Overweight and obesity rates have risen dramatically in the United States, with subsequent detrimental comorbidity risks. The rates for obesity among children with congenital and acquired heart disease have rarely been reported. A retrospective cross-sectional study was conducted to determine the prevalence of overweight and obesity in children with heart disease and to identify subgroups at increased risk. A total of 795 cases were identified from a chart review of patients presenting to an urban center's Pediatric Cardiology Program between 1 January and 31 December 2006. A body mass index (BMI) at the 85th percentile or higher was defined as overweight, and a BMI at the 95th percentile or higher was defined as obese. Subjects with comorbidities affecting body habitus were excluded from the study. Overall, overweight and obesity rates were similar to national data. No significant differences in overweight or obesity rates were detected between heart disease and non-heart disease groups (P = 0.50). According to multivariate analysis, Hispanic ethnicity and male gender were the only predictors of obesity. This study shows that children with heart disease are not immune to the common predictors of obesity such as gender and ethnicity and that the future care of children with heart disease should include general discussions about the risks for obesity.

Objective To examine the relationship between parent health literacy and “obesogenic” infant care behaviors. Study design Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based, early childhood obesity prevention program (Greenlight). English and Spanish-speaking parents of 2 month old children enrolled (n=844). The primary predictor variable was a parent health literacy (Short Test of Functional Health Literacy in Adults (STOFHLA); adequate>=23; low<23). Primary outcome variables involving self-reported obesogenic behaviors: (1) feeding content (more formula than breastmilk, sweet drinks, early solid food introduction) and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, non-responsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out of home care, WIC status, parent age, race/ethnicity, language, number of adults/children in home, income, and site. Results 11.0% of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk (AOR=2.0 [95%CI:1.2–3.5]), immediately feed when their child cries (AOR=1.8[1.1–2.8]), bottle prop (AOR=1.8 [1.002–3.1]), any infant TV watching (AOR=1.8 [1.1–3.0]), and inadequate tummy time (<30 minutes/day) (AOR=3.0[1.5–5.8]). Conclusions Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity.

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La medicina es un campo de aprendizaje a lo largo de toda la vida. Como estudiantes de medicina, nos enseñan residentes y profesores; como residentes, nos enseñan los médicos especialistas, y como mé dicos especialistas, nos enseñan constantemente nuestros pacientes, compañeros y colegas séniors. Cada década en sanidad representa grandes avan ces respecto a los años anteriores en cuanto a la cantidad creciente de conocimientos clínicos, avan ces tecnológicos, sistemas y procesos innovadores [1]. En ausencia del ciclo constante de enseñanza y aprendizaje, la medicina se detendría. Mientras que la enseñanza y el aprendizaje son la clave para avan zar en medicina, se dedica poco tiempo a cómo en señar [2]. Tradicionalmente, los estudiantes de me dicina en Estados Unidos rotan a través de las espe cialidades médicas estándares con el objetivo de aprender a diagnosticar y tratar las enfermedades Reflexiones sobre una rotación educativa en simulación médica Shilpa Mukunda, Rachel J. Shustak, Demian Szyld, Ignacio del Moral, José M. MaestreResumen. Mientras que la enseñanza y el aprendizaje son la clave para avanzar en medicina, se dedica poco tiempo a cómo enseñar. Tradicionalmente, los estudiantes de medicina rotan a través de las especialidades médicas estándares con el objetivo de aprender a diagnosticar y tratar las enfermedades más comunes. Muy pocas facultades de medicina ofrecen una rotación o un currículo formal sobre educación médica. Se reflexiona sobre la experiencia de unos estudiantes de medicina al realizar una rotación educativa electiva en el Hospital virtual Valdecilla, un centro de simulación clínica en España con la misión de mejorar la seguridad del paciente mediante el entrenamiento de los profesionales sanitarios y estudiantes de pregrado a través de la simulación clínica en todas sus aplicaciones. La rotación de los estudiantes se realizó a través del Programa Internacional de Salud de la Facultad de Medicina de la Universidad de Nueva York. Se repasan los objetivos de aprendizaje abordados (creación de entornos de aprendizaje psicológicamente seguros, diseño de las estrategias docentes basadas en la teoría de aprendizaje del adulto de Kolb, exposición a los diferentes tipos de simulaciones, introducción al debriefing y al trabajo en equipo, y participación en un proyecto de investigación educativa) y se compara la experiencia con su participación en las simulaciones como estudiantes durante la facultad. Reflections on an educational rotation in medical simulationSummary. While teaching and learning are key elements to advance medicine, little time is spent educating medical professionals on how to teach. Traditionally, medical students rotate through the standard medical specialties with the goal of learning how to diagnose and treat the most common diseases. Few medical schools offer a teaching rotation or formal curriculum in education. We reflect on the experience of medical students in a one-month educational elective at the Hospital virtual Valdecilla in Santander (Spain), a simulation ce...