Use of e-mail for Parkinson's disease consultations: Are answers just a clic away? / El correo electrónico en la consulta de Parkinson: ¿soluciones a un clic?

INTRODUCTION: The clinical problems of patients with movement disorders (MD) are complex, and the duration and frequency of face-to-face consultations may be insufficient to meet their needs. We analysed the implementation of an e-mail-based query service for our MD unit's patients and their primary care physicians (PCPs). METHODS: We retrospectively reviewed all consecutive emails sent and received over a period of 4 months, one year after implementation of the e-mail inquiry system. All patients received the during consultations, and PCPs, during scheduled informative meetings. We recorded and later analysed the profile of the questioner, patients' demographic and clinical data, number of queries, reason for consultation, and actions taken. RESULTS: From 1 January 2015 to 30 April 2015, the service received 137 emails from 63 patients (43% male, mean age 71±10.5) diagnosed with Parkinson's disease (76%), atypical parkinsonism (10%), and others (14%); 116 responses were sent. Twenty (32%) emails were written by patients, 38 (60%) by their caregivers, and 5 (8%) by their PCPs. The reasons for consultation were clinical in 50 cases (80%): 16 (32%) described clinical deterioration, 14 (28%) onset of new symptoms, and 20 (40%) side effects or concerns about medications. In 13 cases (20%), the query was bureaucratic: 11 were related to appointments (85%) and 2 were requests for clinical reports (15%). In response, new appointments were scheduled in 9 cases (14%), while the rest of the questions were answered by email. Patients were satisfied overall and the additional care burden on specialists was not excessive. CONCLUSIONS: Implementing an e-mail-based consultation system is feasible in MD units. It facilitates both communication between neurologists and patients and continued care in the primary care setting.

[Alcohol consumption in schoolchildren: motivations and attitudes]. / Consumo de alcohol en escolares: motivaciones y actitudes.

OBJECTIVE: To determine the levels of alcohol consumption among 8th grade (EGB) students in Cuenca, including the predisposing circumstances and factors as well as the children's motivation and attitudes. DESIGN: Descriptive observation study of a cross-sectional [correction of crossover] design. SETTING: Primary Care: the school population of the city of Cuenca. PATIENTS AND OTHER PARTICIPANTS: 672 school-children of both sexes in 8th grade (EGB). MEASUREMENTS AND MAIN RESULTS: An anonymous questionnaire with 30 closed questions was administered. 60% of the school-children had consumed alcohol on some occasion. In 54.94% of cases, friends first invited them to drink alcohol; in 33.59%, a family member. 1.4% of the children admitted to drinking alcohol daily (2.1% of boys against 0.7% of girls). 57.3% of fathers, 24.3% of mothers, 25.8% of brothers and 38% of friends consumed alcohol habitually. 36.9% of the children did not think that alcohol was a drug. CONCLUSIONS: The levels of alcohol consumption in the section of the population studied were high. Children began early and had easy access to alcoholic drinks. The level of consumption in their family and social environment was very high and was related to children's consumption. These results highlight the need for a preventive programme.