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5.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(10): 830-840, dic. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-185605

RESUMO

Introducción: La exposición solar en la infancia es el principal factor de riesgo para el desarrollo de cáncer de piel en la vida adulta. Las intervenciones basadas en programas y políticas de fotoprotección escolar han demostrado ser las estrategias más eficaces y coste-efectivas para la prevención del cáncer de piel. Objetivos: Elaborar un modelo de certificación que permita identificar de forma objetiva aquellos centros escolares que promueven activamente la fotoprotección. Métodos: Se empleó metodología de consenso basada en panel de expertos, recurriendo al método Delphi en 2 rondas. Se analizaron las medianas de las valoraciones de la importancia y factibilidad de cada una de las recomendaciones, y el porcentaje de respuestas positivas para los niveles de cada una de ellas. Resultados: Se obtuvo un modelo integrado por 14 recomendaciones junto a sus criterios de evaluación, relativas a 7 dimensiones: 1) liderazgo organizacional (5 recomendaciones), 2) comunicación efectiva (2 recomendaciones), 3) elementos estructurales (2 recomendaciones), 4) formación de profesionales (una recomendación), 5) currículum escolar (una recomendación), 6) modelos de conducta (2 recomendaciones) y 7) hábitos del alumnado (una recomendación). Todas las recomendaciones mostraron un alto nivel de acuerdo, tanto en la valoración de la importancia y factibilidad como en la categorización de los niveles de complejidad. Conclusión: Se trata del primer distintivo de fotoprotección escolar que se desarrolla en nuestro país. Se necesitan estudios que evalúen el grado de aceptación de la estrategia y su impacto en los hábitos de fotoprotección de los escolares


Introduction: Sun exposure during childhood is the main risk factor for skin cancer in later life. School-based sun protection policies and practices have proven to be the most effective and cost-effective strategies for preventing skin cancer. Objective: To develop a sun protection accreditation program known as «Soludable» (a play on the Spanish words sol [sun] and saludable [healthy]) to objectively identify schools that actively promote sun protection behaviors among students. Methods: The consensus method used was a 2-round Delphi technique with input from a panel of experts. We then calculated the median scores for the importance and feasibility of each of the recommendations proposed and the level of complexity assigned to each recommendation by counting the percentage of experts who chose each difficulty category. Results: The resulting accreditation model consists of 14 recommendations with corresponding evaluation criteria divided into 7 domains: 1) organizational leadership (5 recommendations), 2) effective communication (2 recommendations), 3) structural elements (2 recommendations), 4) training of professionals (1 recommendation), 5) school curriculum (1 recommendation), 6) behavioral models (2 recommendations), and 7) student habits (1 recommendation). A high level of agreement among experts was observed for all recommendations, in terms of both their perceived importance and feasibility and their categorization by levels of complexity. Conclusions: This is the first sun protection accreditation program developed for Spanish schools. Studies are needed to evaluate how this program is received and how it affects students' sun protection behaviors


Assuntos
Humanos , Queimadura Solar/prevenção & controle , Política de Saúde , Instituições Acadêmicas , Exposição Ambiental/prevenção & controle , Consenso , Técnica Delfos , Liderança , Estilo de Vida Saudável
7.
Actas Dermosifiliogr (Engl Ed) ; 110(10): 830-840, 2019 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31399150

RESUMO

INTRODUCTION: Sun exposure during childhood is the main risk factor for skin cancer in later life. School-based sun protection policies and practices have proven to be the most effective and cost-effective strategies for preventing skin cancer. OBJECTIVE: To develop a sun protection accreditation program known as «Soludable¼ (a play on the Spanish words sol [sun] and saludable [healthy]) to objectively identify schools that actively promote sun protection behaviors among students. METHODS: The consensus method used was a 2-round Delphi technique with input from a panel of experts. We then calculated the median scores for the importance and feasibility of each of the recommendations proposed and the level of complexity assigned to each recommendation by counting the percentage of experts who chose each difficulty category. RESULTS: The resulting accreditation model consists of 14 recommendations with corresponding evaluation criteria divided into 7 domains: 1) organizational leadership (5 recommendations), 2) effective communication (2 recommendations), 3) structural elements (2 recommendations), 4) training of professionals (1 recommendation), 5) school curriculum (1 recommendation), 6) behavioral models (2 recommendations), and 7) student habits (1 recommendation). A high level of agreement among experts was observed for all recommendations, in terms of both their perceived importance and feasibility and their categorization by levels of complexity. CONCLUSIONS: This is the first sun protection accreditation program developed for Spanish schools. Studies are needed to evaluate how this program is received and how it affects students' sun protection behaviors.


Assuntos
Acreditação , Guias como Assunto/normas , Instituições Acadêmicas , Neoplasias Cutâneas/prevenção & controle , Luz Solar , Comportamento , Criança , Vestuário , Comunicação , Consenso , Currículo , Técnica Delfos , Docentes/educação , Estudos de Viabilidade , Humanos , Liderança , Luz Solar/efeitos adversos
14.
J Eur Acad Dermatol Venereol ; 32(6): 1034-1037, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29220103

RESUMO

INTRODUCTION: In recent years, increasing use has been made of oral anticholinergics such as oxybutynin for the management of hyperhidrosis. The primary aim of this study is to determine the variables associated with adherence to this treatment, and secondarily to obtain data on its effectiveness, safety and adverse effects. MATERIAL AND METHODS: This is a prospective study of patients with hyperhidrosis, at any location, receiving treatment with oral oxybutynin in the period 2007-2016. Epidemiological variables, treatment details, effectiveness and adverse effects were recorded. Effectiveness was determined according to the Hyperhidrosis Disease Severity Scale (HDSS) at baseline, at 3 and 12 months and in successive visits. A descriptive analysis was performed, and Cox's bivariate and multivariate regressions were calculated to determine the variables associated with treatment adherence. RESULTS: A total of 201 patients (140 women) with a mean age of 34 years were included. The mean initial HDSS score was 3.8, and the median follow-up period was 29 months. At 3 months, 84.57% of the patients had responded to treatment (excellent response: 72.94%), but adverse effects were reported by 68.2%. At 12 months, 54.23% had responded (excellent response: 79.82%), with adverse effects in 75.2%. The main variable associated with greater adherence was affected areas: palms of the hands and soles of the feet. The following variables were associated with poorer adherence: onset of hyperhidrosis in adolescence, failure to provide an incrementally increasing, individualized dose, initial HDSS score of 3 and partial initial response. The multivariate analysis confirmed the association between the onset of hyperhidrosis during adolescence, the failure to provide a progressively increasing dose and palmar affectation. DISCUSSION: This study was conducted to identify the variables associated with adherence to treatment by hyperhidrosis patients treated with oral oxybutynin. This information would facilitate selection of patients for this treatment and enhance our understanding of the biological behaviour of such anticholinergics when used to treat hyperhidrosis.


Assuntos
Hiperidrose/tratamento farmacológico , Ácidos Mandélicos/uso terapêutico , Parassimpatolíticos/uso terapêutico , Cooperação do Paciente , Administração Oral , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Ácidos Mandélicos/administração & dosagem , Ácidos Mandélicos/efeitos adversos , Pessoa de Meia-Idade , Parassimpatolíticos/efeitos adversos , Estudos Prospectivos , Adulto Jovem
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