penal / Fernando Vázquez-Portomeñe Seijas y María Castro Corredoira (pp. 275-286). -- El jurista del siglo XXI y la Universidad del siglo pasado: ¿realidades irreconciliables? / Amaya Arnáiz Serrano (pp. 289-307). -- La formación del abogado del siglo XXI / Emiliano Carretero Morales (pp. 309-321). -- El cambio del perfil del alumno y su influencia a la enseñanza superior / Anna Fiodorova (pp. 323-335). -- La enseñanza del derecho en el marco Bolonia: reflexiones en base a las distintas tradiciones jurídicas / Mercedes Llorente Sánchez-Arjona (pp. 337-355)

Factores de Riesgo en la Osteoporosis

Osteoporosis is an important pathologic state dueto the large number of peo ple who suffer from it ali o ver the wold It is linked to the increase of the survival rate and cause serious socioeconomic problems. It is of great value to know its risk factors so that, avoiding them maximun it mays minimize the loss of osseus tissue and its complications. Sixty patients were studied, forty of them affected of clinical osteoporosis, realizing the marrow relation between the illness and the risk factors such as sex menopause, sun exposure, diet and physical activity