Effectiveness of a digital application to improve stroke knowledge for kids.

INTRODUCTION: Stroke is highly prevalent in Latin America and one of the leading causes of morbidity and mortality in the world. Educating children about stroke has been established as an effective method to detect symptoms early, reduce hospital visits, and raise awareness among adults. OBJECTIVE: To analyze the effectiveness of a mobile application to improve knowledge and understanding of stroke among children. METHOD: We conducted a focus group session including 12 children in order to analyze the behavior of 6 questions previously validated by expert neurologists. Subsequently, 105 primary school students between the ages of 7 and 12 completed a questionnaire on stroke symptoms and how to contact the emergency services before and after using an application on stroke symptoms. Qualitative analyses and the Student t test were used to verify the existence of differences between pre- and post-intervention test results. RESULTS: After a single 40-min working session with the application, between 50% and 67% of the children were able to identify the signs of stroke, and 96.2% knew the national emergency services telephone number. Statistical analysis revealed statistically significant differences before and after the intervention with the digital application (t=19.54; p<0.001) and intragroup differences in the post-intervention test results (t=40.71; p<0.001). CONCLUSION: Primary school children who used our digital application increased their knowledge, understanding, and learning of stroke symptoms.

Effectiveness of a digital application to improve stroke knowledge for kids / Efectividad de una aplicación móvil para mejorar el conocimiento sobre los síntomas de ictus en una población pediátrica de Colombia

Introduction: Stroke is highly prevalent in Latin America and one of the leading causes of morbidity and mortality in the world. Educating children about stroke has been established as an effective method to detect symptoms early, reduce hospital visits, and raise awareness among adults. Objective: To analyze the effectiveness of a mobile application to improve knowledge and understanding of stroke among children. Method: We conducted a focus group session including 12 children in order to analyze the behavior of 6 questions previously validated by expert neurologists. Subsequently, 105 primary school students between the ages of 7 and 12 completed a questionnaire on stroke symptoms and how to contact the emergency services before and after using an application on stroke symptoms. Qualitative analyses and the Student t test were used to verify the existence of differences between pre- and post-intervention test results. Results: After a single 40-min working session with the application, between 50% and 67% of the children were able to identify the signs of stroke, and 96.2% knew the national emergency services telephone number. Statistical analysis revealed statistically significant differences before and after the intervention with the digital application (t = 19.54; p < 0.001) and intragroup differences in the post-intervention test results (t = 40.71; p < 0.001). Conclusion: Primary school children who used our digital application increased their knowledge, understanding, and learning of stroke symptoms.(AU)

Introducción: El ictus es muy prevalente en Latinoamérica y constituye una de las principales causas de morbimortalidad a nivel mundial. Se ha sugerido que enseñar a los niños a reconocer los primeros síntomas de ictus puede ayudar a reducir el número de ingresos por esta enfermedad y a concienciar a la población adulta. Objetivo: Analizar la efectividad de una aplicación móvil para aumentar el conocimiento del ictus en los niños. Método: Llevamos a cabo una sesión con un grupo focal de 12 niños para analizar el comportamiento de 6 preguntas previamente validadas por un grupo de neurólogos expertos. Posteriormente, administramos un cuestionario sobre síntomas de ictus y servicios de emergencias a 105 niños de entre 7 y 12 años en dos momentos diferentes: antes y después de usar la aplicación sobre síntomas de ictus. Se realizaron análisis cualitativos y se aplicó la prueba t de Student para confirmar la presencia de diferencias en las respuestas al cuestionario antes y después de la intervención. Resultados: Tras una única sesión de 40 minutos con la aplicación, entre el 50% y el 67% de los niños eran capaces de identificar los síntomas de ictus y el 96,2% se sabían el número de teléfono de emergencias. El análisis estadístico reveló diferencias estadísticamente significativas entre los resultados del cuestionario antes y después de la intervención (t = 19,54; P < 0,001), así como diferencias intragrupo en los resultados postintervención (t = 40,71; P < 0,001). Conclusión: Los niños que utilizaron nuestra aplicación acabaron sabiendo más sobre los síntomas de ictus y cómo actuar.(AU)

Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument.

BACKGROUND: There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE. We aimed to evaluate the prevalence of non-severe maternal morbidities in puerperal women and factors associated to impaired clinical, social and mental health conditions. METHOD: A cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; the second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions. RESULTS: Five hundred seventeen women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities. CONCLUSION: During postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to violence. These aspects of women's health need further evaluation and specific interventions to improve quality of care.

Evaluación radiológica del vaciamiento gástrico de medio de contraste hidrosoluble: nuevos datos de seguridad de un estudio longitudinal / Radiologic assessment of gastric emptying of water-soluble contrast media: New data security from a longitudinal study

Antecedentes y objetivos: En la actualidad, las guías de práctica clínica para ayuno preoperatorio no han establecido claramente el tiempo de espera necesario tras la administración de un medio de contraste hidrosoluble. Nuestro objetivo fue determinar el tiempo requerido para el vaciamiento gástrico posterior a la administración de un medio de contraste hidrosoluble en pacientes con abdomen agudo. Materiales y métodos: Este estudio longitudinal prospectivo incluyó 68 pacientes, mayores de 18 años, con abdomen agudo, a quienes se administró un medio de contraste hidrosoluble para la realización de una tomografía abdominal. Se obtuvieron radiografías cada hora hasta completar el vaciamiento gástrico del medio de contraste. Se excluyeron pacientes con sospecha de obstrucción intestinal. Resultados: Treinta y uno (45,6%), 54 (79,4%) y 64 (94,1%) pacientes alcanzaron la eliminación gástrica completa de bario en 1, 2 y 3 h, respectivamente. La totalidad de los pacientes alcanzó el vaciamiento gástrico completo dentro de las 6 primeras h. No se encontraron diferencias respecto al género (P=0,44), índice de masa corporal (P=0,35), tiempo de ayuno previo al contraste (P=0,12), administración de opioides en urgencias (P=0,7), ni presencia de comorbilidades (P=0,36). Conclusión: El 94% de los pacientes con abdomen agudo alcanzaron el vaciamiento gástrico completo dentro de las primeras 3 h posteriores a la administración de medio de contraste. A las 6 h, la totalidad de los participantes habían aclarado el medio de contraste. Consideramos relevante esperar las 6 h de ayuno posteriores a la ingesta oral del medio de contraste para asegurar el tránsito completo a través del estómago y evitar riesgos innecesarios

Background and objectives: Practice guidelines for preoperative fasting have not clearly established the fasting time needed after oral administration of water-soluble contrast media. The aim of this study was to determine the time required for the gastric emptying during the water-soluble contrast media in patients with acute abdominal pain. Methods: This prospective longitudinal study included sixty-eight patients older than 18 years of age with acute abdominal pain, who required a water-soluble contrast media enhanced abdominal computed tomography study. Plain radiographs were obtained hourly until complete the gastric emptying. Patients with probable bowel obstruction were not included in the study. Results: A total of 31 (45,6%), 54 (79,4%), and 64 (94,1%) patients achieved a complete gastric clearance of barium in 1, 2 and 3 hours, respectively. All patients achieved complete emptying of water-soluble contrast media within 6 hours. Gastric emptying time was not associated with gender (P=0,44), body mass index (P=.35), fasting time prior to water-soluble contrast media intake (P=0,12), administration of opioids in the emergency room (P=0,7), and the presence of comorbidities (P=0,36). Conclusion: Ninety-four percent of the patients with acute abdominal pain achieved complete gastric emptying within 3hours after the administration of water-soluble contrast media. All of them achieved complete gastric emptying within 6hours. The results suggested 6hours after oral intake of the contrast media is enough to complete transit of water-soluble contrast media through the stomach and avoid unnecessary risks

Radiologic assessment of gastric emptying of water-soluble contrast media: New data security from a longitudinal study. / Evaluación radiológica del vaciamiento gástrico de medio de contraste hidrosoluble: nuevos datos de seguridad de un estudio longitudinal.

BACKGROUND AND OBJECTIVES: Practice guidelines for preoperative fasting have not clearly established the fasting time needed after oral administration of water-soluble contrast media. The aim of this study was to determine the time required for the gastric emptying during the water-soluble contrast media in patients with acute abdominal pain. METHODS: This prospective longitudinal study included sixty-eight patients older than 18 years of age with acute abdominal pain, who required a water-soluble contrast media enhanced abdominal computed tomography study. Plain radiographs were obtained hourly until complete the gastric emptying. Patients with probable bowel obstruction were not included in the study. RESULTS: A total of 31 (45,6%), 54 (79,4%), and 64 (94,1%) patients achieved a complete gastric clearance of barium in 1, 2 and 3 hours, respectively. All patients achieved complete emptying of water-soluble contrast media within 6 hours. Gastric emptying time was not associated with gender (P=0,44), body mass index (P=.35), fasting time prior to water-soluble contrast media intake (P=0,12), administration of opioids in the emergency room (P=0,7), and the presence of comorbidities (P=0,36). CONCLUSION: Ninety-four percent of the patients with acute abdominal pain achieved complete gastric emptying within 3hours after the administration of water-soluble contrast media. All of them achieved complete gastric emptying within 6hours. The results suggested 6hours after oral intake of the contrast media is enough to complete transit of water-soluble contrast media through the stomach and avoid unnecessary risks.