Impacto de una intervención educativa sobre asma en los profesores de Educación Infantil y Primaria de una zona básica de salud / Impact of an educational intervention about asthma on early childhood and primary education teachers in one health district

INTRODUCCIÓN: un adecuado conocimiento sobre asma por los profesores de los centros educativos es necesario para un correcto control de la enfermedad. OBJETIVO: determinar el impacto de una intervención educativa en el nivel de conocimientos sobre el asma y su manejo en profesores de Educación Infantil y Primaria. MATERIAL Y MÉTODOS: estudio cuasiexperimental, tipo antes y después, de una intervención educativa (IE) sobre asma en profesores de centros escolares de una zona básica de salud de Valladolid. Se realizó un cuestionario previo a la intervención educativa, inmediatamente después y a los seis meses. RESULTADOS: participaron 100 docentes (69,93%) de cinco colegios. Edad media 44,2 ± 8 años (rango: 28-59). Mujeres: 82%. El nivel de conocimientos sobre asma es bajo. Identifica los principales síntomas del asma el 65% de los participantes y los desencadenantes de una crisis el 59%. No sabe si los niños con asma pueden hacer deporte de competición el 30%. Cree que una crisis no puede ser evitada durante el ejercicio el 26%. Considera el tratamiento inhalado el más eficaz el 79% y los antibióticos parte del tratamiento el 7%. Cree que el salbutamol daña el corazón el 5%. Después de la intervención educativa observamos un incremento significativo en los conocimientos sobre asma (p <0,001) y se mantiene a los seis meses. CONCLUSIONES: una intervención educativa dirigida a los profesores aumenta significativamente el nivel de conocimientos sobre el asma. Este incremento se mantiene durante al menos seis meses. Son necesarias actividades educativas y medidas organizativas sobre asma en la escuela

INTRODUCTION: an appropriate knowledge about asthma by teachers in schools is essential for its control. OBJECTIVE: to determine the impact of an educational intervention on the knowledge of teachers about asthma and its management in the primary schools located in one health district. PATIENTS AND METHODS: quasi-experimental pre-post intervention study assessing an educational intervention aimed at improving the knowledge on asthma of teachers. A questionnaire was administered before, immediately after and 6 months after the educational intervention. RESULTS: 100 teachers (69.93%) employed in 5 schools participated in the study. The mean age was 44.2 ± 8 years (range, 28-59 years), 82% were women. We found a low level of asthma knowledge in the teaching staff. Many participants could identify the main symptoms of asthma (65%) and the main triggers (59%). Thirty percent did not know whether these students could participate in competitive sports, and 26% believed it was not possible to prevent exercise-induced asthma attacks. Seventy-nine percent knew that inhaled therapy was the best approach. Seven percent stated that antibiotics are a component of asthma treatment. Five percent believed salbutamol could damage the heart. After the educational intervention, we noticed a significant increase on asthma knowledge (p <0.001). The level of knowledge was maintained 6 months after the intervention. CONCLUSIONS: educational interventions aimed at teachers significantly increase the level of asthma knowledge. This improvement is maintained for at least 6 months. Educational activities and organizational measures on asthma are necessary in the school setting

Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis. / Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico.

Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.

Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que en la población general. El infradiagnóstico de patología dual puede tener diversas consecuencias negativas; una valoración precoz con herramientas de cribaje como la escala CAGE podría mejorar el pronóstico de estos pacientes. El objetivo de este estudio es valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios con una CAGE modificada, considerando la influencia de edad, género, y diagnóstico psiquiátrico. Se realizó un estudio descriptivo observacional, multicéntrico. La escala CAGE de 4 ítems, camuflada en un cuestionario de vida saludable, se aplicó utilizando el punto de corte de 1. Se valoraron 559 pacientes. El 54% eran mujeres, y la edad media fue de 50,07 años. 182 pacientes presentaron una puntuación ≥1 (45,1% de los hombres y 21,9% de las mujeres). El género fue el predictor principal de un resultado positivo en la escala CAGE, siendo 3,03 veces más probable que los hombres obtengan una puntuación ≥1 (p < ,001, 95% IC: 0,22-0,49). El trastorno bipolar y los trastornos de personalidad presentaron las tasas más altas de puntuaciones ≥1 (45,2 y 44,9%, respectivamente) con una asociación significativa entre diagnóstico y un resultado positivo (p = ,002). Los pacientes de más de 60 años mostraron 2,5 veces menos probabilidades de obtener una puntuación positiva (p = ,017, 95% IC: 0,19-0,85). Cuestionarios específicos, como CAGE, pueden ser herramientas sencillas y útiles para valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios. Los pacientes hombres con trastorno bipolar o de personalidad presentan un riesgo más elevado de TUA.

Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico / Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis

Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que en la población general. El infradiagnóstico de patología dual puede tener diversas consecuencias negativas; una valoración precoz con herramientas de cribaje como la escala CAGE podría mejorar el pronóstico de estos pacientes. El objetivo de este estudio es valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios con una CAGE modificada, considerando la influencia de edad, género, y diagnóstico psiquiátrico. Se realizó un estudio descriptivo observacional, multicéntrico. La escala CAGE de 4 ítems, camuflada en un cuestionario de vida saludable, se aplicó utilizando el punto de corte de 1. Se valoraron 559 pacientes. El 54% eran mujeres, y la edad media fue de 50,07 años. 182 pacientes presentaron una puntuación ≥1 (45,1% de los hombres y 21,9% de las mujeres). El género fue el predictor principal de un resultado positivo en la escala CAGE, siendo 3,03 veces más probable que los hombres obtengan una puntuación ≥1 (p < ,001, 95% IC: 0,22-0,49). El trastorno bipolar y los trastornos de personalidad presentaron las tasas más altas de puntuaciones ≥1 (45,2 y 44,9%, respectivamente) con una asociación significativa entre diagnóstico y un resultado positivo (p = ,002). Los pacientes de más de 60 años mostraron 2,5 veces menos probabilidades de obtener una puntuación positiva (p = ,017, 95% IC: 0,19-0,85). Cuestionarios específicos, como CAGE, pueden ser herramientas sencillas y útiles para valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios. Los pacientes hombres con trastorno bipolar o de personalidad presentan un riesgo más elevado de TUA

Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients’ prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD

Prenatal exposure to mirex impairs neurodevelopment at age of 4 years.

BACKGROUND: Some studies have suggested that certain organochlorine (OC) compounds may impair neurodevelopment in animals and humans. The objective of this study was to investigate the association between prenatal exposure to an OC pesticide, mirex, and cognitive development in children at age of 4 years. METHODS: A population-based birth cohort in Granada (Spain) recruited between 2000 and 2002 was studied between 2005 and 2006, when the children were 4 years old. Complete data for analyses, including mirex determination in placentas, were gathered on a random sample of 104 children. A standardized version of the McCarthy Scales of Children's Abilities (MSCA) was used to assess children's motor and cognitive abilities. Multivariate analyses were performed to evaluate the relation between MSCA scores and prenatal exposure to mirex, adjusting for potential confounders. RESULTS: The presence of mirex in placenta was inversely associated with cognitive development at 4 years of age: children with prenatal exposure to mirex (>or=limit of quantification: 26%; median: 1.4 ng/g placenta) showed a decrease of 5.15 points in working memory and of 7.33 points in the quantitative area with respect to children of the same age not prenatally exposed to mirex. CONCLUSION: The deficit found in intellectual function during early childhood suggests that prenatal exposure to mirex may have a significant impact on school performance.

Association of traffic-related air pollution with cognitive development in children.

BACKGROUND: Air pollution from traffic has been associated with cardiorespiratory diseases in children and adults, but there is little information on its potential neurotoxic effects. This study aimed to investigate the association between exposure to nitrogen dioxide (NO(2)), as a marker of traffic-related air pollution, and cognitive development in children. METHODS: A population-based birth cohort from southern Spain was followed from the age of 4 years for 1 year. Complete data for analyses were gathered on 210 children living in urban and rural areas. NO(2) exposure was predicted by means of land use regression models. A standardised version of the McCarthy Scales of Children's Abilities (MSCA) was used to assess children's motor and cognitive abilities. Multivariate analyses were performed to evaluate the relation between exposure to NO(2) and MSCA outcomes, adjusting for potential confounders. RESULTS: A negative effect of NO(2) was found across all MSCA subscales, despite low predicted NO(2) exposure levels (5-36 microg/m(3)). Children exposed to higher NO(2) (>24.75 microg/m(3)) showed a decrease of 4.19 points in the general cognitive score and decreases of 6.71, 7.37 and 8.61 points in quantitative, working memory and gross motor areas, respectively. However, except for gross motor function, associations were not statistically significant. CONCLUSION: Although results were not statistically significant, the associations found between exposure to NO(2) and cognitive functions suggest that traffic-related air pollution may have an adverse effect on neurodevelopment, especially early in life, even at low exposure levels.