Potential and clinical relevant drug-drug interactions among elderly from nursing homes: a multicentre study in Murcia, Spain / Interações medicamentosas potenciais e clinicamente relevantes em instituições de longa permanência para idosos: um estudo multicêntrico em Murcia, Espanha

Abstract This study purposes to determine the prevalence of potential and clinical relevant Drug-Drug-Interactions (pDDIs) in institutionalized older adults and to identify the pertinent factors associated. We conduct an observational, multicenter and cross-sectional study during the last quarter of 2010. We selected a sample of 275 subjects (aged ≥ 65 years) from 10 nursing homes of Murcia (Spain) by a two-stage complex sampling. pDDIs were identified using the College of Pharmacists Database. We only considered pDDIs of clinical relevance, and thereafter the relevant factors were identified through uni-level and multi-level regression analyses. A total of 210 pDDIs were identified, 120 of which were considered clinically relevant (57.1%), affecting a total of 70 elderly (25.8%). Eight pharmacological groups made up 70.2% of the clinically relevant pDDIs. More clinically relevant DDIs were found in people suffering several pathologies (OR = 2.3; 95%CI = 1.4-4.5), and also in people who take ten or more drugs daily (OR = 9.6; 95%CI = 4.8-19.1), and people who take anti-inflammatory drugs (OR = 3.9; 95%CI = 1.4-10.4). This study reveals that clinically relevant pDDIs are very common in institutionalized elderly people, and that caregivers should aim at improving their practice in order to reduce the prevalence of this phenomenon.

Resumo Este estudo pretende identificar a prevalência de interações medicamentosas potenciais (IMP) em idosos institucionalizados e seus fatores associados. Realizamos um estudo observacional, multicêntrico e transversal, durante o último trimestre de 2010. Selecionamos uma amostra de 275 sujeitos (≥ 65 anos) de 10 instituições para idosos de Murcia (Espanha) mediante amostragem aleatória complexa em duas etapas. As IMP foram identificadas usando a base de dados do College of Pharmacists. Estimamos a prevalência de IMP de relevância clínica e analisamos os fatores associados com análise de regressão uni e multinível. Identificamos 210 IMP, das quais 120 foram consideradas clinicamente relevantes (57,1%) e afetaram 70 idosos (25,8%). Oito grupos farmacológicos constituíram 70,2% das IMP clinicamente relevantes. A prevalência de IMP esteve associada à multimorbidade (OR = 2,3; IC 95% = 1,4-4,5) e tomar dez ou mais medicamentos diariamente (OR = 9,6; IC95% = 4,8-19,1) e uso de medicamentos anti-inflamatórios (OR = 3,9; IC 95% = 1,4-10,4). Este estudo revela que as IMP clinicamente relevantes são muito comuns em idosos institucionalizados e que os serviços devem melhorar seus processos para reduzir a prevalência deste fenômeno.

Recesión económica (2006-2012) y cambios en el estado de salud de la población española / Economic recession (2006-2012) and changes in the health status of the Spanish population

Objetivo. Analizar la relación de los problemas de salud mental en población española con la recesión económica (2006-2012) y establecer en qué sentido afecta a la autopercepción del estado de salud. Material y métodos. Estudio transversal comparativo utilizando la Encuesta Nacional de Salud de España, 2006/2007 y 2011/2012. Mediante modelos de regresión logística, se analizaron tres indicadores relacionados con la salud mental y la salud percibida. Resultados. En 2011/2012 aumentó el consumo de medicamentos ansiolíticos y somníferos en hombres y mujeres. La disfunción mental aumentó durante el periodo de crisis económica en la población de varones. La percepción de una salud óptima no sufrió cambios significativos en hombres ni en mujeres. Conclusiones. La recesión económica mostró una relación variable con la salud mental y general de la población, y coincidió con un aumento de los trastornos de salud mental, como la ansiedad.

Objective. To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. Materials and methods. Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. Results. In 2011/2012 the consumption of anti-anxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. Conclusions. The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety.

El nivel educativo como factor asociado al bienestar subjetivo y la salud mental en la población española / Educational Level as a Member of the Subjective Well-Being and Mental Health in the Spanish Population

El objetivo de este trabajo fue evaluar la asociación entre el nivel educativo alcanzado con el bienestar emocional y la salud mental de los españoles. Un total de 29.478 personas adultas participaron en la Encuesta Nacional de Salud de España 2006, encontrándose que un nivel educativo bajo se asocia con peor salud mental (OR 1.65 hombres y OR 2.36 mujeres), valoración mala o muy mala de la salud (OR 2.10 hombres y OR 2.53 mujeres), menor apoyo social (OR 1.31 hombres y OR 1.66 mujeres) y sedentarismo (OR 2.09 hombres y OR 1.80 mujeres). En la muestra estudiada, el nivel educativo es un factor asociado a diferentes dimensiones de la salud relacionadas con el bienestar subjetivo y la salud mental.

The aim of this study was to evaluate the association between the educational level with the perceived emotional well-being and the mental health of the Spanish population. In a total of 29,478 adults, participating in the Spanish National Health Survey 2006, we found that low education level is related with poor mental health (OR 1.65 in men and OR 2.36 in women), poor or very poor self-perceived health (OR 2.10 OR 2.53 for men and women), less social support (OR 1.31 OR 1.66 for men and women) and inactivity (OR 2.09 OR 1.80 for men and women). In the Spanish population the educational level is an associated factor related with different health dimensions and to the subjective well-being and mental health perceptions.

De la inter a la transdiciplinariedad en el abordaje del hecho alimentario: una reflexión para compartir desde la educación / From Inter to transsing the food. A reflectiodisciplinarity made in addresn to share from the education

El presente artículo presenta en primer lugar, una descripción de la evolución del pensamiento transdisciplinario, en segundo término, la explicación de sus principales implicaciones, en tercer término se describe como la reflexión interdisciplinaria evoluciona hacia la transdisciplinaria generando lenguaje y categoría de análisis, en cuarto término la explicación de la alimentación como proceso social y cultural, y por último, se describe una propuesta transdiciplinar a partir del abordaje de los principales temas vinculados a la alimentación y nutrición, desde la perspectiva educativa y considerando sus diversas dimensiones y contextos. Este artículo pretende ser una aproximación al pensamiento complejo que plantea esta tendencia ya que a través de él puede lograrse una comprensión más profunda de los objetos de estudio abordados(AU)

The present article presents at first, a description of the evolution of transdisciplinary, thought in the second term, the explanation of his principal implications, in the third term. is described as the interdisciplinary reflection evolves towards the transdisciplinary generating language and a category of analysis and in the fourth term the explanation of the transdisciplinaryas a social and cultural process. Finally, we describe a proposal from transdisciplinary approaches as the main issues related to food and nutrition, from an educational perspective and considering its various dimensions and contexts. This article tries to be an approximation to the complex thought that raises this trend since through him, a deeper comprehension of the objects of study approached can be achieved(AU)

Health-related fitness in school children: compliance with physical activity recommendations and its relationship with body mass index and diet quality / Condición física relacionada con la salud en escolares: observancia de las recomendaciones de práctica de actividad física y su relación con el índice de masa corporal y la calidad de la dieta

This study establishes the relationship between the compliance with the governmental physical activity guidelines (at least a minimum of one hour of moderate to vigorous physical activity, MVPA, five times a week), health-related physical fitness and different health related lifestyle variables in a representative sample of Spanish children. Subjects were a representative group of scholars from five schools randomly selected in Extremadura, a mainly rural region with a very low population density. Statistical analysis comprises a t-test to calculate physical fitness differences between groups, according to the compliance with the mentioned physical activity guidelines. A multinomial logistic regression coefficient is established to determine the differences between the better physical fitness status group (= percentile 75) and the poorer physical fitness status group (= percentile 25) for each fitness test and gender, body mass index, physical activity, Mediterranean diet index and population size. Main findings show that the compliance with physical activity guidelines result in a better handgrip strength in left hand (p<0.05), leg strength (p<0.000), speed-agility run (p<0.000) and 20 m endurance shuttle run (p<0.000). Being a girl, being overweighed and living in an urban setting are associated with a lower physical fitness (= percentile 25), whereas there is no relationship between diet quality and subjects’ performance in all physical fitness test evaluated. As a conclusion, this study emphasizes the need to promote an active lifestyle in which physical activity suppose a minimum of one hour of regular MVPA, at least five times a week, to achieve a healthy fitness status.

Este estudio establece la relación entre el cumplimiento de las directrices gubernamentales de actividad física (una hora de actividad física moderada o vigorosa, MVPA, cinco veces a la semana), la condición física saludable, la calidad de la dieta y otras variables en una muestra de escolares de Extremadura (España). Se ha utilizado un t-test para calcular las diferencias de condición física entre los grupos, de acuerdo con el cumplimiento de las mencionadas directrices de actividad física. Se ha establecido un coeficiente de regresión logística multinomial para determinar las diferencias entre el grupo con mejor condición física (= percentil 75) y el grupo con peor condición física (= percentil 25), en función del sexo, índice de masa corporal, actividad física, índice mediterráneo de calidad de la dieta y tamaño de la población. El cumplimiento de las directrices de actividad física se relaciona con mejor fuerza de prensión en la mano izquierda (p <0,05), mayor potencia de las piernas (p <0,000), mejor agilidad (p <0,000) y mayor aptitud cardiorrespiratoria (p <0,000). Ser niña, tener exceso de peso y vivir en un entorno urbano se asocia con peor condición física (= percentil 25), mientras que no existe relación entre calidad de la dieta y la actuación de los sujetos en las pruebas de condición física realizadas. Este estudio enfatiza la necesidad de promover un estilo de vida activo en el que exista al menos una hora de actividad física (MVPA) durante cinco días a la semana, para alcanzar un estado físico saludable.