Analysis of a sustained educational intervention to teach cardiopulmonaryresuscitation to schoolchildren. / Análisis de una experiencia perdurable de un proyecto educativo de reanimación cardiopulmonar en un centro escolar.

EN: This project analyzed the feasibility, effectiveness, and sustainability of an educational project to teach cardiopulmonary resuscitation (CPR). This project has been carried out in a publicly subsidized school in a town in Asturias, Spain (population, over 80 000 inhabitants). The enrollment included students in preschool and both primary and secondary education classes. The project had 3 phases: 1) health care experts trained the teachers in CPR and they designed the educational project together; 2) health care experts taught CPR to schoolchildren, and 3) teachers taught CPR to the children. All the children enrolled in preschool and primary school (aged 3 to 12 years) initially participated in the study. Training followed the 2005 guidelines of the International Liaison Committee on Resuscitation (ILCOR) in effect at the time of the study. In the first phase (2006), 19 teachers (79.2% of the faculty) were trained in basic CPR and collaborated with the health care professionals in designing the course, including setting its objectives and developing materials. In the second phase (2006-2011), the health care professionals trained 646 preschool and primary school children and accredited 13 teachers (54.2% of the faculty) in the use of an automated external defibrillator (AED) and to serve as CPR instructional monitors. In the third phase (2012-2014), 7 teachers trained 703 preschool and primary and secondary school students, and 17 teachers (70.8% of the faculty) received training to become CPR monitors and/or to update their knowledge of AED use. A total of 1349 students between the ages of 3 and 15 years received instruction in CPR. The school has had an AED on its premises since 2011. The teachers have made further improvements in the courses, incorporating new teaching materials, updating the objectives, and extending instruction to secondary school students. The implementation of an educational program to teach CPR in a school that enrolls preschool through secondary school students was feasible and sustainable. Teachers have improved the program, extended it to secondary school students, and made the project known in the local media and on the school's web site, thus contributing to the creation of a CPR culture that reached out to the community.

ES: Se analiza la experiencia de un proyecto educativo de reanimación cardiopulmonar básica (RCPB) en un centro escolar valorando si es viable, efectivo y perdurable en el tiempo. Se trata de un proyecto desarrollado en un centro de enseñanza concertada de educación infantil (EI), primaria (EP) y secundaria (ESO), ubicado en un concejo muy poblado de Asturias, de más de 80.000 habitantes, en tres fases: 1) formación de maestros por personal sanitario y diseño conjunto del proyecto; 2) formación de escolares por personal sanitario, y 3) formación de niños por sus profesores. Se incluyeron todos los alumnos matriculados en el colegio en EI y EP (3 a 12 años). La formación impartida siguió las recomendaciones ILCOR (International Liaison Committee on Resuscitation) 2005, vigentes en aquel momento. En la fase 1 (año 2006) 19 profesores (79,2% de la plantilla) recibieron formación en RCPB y diseñaron con el personal sanitario los objetivos y material a emplear para cada curso. En la fase 2 (2006-2011) el personal sanitario formó a 646 escolares de EI y EP, y acreditó a 13 maestros (54,2% de la plantilla) para utilizar un DEA y como monitores de RCPB. En la fase 3 (2012-2014) 7 maestros formaron a 703 alumnos de EI, EP y ESO; 17 profesores (70,8% de la plantilla) recibieron cursos de monitor de RCPB y reciclajes DEA. En total recibieron formación en RCPB 1.349 niños entre 3 y 15 años. Desde el año 2011, el colegio cuenta con un DEA. Los profesores han mejorado el proyecto incorporando nuevos materiales, adelantado objetivos y extendiéndolo a los alumnos de ESO. La implantación de un proyecto educativo en RCPB en un colegio de enseñanza concertada de EI, EP y ESO de Asturias fue viable y ha perdurado. El profesorado ha mejorado el proyecto y lo ha extendido a los alumnos de secundaria, difundiendo la RCPB en medios de comunicación locales y en su página web, creando una cultura de la RCPB y acercándola a toda la comunidad.

Use of anthropometric measures to predict insulin resistance.

OBJECTIVE: Obesity is closely related to insulin-resistance (IR) but it is evaluated differently in the diverse definitions of the metabolic syndrome. The objective of this study was to verify the utility of different anthropometric measures to predict IR and to evaluate the best cut-off points. SUBJECTS AND METHOD: We performed a cross-sectional study of the general population aged 40 to 70 years old (n=2,143); a simple random sample of 305 non-diabetic persons was obtained. Sociodemographic data, physical examination and routine biochemical analysis with insulinemia were obtained. IR was defined by a HOMA index (Homeostasis Model Assessment) ≥2.9. To obtain the best variables to predict IR, a forward stepwise logistic regression was performed. Subsequently, a logistic equation was constructed and its predictive capacity was compared with the different anthropometric variables by the area under the ROC (receiver-operating characteristic) curve (AUC). The best cut-off points were established according to the Youden index. RESULTS: Body mass index (BMI) and the waist/hip ratio ×100 were entered into the model, but age, sex, waist, hip and body surface were not. The logistic equation found: p(RI)=1/1+exp{-[-14.295]-[0.234×IMC]-[0.07×(waist/hip×100)]} showed good adjustment, and the probability calculated on the basis of this equation showed the greatest AUC overall and in both sexes, followed in women by BMI and by waist measurement in men, but without significant differences. CONCLUSIONS: No significant differences were found between the BMI, waist or hip measurements and the logistic model to predict IR.

[Differences in the prevalence of metabolic syndrome according to the ATP-III and WHO definitions]. / Diferencias en la prevalencia del síndrome metabólico según las definiciones del ATP-III y la OMS.

BACKGROUND AND OBJECTIVE: The objective of the study is to know the prevalence of the metabolic syndrome (MS), as well as to know the differences in its prevalence according to the Adult Treatment Panel of the National Cholesterol Education Program (ATP-III) and World Health Organization (WHO) criteria. PATIENTS AND METHOD: Cross-sectional descriptive study performed in primary care in population of both sexes aged between 40 and 74 years. Variables studied were risk factors as well as each one of the components of MS, according to both definitions. RESULTS: We studied 358 patients, 161 (45%) men and 197 women. The prevalence of MS using the WHO criteria was 17.9% and according with the ATP-III criteria it was 23.5%. The prevalence increased with age and the body mass index. Both definitions agreed in the classification of MS in 80% of cases (kappa = 0.38). If we considered the definition of MS according to the WHO taken as the "gold standard", the ATP-III definition displays a sensitivity of 59.4%, specificity of 84.4% and negative predictive value of 90.5%. The agreement is greater in women and older than 60 years. CONCLUSIONS: The prevalence of MS is smaller with the WHO criteria. The agreement between both methods is scarce and the clinical application of the ATP-III criteria in primary care needs its homologation with clinic-epidemiological studies.

[Comparison of the SCORE and Framingham models in calculating high cardiovascular risk for a sample of males within the 45-65 age range in Asturias, Spain]. / Comparación de los modelos SCORE y Framinghan en el cálculo de alto riesgo cardiovascular para una muestra de varones de 45 y 65 años de Asturias.

BACKGROUND: The Spanish Interdisciplinary Committee for Cardiovascular Prevention has recently drafted a consensus for adapting the European Cardiovascular Prevention Guide to the Spanish population, using SCORE as the risk-calculation method. This study is aimed as ascertaining the differences involved in changing over from the Framingham to the SCORE criterion in the classification of males within the high-risk group. METHODS: Descriptive cross-sectional study conducted in primary care. A total of 379 males within the 45-65 age range, corresponding to four (4) groups from general practitioners from three healthcare centers in the Principality of Asturias. MAIN MEASUREMENTS: calculation of the cardiovascular risk and high-risk prevalence by the conventional Framingham method and according to SCORE. High-risk prevalence curve estimated by logic regression. RESULTS: The high-risk prevalence according to the Framingham equation was 24% (CI95%=19.9-28.7) and was 17.9% (CI95%=14.3-22.3) for SCORE, the difference being statistically significant (p=0.02). The SCORE model shows lower prevalences among subjects under age 60 and higher for those over age 60. Among male smokers, SCORE shows lower prevalences among individuals under 58 years of age, the high-risk males with Framingham and low-risk with SCORE being younger, smokers and having lower average blood pressure figures and moderate cholesterol figures. CONCLUSIONS: On applying the SCORE model, we classify fewer males as high-risk, especially among those under 58 years of age who are smokers having moderate cholesterol figures than when the Framingham scale is used.