Hábitos del sueño en niños de 8 a 12 años escolarizados en el barrio «La Mina» / Sleep habits in 8-to-12-year-old school children from the «La Mina» area

OBJETIVO: describir los hábitos del sueño en la población infantil de entre 8 y 12 años escolarizados; y estudiar la influencia de factores sociodemográficos y de los hábitos de sueño en el sobrepeso y la obesidad. MÉTODO: estudio descriptivo transversal en niños y niñas de 8 a 12 años, escolarizados entre 3º y 6º de Educación Primaria (EP) del barrio de La Mina de Sant Adrià de Besòs (Barcelona). Recogida de los datos: cuestionario Children Sleep Habits Questionnaire (CSHQ). Se calculó el percentil IMC (pIMC) según las curvas y tablas de crecimiento de Orbegozo. Tratamiento de los datos: pruebas de contraste de hipótesis (Chi cuadrado, U de Mann-Whitney y Kruskall Wallis). RESULTADOS: se estudiaron 337 niños/as. Un 4,2% de los escolares tenía sobrepeso y un 23,7% obesidad. El 55,9% de quienes tenían normopeso habitualmente estaba preparado para ir a dormir, en contraposición del 42,5% de quienes presentaban obesidad (p= 0,02). El 29,5% se mantenía despierto/a en la cama mientras sus padres creían que estaba durmiendo (aumenta el porcentaje a medida que aumenta el curso (p= 0,03), en los varones (p= 0,01) y en con obesidad (p= 0,04). Existía diferencia estadísticamente significativa entre las escuelas y la puntuación de la dimensión relacionada con los trastornos del sueño y la puntuación total de la suma de todas las dimensiones (p< 0,01); se obtuvieron mejores puntuaciones en el colegio concertado. CONCLUSIONES: los escolares de mayor edad y las niñas siguen mejores hábitos del sueño. Atendiendo a las puntuaciones obtenidas en el CSHQ, quienes estaban en la escuela concertada reflejaron mejores hábitos del sueño. Los escolares con normopeso tienen mejores hábitos de sueño

OBJECTIVE: to describe the sleep habits in a population of 8-to-12-year-old school children, and to study the influence of sociodemographical factors and sleep habits upon excess weight and obesity. METHOD: a descriptive transversal study in 8-to-12-year-old boys and girls, attending from 3rd to 6th term of Primary Education (PE), at the La Mina de Sant Adrià de Besòs neighbourhood in Barcelona. Data collection: Children Sleep Habits Questionnaire (CSHQ). The BMI rate was calculated according to growth curves and tables by Orbegozo. Data treatment: hypothesis contrast tests (Chi Square, Mann-Whitney's U-Test, and Kruskall Wallis). RESULTS: the study included 337 boys and girls; 4.2% of them had excess weight, and 23.7% suffered obesity. From those school children with normal weight, 55.9% were usually ready to go to sleep, unlike the 42.5% who presented obesity (p= 0.02). 29.5% stayed awake in bed while their parents believed they were sleeping; the rate increased for latter terms (p= 0.03), for boys (p= 0.01) and for those with obesity (p= 0.04). There was a statistically significant difference between schools and the score in the dimension associated with sleep disorders and the total score for the sum of all dimensions (p< 0.01); there were better scores in the private school with public funding. CONCLUSIONS: older school-children and girls presented better sleep habits. According to the scores from the CSHQ, those attending the private school with public funding showed better sleep habits. Schoolchildren with normal weight have better sleep habits

Safety of the reuse of needles for subcutaneous insulin injection: A systematic review and meta-analysis.

OBJECTIVE: Many people with diabetes often reuse disposable needles for subcutaneous insulin injection. We aimed to identify, critically appraise and summarize the available evidence about the safety of this practice. DESIGN: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES: MEDLINE (via PubMed), CINALH (via EBSCO), SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials and Open Grey were searched from their inception to December 2015, with no language restrictions. REVIEW METHODS: Epidemiologic and experimental studies assessing adverse effects of reusing needles in people of any age or sex, with or without diabetes, were included. Two reviewers independently assessed the methodological quality of included studies using a multi-design tool. RESULTS: In total, 25 studies were included. All studies had a high risk of bias and data from only nine studies could be pooled. Five studies showed no association between infection at site of injection and reuse of needles (risk difference=-0.00; 95% confidence interval=-0.12-0.11; P=0.99); heterogeneity between these studies was substantial (I(2)=66%; P=0.02). Five cross-sectional studies showed an association between lipohypertrophy and needle reuse (risk difference=0.16, 95% confidence interval=0.05-0.28, P=0.006); there was strong evidence of heterogeneity between these studies (I(2)=87%; P<0.001). Pooled data of two studies with no evidence of heterogeneity between them showed more perceived pain among reusers (risk difference=0.24; 95% confidence interval=0.06-0.43; P=0.006). Reusing a pen needle or disposable syringe-needle was not associated with worse glycaemic control. CONCLUSIONS: There is currently no clear scientific evidence to suggest for or against the reuse of needles for subcutaneous insulin injection. This practice is very common among people with diabetes; consequently, further research is necessary to establish its safety.

Evaluation of the relationship between effervescent paracetamol and blood pressure: clinical trial.

BACKGROUND: Paracetamol's solubility is achieved by adding to the excipient sodium salts, either as bicarbonate, carbonate or citrate. As the relationship between salt and hypertension is well known, due to the sodium content it has raised a hypothesis that may interfere with the control of that risk factor. Therefore, the objective of this study is to evaluate the effect on blood pressure of effervescent paracetamol compared to non-effervescent, in hypertensive patients. METHODS/DESIGN: This is the protocol of a phase IV multicenter clinical trial, randomized, controlled, crossover, open, which will compare the effect of two different formulations of paracetamol (effervescent or non-effervescent) in the blood pressure of hypertensive patients, with a seven weeks follow up. 49 controlled hypertensive patients will be included (clinical BP lower than 150 and 95 mmHg, and lower than 135 mmHg and 85 mmHg in patients with diabetes or a history of cardiovascular event, and daytime ambulatory measurements lower than 140 and 90 mmHg) and mild to moderate pain (Visual Analog Scale between 1 and 4). The study was approved by the ethics committee of the Fundació Jordi Gol i Gurina and following standards of good clinical practice. The primary endpoint will be the variations in systolic BP in 24 h Ambulatory Blood Pressure Monitoring, considering significant differences 2 or more mmHg among those treated with non-effervescent and effervescent formulations. Intention-to-treat and per-protocol analysis will be held. DISCUSSION: Despite the broad recommendation not to use effervescent drugs in patients with hypertension, there are relatively little studies that show exactly this pressor effect due to sodium in salt that gives the effervescence of the product. This is the first clinical trial designed to study the effect of effervescence compared to the non-effervescent, in well-controlled hypertensive patients with mild to moderate pain, performed in routine clinical practice. TRIAL REGISTRATION: NCT 02514538.

Effects of the economic crisis and social support on health-related quality of life: first wave of a longitudinal study in Spain.

BACKGROUND: Economic recession affects quality of life by increasing rates of mental disorders in particular. Social support can be an important protective factor. AIM: To estimate the impact of being personally affected by an economic crisis on health-related quality of life (HRQoL), taking into account the possible buffering effect of perceived social support. DESIGN AND SETTING: Data from the first wave (March 2012 to November 2012) of the 'Social Support and Quality of Life Study', a longitudinal study carried out in a primary health care centre in a deprived neighbourhood of Barcelona, Spain. METHOD: A total of 143 participants were assessed using the 12-item Short-Form Health Survey, the List of Threatening Experiences and the Duke Social Support scales. The effect of economic crisis on mental and physical HRQoL was assessed using ordinary least squares regression models to test the interaction between social support and having experienced an economic crisis. RESULTS: There was no statistical association between having suffered an economic crisis and physical HRQoL. The interaction between social support and economic crisis was also tested without finding any statistical association. An interaction was detected between social support and economic crisis in relation to mental HRQoL; those who had low levels of social support and had also experienced an economic crisis had the lowest levels of mental HRQoL. CONCLUSION: Social support constitutes a safety net that offers protection against the adverse effect of economic recessions on mental health. Primary care professionals are in a key position to promote social activities and to strengthen social networks in the community.