Necesidades de apoyo y satisfacción en los acogimientos con familia extensa / Support needs and satisfaction in kinship foster care

Los estudios sobre la necesidad de apoyo con familia extensa han puesto de manifiesto que estos acogimientos se caracterizan por recibir menos apoyo que otros tipos de acogimiento. Se ha llevado a cabo un estudio con 54 abuelos acogedores, con una media de edad de 65.9 años para los abuelos y de 63.6 años para las abuelas, que tienen acogidos a 70 adolescentes con una media de edad de 14 años (rango entre 11 y 17 años) de la provincia de Málaga. Los datos fueron obtenidos mediante una entrevista realizada a los abuelos/as en su domicilio familiar. Este trabajo pretende conocer las necesidades de apoyo social, material y emocional recibido y deseado por los abuelos/as acogedores, así como el grado de satisfacción de los acogedores/as en relación con el apoyo recibido. Los resultados de esta investigación confirman la escasez de ayuda y que los abuelos/as acogedores desean más apoyo del que reciben. También informan que pueden contar con la ayuda de otros familiares y amigos. Además, muestran una alta satisfacción por el hecho de haber acogido a sus nietos/as. Dicha satisfacción puede ser mayor o menor en función de las necesidades y el apoyo recibido (AU)

Research shows that on kinship foster care the caregivers receive less support, than other kind of foster care. This research analysed 54 grandparents with custody of their grandchildren to determine what support they were receiving. The mean age was 65.9 for the grandfathers and 63.6 for grandmother. In total, they were caring for 70 adolescents with a mean age of 14 years old, ranging between 11 and 17. The questionnaire was filled in by grandparents in their homes. The aim research is to know social, economic and emotional support received and expressed by grandparents, and to know the satisfaction with the foster care in relation with support received. The results show what little support the grandparents receive. The grandparents expressed a need for more economic support and more information about the foster care process, but not more professional supervision after foster care. The grandparents also stated that they have support from both family and friends. Furthermore, grandparents expressed high satisfaction with care their grandchildren. This satisfaction was in relation with support received (AU)

[Ultrasound measurements of intra-abdominal adiposity and factors associated with cardiovascular risk in obese children]. / Mediciones de adiposidad intraabdominal por ultrasonido y factores asociados con riesgo cardiovascular en niños obesos.

BACKGROUND: Cardiovascular risk factors are commonly present in obese children. AIM: To evaluate the association among radiological measurements of intra-abdominal adipose tissue, and cardiovascular risk factors, in prepuberal obese children. PATIENTS AND METHODS: We evaluated 30 obese (body mass index > p95) children aged 6 to 12 years (15 males). Anthropometry and blood pressure were measured. Subcutaneous and intra-abdominal fat thickness and fat area were measured by ultrasound (US) and computed tomography. Serum insulin, glucose and lipid profile were measured in a fasting blood sample. Homeostasis model assessment (HOMA) was calculated as an index of insulin resistance. RESULTS: There was a significant correlation between US intra-abdominal fat thickness and HOMA (r = 0.47, p < 0.01), serum triglycerides (r = 0.46, p < 0.05) and with positive criteria for metabolic syndrome (r = 0.66, p < 0.01). A receiver operating curve (ROC) analysis showed that, above a cut-off of 45 mm for intra-abdominal fat thickness, US was able to identify insulin resistance with a sensibility and specificity of 79 and 69% respectively and metabolic syndrome with sensibility and specificity of 100 and 67% respectively. US and computed tomography measurements for intra-abdominal fat thickness were significantly correlated (r= 0.62, p < 0.01). CONCLUSIONS: US measurements of intra-abdominal fat thickness identify obesity-associated damage in childhood. Age-specific measurements of intra-abdominal adipose tissue may improve the detection power of this approach.

Mediciones de adiposidad intraabdominal por ultrasonido y factores asociados con riesgo cardiovascular en niños obesos / Ultrasound measurements of intra-abdominal adiposity and factors associated with cardiovascular risk in obese children

Background: Cardiovascular risk factors are commonly present in obese children. Aim: To evaluate the association among radiological measurements of intra-abdominal adipose tissue, and cardiovascular risk factors, in prepuberal obese children. Patients and Methods: We evaluated 30 obese (body mass index > p95) children aged 6 to 12 years (15 males). Anthropometry and blood pressure were measured. Subcutaneous and intra-abdominal fat thickness and fat area were measured by ultrasound (US) and computed tomography. Serum insulin, glucose and lipid profile were measured in a fasting blood sample. Homeostasis model assessment (HOMA) was calculated as an index of insulin resistance. Results: There was a significant correlation between US intra-abdominal fat thickness and HOMA (r = 0.47, p < 0.01), serum triglycerides (r = 0.46, p < 0.05) and with positive criteria for metabolic syndrome (r = 0.66, p < 0.01). A receiver operating curve (ROC) analysis showed that, above a cut-off of 45 mm for intra-abdominal fat thickness, US was able to identify insulin resistance with a sensibility and specificity of 79 and 69 percent respectively and metabolic syndrome with sensibility and specificity of 100 and 67 percent respectively. US and computed tomography measurements for intra-abdominal fat thickness were significantly correlated (r= 0.62, p < 0.01). Conclusions: US measurements of intra-abdominal fat thickness identify obesity-associated damage in childhood. Age-specific measurements of intra-abdominal adipose tissue may improve the detection power of this approach.

[Visceral adiposity and its association with serum lipids in female obese teenagers]. / Adiposidad visceral y su asociación con lípidos séricos e insulinemis en adolescentes obesas.

BACKGROUND: Increased visceral or abdominal adipose tissue in children and adults is strongly associated with metabolic and a variety of chronic diseases. AIM: To study the association between visceral or external body measurements of adiposity with blood lipids, glucose and insulin levels, in obese female adolescents. MATERIAL AND METHODS: In a cross-sectional study, 47 obese female adolescents (body mass index (BMI) >95th percentile) aged 10 to 15 years, were analyzed. Weight, height, BMI, Tanner pubertal stages, skinfold thickness, waist circumference, waist-to-hip ratio, fasting and 120 min post prandial blood glucose, serum insulin, and lipid profile were studied. Visceral fat was assessed by computed tomography at the L4-L5 level, measuring the fat area or the length of a straight drawn line between the spine and the internal border of the rectus abdominus muscle. RESULTS: No association between lipid profile and BMI or external body measurements (skinfold thickness, waist circumference, waist-to-hip ratio) was observed. Total serum cholesterol >170 mg/dL was positively associated with the straight line over 63 mm (a cut-off obtained by ROC analysis (RR 2.64; 1.15-6.08). This association was statistically significant in girls in Tanner I + II (n =21; Fisher, p <0.023), but not with Tanner III + IV (n=26) stages. Increased cholesterol (>170 mg/dL) was also positively associated with a serum insulin >17 uU/mL in the Tanner I + II group (Fisher p<0.05), but not with the homeostasis model assessment of insulin resistance (HOMA). CONCLUSIONS: No external body measurement of adiposity was associated to increased serum cholesterol in these obese female adolescents. Increased total cholesterol (>170 mg/dL) was associated with visceral fat (evaluated through the straight line spina-rectus abdominus muscle), and also with a serum insulin >17 uU/ml in those teenagers with Tanner I or II pubertal stages.

Adiposidad visceral y su asociación con lípidos séricos e insulinemis en adolescentes obesas / Visceral adiposity and its association with serum lipids in female obese teenagers

Background: Increased visceral or abdominal adipose tissue in children and adults is strongly associated with metabolic and a variety of chronic diseases. Aim: To study the association between visceral or external body measurements of adiposity with blood lipids, glucose and insulin levels, in obese female adolescents. Material and methods: In a cross-sectional study, 47 obese female adolescents (body mass index (BMI) >95th percentile) aged 10 to 15 years, were analyzed. Weight, height, BMI, Tanner pubertal stages, skinfold thickness, waist circumference, waist-to-hip ratio, fasting and 120 min post prandial blood glucose, serum insulin, and lipid profile were studied. Visceral fat was assessed by computed tomography at the L4-L5 level, measuring the fat area or the length of a straight drawn line between the spine and the internal border of the rectus abdominus muscle. Results: No association between lipid profile and BMI or external body measurements (skinfold thickness, waist circumference, waist-to-hip ratio) was observed. Total serum cholesterol >170 mg/dL was positively associated with the straight line over 63 mm (a cut-off obtained by ROC analysis (RR 2.64; 1.15-6.08). This association was statistically significant in girls in Tanner I + II (n =21; Fisher, p <0.023), but not with Tanner III + IV (n =26) stages. Increased cholesterol (>170 mg/dL) was also positively associated with a serum insulin >17 uU/mL in the Tanner I + II group (Fisher p<0.05), but not with the homeostasis model assessment of insulin resistance (HOMA). Conclusions: No external body measurement of adiposity was associated to increased serum cholesterol in these obese female adolescents. Increased total cholesterol (>170 mg/dL) was associated with visceral fat (evaluated through the straight line spina-rectus abdominus muscle), and also with a serum insulin >17 uU/ml in those teenagers with Tanner I or II pubertal stages.