The effect of physical activity on asthma incidence over 10†years: population-based study.

Although there are many health benefits from being active, there was no benefit observed in this study from vigorous physical activity in reducing the risk of asthma onset in middle-aged adults https://bit.ly/3bEtHDn.

Characteristics of the provision of case management services in the community setting in Andalusia based on the RANGECOM registry. / Características de la provisión del servicio de gestión de casos en el entorno comunitario en Andalucía a partir del registro RANGECOM.

OBJECTIVE: To describe the characteristics of case management in terms of population served, interventions, use of services and outcomes such as mortality, readmissions, pressure ulcers, falls, drug problems and institutionalization. METHOD: Follow-up study of a cohort, from the RANGECOM Multicentric Registry of Andalusia. The study population were patients included in the case management services of Health Centres and their family caregivers. RESULTS: Data from 835 patients with a mean age of 76.8years (SD:12.1), 50.24% women, are presented. They had an important comorbidity (Charlson 3.1, SD:2.5) and high dependence (Barthel 37.5, SD:31.4). Sixty-two point two percent of the interventions deployed by the case managers were grouped into three domains: behavioural (26.0%), health system (20.2%) and safety (14.1%). Mortality was 34.4% and hospital admissions 38.1%. Patients with more hospital readmissions had more visits to the Emergency Department (OR:1.41; 95%CI: 1.22-1.63), more telephone interventions by case managers (OR:1.12; 95%CI: 1.02-1.24) and imaging tests (OR:1.37; 95%CI: 1.17-1.60), together with greater caregiver burden (OR:1.31; 95%CI: 1.08-1.59), the presence of medical devices at home (OR:1.69; 95%CI: 1.00-2.87) and received less "Case Management" intervention. CONCLUSIONS: The patients who absorb the demand of case management nurses present high complexity, for which they deploy behavioural interventions, navigation through the health system and clinical safety.

[Predictors of cognitive impairment in population over 64 years institutionalized and non-institutionalized]. / Factores predictores de deterioro cognitivo en población mayor de 64 años institucionalizada y no institucionalizada.

AIM: Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. METHOD: Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. RESULTS: The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. CONCLUSIONS: Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

RATIONALE, AIMS AND OBJECTIVES: Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. METHODS: The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. RESULTS: A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. CONCLUSIONS: The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events.

[Research lines proposed by Andalusian Association of Community Nursing]. / Líneas de investigación propuestas por la Asociación de Enfermería Comunitaria de Andalucía.

OBJECTIVE: To define and prioritise the future research lines of the Andalusian Association of Community Nursing (ASANEC). METHOD: Application of the Delphi technique within the members of the Working Group of the Research area of ASANEC, consisting of Community nurses from clinical and educational settings, as regards research in seven Andalusian provinces. Three rounds of participation were performed, with the last one being prioritised using a Linear Scale. Averages and standard deviations have been calculated. RESULTS: The total number of participants on this technique was 13 professionals (54.16%). The main research lines finally agreed and prioritised, were the following, in decreasing order: «care management¼, «quality of life¼, «lifestyles and health education in children and adolescent population¼, «design and validation of nursing assessment tools¼, «patient safety¼, «accessibility to healthcare services and development of self-care capacity¼. CONCLUSIONS: Research on the new model of care management introduced into Andalusian primary care was given priority, although there are more emerging research lines related to Health Promotion and Prevention of Health problems in the general population, children, young people and vulnerable populations. These results have been the deciding factors in the choice of the current research lines developed by the ASANEC Research Group.