Therapist characteristics that predict the outcome of multipatient psychotherapy: systematic review of empirical studies.

We defined multipatient psychotherapy as the set of psychotherapeutic techniques applied with more than one patient in the room. Assumptions of what makes a psychotherapist effective guide training programmes but may not be supported by evidence. We need to identify the empirical data on what makes a multipatient psychotherapist effective. We undertook the systematic review of empirical studies which correlate therapist characteristics with measurable patient outcome in multipatient psychotherapy. We found that the scientific literature on the topic is broad and heterogeneous in scope, studying demographic, professional and psychosocial characteristics of the therapists, but is poor in quality. The most solid results are that ethnic matching improves the outcome of family therapy with drug abusing adolescents in some ethnic minorities and that therapist knowledge patterns affect patient satisfaction. We concluded that the therapist characteristics that affect clinical outcome seem to be internal to the therapist and depend on the patient treated.

Latitude modifies the effect size of factors related to recurrent wheeze in the first year of life.

BACKGROUND: Although the association between latitude and asthma prevalence has been studied to a certain extent, its influence on the magnitude of the association of risk/protective factors with recurrent wheeze in infants has never been reported. METHODS: The adjusted odd ratios (aOR) of various risk/protective factors for recurrent wheeze from 31,920 infants from 19 centres of the "Estudio Internacional de Sibilacias en Lactantes" (EISL) in very different parts of the world were used to build a meta-regression using the strength of the aOR of each factor as dependent variable and centre latitude as explanatory variable. The meta-regression was further adjusted for continent. RESULTS: There was a positive significant correlation between latitude and the magnitude of the aOR between recurrent wheeze and having cold(s) during the first three months of life (p = 0.004); attending a nursery school (p = 0.011); and having additional siblings (p = 0.003). Furthermore, there was a negative correlation for having been breastfed for at least three months (p = 0.044). Heterogeneity (as measured by I2) of the magnitude of aORs between centres was quite high except for breast feeding: 73.1% for colds; 66.9% for nursery school; 52.6% for additional siblings; and 18.1% for breast feeding. Latitude explained a considerable amount of that heterogeneity: 63.8% for colds; 52.8% for nursery school; 86.6% for additional siblings; and 100% for breast feeding, probably as a consequence of its low heterogeneity. CONCLUSION: The magnitude in which some risk/protective factors are associated to recurrent wheeze during the first year of life varies significantly with latitude.

Concordance of lateral flow and skin prick tests in the assessment of allergen sensitisation in the epidemiological field in children.

BACKGROUND: A new lateral flow test (LFT) for office use provides information about sensitisation to common allergens. Concordance between LFT and skin-prick test (SPT) has not been assessed in epidemiological studies. The aim of this study is to determine LFT-SPT concordance in this field. METHODS: Plasma samples (n = 270) from children aged 9-12 years previously SPT tested were used for the analysis. We selected 180 samples from children SPT positive to any of the 6 allergens which were common to SPT and LFT (cat, birch, timothy-grass, olive, pellitoryand Dermatophagoides pteronyssinus), and 90 samples from children SPT negative. The intensity of the LFT colour line which indicates a positive reaction was rated from 0 to 4. RESULTS: Only results on cat, olive and D. pteronyssinus were analysed, as only these had an acceptable number of individuals. When atopy was defined as at least 1 wheal with a mean diameter > or =3 mm, agreement was excellent (Cohen's kappa = 0.81) when a lightly visible line was considered positive in the LFT, and dropped substantially (Cohen's kappa = 0.68) when this value of LFT was considered negative. The correlation between the SPT wheal diameter and the intensity of the LFT line was 0.71 for cat, 0.81 for olive and 0.78 for D. pteronyssinus. CONCLUSIONS: As compared to SPT, LFT is a reliable method to screen for sensitisation to cat dander, olive pollen and D. pteronyssinus in the epidemiological field among schoolchildren. There is a good correlation between the SPT wheal diameter and the intensity of the LFT line.

[Trends in asthma mortality in Spain from 1960 to 2005]. / Evolución de la mortalidad por asma en España, 1960-2005.

BACKGROUND AND OBJECTIVE: No data have been published on trends in asthma mortality in Spain between 1960 and 2005. The aim of this study was to trace these trends for both the general population and the 5- to 34-year age group in Spain. MATERIAL AND METHODS: The data on asthma mortality for the general population and by age and sex were obtained from the Spanish National Institute of Statistics and used to calculate the asthma mortality rates per 100 000 inhabitants. RESULTS: The overall asthma mortality rate per 100 000 inhabitants was 9.36 in 1960 and 2.22 in 2005, showing a reduction from 12.26 to 0.96 in males and from 6.58 to 3.44 in females. In the 5- to 34-year age group, the mortality rate for both sexes ranged from 0.4 to 0.1, showing great variability over time. CONCLUSIONS: Asthma mortality decreased in the period analyzed, but less in women than in men. The trend and rates in Spain are similar to those of most countries for which data are available.

Evolución de la mortalidad por asma en España, 1960–2005 / Trends in Asthma Mortality in Spain from 1960 to 2005

Introducción y objetivo: no hay datos publicados sobre la evolución de la mortalidad por asma en España en el período 1960–2005. El objetivo de este estudio ha sido describir la evolución de la tasa de mortalidad debida al asma en España entre 1960 y 2005, tanto en el total de la población como en el grupo de edad de 5 a 34 años.Material y métodos: los datos necesarios para calcular la tasa de mortalidad, esto es, número de defunciones debidas al asma y población, proceden del Instituto Nacional de Estadística. En cada caso se obtuvieron los valores totales, por grupo de edad y sexo. A partir de estos datos se calculó la tasa de mortalidad por asma, por 100.000 habitantes.Resultados: la tasa de mortalidad por asma para todas las edades era en 1960 de 9,36, y en 2005 de 2,22, con una reducción en los varones de 12,26 a 0,96 y en las mujeres de 6,58 a 3,44. En el grupo de edad de 5 a 34 años, los valores de la tasa de mortalidad para ambos sexos oscilan entre 0,4 y 0,1, y se observa una gran variabilidad en su evolución a lo largo de los años.Conclusiones: la mortalidad por asma ha disminuido a lo largo del período analizado, si bien de forma diferente en varones y mujeres, entre las que el descenso es mucho menor. La tendencia y las tasas de España son similares a las de la mayoría de los países de los que se dispone de datos(AU)

Background and Objective: No data have been published on trends in asthma mortality in Spain between 1960 and 2005. The aim of this study was to trace these trends for both the general population and the 5- to 34-year age group in Spain.Material and Methods: The data on asthma mortality for the general population and by age and sex were obtained from the Spanish National Institute of Statistics and used to calculate the asthma mortality rates per 100 000 inhabitants.Results: The overall asthma mortality rate per 100 000 inhabitants was 9.36 in 1960 and 2.22 in 2005, showing a reduction from 12.26 to 0.96 in males and from 6.58 to 3.44 in females. In the 5- to 34-year age group, the mortality rate for both sexes ranged from 0.4 to 0.1, showing great variability over time.Conclusions: Asthma mortality decreased in the period analyzed, but less in women than in men. The trend and rates in Spain are similar to those of most countries for which data are available.