The Impact of Caregiver Depression on Child Asthma Outcomes: Pathways and Mechanisms.

BACKGROUND: Depression is common in caregivers of children with asthma and is associated with poor outcomes in their child. No prior studies have longitudinally examined caregiver depression remission as a predictor of improvement in child asthma control. OBJECTIVE: This 2-site study examined whether the proportion of time a caregiver was in depression remission predicted subsequent child asthma control at exit. METHOD: Caregivers (n = 205) with current major depressive disorder and their children, ages 7 to 17, with persistent asthma were observed every 4 weeks for 52 weeks. Caregiver depressive symptoms were measured using the 17-item Hamilton Rating Scale for Depression (HRSD). Child asthma was assessed with the (Childhood) Asthma Control Test (cACT/ACT) and spirometry, and depression with the Children's Depression Inventory (CDI). Linear regression analyses were conducted with change in cACT/ACT, CDI, and forced expiratory volume in 1 second (FEV1)% predicted as outcomes and proportion of time the caregiver was in remission (HRSD score ≤ 7) as the predictor. Multilevel mediation analyses examined the role of child depressive symptoms and asthma controller medication adherence. RESULTS: Children were, on average, 54.1% female and 11 years old. Caregiver proportion of time in HRSD-assessed remission of depression was a significant predictor of improvement in cACT/ACT, CDI, and FEV1% predicted. Child CDI score, but not medication adherence, mediated the relationship between caregiver HRSD scores and child asthma control scores. CONCLUSIONS: Improvement in caregiver depression positively influences child asthma outcomes partially through improvement in child depressive symptom severity. Caregiver depression screening and treatment might lead to improvement in child asthma outcomes.

Multivariate Association of Child Depression and Anxiety with Asthma Outcomes.

BACKGROUND: Pediatric asthma is associated with increased health services utilization, missed school days, and diminished quality of life. Children with asthma also report more frequent depressive and anxiety symptoms than children without asthma, which may further worsen asthma outcomes. OBJECTIVE: The current study investigated the relationship between depressive and anxiety symptoms and 4 asthma outcomes (asthma control, asthma severity, lung function, and asthma-related quality of life) in children (N = 205) with moderate to severe persistent asthma. METHODS: The data were analyzed using a canonical correlation analysis, a multivariate framework that allows examination of all variables of interest in the same model. RESULTS: We found a statistically significant relationship between symptoms of depression and anxiety and asthma outcomes (1 - Λ = .372; P < .001). A large effect size suggests that 37.2% of variance is shared between depression and anxiety symptoms and 4 asthma outcomes (particularly asthma control and asthma-related quality of life) in the overall sample. Among girls (vs. boys), asthma control (measured by the Asthma Control Test) emerged as a stronger contributor to asthma outcomes compared with boys. CONCLUSIONS: These results suggest that psychiatric symptoms, especially anxiety, are associated with poor asthma-related quality of life, and more negative perception of asthma control in girls compared with boys (with no observed sex difference in physiological lung function). Clinicians should consider incorporating questions about psychiatric symptoms as part of routine asthma management, and focus patient education on unique differences in which boys and girls perceive their asthma symptoms.

Prevalencia de parasitosis intestinal y los hábitos de higiene, en estudiantes universitarios de Ciudad Universitaria, Universidad Nacional Autónoma de Honduras. noviembre-diciembre 2015

Objetivo: Determinar la prevalencia de parasitosis intestinal en estudiantes de la Ciudad Universitaria, y los hábitos de higiene relacionados con la misma, en la Universidad NacionalAutónoma de Honduras en el periodo comprendido de noviembre – diciembre 2015.Problema: ¿Cuál es la prevalencia de parasitosis intestinal en estudiantes de la CiudadUniversitaria, y los hábitos de higiene relacionados con la misma, en la UniversidadNacional Autónoma de Honduras en el periodo comprendido de noviembre – diciembre2015? Metodología: Es un estudio descriptivo, de corte transversal, se trabajó con un universofinito de 196 estudiantes de edades comprendidas entre 17 años y más. Se aplicó unaencuesta que consta de los siguientes datos: Características sociodemográficas, hábitosde higiene, resultado del examen de laboratorio, posteriormente se entregó los recipientesapropiados para la recolección de la muestra, que una vez obtenidas bajo las normas debioseguridad y control de calidad se les realizo un examen coproparasitológico en ellaboratorio clínico “Rosa Marina Trejo” dependiente del Área de Salud – VOAE. Resultados. Se realizaron 196 exámenes coproparasitológicos de los cuales el 89% seobservaron parásitos y 19% de estas no se encontraron. Los estudiantes que más sepresentaron se encuentran en el rango de edad de 17 -25 años. El 30% de los estudiantesno practican los hábitos de higiene. Los parásitos encontrados en las muestras fueron Blastocystis hominis (56%), Endolimax nana (27%), Entamoeba coli (11%), Iodamoeba Buetschlii (3%), Entamoeba hartmanni (3%). Conclusión: Se determinó una elevada prevalencia de parásitos intestinales en losestudiantes universitarios. No hubo diferencia estadísticamente significativa entre la edad(relación 1:1). Los parásitos con mayor prevalencia fueron los protozoos con predominio de Blastocystis hominis.