Changes in and the mediating role of physical activity in relation to active school transport, fitness and adiposity among Spanish youth: the UP&DOWN longitudinal study.

BACKGROUND: Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents. METHODS: This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011-12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators. RESULTS: Multilevel analyses observed decreases in LPA between T0-T1 (ß = - 11.27; p < 0.001) and T0-T2 (ß = - 16.27; p < 0.001) and decreases in MVPA between T0-T2 (ß = - 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (ß = 0.78; p = 0.028) and T0-T2 (ß = 0.81; p = 0.046). Path analyses showed that AST was directly positively associated with MVPA at T1 (all, ß ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (ß = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations. CONCLUSIONS: Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

Sun Protection Habits and Sun Exposure of Physical Education Teachers in the South of Spain.

The high prevalence and increasing incidence of skin cancer (SC) is a significant public health problem. We can address its main risk factor, which is incident and accumulated solar radiation, and its damages by disseminating knowledge and promoting changes in habits and attitudes toward the sun. The influence of teachers in the education of young people is crucial. Physical education teachers (PET) spend the majority of their time outdoors, thereby exposing themselves to solar radiation daily and greatly increasing the risk of SC. We carried out a case-control study matching for age and gender through surveys about photoexposure and photoprotection habits on a sample of 200 teachers (100 PET and 100 non-PET) on South of Spain. The results confirmed that there is a significant difference in sun exposure during the workday; PET group showed higher exposure (P < 0.01). We ascertained that photoprotection habits are deficient across the population. These data contribute to the understanding of the danger associated with poor sun protection among teachers (primary and secondary school teachers) and its mitigation. It is also worth noting that future prevention campaigns will be necessary for the subsequent correct transmission of the habits to students.

Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes. / Actitudes y percepción del profesorado de centros educativos públicos sobre la atención a alumnos con diabetes tipo 1.

OBJECTIVE: To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) METHODS: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. RESULTS: Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. CONCLUSIONS: The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies.

Inflammatory biomarkers and academic performance in youth. The UP & DOWN Study.

Inflammation influences cognitive development in infants and older adults, however, how inflammation may affect academic development during childhood and adolescence remains to be elucidated. This study aimed to examine the association between inflammatory biomarkers and academic performance in children and adolescents. A total of 494 youth (238 girls) aged 10.6 ± 3.4 years participated in the study. Four inflammatory biomarkers were selected: C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and white blood cell (WBC) count. An inflammatory index was created using the above mentioned biomarkers. Academic performance was assessed through schools records. Results showed that three of the four inflammatory biomarkers (CRP, IL-6 and WBC) and the inflammatory index were negatively associated with all academic indicators (ß values ranging from -0.094 to -0.217, all P<0.05) independent of confounders including body fat percentage. Indeed, youth in the highest tertile of the inflammatory index had significantly lower scores in all academic indicators compared with youth in the middle tertile (scores ranging from -0.578 to -0.344) and in the lowest tertile (scores ranging from -0.678 to -0.381). In conclusion, inflammation may impair academic performance independently of body fat levels in youth. Our results are of importance because the consequences of childhood and adolescence inflammation tend to continue into adulthood. Lifestyle interventions in youth may be promising in reducing levels of inflammation beyond the reduction in body fat in order to achieve cognitive benefits.

Uso del droperidol como agente antiemético por vía peridural en combinación con morfina para el control del dolor postoperatorio / Use of epidural droperidol as antiemetic agent combined with morphine for posoperative pain control

Objetivo: Evaluar la efectividad del droperidol como agente antiemético por vía peridural administrado conjuntamente con sulfato de morfina para el manejo de dolor postoperatorio. Material y métodos: 40 pacientes femeninas asignadas al azar, divididas en dos grupos de 20 cada uno, ASA I-II, edades entre 20 y 50 años, peso corporal de 60 a 70kg, postoperadas de histerectomía abdominal bajo anestesia peridural continua. Iniciando analgesia postoperatoria epidural al término de la cirugía. Grupo I con morfina dosis inicial en bolo de 30mcgrs/kg mas infusión continua de 50mcgrs/kg/día a través de una bomba electrónica PCA CADD PRIZM. Grupo II con morfina dosis inicial en bolo de 30mcgrs/kg mas droperidol dosis inicial en bolo de 2.5mgs, más infusión continua con una dosis de morfina 50mcgrs/kg/día conjuntamente con droperidol dosis de 2.5mgs/día por a través de una bomba electrónica PCA CADD PRIZM. Se valoró para ambos grupos: frecuencia cardiaca, frecuencia respiratoria, presión arterial no invasiva, oximetría de pulso, escala visual análoga de dolor (EVAD), escala de Bromage modificada, Ramsay y efectos sistémicos secundarios presentes basales, 1, 3, 6, 12, 24, 36, 48, 60 y 72 horas. Resultados: Grupo 1 50mcrs/kg/día., la EVA basal fue en promedio de 2.3, manteniéndose en promedio de 2.4 en ambos grupos, las constantes hemodinámicas se mantuvieron en parámetros aceptables, la escala de sedación de Ramsay basal de 2 sin diferencia estadísticamente significativa, manteniéndose en promedio para ambos grupos de 2.5,. Efectos colaterales: vómito en un 50 por ciento, náusea 95 por ciento, retención urinaria 2.5 por ciento y prurito 2.5 por ciento. principalmente para el grupo 1. Conclusión: el droperidol administrado vía peridural conjuntamente con morfina resulta ser un buen agente para contrarrestrar la náusea y vómito como efecto colateral importante de la morfina cuando se administra sola por vía peridural.