La promoción de la lectura y su relación con las vocaciones y entornos profesionales / Reading promotion and its association with professional vocations and care settings

Introducción: la promoción de hábitos de vida saludables es una práctica habitual entre los pediatras. Dentro de estos se encuentra la promoción de la lectura, que entraña numerosos beneficios para la infancia: estimula la actividad cerebral y su reserva cognitiva, aumenta la concentración y el desarrollo del lenguaje y permite trabajar las emociones. El objetivo de este estudio es conocer la realidad de la práctica de la promoción de la lectura desde las consultas de Pediatría, así como su relación con la vocación pediátrica (clínica, preventiva y social) y los entornos profesionales (residencia, hospital y Atención Primaria). Material y métodos: estudio transversal, descriptivo de ámbito nacional, mediante encuesta en línea a residentes de Pediatría, pediatras hospitalarios/as y de Atención Primaria llevado a cabo en marzo de 2022. Resultados: participaron 326 pediatras, un 16,8% hospitalarios/as, un 69,8% de Atención Primaria y 13,4% residentes de Pediatría. El 18,8% seleccionaron la vocación preventiva, el 60,8%, la clínica y el 20,5%, la social. Junto con una descripción detallada del tipo de actividades de promoción de la lectura que se realizan en nuestro país, los resultados mostraron, en primer lugar, que la vocación médica se relacionó con su mayor o menor realización (χ2(2) = 13,11, p <0,001), siendo los pediatras con vocación social los que informaron llevarlas a cabo en un mayor porcentaje. En segundo lugar, también el ámbito de trabajo apareció como un condicionante para la realización de estas actividades (χ2(2) = 19,0, p <0,001), que se llevan a cabo más frecuentemente en las consultas de Atención Primaria. Conclusiones: las actividades de promoción de la lectura son realizadas mayormente por los profesionales de Atención Primaria, en el marco de otras actividades de promoción de la salud, vinculadas principalmente con su mayor vocación por la Pediatría social. (AU)

Introduction: healthy lifestyle promotion is a common practice among paediatricians. Reading promotion is included in that practice. It has numerous benefits for children: it stimulates brain activity and cognitive reserve, improves concentration and language development and helps develop emotional skills.The aim of our study was to assess the implementation of reading promotion activities in real-world paediatric care practice, as well as its association with the underlying vocation for paediatrics (clinical, preventive or social) and the care setting (residency programme, hospital and primary care). Material and methods: cross-sectional, descriptive study of national scope through an online survey of paediatrics residents and hospital-based and primary care paediatricians carried out in March 2022. Results: 326 paediatricians participated, of who 16.8% worked in hospitals, 69.8% in primary care and were 13.4% paediatrics residents. Of this total, 18.8% reported a vocation for preventive care, 60.8% for clinical work and 20.5% for social paediatrics. In addition to carrying a detailed descriptive analysis of the type of reading promotion activities carried out in Spain, we found, firstly, that the vocation for medical practice was associated to the frequency of reading promotion (χ2(2)=13.11; p<0.001), with a higher proportion of paediatricians with a social vocation reporting performance of these activities. Secondly, the care setting also seemed to be a determining factor for the performance of these activities (χ2(2)=19.0; p<0.001), which were conducted more frequently in the primary care setting. Conclusion: activities to promote reading are carried out mainly by primary care professionals within the framework of other health promotion work, and their performance was mainly associated with the greater proportion of primary care professionals with a vocation for social paediatrics. (AU)

Uso de móviles, problemas de sueño y obesidad en una zona de exclusión social / Mobile phone use, sleep disorders and obesity in a social exclusion zone

Introducción: Existe poca información del impacto del abuso del teléfono móvil (AM) en zonas con necesidad de transformación social (ZNTS). Nuestro objetivo es estimar la prevalencia de AM en ZNTS, y su asociación con problemas de sueño, rendimiento escolar y obesidad. Pacientes y métodos: Muestreo consecutivo de sujetos entre 10 y 17 años que acuden a consulta de atención primaria en ZNTS entre octubre 2019 y marzo de 2020. Realización de entrevista clínica, antropometría, datos sociodemográficos, de uso de móvil y sueño. Resultados: Se estudiaron 214 sujetos. El AM durante la semana (más de dos horas diarias) fue de 37,5% en el grupo de 10-12 años y de 65,2% en el grupo de 13 a 17 años; durante el fin de semana, las prevalencias fueron de 66,6 y 81,3%, respectivamente. El AM durante la semana se asoció a más obesidad; menor nivel de estudios maternos, mayor dificultad para despertarse, somnolencia diurna y mayor frecuencia de suspensos. El riesgo ajustado se duplica para sobrepeso u obesidad (odds ratio [OR] 1,90; intervalo de confianza del 95% [IC 95%] 1,04 a 3,47), obesidad (OR 2,45; IC 95% 1,23 a 4,89) y problemas de sueño o duración de sueño menor de siete horas (OR 2,26; IC 95% 1,31 a 3,92). El AM durante el fin de semana se asoció a problemas de sueño o duración menor de siete horas (OR 2,68; IC 95% 1,40 a 5,11). Conclusiones: Existe una alta prevalencia de AM en zonas de exclusión social, que se asocia con problemas del sueño, suspensos escolares y obesidad. (AU)

Introduction: There is little information on the impact of mobile phone overuse (MPO) in areas in need of social transformation (ANST). Our objective was to estimate the prevalence of MPO in an ANST and its association with sleep disorders, academic performance and obesity. Patients and methods: Consecutive sampling of patients aged 10–17 years who visited a primary care centre in an ARST between October 2019 and March 2020. The study involved performance of a clinical interview with collection of anthropometric, sociodemographic, mobile phone use and sleep data. Results: The analysis included 214 participants. The prevalence of MPO during weekdays (more than 2 h a day) was 37.5% in children aged 10–12 years and 65.2% in 13- to 17-year-olds; in the weekend, the prevalence increased to 66.6% and 81.3%, respectively. In weekdays, MPO was associated with an increased prevalence of obesity, lower maternal educational attainment, greater difficulty waking up, daytime sleepiness and higher frequency of school failure. The adjusted risk was double for excess weight (odds ratio [OR] 1.90, 95% confidence interval [95% CI] 1.04–3.47), obesity (OR 2.45, 95% CI 1.23–4.89) and sleep disorders or sleep duration of less than 7 h (OR 2.26; 95% CI 1.31–3.92). Weekend MPO was associated with sleep disorders or sleep duration of less than 7 h (OR 2.68; 95% CI 1.40–5.11). Conclusions: The prevalence of mobile phone overuse is high in areas of social exclusion and is associated with sleep disorders, school failure, and obesity. (AU)

Mobile phone use, sleep disorders and obesity in a social exclusion zone.

INTRODUCTION: There is little information on the impact of mobile phone overuse (MPO) in areas in need of social transformation (ANST). Our objective was to estimate the prevalence of MPO in an ANST and its association with sleep disorders, academic performance and obesity. PATIENTS AND METHODS: Consecutive sampling of patients aged 10-17 years who visited a primary care centre in an ARST between October 2019 and March 2020. The study involved performance of a clinical interview with collection of anthropometric, sociodemographic, mobile phone use and sleep data. RESULTS: The analysis included 214 participants. The prevalence of MPO during weekdays (more than 2 h a day) was 37.5% in children aged 10-12 years and 65.2% in 13- to 17-year-olds; in the weekend, the prevalence increased to 66.6% and 81.3%, respectively. In weekdays, MPO was associated with an increased prevalence of obesity, lower maternal educational attainment, greater difficulty waking up, daytime sleepiness and higher frequency of school failure. The adjusted risk was double for excess weight (odds ratio [OR] 1.90, 95% confidence interval [95% CI] 1.04-3.47), obesity (OR 2.45, 95% CI 1.23-4.89) and sleep disorders or sleep duration of less than 7 h (OR 2.26; 95% CI 1.31-3.92). Weekend MPO was associated with sleep disorders or sleep duration of less than 7 h (OR 2.68; 95% CI 1.40-5.11). CONCLUSIONS: The prevalence of mobile phone overuse is high in areas of social exclusion and is associated with sleep disorders, school failure and obesity.

[Summary PAPPS Childhood and Adolescence 2022]. / Resumen PAPPS Infancia y Adolescencia 2022.

Two important topics about children and adolescents in our primary care activity are presented in this update document: tobacco smoking prevention in adolescence and prophylaxis with vitamin K to prevent the hemorrhagic disease of the newborn.

[Promoting early reading in a social exclusion district in primary care]. / Promoción de la lectura en etapas precoces desde atención primaria en una zona de exclusión social.

INTRODUCTION: Reading is a tool that stimulates brain activity, increasing its cognitive reserve and providing innumerable benefits such as the stimulation of empathy, concentration or language development. Promoting reading at a very early age helps develop reading skills correctly. However, social inequalities can result in this practice being carried out less in groups of low socioeconomic, social or cultural levels. The purpose of this study was to assess the outcomes of a promoting reading habits intervention in a primary health care center located in a social transformation district by talking to the parents, providing books to families and encouraging books to become a part of children's play preferences. MATERIALS AND METHODS: A non-random intervention study in which children born in 2015 and registered in a particular health center took part. A reading promotion intervention was carried out at the ages of 4, 6, 12 and 18 months and at 24 months their preference for reading activities was assessed in relation to other leisure activities. RESULTS: Three hundred forty-two subjects were included, 154 allocated in the intervention group and 188 in the control group. The children in the intervention group exhibited a greater preference for reading as a leisure activity as compared to those in the control group (reading ranked in last position of favourite activities in 18.8 vs. 33.9%; p=0.003). The variables found on multivariate analysis to have a greater influence on reading position in the ranking of favorite activities were not having participated in the intervention OR: 2.06 (1.19-3.58) and gipsy ethnicity, OR: 2.37 (1.38-4.09). CONCLUSIONS: Results reveal a slight improvement in the preference for reading as an activity in the children that took part in the literacy program.

¿Es posible ofrecer un algoritmo de decisión clínica en la enfermedad COVID-19 en Atención Primaria? / Is it possible to offer a clinical decision algorithm in COVID-19 disease in Primary Care?

Hasta ahora, los datos recogidos en los casos de procesos clínicos provocados por el coronavirus SARS-CoV-2 (COVID-19) en niños sugieren que son cuadros leves en comparación con las infecciones en pacientes adultos; no obstante, se ha informado de casos graves, como el síndrome inflamatorio multisistémico (SIM), que precisa de valoración y actuación de emergencia. En el contexto de la consulta del pediatra de Atención Primaria y coincidiendo con el inicio del curso escolar, en una época en la que habitualmente aumenta la incidencia de procesos como la gripe, infección por el virus respiratorio sincitial (VRS) y otros cuadros respiratorios, es habitual la demanda por síntomas que pueden hacer sospechar cualquiera de estas infecciones. En este sentido, es importante llegar a un diagnóstico que permita el manejo más adecuado del paciente. Epidemiológicamente, de manera que se pueda disminuir la transmisión comunitaria tomando las medidas adecuadas y clínicamente para así poder ponderar el nivel de gravedad y poner en marcha las actuaciones más adecuadas. Dado que no existen escalas válidas que ofrezcan un puntaje para valorar cuál es la actuación más adecuada ante la sospecha de una infección COVID-19, planteamos los beneficios de un algoritmo de decisión clínica que tiene en cuenta las connotaciones epidemiológicas, basado en la gravedad clínica, para ofrecer la atención clínica más adecuada a los pacientes

So far, the data collected in the cases of clinical processes caused by the SARS-CoV-2 (COVID-19) coronavirus in children suggest that they are mild compared to infections in adult patients; However, serious cases such as multisystemic inflammatory syndrome (SIM) have been reported, which requires assessment and emergency action. In the context of the of the Primary Care pediatrician consultation and coinciding with the beginning of the school year, at a time when the incidence of influenza, RSV infection and other respiratory conditions usually increases, consultations for symptoms that can lead to suspect these infections. Therefore, it is important to reach a diagnosis that allows the most appropriate management of the patient and decreasing the community transmission by taking pertinent measures. Given that there are no valid scales that offer a score to assess which is the most appropriate action in the event of a suspected COVID-19 infection, we propose the benefits of a clinical decision algorithm that takes into account epidemiological connotations, based on clinical severity to offer the most appropriate clinical care to patients

Atención Primaria y promoción de la salud bucodental: evaluación de una intervención educativa en población infantil / Primary Care and oral health promotion: Assessment of an educational intervention in school children

Objetivo: Evaluar a corto y medio plazo la efectividad de una intervención de promoción de la salud bucodental impulsada desde Atención Primaria. Diseño: Ensayo comunitario de intervención no aleatorizado. Emplazamiento: Tres centros educativos de características sociodemográficas similares de un barrio empobrecido de Granada. Participantes: Participaron en el estudio 82 alumnos de entre 5 y 6 años del colegio intervención (CI) y 109 de los colegios control (CC), así como los profesores y padres/madres de los alumnos del CI. Intervención: Actividades escolares de promoción de la salud bucodental dirigidas a los alumnos, y reuniones periódicas con los profesores y padres/madres del CI durante 2 cursos consecutivos. Mediciones principales: Conocimientos sobre salud bucodental y hábitos higiénico-dietéticos de los alumnos, valorados mediante cuestionarios distribuidos antes de la intervención y transcurridos 6 y 18 meses. Resultados: Transcurridos 18 meses, los conocimientos adquiridos fueron significativamente superiores en el CI (OR 3,54; IC 95% 1,46-8,58) en comparación con los CC. El consumo de alimentos saludables aumentó significativamente en el desayuno (OR 2,95; IC 95% 1,26-6,89) y la merienda (OR 3,67; IC 95% 1,49-9,05) y disminuyó el consumo de bollería (OR 4,05; IC 95% 1,68-9,81) y refrescos azucarados (OR 3,79; IC 95% 1,57-9,12) respecto a los CC. No se observaron mejoras en relación con la higiene bucodental en el CI. Conclusiones: Las intervenciones escolares de educación sanitaria, desarrolladas de forma intersectorial, participativa y considerando los contextos socioeconómicos particulares, resultan eficaces en la mejora del conocimiento y los hábitos dietéticos de los alumnos

Objective: To evaluate the short and medium term effectiveness of a Primary Care-driven oral health promotion intervention. Design: A non-randomised community intervention trial. Setting: Three socio-demographically similar primary schools of a deprived neighborhood in Granada, Spain. Participants: Eighty-two intervention and 109 control students aged 5 to 6, as well as the teachers and the parent's association of the intervention school (IS) participated in the study. Intervention: School-based health promotion activities aimed at students, and regular meetings with the teachers and parents of the IS during 2 consecutive years. Main measurements: Students' oral health-related knowledge and behavior, assessed via questionnaires distributed before the intervention, and 6 and 18 months afterwards. Results: Compared to the control groups at 18 months, students belonging to the IS reported enhanced oral health knowledge (OR 3.54; 95% CI 1.46-8.58), and an increased consumption of healthy food at breakfast (OR 2.95; 95% CI 1.26-6.89) and during mid-afternoon snack (OR 3.67; 95% CI 1.49-9.05). A significant decrease was seen in the intake of pastries (OR 4.05; 95% CI 1.68-9.81) and sweetened soft drinks and juices (OR 3.79; 95% CI 1.57-9.12) amongst intervention compared to control students in the medium term (18 months). No significant improvements were observed concerning oral hygiene in the IS. Conclusions: School-based educational interventions, when developed through an intersectoral and participative approach and considering the socio-economic context, appear to be effective in improving students’ diet-related knowledge and behaviors

[Primary Care and oral health promotion: Assessment of an educational intervention in school children]. / Atención Primaria y promoción de la salud bucodental: evaluación de una intervención educativa en población infantil.

OBJECTIVE: To evaluate the short and medium term effectiveness of a Primary Care-driven oral health promotion intervention. DESIGN: A non-randomised community intervention trial. SETTING: Three socio-demographically similar primary schools of a deprived neighborhood in Granada, Spain. PARTICIPANTS: Eighty-two intervention and 109 control students aged 5 to 6, as well as the teachers and the parent's association of the intervention school (IS) participated in the study. INTERVENTION: School-based health promotion activities aimed at students, and regular meetings with the teachers and parents of the IS during 2 consecutive years. MAIN MEASUREMENTS: Students' oral health-related knowledge and behavior, assessed via questionnaires distributed before the intervention, and 6 and 18 months afterwards. RESULTS: Compared to the control groups at 18 months, students belonging to the IS reported enhanced oral health knowledge (OR 3.54; 95% CI 1.46-8.58), and an increased consumption of healthy food at breakfast (OR 2.95; 95% CI 1.26-6.89) and during mid-afternoon snack (OR 3.67; 95% CI 1.49-9.05). A significant decrease was seen in the intake of pastries (OR 4.05; 95% CI 1.68-9.81) and sweetened soft drinks and juices (OR 3.79; 95% CI 1.57-9.12) amongst intervention compared to control students in the medium term (18 months). No significant improvements were observed concerning oral hygiene in the IS. CONCLUSIONS: School-based educational interventions, when developed through an intersectoral and participative approach and considering the socio-economic context, appear to be effective in improving students' diet-related knowledge and behaviors.

Las redes sociales en la pie / Social networks in the skin

La preadolescencia es una etapa de transición entre la infancia y la adolescencia que acontece normalmente entre los 8 y los 11 años. En este periodo se producen cambios físicos notables y un gran progreso a nivel psicológico, aumentando la capacidad para reflexionar y pensar de forma abstracta. En el siglo XXI, las nuevas tecnologías forman parte de la vida y realidad social de nuestros jóvenes. Las redes sociales son una potente herramienta de comunicación y a su vez, un gran peligro si padres y educadores no enseñamos a usarlas con prudencia, ya que es imposible frenar su necesidad de estar "conectados"

The preadolescence is a transitional phase between the childhood and the adolescence and occurs between the ages of 8-11. In this phase considerable physical changes and a substantial progress on a psychological level take place. In this way, the ability to reflect and to think abstractly increases. In the 21st century, new technologies are part of life and the social reality of young people. Social networks are a powerful tool of communication but can become a great danger if parents and educators do not teach young people how to use them prudently, because it is impossible to stop their need to be "connected"