RESUMO
Effective interventions to prevent obesity in children have never been more necessary. There have been over 30 published reviews and meta-analyses on such interventions (randomized and controlled trials) since 2008. In summary, interventions which involve the whole community (community-based) in complex interventions (promoting healthy eating, reduction in sedentary behaviours and increase in physical activity) that target environments and upstream determinants appear to be more effective. In this article the strengths and weaknesses of community-based complex interventions which aim to prevent obesity in children will be discussed and a selection of recent and ongoing interventions that are shaping the evidence-base in this field will be highlighted (beyond those reported in other papers in this supplement: KOPS, CHILT, TigerKids, IDEFICS and TrinkFit). This paper reviews the challenges and opportunities associated with designing and evaluating community-based complex interventions and initiatives. These include a) design issues (strengths and weaknesses of different types of evidence), b) measurement of (effectiveness) outcomes, c) development of interventions (pilot work, planning frameworks and underpinning theories), d) partnership working and community engagement and e) health inequalities.
Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Medicina Baseada em Evidências/estatística & dados numéricos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Prevenção Primária/estatística & dados numéricos , Adolescente , Criança , Feminino , Humanos , Masculino , Prevalência , Resultado do TratamentoRESUMO
A case is presented of a diabetic, hypertensive, female patient who suffers from a bleeding complication from application of an ambulatory blood pressure monitor. A recent literature search is referred to and practitioners are cautioned against this adverse reaction.
Assuntos
Monitores de Pressão Arterial/efeitos adversos , Equimose/etiologia , Púrpura/etiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Vaccinia virus cores prepared in vitro can be uncoated by incubation with extracts of cells infected with vaccinia virus, as determined by the conversion of the genome to DNase susceptibility. This uncoating activity had all the characteristics of the corresponding in vivo activity and of the agent responsible for non-genetic reactivation. Thus, it was not induced by heat-inactivated virus, nor was it produced in the presence of inhibitors of RNA or protein synthesis. The uncoating protein induced by cowpox virus will uncoat vaccinia virus cores. The uncoating protein was concentrated from infected cell extracts by ultrafiltration and purified by gel filtration and ion-exchange and affinity chromatography. It was characterized as a trypsin-like protease with a mol. wt. of 23,050. Cores treated with the purified uncoating protein had an altered sedimentation rate but no differences between treated and untreated cores were detected by electron microscopy or polyacrylamide gel electrophoresis.
