An Animation- Versus Text-Based Computer-Tailored Game Intervention to Prevent Alcohol Consumption and Binge Drinking in Adolescents: Study Protocol.

The purpose of this paper is to describe the protocol for the design, implementation, and evaluation of an animation- versus text-based computer tailoring game intervention aimed at preventing alcohol consumption and binge drinking (BD) in adolescents. A cluster-randomized controlled trial (CRCT) is carried out in students aged 14-19 enrolled in 24 high schools from Andalusia (Spain), which are randomized either to experimental (EC-1, EC-2) or waiting-list control conditions (CC). EC-1 receives an online intervention (Alerta Alcohol) with personalized health advice, using textual feedback and several gamification techniques. EC-2 receives an improved version (Alerta Alcohol 2.0) using animated videos and new gamification strategies. Both programs consist of nine sessions (seven taking place at high school and two at home): session 1 or baseline, sessions 2 and 3 that provide tailored advice based on the I-Change Model; sessions 4, 5, 7, and 8 are booster sessions, and sessions 6 and 9 are follow-up questionnaires at six and twelve months. The CC completes the baseline and the evaluation questionnaires. The primary outcome is BD within 30 days before post-test evaluations, and as secondary outcomes we assess other patterns of alcohol use. The findings should help the development of future alcohol drinking prevention interventions in adolescents.

International Multicenter Study on Drug Consumption in Nursing Students.

BACKGROUND: The prevalence of illicit drug use among young people is high, with many being highly vulnerable to substance abuse. The nursing profession is not immune to the impacts of substance misuse. Knowing the current levels of consumption of illicit drugs in nursing students will allow for the introduction of preventive actions. METHODS: Multi-center, descriptive, and cross-sectional study involving nursing schools from four different countries (Spain, Belgium, France, and Brazil). A total of seven centers participated. An adapted version of the Global School-based Student Health Survey (GSHS) was used as a tool, which selected only the module on illicit drugs. Standard logistic regression analysis was performed. RESULTS: A total of 496 nursing students participated in the study. Illicit drug shows positive representation among nursing students. A significant difference was observed between the gender and the age of first drug use, illicit drug consumption, cannabis use, and cocaine use ever in life, with higher use of illicit drugs by male, although at later ages than girls. The bivariate analysis, gender, problems as result of drugs, and nationality were significantly associated with the consumption of illicit drugs, cannabis, cocaine, and ecstasy ever in life. CONCLUSIONS: High rates of illicit drug use were found among nursing students, as well as factors that can influence consumption such as nationality or gender. These results can serve as a basis for the development of educational and policy interventions within nursing schools that are based on evidence, with significant implications for nurse educators, academic administrators, and practice.

Why are Spanish Adolescents Binge Drinkers? Focus Group with Adolescents and Parents.

Binge drinking in adolescents is a worldwide public healthcare problem. The aim of this study was to explore the perceptions about determinants of binge drinking in Spanish adolescents from the perspective of adolescents and parents. A qualitative study using fourteen semi-structured focus groups of adolescents was conducted during the 2014/2015 school year (n = 94), and four with parents (n = 19), based on the I-Change Model for health behaviour acquisition. Students had a low level of knowledge and risk perception and limited self-efficacy. Girls reported more parental control, and when they get drunk, society perceives them worse. Adolescents suggested focus preventive actions to improve self-efficacy and self-esteem. Parents were permissive about alcohol drinking but rejected binge drinking. They offered alcohol to their children, mainly during celebrations. A permissive family environment, lack of control by parents, adolescents' low-risk perception, low self-esteem and self-efficacy, as well as the increase of binge drinking in girls as part of the reduction of the gender gap, emerge as risk factors for binge drinking. Future health programmes aimed at reducing binge drinking should focus on enhancing motivational factors, self-esteem, and self-efficacy in adolescents; supervision and parental control; as well as pre-motivational factors by increasing knowledge and risk awareness, considering gender differences.

A Web-Based, Computer-Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized Controlled Trial.

BACKGROUND: Alcohol consumption, including binge drinking (BD) and heavy episodic drinking (HED), is one of the leading risk factors among Spanish adolescents leading to significant social, health, and economic consequences. Reduction of BD and HED in adolescents can be achieved using Web-based, computer-tailored (CT) interventions, providing highly personalized feedback that is adapted to a person's individual characteristics and needs. Randomized controlled trials assessing the effects of tailored BD reduction programs among Spanish adolescents are scarce. OBJECTIVE: The aim of this study was to test the effectiveness of the Web-based, CT intervention Alerta Alcohol, aimed at the prevention of BD in Spanish adolescents. As a secondary outcome, effects on HED, weekly consumption, and any consumption were also assessed. The adherence and process evaluation were assessed. METHODS: A cluster randomized controlled trial conducted among 15 Spanish schools was developed. Each school was randomized into either an experimental condition (EC) (N=742) or a control condition (CC) (N=505). Finally, 351 participants for the EC and 261 for the CC were included in the analysis (N=612). Baseline assessment took place in January and February 2017. Demographic variables and alcohol use were assessed at baseline. Follow-up assessment of alcohol use took place 4 months later in May and June 2017. Participants were compared according to their randomization group (EC versus CC). After the baseline assessment, participants in the EC started the intervention, which consisted of short stories about BD, in which CT feedback was based on the I-Change Model for behavior change. Participants in the CC group only received the baseline questionnaire. Effects of the intervention were assessed using a three-level mixed logistic regression analysis for BD, HED, and any consumption, and a three-level mixed linear regression analysis for weekly consumption. RESULTS: In total, 1247 adolescents participated in the baseline assessment and 612 participated in the follow-up assessment; the attrition rate was 50.92%. The intervention was effective in reducing HED among adolescents; the odds of HED in the CC was nine times that in the experimental condition (P=.04). No effects were found for BD, weekly consumption, and any consumption. Process evaluations revealed that the adolescents were satisfied with the program (68.8%), would use the program again (52.9%), and would recommend it to someone else (62.8%). Females and non-binge drinkers showed better responses in the process evaluation. CONCLUSIONS: Our intervention was effective regarding HED but not regarding BD, weekly consumption, and any consumption. It may be that limiting alcohol consumption to prevent HED was easier in the Spanish context than it was to carry out further steps, such as reducing other patterns of alcohol consumption. Hence, additional actions are needed to accomplish these latter goals, including community approaches and policy actions aimed at denormalizing alcohol consumption among Spanish adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT03288896; https://clinicaltrials.gov/ct2/show/NCT03288896. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-018-5346-4.

Influence of Personality Traits and Its Interaction with the Phenomenon of Bullying: Multi-Centre Descriptive Study.

Bullying affects thousands of teenagers worldwide and has devastating consequences. Various studies suggest that the personality of teenagers is a risk profile for bullying. The aim of this study was to analyse the relationship between the personality of teenagers aged 14 to 16 years from three education centres located in the province of Seville (Spain) and bullying in any of its victim or aggressor roles. A multi-centre cross-sectional observational descriptive study was conducted in three education centres in the province of Seville (Spain). The sample consisted of 93 students. In order to measure the two main variables, the Bull-S test was used for bullying, and the EPQ-J questionnaire was used for personality traits. A descriptive and correlation analysis was performed between variables. The results showed that 14% (n = 13) of the sample were detected as victims and another 14% (n = 13) were detected as aggressors. Statistically significant differences were found between neuroticism (p = 0.044; Phi = 0.615), sincerity (p = 0.016; V de Cramer = 0.474), and anti-social behaviour (p = 0.007; Phi = 0.620) with the variables victim/aggressor. Bullies are typically males who score high on neuroticism and anti-social behaviour, with a tendency towards social dissimulation.

Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo / Characteristics present in secondary school students who do not smoke and who have no intention to smoke

Objetivo: Conocer las variables presentes en escolares de primero y segundo de secundaria que no consumen tabaco o no tienen intención de fumar desde un modelo de salud positiva. Métodos: Estudio transversal con 482 estudiantes en Andalucía y Cataluña usando un cuestionario validado (proyecto ESFA y PASE). Se realizaron análisis de regresión logística binaria. Resultados: Quienes no tenían intención de fumar presentaron una actitud desfavorable al tabaco y una alta autoeficacia (p <0,001). En los/las no consumidores/as las variables más asociadas fueron la actitud, el modelo social (p <0,001) y la autoeficacia (p = 0,005). Conclusiones: Los resultados reflejan factores motivacionales presentes en escolares que no fuman ni pretenden hacerlo. La actitud y la autoeficacia se asocian fuertemente con la intención y con el comportamiento. Esta información puede ser útil para desarrollar estrategias positivas de promoción de la salud desde un modelo salutogénico

Objective: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. Methods: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. Results: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). Conclusions: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach

[Characteristics present in secondary school students who do not smoke and who have no intention to smoke]. / Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo.

OBJECTIVE: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. METHODS: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. RESULTS: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). CONCLUSIONS: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach.

Design, implementation and evaluation of a web-based computer-tailored intervention to prevent binge drinking in adolescents: study protocol.

BACKGROUND: Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation and evaluation of the first web-based computer tailored intervention aimed at the prevention of binge drinking in Spanish adolescents. METHODS: The Alerta Alcohol program is based on the I-Change Model. First, feedback from focus and Delphi groups are used for cultural adaptation and to obtain further information on the items to be included on the program. A pilot study is then conducted to assess feasibility and to identify strengths and weaknesses. Second, a Cluster Randomized Controlled Trial is conducted to test the effectiveness of Alerta Alcohol in students aged 16 to 18 years. The study is performed in 16 high schools from Andalusia (southern Spain), which are randomized either to the experimental or the control condition (EC and CC). The EC receives the Alerta Alcohol intervention, which consists of four sessions at school (baseline questionnaire, two sessions in three scenarios: at home, celebrations, and public places, and a final evaluation). The adolescents are provided with answers related to their views of each scenario; this information is used to provide highly specific feedback regarding their knowledge, risk perception, self-esteem, attitude, social influence, and self-efficacy. In addition, two booster sessions are given at home to reinforce the previous messages. The CC just completes the baseline and the final evaluation questionnaires and then they are allowed to receive the intervention as well (as a waiting list). Evaluation takes place after four months. The primary endpoint is binge drinking within 30 days prior to the evaluation and alcohol use in the previous week. It is expected that Alerta Alcohol reduce the prevalence of binge drinking by 10%. Follow up analyses are carried out to determine the differences in effectiveness according to the compliance of the program (quality of the implementation). DISCUSSION: The results are expected to be applicable and may incorporate improvements in the practice of the Healthcare and Education Systems. If the program proves to be effective, regional and eventual national implementation should be considered. TRIAL REGISTRATION: Trial registration number (ClinicalTrials.gov): NCT03288896 . This study was retrospectively registered on 19/09/2017.

Factores relacionados con la calidad de vida en la adolescencia / Quality-of-life-related factors in adolescents

Objetivo: Conocer la calidad de vida (CV) y su relación con estilos de vida en adolescentes de educación secundaria. Método: Estudio observacional transversal con 256 estudiantes de 12 a 17 años de edad, de la provincia de Sevilla (España). Se utilizaron modelos de regresión lineal múltiple (p <0,05). Resultados: Los chicos presentan mayor puntuación en diversas dimensiones de CV, relacionándose inversamente el ser chica y la CV física, psicológica, familiar y el índice general de CV (p <0,05). El funcionamiento familiar y la realización de actividad física se asociaron fuertemente a una mejor CV, en todas sus dimensiones. Los modelos multivariados fueron estadísticamente significativos y explicaron desde el 11% de variabilidad de la CV social hasta el 35% del Índice general de CV. Conclusiones: Los hallazgos podrían ser útiles para el desarrollo de intervenciones de promoción de la salud escolar dirigidas a promover estilos de vida saludables y CV (AU)

Objective: To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools. Methods: Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05). Results: The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index. Conclusions: The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL (AU)

[Quality-of-life-related factors in adolescents]. / Factores relacionados con la calidad de vida en la adolescencia.

OBJECTIVE: To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools. METHODS: Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05). RESULTS: The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index. CONCLUSIONS: The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL.

Estrategias de afrontamiento familiar y repercusiones en la salud familiar: una revisión de la literatura / Family coping strategies and impacts on family health: a literature review

Introducción: la salud familiar ha constituido una preocupación para todos aquellos que trabajan con la familia. La forma que tiene la familia de enfrentarse a los acontecimientos y proceso vitales estresantes es conocida como afrontamiento familiar y tiene repercusión en la salud familiar. El objetivo del estudio fue conocer las estrategias de afrontamiento familiar y su relación con la salud familiar. Metodología: se realizó una revisión de la literatura científica a través de las siguientes bases de datos: PubMed/Medline, SCOPUS, PsycINFO y Dialnet, desde 2010 hasta 2016. Resultados: las estrategias iniciales de búsqueda identificaron un total de 1074 resultados, siendo finalmente seleccionados 23 estudios. En cuanto a las principales situaciones familiares estresantes fueron: enfermedades crónicas, Trastornos del Espectro Autista (TEA), enfermedades mentales y adicciones, accidentes y discapacidad, reajuste familiar, problemas laborales y financieros. Y las principales estrategias de afrontamiento familiar fueron: positivas como búsqueda de información, búsqueda de apoyo familiar, social o espiritual, aceptación y mejora de la autoestima. Y las negativas fueron negación, ocultación, desconexión, auto-culpa, distanciamiento emocional, consumo de sustancia, entre otros. Conclusiones: los acontecimientos estresantes alteran el equilibrio dinámico familiar, de ahí la importancia de que la unidad familiar posea buenas estrategias de afrontamiento. Por otro lado, es importante que los profesionales de la salud conozcan los principales estresores, así como las estrategias de afrontamiento familiar positivas, para mediante la promoción de la salud, poder prevenir los problemas derivados de un inadecuado afrontamiento familiar

Introduction: family health has been a concern for all those working with the family. The way how the family has to face the stressful events and vital process is known as family coping and has impact on family health. Objective: to find family coping strategies and their relationship to family health. Methods: a review of the scientific literature was conducted through the following databases: PubMed / Medline, Scopus, PsycINFO and Dialnet from 2010 to 2016. Results: the initial search strategies identified a total of 1074 results that finally being selected 23 studies. The main stressful family situations were: chronic diseases, Autism Spectrum Disorders (ASD), mental illness, addictions, accidents and disability, family adjustment, labor and financial problems. And the main family coping strategies were: positive like finding information, search family, social or spiritual support, acceptance and improved self-esteem. And negative like denial, concealment, disconnection, self-blame, emotional detachment, substance use, among others. Conclusions: stressful events alter the dynamic balance family, hence the importance of the family unit have a good coping strategies. On the other hand, it is important that health professionals know the main stressors, as well as positive family coping strategies, so by promoting health, to prevent problems arising from inadequate family coping

El método buttonhole como técnica de punción de la fístula arteriovenosa en hemodiálisis: una revisión de la literatura / The buttonhole method like puncture technical of arteriovenous fistula in hemodialysis. A literature review

Introducción: La hemodiálisis es el tratamiento de elección en los pacientes con insuficiencia renal crónica. La clave para un tratamiento adecuado es tener un buen acceso vascular. Por ello, las fístulas arteriovenosas son consideradas la mejor opción. Uno de los principales factores que influyen en la supervivencia de estas es la técnica de punción realizada. El objetivo principal del estudio fue conocer el método buttonhole como técnica de punción de la fístula arteriovenosa en la hemodiálisis. Metodología: Se realizó una revisión de la literatura científica a través de las siguientes bases de datos: PubMed/Medline, Scopus, Cinahl y Cuiden Plus, desde 2011 hasta 2016. Además, se realizó una búsqueda secundaría manual. Resultados: Las estrategias iniciales de búsquedas identificaron un total de 84 resultados, siendo finalmente seleccionados 7 estudios. Los resultados encontrados han sido muy diversos, encontrándose resultados para el dolor, tasas de infección, tiempo de hemostasia, dilataciones aneurismáticas, flujo sanguíneo, presión venosa, número de intentos de canulación, seguridad, estética del brazo portador de la fístula y calidad de vida del paciente. Conclusiones: El método buttonhole parece ser una buena alternativa de punción, ya que está prácticamente exenta de las complicaciones habituales existentes en otras técnicas, como extravasaciones, hematomas, aneurismas, entre otras. Además, facilita la auto-punción en los domicilios. Por otro lado, es necesario un buen aprendizaje previo a la incorporación de esta técnica y un periodo de adaptación por parte de los profesionales, requiriendo implicación por parte de los mismos y del centro (AU)

Introduction: Hemodialysis is the treatment of choice in patients with chronic renal failure. The key to proper treatment is having a good vascular access. Therefore, arteriovenous fistulas are considered the best option. One of the main factors that influence the survival of these is the technique of puncture performed. The main objective of the study was to know the method buttonhole like puncture technique arteriovenous fistula in hemodialysis. Methods: A review of the scientific literature was conducted through the following databases: PubMed/Medline, Scopus, Cinahl and Cuiden Plus, from 2011 to 2016. In addition, a secondary manual search was conducted. Results: The initial search strategies identified a total of 84 results that finally being selected 7 studies. The results have been mixed, finding results for pain, infection rates, hemostasis time, aneurysmal dilations, blood flow, venous pressure, number of cannulation attempts, security, aesthetics of the carrier arm of the fistula and quality of life of the patient. Conclusions: The method buttonhole seems to be a good alternative lancing because it is substantially free of existing common complications in other techniques, like extravasations, hematomas and aneurysms, among others. It also facilitates self-lancing at home. Furthermore, a good prior learning incorporating this technique is needed and a period of adaptation by professionals, requiring involvement by them and the center (AU)

Necesidades de formación sobre reanimación cardiopulmonar en el ámbito deportivo del fútbol / Need of cardiopulmonary resuscitation training in the sport of soccer

OBJETIVO: En España se producen alrededor de 25.000 paradas cardiorrespiratorias, numerosas de ellas en presencia de personal no sanitario. En menos del 25% de las paradas cardiorrespiratorias presenciadas los testigos inician la reanimación cardiopulmonar. El fútbol es un deporte de contacto, con unas características y unos requerimientos físicos que hace poner al límite el organismo, y que por lo tanto presenta un porcentaje mayor de probabilidades de presentar numerosas lesiones, entre ellas, paradas cardiorrespiratorias. Por ello, se planteó como objetivo conocer la situación actual sobre la formación en soporte vital básico en el ámbito deportivo del fútbol. MÉTODO: Se realizó una revisión bibliográfica en diferentes bases de datos, tanto nacionales (IME, CUIDEN, ENCUENTR@, ENFERMERÍA AL DÍA, ISOC) como internacionales (PUBMED, SCOPUS, CINAHL), con diferentes descriptores MESH relacionados con el tópico. RESULTADOS: Se identificaron un total de 395 referencias, seleccionándose finalmente 17 estudios, 8 de ellos tenían como tema principal la reanimación cardiopulmonar y los 9 restantes eran sobre utilización de desfibriladores semiautomáticos. CONCLUSIONES: Existe una escasez de investigaciones sobre este tópico en el ámbito deportivo del fútbol. Hecho que nos llama la atención, ya que en este ámbito podrían encontrarse situaciones que requieran una actuación inmediata salvadora. Por ello, queremos resaltar la importancia de la reanimación cardiorrespiratoria temprana, siendo fundamental la formación sobre soporte vital básico y desfibriladores semiautomáticos en el ámbito deportivo del fútbol

OBJECTIVE: In Spain there are around 25,000 cardiac arrests, many of them in the presence of non-medical personnel. In less than 25% of the cardio-respiratory arrests witnessed, witnesses began cardiopulmonary resuscitation. Soccer is a contact sport with multiple physical characteristics and requirements which pushes your body to the limit, thus leading to a higher chance of developing multiple lesions, including cardio-respiratory arrest. Therefore, our goal was to know the actual situation on training in basic life support in soccer. Method: A literature review was performed on different databases both national (IME, CUIDEN, ENCUENTR@, ENFERMERÍA AL DÍA, ISOC) and international (PUBMED, SCOPUS, CINAHL), with different MESH descriptors related to the topic. RESULTS: A total of 395 references were identified.17 studies were selected; 8 of them had like main theme cardiopulmonary resuscitation and the remaining 9 spoke on the use of semi-automatic defibrillators. CONCLUSIONS: There is a lack of research on this topic in soccer. This strikes our attention because in this area there could be situations requiring immediate rescue action. Therefore, we emphasize the importance of early cardio-respiratory resuscitation because training in basic life support and semi-automatic defibrillators in soccer are fundamental

[Need of cardiopulmonary resuscitation training in the sport of soccer]. / Necesidades de formación sobre reanimación cardiopulmonar en el ámbito deportivo del fútbol.

OBJECTIVE: In Spain there are around 25,000 cardiac arrests, many of them in the presence of non-medical personnel. In less than 25% of the cardio-respiratory arrests witnessed, witnesses began cardiopulmonary resuscitation. Soccer is a contact sport with multiple physical characteristics and requirements which pushes your body to the limit, thus leading to a higher chance of developing multiple lesions, including cardio-respiratory arrest. Therefore, our goal was to know the actual situation on training in basic life support in soccer. METHOD: A literature review was performed on different databases both national (IME, CUIDEN, ENCUENTR@, ENFERMERÍA AL DÍA, ISOC) and international (PUBMED, SCOPUS, CINAHL), with different MESH descriptors related to the topic. RESULTS: A total of 395 references were identified. 17 studies were selected; 8 of them had like main theme cardiopulmonary resuscitation and the remaining 9 spoke on the use of semi-automatic defibrillators. CONCLUSIONS: There is a lack of research on this topic in soccer. This strikes our attention because in this area there could be situations requiring immediate rescue action. Therefore, we emphasize the importance of early cardio-respiratory resuscitation because training in basic life support and semi-automatic defibrillators in soccer are fundamental.