Researchers wanted to learn which tool is the most effective in identifying patients who are at risk for developing pressure ulcers. They reviewed the literature and summarized evidence from 14 databases. They then tabulated the results using efficacy studies and validity metrics. Their conclusion was that across numerous studies and settings, the Braden Scale has the best validity and reliability indicators. In addition, they noted that both Braden and Norton Scales predict pressure ulcer development better than nurses' clinical judgment. The Waterlow Scale, they found, is highly sensitive but not as accurate in predicting development of pressure ulcers.

We have three series on wound care. Advanced Wound Management (520) provides an excellent resource for the identification of those at risk for decubiti as well as their assessment, and management. This 10-part interactive CD series also contain information on wound healing and evaluation; arterial, venous, neuropathic, and atypical wounds; debridement; dressings; and treatments using physical modalities. This series can be used for inservices, updates, and orientation for advanced practice nurses such as clinical nurse specialists, nurse practitioners, and wound care specialists as well as physicians and physician's assistants. Beginning Wound Management (126) and Wound Management for Long-Term Care (127), both of which contain less complex information on pressure ulcers, are tailored for acute nurses and other healthcare providers in hospitals, clinics, and long-term care facilities.

According to researchers in Texas, fat starts to build up in the hearts of people with pre-diabetes before symptoms of either diabetes or heart disease are noted. Earlier studies showed that these fat deposits are present in individuals with heart failure and diagnosed type 2 diabetes.

Dr. Lidia Szczepaniak, the lead author, described a new technique which combines MRI and special software that changes the signals of the beating heart into still images. Using this methodology, scientists discovered that fat build-up in the heart occurs in people before diabetes and the buildup is related to abnormal metabolism of glucose rather than body weight or the amount of fat in the bloodstream or liver. However, it is related to the amount of fat in the area of the stomach.

Researchers hope that this discovery can become a screening device for people with risk of both diabetes and heart failure.

Our series on Diabetes (685), Cardiac Disorders: Heart Failure (116), and Cardiac Disorders: Coronary Artery Disease (115) can be used in schools of nursing, hospitals, clinics, and physicians' offices.

Are sports harming our children? Many youngsters are playing one sport year-round, even joining competitive leagues or travel teams in the hopes this will help them get a college scholarship or place on a professional team. What this might do, however, is cause them injury. In fact, as many as 40 percent of emergency department visits for children between ages 5 and 14 are sports-related, and many of them are "overuse injuries."

"Any sport can produce an overuse injury," explained Dr. Cynthia LaBella, medical director of the Institute for Sports Medicine at Children's Memorial Hospital in Chicago. "Overuse injuries are increasing for a couple of reasons. Sports are much more competitive at an earlier age, and many children are playing one sport year-round now. They're not getting enough time off for their bodies to recover. Or, they might be playing three sports at once, and what that amounts to is that they never get a day off." Even though today's parents note that they were physically active during own childhoods and did not suffer serious injuries, LaBella noted that they were then able to plan their own activities. "Kids are now subject to adult schedules and organizational formats for adult-driven sports. In the past, kids directed the activities in the backyard. Where adults provide schedule and structure, kids may be pushed beyond what they would do on their own. When they play on their own, they take breaks and moderate themselves," she said.

Children are prone to repetitive injuries, especially in the areas of the growth-plates, which are found at the end of the long bones. These types of injuries occur twice as often in boys as in girls, particularly in 14- to 16-year-old boys and 11- to 13-year-old girls.

Parents need to take responsibility for monitoring their children's involvement in sports, and be particularly aware of any injuries that occur. "Kids are always going to push, and they're always going to want to play. Even when hurt, a child probably won't make the right decision," said Dr. Michael Kelly from Hackensack University Medical Center in New Jersey, adding that the parents may have to step in to stop the child from playing. This can be difficult with teens in high school who may have college scholarships riding on their ability to play. "I make it clear to parents that they can keep the next six months in mind, but they need to focus on the next 70 years," he said.

According to LaBella, youngsters should never play through pain. "Pain is a sign of injury, and it's a sign that you need to rest," she said. If the pain does not subside in a few days, the child should be evaluated by a physician. In addition, she noted that youngsters should not specialize in one sport until after puberty and that they should take part in only one sport per season, making sure to rest a month or two between organized sports. Instead, they should remain physically active by riding a bike or playing soccer in their backyards.

Our award-winning programs on human development discuss the physical maturation of children as well as the psychosocial, emotional, and cognitive changes that occur as they grow. The series include Human Development: Birth to 2½ (670), Human Development: 2½ to 6 Years (620), Human Development: 6 to 12 Years (650), and Human Development: Enhancing Social and Cognitive Growth in Children (630). These ever-green programs can be used in schools of nursing, education, social work, child life, child development, or psychology as well as facilities that work with children of all ages such as schools, hospitals, clinics, day-care centers, sports facilities, and counseling centers.

• September 20, 2007: New Guidelines for Controlling Asthma in Adults and Children
• September 13, 2007: New Data Analyses Techniques Show Long-Term Survival Better for Cancer Patients
• September 6, 2007: Cortical Stimulation Gives New Hope to Stroke Patients
• August 30, 2007: 50% of All Cancer Deaths can be Linked to Obesity and Smoking
• August 23, 2007: Physical Activity Found to Improve Cardiovascular Risk in Children with Type 1 Diabetes
• August 16, 2007: Hostility and Depression Harmful to Men's Immune System
• August 7, 2007: Decrease in Women's Use of Hormone Therapy Linked to Drop in Breast Cancer
• August 2, 2007: Use of SSRI's Down in Teens While Suicide Number Rises
• July 26, 2007: New Definitions from the International Diabetes Federation

Concept Media produces and distributes award winning education media for colleges, healthcare institutions, social service agencies and counseling centers throughout North America, Europe, and the South Pacific. Most programs come in VHS, DVD and CD formats. Site Licenses and Distance Learning packages are also available for our library of programs.

Concept Media is best known in the area of professional nursing education and represented in more than 95% of the nation's nursing school media libraries. We have developed partnerships with leading nursing education institutions including Brigham Young University, Drexel University, and ICN/ Washington State University College of Nursing. Concept Media is well-respected and has received numerous awards for programs on diabetes, human development, mental health, substance abuse, counseling, and addiction.

For your convenience, Concept Media also offers additional resources in the form of Instructor's Guides which are available online. And, in keeping with our mission to focus on the needs of educators in the healthcare field, we invite you to call with any suggestions, questions, program requests, or ways in which we can better serve you.

We would like to hear from you. Please email us on any topics you would like to see covered in Hot Topics.

hottopics@conceptmedia.com. Or call us at (800) 233-7078.