[Sleeping in the supine position in the ASL 11 region of Piemonte. Assessment of the efficacy of a promotional campaign]

OBJECTIVES

To record the prevalence of the sleeping position of sucklings living in the ASL 11-Regione Piemonte; to make an information campaign about the utility of sleeping in the supine position (most important protection factor against the SIDS); to find out its efficacy for a short or long time.

METHODS

During the first two months of 2002 all the parents coming to the consulting rooms for the compulsory vaccinations of their 3 and 5 months old babies have been interviewed about the position of their babies during sleep. The same recording has been made in the first two months of 2003 and 2004. During 2002 various consciousness campaigns have been made, above all for medical operators of hospital nurseries and of Mother-and-Child Departments and Prevention Departments in ASL 11 area.

RESULTS

Before the consciousness campaign the percentage of 3 months old sucklings sleeping in the supine position was 62,3% and 55% for the 5 months old suckings; after the campaign the percentage has grown to 77,4% for 3 months old sucklings and 74,5% for 5 months old sucklings during 2003 and during 2004 the percentage has grown to 80,3% and 74,2%, respectively.

CONCLUSIONS

A simple and not expensive but capillary consciousness and information campaign addressed to medical operators has obtained valid and statistically relevant results in a short time.

[Nutritional management of patients suffering of chronic renal failure]

Nutritional support constitutes a fundamental approach to favour the management of chronic renal failure and to postpone the need of kidney dialysis. The specific goals of the nutrition intervention are: control of protein intake, control of phosphate and of calcium intake, control of potassium intake, control of energy intake, control of lipid intake with clear identification of the polyunsaturated vs monounsaturated vs saturated fatty acid rate, control of vitamin intake, prevention of malnutrition and intervention with oral supplements or artificial nutrition (even if for short time) if malnutrition occurs. The proper management of the nutritional problems of patients with chronic renal failure slows the disease progression, prevents or controls symptoms associated with uremia and postpones the beginning of substitutive treatment that is of hemodialysis or of peritoneal dialysis, thus allowing a better quality of life either in the short or long term for patients suffering of chronic renal failure.

[Epidemiology of obesity]

Overweight and obesity are conditions characterized by weight levels higher than the normal limits for age, sex, and height. Because people stratified for sex and age vary in stature and this influences weight, criteria for being overweight must take height into account: this is defined and set out in WHO guidelines on the basis of Body Mass Index (BMI): weight (kg)/height2 (m2). Obese and overweight individuals are at a greater risk of developing chronic metabolic conditions and general ill health, than those whose weights are within the recommended guidelines. Besides these chronic related conditions for which obesity is a major risk factor incur enormous expenditure. The health hazards of obesity are compounded by the influence of central fat distribution. The disease associations of central fat are present even in people who are not overweight. Waist circumference is a simple measure that gives a very reasonable estimate of the amount of central fat. Data collected in the USA and Europe show a common trend: the increase of obesity and overweight among the adult and children population. Obesity appears to be the result of several factors that interact among them such as: genetic, environment, and behaviour. Current strategies, such as reducing food intake, seem to lead to poor long term outcomes. Management has tended to neglect the unavoidable need to consider obese subjects as chronically ill patients, requiring continuous assistance for active steps to maintain weight loss. Treatments should be multidisciplinary aiming at the achievement of radical changes in the individual's lifestyle. The planning and management of preventive programs for young people such as pubertal children have been disregarded up to now. They require not only attention, but also organization, clear goals and standardized methods. Moreover, a correct education is a key-element of these issues. Our unit has designed for this purpose an observational study aimed to reach a better comprehension of the proportion of ''weight problems'' and eating behavioural patterns in a population of adolescents.