Diuretic use and risk of falls in older women with urinary incontinence.

OBJECTIVE: To determine the association between diuretic use and falls in community-dwelling older women with urinary incontinence (UI). METHODS: We conducted an analytic cross-sectional study using patients' electronic medical records. Patients were women with UI, 65 years or older seen at a urogynecology clinic between January 1, 2018 and September 30, 2019. We used logistic regression analysis to explore the associations between falls and diuretic use. RESULTS: The study included 108 women, mean age of 75.2 ±7.5 years. Twenty-two (20%) reported one or more falls within the past year and 32 (30%) were diuretic users. Fall prevalence in diuretic users and non-users were 25% (8/32) and 18.4% (14/76), respectively. Diuretic use was not associated with falls (OR = 0.74, 95%CI = 0.22-2.52). Post-hoc analysis revealed inadequate sample size. CONCLUSIONS: Diuretics use may not be a risk factor for falls in ambulatory older women with UI. A larger sample will be needed to confirm.

Association of obesity with severity outcomes in hospitalized pediatric asthma exacerbations.

INTRODUCTION: While there seems to be an association between obesity and asthma, the exact nature of the relationship remains unknown. It is unclear if there is increased severity of exacerbation for those that require hospitalization. We examine the association between obesity and severity outcomes such as hospital length of stay, intensive care admissions, and need for continuous albuterol or magnesium administration. METHODS: Patients 4 to 17 years old admitted between 1/1/2012-1/1/2016 with asthma identified by discharge codes were reviewed. Obesity was defined as BMI ≥95%. Clinical data such as age, gender, family history of asthma, use of controller medication along with outcome data such as length of stay, ICU admission, use of continuous albuterol, and use of magnesium were collected. Binary outcomes were analyzed with multivariate logistic regression while length of stay was analyzed with negative binomial regression. RESULTS: Overall, 995 patients met inclusion criteria. The median age was 7 years old with 170 (17%) patients categorized as obese. We find no difference in length of stay (IRR 0.99 [0.91, 1.09], p = 0.9), PICU admission (OR 0.72 [0.43, 1.21], p = 0.22), or magnesium administration (OR 1.34 [0.95, 1.88], p = 0.09) between obese and non-obese patients. There were increased odds of continuous albuterol use (OR 1.47 [1.02, 2.11]) for obese patients. CONCLUSION: We find no association between obesity and outcomes of length of stay, ICU admission, or magnesium administration. While growing evidence links obesity with asthma, our study suggests it may not be associated with the severity of exacerbation.

Papás Saludables, Niños Saludables: Perspectives From Hispanic Parents and Children in a Culturally Adapted Father-Focused Obesity Program.

OBJECTIVE: Qualitatively assess culturally adapted lifestyle intervention, Papás Saludables, Niños Saludables (PSNS; Healthy Dads, Healthy Kids), for Hispanic fathers and children. METHODS: Semistructured interviews of parents and children after participation in 10-week PSNS program for Hispanic fathers and children. Qualitative data double-coded inductively and deductively until consensus reached. RESULTS: Total of 26 fathers, 26 mothers, and 45 children interviewed. Parents and children had positive feedback about program content on culturally relevant nutrition and physical activity and reported improved father-child bonding. Mothers noted increased involvement among fathers in child's well-being. Participants suggested lengthening the program. CONCLUSIONS AND IMPLICATIONS: Papás Saludables, Niños Saludables is an innovative approach with promise in engaging Hispanic fathers and children in a lifestyle program that emphasizes the role of fathers in children's lifestyle behaviors. Familism, respeto (respect), and promoting father-child relationships were important to engage fathers. Results from this study will inform future trials of PSNS and help identify ways to increase engagement of Hispanic men in other programs.

Feasibility of Targeting Hispanic Fathers and Children in an Obesity Intervention: Papás Saludables Niños Saludables.

Background: Hispanic children and men carry a high burden for obesity and associated medical conditions. Healthy Dads Healthy Kids was the first obesity prevention intervention targeting fathers and demonstrated weight loss among fathers and behavior change among fathers and children in Australia. The aim of this study was to assess the feasibility of a culturally adapted version of the program for Hispanic families, Papás Saludables Niños Saludables. Methods: A randomized waitlist controlled trial with a process evaluation was conducted to assess the feasibility of Papás Saludables Niños Saludables(NCT03532048). Fathers, their partner (mother), and one to three children were enrolled. A priori feasibility criteria were: (1) recruit 40 Hispanic fathers and their families in ≤4 months; (2) retain 80% of participants for pre- and postassessments; (3) maintain ≥70% attendance to the 10 sessions; (4) obtain 80% "excellent" or "good" satisfaction from participants; and (5) collect anthropometric and behavioral data on ≥75% of participants at baseline and follow-up. Results: The study enrolled 90% (n = 36) of the goal from one local pediatric clinic between May and August 2018; retained 75% of participants for postassessment; maintained 72% attendance among those who started the program; and achieved 100% "excellent/good" satisfaction ratings among the participating fathers and mothers. One hundred percent of participants had most anthropometric and behavioral data at baseline and 72% at follow-up. Conclusions: With oversampling and improvements in the recruitment strategies, Papás Saludables Niños Saludables is feasible for a randomized controlled clinical trial to address whether a father-targeted lifestyle program is efficacious among low-income Hispanic men and their children.