Comparación de las expectativas académicas de universitarios colombianos de primer año según el nivel de escolaridad de los padres

Introducción: Las expectativas académicas representan aquello que los estudiantes esperan alcanzar durante su formación y son un factor predictivo del desempeño académico y social. Estas expectativas académicas son moldeadas por los padres, luego la educación de estos es una variable importante en el desarrollo académico de los hijos. Si bien los progenitores proyectan sus anhelos sobre sus hijos, los motivan a tener altos niveles de aspiración y son los responsables de crear ambientes intelectualmente más estimulantes; el objetivo de este estudio fue identificar las diferencias en las expectativas académicas de una muestra de estudiantes, según el nivel de escolaridad de sus padres. Método: Esta investigación contó con la participación de 261 estudiantes colombianos universitarios quienes están cursando su primer año de pregrado, entre los 16 y 54 años (media=21,9). Para este estudio se utilizó el Cuestionario de percepciones académicas-expectativas (CPA-E; Deaño et al., 2015); se obtuvieron los puntajes de cada participante, junto con sus datos sociodemográficos que estipulaban el nivel de escolaridad de los padres, y se llevaron a cabo los análisis descriptivos de cada grupo, y los análisis de varianza unidireccional (ANOVA). Resultados: Las expectativas académicas de los estudiantes con ambos padres sin educación superior (media = 189.176), se encuentran por debajo de la media, siendo significativamente diferentes a los puntajes de expectativas académicas de individuos con uno (media = 202.050) o ambos padres con estudios superiores (media = 204.286, p < 0,001). Discusión: Se demuestra la relevancia y necesidad del acceso a la educación para la mayoría de la población colombiana, entendiendo que este es un factor influyente en las expectativas académicas de una persona, y que debe tenerse un acompañamiento diferencial a los estudiantes con padres sin formación profesional.

Introduction: Academic expectations represent what students hope to achieve during their training and are a predictor of academic and social performance. These academic expectations are shaped by the parents, therefore their education is an important variable in the academic development of the children. Although parents project their aspirations on their children, motivate them to have high levels of aspiration and are responsible for creating more intellectually stimulating environments, the objective of this study was to identify the differences in the academic expectations of a sample of students, according to the level of education of their parents. Method: This research had the participation of 261 Colombian university students who are studying their first year of undergraduate, between the ages of 16 and 54 (mean = 21,9). For this study, the Academic Perceptions-Expectations Questionnaire (CPA-E; Deaño et al., 2015), was used, the scores of each participant were obtained, together with their sociodemographic data stipulating the parents' level of education, and descriptive data and one-way variance (ANOVA) analyzes were done. Results: The academic expectations of students with both parents without higher education (mean= 189.176), are below the average, being significantly different from the academic expectations scores of individuals with one (mean= 202.050) or both parents with higher education (mean= 204.286, p < 0,001). Discussion: The relevance and need of access to education for most of the Colombian population is demonstrated, understanding that this is an influential factor in the academic expectations of a person, and that there must be differential support for students with parents without training professional.

Trend of incompleteness of the schooling and race/skin color maternal variables in the information system on live births in Brazil, 2012-2020 / Tendencia de incompletitud de las variables escolaridad incompleta y raza/color de piel materno en el sistema de información sobre nacidos vivos en Brasil, 2012-2020 / Tendência da incompletude das variáveis Escolaridade e Raça/cor da pele da mãe no Sistema de Informações sobre Nascidos Vivos do Brasil, 2012-2020

Objective: to analyze the trend of incompleteness of the variables of maternal education and skin color in the Live Birth Information System (Sinasc), in Brazil, between 2012 and 2020. Methods: ecological time series study of the incompleteness of maternal education and skin color for Brazil, regions and federation units, through joinpoint regression and calculation of annual percentage change (APC) and average annual percentage change. Results: a total of 26,112,301 births were registered in Brazil in the period. Brazil (APC = -8.1%) and the Southeast (APC = -19.5%) and Midwest regions (APC = -17.6%) decreased the incompleteness of maternal education; as for race/skin color, there was a downward trend for Brazil (APC = -8.2%) and all regions, except Northeast, and nine FUs and Federal District showed stationary trend. Conclusion: there was an improvement in filling out these variables in Sinasc, but with regional disparities, mainly for skin color.

Objetivo: analizar la tendencia de incompletitud de educación y raza/color de piel materna en el Sistema de Información de Nacidos Vivo (Sinasc), Brasil, entre 2012-2020. Métodos: estudio ecológico de serie temporal sobre la incompletitud de la educación y raza/color de piel materna para Brasil, regiones y unidades de la federación, a través de regresión de joinpoint y cálculo de cambio porcentual anual (APC) y cambio porcentual anual promedio. Resultados: se registraron 26.112.301 nacimientos en Brasil en el período. Brasil (APC = -8,1%) y regiones Sudeste (APC = -19,5%) y Centro-Oeste (APC = -17,6%) disminuirán la incompletud de la educación materna. En cuanto a raza/color de piel, hubo un descenso para Brasil (APC = -8,2%) y todas las regiones, excepto Nordeste, y nueve UF y Distrito Federal presentaron tendencia estacionaria. Conclusión:e llenado das variables en el Sinasc ha mejorado, pero con disparidades regionales, principalmente por raza/color de piel.

Objetivo: analisar a tendência da incompletude das variáveis Escolaridade e Raça/cor da pele da mãe no Sistema de Informações sobre Nascidos Vivos (Sinasc), Brasil, entre 2012 e 2020. Métodos: estudo ecológico de série temporal sobre a incompletude da Escolaridade e da Raça/cor da pele da mãe para o Brasil, suas macrorregiões e Unidades da Federação, pela regressão por joinpoint, e cálculo da variação percentual anual (VPA) e da variação percentual anual média. Resultados: foram registrados 26.112.301 nascimentos no Brasil, no período; no país (VPA = -8,1%) e em suas regiões Sudeste (VPA = -19,5%) e Centro-Oeste (VPA = -17,6%), houve redução da incompletude da escolaridade materna; quanto à raça/cor da pele da mãe, observou-se queda para o Brasil (VPA = -8,2%) e todas suas regiões, exceto a Nordeste, e nove UFs e o Distrito Federal com tendência estável. Conclusão: o preenchimento das variáveis no Sinasc melhorou, porém com disparidades regionais, principalmente quanto à raça/cor da pele.

Pain and late-onset of hidradenitis suppurativa can have a negative influence on occupational status and educational level. A cross-sectional study. / [Artículo traducido] El dolor y la aparición tardía de la hidrosadenitis supurativa pueden tener una influencia negativa en el estatus ocupacional y el nivel educativo. Estudio transversal.

BACKGROUND AND OBJECTIVES: Hidradenitis suppurativa (HS) is a chronic and painful condition with negative impact on daily activity. Little information on the impact of disease-specific factors on educational level and occupational status in hidradenitis suppurativa patients has been reported. We sought to identify how disease-specific factors could influence occupational status and educational level in patients with HS. METHODS: Cross-sectional study of patients with HS seen between September 2017 and September 2018. Disease-specific variables were analyzed to find associations in patients with different educational levels and occupational status. RESULTS: Ninety-eight patients were included. Patients with non-university studies had more frequently ≥ 3 affected areas (22.5% [16/73] vs. 4.8% [1/22], p = 0.049), a higher number of painful days (8.5 [SD 8.8] vs. 4.6 [SD 4.8], p = 0.048) and a higher score on the VAS scale (6.7 [SD 2.8] vs. 5.0 [3.3], p = 0.031). Patients from the inactive group had a significantly increased number of painful days (11.2 [SD 10.4] vs. 5.7 [SD 6.2], p = 0.004). This group had a greater number of patients with a history of depression (61.3% [19/31] vs. 27.4% [17/62], p = 0.002) and a higher mean BMI (32.3 [9.1] vs. 28.4 [6.4], p = 0.016). Late disease onset was significantly associated with being «inactive¼ (26.7% [8/31] vs. 6.5% [4/62], p = 0.026). No significant differences between severity scales of HS and educational level or occupational status were found. LIMITATIONS: cross-sectional and single center study. CONCLUSIONS: Pain, ≥ 3 affected areas, history of depression, higher mean BMI, and late onset of HS, are associated with low education level and inactive occupational status.

Pain and Late-Onset of Hidradenitis Suppurativa Can Have a Negative Influence on Occupational Status and Educational Level. A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Hidradenitis suppurativa is a chronic and painful condition with negative impact on daily activity. Little information on the impact of disease-specific factors on educational level and occupational status in hidradenitis suppurativa patients has been reported. We sought to identify how disease-specific factors could influence occupational status and educational level in patients with hidradenitis suppurativa. METHODS: Cross-sectional study of patients with hidradenitis suppurativa seen between September 2017 and September 2018. Disease-specific variables were analyzed to find associations in patients with different educational levels and occupational status. RESULTS: Ninety-eight patients were included. Patients with non-university studies had more frequently≥3 affected areas (22.5% [16/73] vs 4.8% [1/22], p=0.049), a higher number of painful days (8.5 [SD 8.8] vs 4.6 [SD 4.8], p=0.048) and a higher score on the VAS scale (6.7 [SD 2.8] vs 5.0 [3.3], p=0.031). Patients from the inactive group had a significantly increased number of painful days (11.2 [SD 10.4] vs 5.7 [SD 6.2], p=0.004). This group had a greater number of patients with a history of depression (61.3% [19/31] vs 27.4% [17/62], p=0.002) and a higher mean BMI (32.3 [9.1] vs 28.4 [6.4], p=0.016). Late disease onset was significantly associated with being "inactive" (26.7% [8/31] vs 6.5% [4/62], p=0.026). No significant differences between severity scales of hidradenitis suppurativa and educational level or occupational status were found. LIMITATIONS: cross-sectional and single center study. CONCLUSIONS: Pain, ≥3 affected areas, history of depression, higher mean BMI, and late onset of hidradenitis suppurativa, are associated with low education level and inactive occupational status.

Tendência da incompletude das variáveis escolaridade e raça/cor da pele da mãe no Sistema de Informações sobre Nascidos Vivos do Brasil, 2012-2020 / Tendencia de incompletitud de las variables escolaridad y raza/color de piel materno en el sistema de información sobre nacidos vivos en Brasil, 2012-2020 / Trend of incompleteness of maternal schooling and race/skin color variables held on the Brazilian Live Birth Information System, 2012-2020

Objective: to analyze the trend of incompleteness of the maternal schooling and race/skin color variables held on the Brazilian Live Birth Information System (SINASC) between 2012 and 2020. Methods: this was an ecological time series study of the incompleteness of maternal schooling and race/skin color data for Brazil, its regions and Federative Units, by means of joinpoint regression and calculation of annual percentage change (APC) and average annual percentage change. Results: a total of 26,112,301 births were registered in Brazil in the period; incompleteness of maternal schooling data decreased for Brazil (APC = -8.1%) and the Southeast (APC = -19.5%) and Midwest (APC = -17.6%) regions; as for race/skin color, there was a downward trend for Brazil (APC = -8.2%) and all regions, except the Northeast region, while nine Federative Units and the Federal District showed a stationary trend. Conclusion: there was an improvement in filling out these variables on the SINASC, but with regional disparities, mainly for race/skin color.

Objetivo: analizar la tendencia de incompletitud de educación y raza/color de piel materna en el Sistema de Información de Nacidos Vivo (Sinasc), Brasil, entre 2012-2020. Métodos: estudio ecológico de serie temporal sobre la incompletitud de la educación y raza/color de piel materna para Brasil, regiones y Unidades de la Federación (UF), a través de regresión de joinpoint y cálculo de cambio porcentual anual (APC) y cambio porcentual anual promedio Resultados: se registraron 26.112.301 nacimientos en Brasil en el período. Brasil (APC = -8,1%) y regiones Sudeste (APC = -19,5%) y Centro-Oeste (APC = -17,6%) disminuirán la incompletud de la educación materna. En cuanto a raza/color de piel, hubo un descenso para Brasil (APC = -8,2%) y todas las regiones, excepto Nordeste, y nueve UF y Distrito Federal presentaron tendencia estacionaria. Conclusión: e llenado das variables en el Sinasc ha mejorado, pero con disparidades regionales, principalmente por raza/color de piel.

Objetivo: analisar a tendência da incompletude das variáveis escolaridade e raça/cor da pele da mãe no Sistema de Informações sobre Nascidos Vivos (Sinasc), Brasil, entre 2012 e 2020. Métodos: estudo ecológico de série temporal sobre a incompletude da escolaridade e da raça/cor da pele da mãe para o Brasil, suas macrorregiões e Unidades da Federação, pela regressão por joinpoint, e cálculo da variação percentual anual (VPA) e da variação percentual anual média. Resultados: foram registrados 26.112.301 nascimentos no Brasil, no período; no país (VPA = -8,1%) e em suas regiões Sudeste (VPA = -19,5%) e Centro-Oeste (VPA = -17,6%), houve redução da incompletude da escolaridade materna; quanto à raça/cor da pele da mãe, observou-se queda para o Brasil (VPA = -8,2%) e todas as suas regiões, exceto o Nordeste, e nove UFs e o Distrito Federal com tendência estável. Conclusão: o preenchimento das variáveis no Sinasc melhorou, porém com disparidades regionais, principalmente quanto à raça/cor da pele.

El impacto del nivel educativo en las valoraciones cognitivas de los pacientes jóvenes ingresados en rehabilitación tras un ictus isquémico / The impact of educational level on cognitive assessments in young patients admitted to rehabilitation after ischaemic stroke

Introducción y objetivo: Proponemos valorar el impacto del nivel educativo en las pruebas cognitivas al ingreso y al alta tras un periodo de rehabilitación cognitiva en los pacientes jóvenes tras un ictus isquémico. Materiales y métodos: Consideramos educación secundaria y superior (grupo A) y menos de 6 años de educación reglada (grupo B). Comparamos A y B mediante χ2 y Kruskal-Wallis. Estudiamos A y B como predictores de memoria verbal y de trabajo al alta. La memoria verbal y la memoria de trabajo las valoramos al ingreso y al alta mediante Rey Auditory Verbal Learning Test (RAVLT) y DIGITS del test Barcelona, espectivamente. Resultados: Analizamos n=277 pacientes (55% pertenecientes al grupo A, 51 años de edad media) ingresados a un centro especializado en España entre 2009 y 2019.Encontramos diferencias significativas (p<0,05) al ingreso, todas en favor del grupo A en las valoraciones de la atención, la inhibición, la visuopercepción, la visuoconstruccion, la fluencia verbal y la comprensión.En DIGITS y RAVLT-aprendizaje encontramos diferencias al ingreso. En DIGITS y RAVLT-reconocimiento encontramos diferencias al alta, todas en favor del grupo A. No encontramos diferencias en la edad, en la severidad, en el tiempo hasta el ingreso, ni en el tiempo de estadía ingresados.Tampoco encontramos diferencias en las ganancias cognitivas ni en la eficiencia del tratamiento en las pruebas de memoria.Los grupos A y B no predicen RAVLT (R2=0,53) ni DIGITS (R2=0,48). Conclusiones: El grupo A puntúa mejor en el 63% de las pruebas al ingreso y en el 75% de las pruebas al alta, los grupos A y B son similares en ganancias y eficiencia en las pruebas de memoria.(AU)

Introduction and objective: We propose to assess the impact of educational level on cognitive tests at admission and discharge after a period of cognitive rehabilitation in young patients after ischaemic stroke. Materials and methods: We considered secondary and higher education (group A) and less than 6 years of formal education (group B). We compared A and B using χ2 and Kruskal–Wallis. We studied A and B as predictors of verbal and working memory at discharge. Verbal and working memories were assessed at admission and discharge using Rey Auditory Verbal Learning Test (RAVLT) and DIGITS of the Barcelona Test respectively. Results: We analysed n=277 patients (55% belonging to A, mean age of 51 years) admitted to a specialised centre in Spain between 2009 and 2019.We found significant differences (P<.05) at admission, all in favour of A in the assessments of attention, inhibition, visuoperception, visuoconstruction, verbal fluency and comprehension.In DIGITS and RAVLT-learning we found differences at admission. In Digits and RAVLT-recognition we found differences at discharge, all in favour of A. We found no differences in age, severity, time at admission, or length of stay in hospital.Nor did we find differences in cognitive gains or treatment efficiency in memory tests.The groups A and B did not predict RAVLT (R2=.53) or DIGITS (R2=.48). Conclusions: A scores better in 63% of tests at admission and in 75% of tests at discharge, A and B are similar in gains and efficiency on memory tests.(AU)

Alteración cognitiva en la distrofia miotónica tipo 1 (enfermedad de Steinert) / Cognitive impairment in myotonic dystrophy type 1 (Steinert's disease)

Tradicionalmente se ha reconocido que los enfermos con distrofia miotónica tipo 1 (DM-1), o enfermedad de Steinert, presentan una conducta muy característica, dejando aparte aquellos casos en que existe patología mental o un retraso del neurodesarrollo. Se describe el sustrato neurológico de dicha conducta. El objetivo de este texto es doble. Por una parte, se pretende que los clínicos, ante un paciente con DM-1, consideren siempre los aspectos cognitivos de la enfermedad. Por otra, se busca desmontar ideas preconcebidas sobre el peculiar comportamiento de estos pacientes (AU)

raditionally, it has been recognized that patients with myotonic dystrophy type 1 (MD-1) – also known as Steinert disease –, they show a specific behaviour, not including those who suffer from mental or neurodevelopmental diseases. The neurological substrate of this behaviour is described. The aim of this text has two purposes. The first intention is that clinical staff, when faced with a patient with MD-1, always consider the cognitive aspects of the disease. On the other hand, it is intended to combat preconceived ideas about the particular behaviour of these patients (AU)

[Cognitive impairment in myotonic dystrophy type 1 (Steinert's disease)]. / Alteración cognitiva en la distrofia miotónica tipo 1 (enfermedad de Steinert).

Traditionally, it has been recognized that patients with myotonic dystrophy type 1 (MD-1) - also known as Steinert disease -, they show a specific behaviour, not including those who suffer from mental or neurodevelopmental diseases. The neurological substrate of this behaviour is described. The aim of this text has two purposes. The first intention is that clinical staff, when faced with a patient with MD-1, always consider the cognitive aspects of the disease. On the other hand, it is intended to combat preconceived ideas about the particular behaviour of these patients.

Determinantes socioeconómicos y sociodemográficos asociados al consumo de frutas y verduras de las madres de familia y los hogares de escolares de Jalisco / Socioeconomic and sociodemographic determinants associated with fruit and vegetable consumption among mothers and homes of schoolchildren in Jalisco

Introducción: incrementar el consumo de frutas y verduras es una prioridad, objetivo fundamental en las políticas públicas a nivel mundial. Dado que dicho consumo en los escolares de Jalisco (México) se encuentra por debajo de las recomendaciones alimentarias, es esencial identificar los determinantes que influyen en su consumo de frutas y verduras, para promover el desarrollo de acciones que contribuyan a mejorarlo. Objetivo: identificar los determinantes socioeconómicos y sociodemográficos del consumo de frutas y verduras en las madres de familia y los hogares de escolares de Jalisco, México. Método: estudio transversal analítico, realizado durante el primer trimestre del año 2020 utilizando una frecuencia de consumo de alimentos validada y un cuestionario sobre factores sociodemográficos y socioeconómicos. Resultados: el bajo nivel educativo de las madres de los escolares se asoció con un menor consumo de verduras y el bajo nivel de ingresos en el hogar se asoció con un menor consumo de frutas por los escolares. Conclusiones: el bajo nivel educativo de las madres y el bajo nivel de ingresos de los hogares fueron determinantes asociados al consumo de frutas y verduras de los escolares. Sin embargo, se presentaron diferencias en cuanto a los determinantes para las frutas y para las verduras. Estos factores y sus diferencias deben de tenerse en cuenta para la planificación de acciones que contribuyan a mejorar la ingesta de frutas y verduras en la población escolar (AU)

Introduction: increasing fruit and vegetable consumption is a priority. It has been prioritized as a fundamental objective of public policies worldwide. Given that such consumption in schoolchildren in Jalisco (Mexico) is below the dietary recommendations it is crucial to identify the determinants that influence this consumption to promote the development of contextualized actions that improve it. Objective: to identify the socioeconomic and sociodemographic determinants of fruit and vegetable consumption among mothers and households of schoolchildren in Jalisco, Mexico. Method: an analytical, cross-sectional study carried out during the first quarter of 2020. A validated food consumption frequency and a questionnaire on sociodemographic and socioeconomic factors were used for its development. Results: a lower educational level of the mothers of schoolchildren was associated with a lower consumption of vegetables by schoolchildren. In turn, a lower household income level was associated with a lower consumption of fruits in schoolchildren. Conclusions: a low educational level of mothers and a low household income were determinants associated with fruit and vegetable consumption in schoolchildren. However, there were differences in the determinants for fruits and vegetables. It is essential to consider these factors and their differences in order to plan actions that contribute to improving fruit and vegetable intake in the school population (AU)

[The impact of educational level on cognitive assessments in young patients admitted to rehabilitation after ischaemic stroke]. / El impacto del nivel educativo en las valoraciones cognitivas de los pacientes jóvenes ingresados en rehabilitación tras un ictus isquémico.

INTRODUCTION AND OBJECTIVE: We propose to assess the impact of educational level on cognitive tests at admission and discharge after a period of cognitive rehabilitation in young patients after ischaemic stroke. MATERIALS AND METHODS: We considered secondary and higher education (group A) and less than 6 years of formal education (group B). We compared A and B using χ2 and Kruskal-Wallis. We studied A and B as predictors of verbal and working memory at discharge. Verbal and working memories were assessed at admission and discharge using Rey Auditory Verbal Learning Test (RAVLT) and DIGITS of the Barcelona Test respectively. RESULTS: We analysed n=277 patients (55% belonging to A, mean age of 51 years) admitted to a specialised centre in Spain between 2009 and 2019. We found significant differences (P<.05) at admission, all in favour of A in the assessments of attention, inhibition, visuoperception, visuoconstruction, verbal fluency and comprehension. In DIGITS and RAVLT-learning we found differences at admission. In Digits and RAVLT-recognition we found differences at discharge, all in favour of A. We found no differences in age, severity, time at admission, or length of stay in hospital. Nor did we find differences in cognitive gains or treatment efficiency in memory tests. The groups A and B did not predict RAVLT (R2=.53) or DIGITS (R2=.48). CONCLUSIONS: A scores better in 63% of tests at admission and in 75% of tests at discharge, A and B are similar in gains and efficiency on memory tests.

[Socioeconomic and sociodemographic determinants associated with fruit and vegetable consumption among mothers and homes of schoolchildren in Jalisco]. / Determinantes socioeconómicos y sociodemográficos asociados al consumo de frutas y verduras de las madres de familia y los hogares de escolares de Jalisco.

INTRODUCTION: Introduction: increasing fruit and vegetable consumption is a priority. It has been prioritized as a fundamental objective of public policies worldwide. Given that such consumption in schoolchildren in Jalisco (Mexico) is below the dietary recommendations it is crucial to identify the determinants that influence this consumption to promote the development of contextualized actions that improve it. Objective: to identify the socioeconomic and sociodemographic determinants of fruit and vegetable consumption among mothers and households of schoolchildren in Jalisco, Mexico. Method: an analytical, cross-sectional study carried out during the first quarter of 2020. A validated food consumption frequency and a questionnaire on sociodemographic and socioeconomic factors were used for its development. Results: a lower educational level of the mothers of schoolchildren was associated with a lower consumption of vegetables by schoolchildren. In turn, a lower household income level was associated with a lower consumption of fruits in schoolchildren. Conclusions: a low educational level of mothers and a low household income were determinants associated with fruit and vegetable consumption in schoolchildren. However, there were differences in the determinants for fruits and vegetables. It is essential to consider these factors and their differences in order to plan actions that contribute to improving fruit and vegetable intake in the school population.

INTRODUCCIÓN: Introducción: incrementar el consumo de frutas y verduras es una prioridad, objetivo fundamental en las políticas públicas a nivel mundial. Dado que dicho consumo en los escolares de Jalisco (México) se encuentra por debajo de las recomendaciones alimentarias, es esencial identificar los determinantes que influyen en su consumo de frutas y verduras, para promover el desarrollo de acciones que contribuyan a mejorarlo. Objetivo: identificar los determinantes socioeconómicos y sociodemográficos del consumo de frutas y verduras en las madres de familia y los hogares de escolares de Jalisco, México. Método: estudio transversal analítico, realizado durante el primer trimestre del año 2020 utilizando una frecuencia de consumo de alimentos validada y un cuestionario sobre factores sociodemográficos y socioeconómicos. Resultados: el bajo nivel educativo de las madres de los escolares se asoció con un menor consumo de verduras y el bajo nivel de ingresos en el hogar se asoció con un menor consumo de frutas por los escolares. Conclusiones: el bajo nivel educativo de las madres y el bajo nivel de ingresos de los hogares fueron determinantes asociados al consumo de frutas y verduras de los escolares. Sin embargo, se presentaron diferencias en cuanto a los determinantes para las frutas y para las verduras. Estos factores y sus diferencias deben de tenerse en cuenta para la planificación de acciones que contribuyan a mejorar la ingesta de frutas y verduras en la población escolar.

La fecundidad en Argentina a inicios del siglo XXI: ¿el fin de la meseta? El papel de la educación en los cambios / Fecundidade na Argentina no início do século 21: o fim do plateau? Efeitos da educação nas mudanças / Fertility in Argentina at the beginning of the 21st century: the end of the plateau? Effects of education on changes

Resumen El presente trabajo ofrece un análisis del comportamiento de la fecundidad desagregado por nivel de instrucción de la madre en Argentina en el siglo XXI y presta especial atención a la evolución de la fecundidad adolescente en el mismo período. A diferencia de lo acontecido en otros países de la región en las últimas dos décadas, donde el descenso de la fecundidad fue casi ininterrumpida, en la Argentina la fecundidad tuvo un comportamiento estable, similar a una meseta, desde comienzos del siglo XXI hasta 2014, a partir de cuando comenzó un descenso sostenido análogo al de sus países vecinos. Para este análisis se usan datos de las estadísticas vitales y de las estimaciones y proyecciones de población del INDEC, y para el análisis por nivel de instrucción, datos de las encuestas permanentes de hogares del INDEC y del Censo Nacional de Población y Vivienda de 2010. En el análisis se puede observar una importante brecha en los niveles de fecundidad entre las mujeres más y menos instruidas, principalmente en la fecundidad adolescente. Esta brecha es un reflejo de inequidad, dado que la alta fecundidad afecta sobre todo a las mujeres de los estratos sociales más vulnerables.

Resumo Este documento faz uma análise do comportamento da fecundidade na Argentina no século 21, desagregado por nível de escolaridade da mãe, com especial atenção à evolução da fecundidade na adolescência nesse período. Ao contrário do que aconteceu em outros países da região nas últimas duas décadas, onde a fecundidade diminuiu quase continuamente, na Argentina a fecundidade teve um comportamento estável, semelhante a um plateau, desde o início do século 21 até 2014, quando começou um declínio sustentado semelhante ao observado nos países vizinhos. Utilizamos dados de estatísticas vitais, estimativas e projeções da população do INDEC e, para a análise por nível de educação, dados das Pesquisas Domésticas do INDEC e do Censo Nacional da População e Habitação 2010. A análise mostra uma lacuna significativa nos níveis de fecundidade entre as mulheres mais e menos instruídas, principalmente na fecundidade adolescente. Esta lacuna é reflexo da desigualdade, uma vez que a alta fecundidade afeta principalmente as mulheres dos estratos sociais mais vulneráveis.

Abstract This paper presents an analysis of Argentina's fertility behavior disaggregated by level of education of the mother in the 21st century, and focuses on the evolution of adolescent fertility during the same period. Unlike what other countries from the region have experienced in the last two decades, where fertility decline occurred almost uninterruptedly, Argentina's fertility had a stable behavior, similar to a plateau, from the beginning of the 21st century until 2014. Since then, it began a sustained decline similar to that evidenced in neighboring countries. Data from vital statistics, INDEC population estimates and projections are used, and data from INDEC Household Surveys and the 2010 National Population and Housing Census are used for the analysis by education level. The analysis shows a significant gap in fertility levels between the most and least educated women, mainly in adolescent fertility. This gap is a reflection of inequity, given that high fertility rates mainly affect women from the most vulnerable social strata.

Elección informada en el cribado del cáncer de mama: el papel del nivel educativo / Informed choice in breast cancer screening: the role of education

Objetivo: Evaluar el efecto de recibir información sobre los beneficios y los efectos adversos del cribado del cáncer de mama en la elección informada, en función del nivel educativo. Método: Análisis secundario de un estudio experimental aleatorizado y controlado, en cuatro programas de cribado en Cataluña y Canarias. Se analizaron 400 mujeres que iban a ser invitadas a participar por primera vez. El grupo de intervención recibió una herramienta informativa que mostraba los beneficios y los efectos adversos del cribado. El grupo control recibió un folleto estándar que recomendaba participar en el cribado. El nivel de estudios se agrupó en dos categorías: bajo y alto. La variable principal fue la elección informada definida como un conocimiento adecuado y la concordancia entre las actitudes y las intenciones. Resultados: La intervención produjo un mayor aumento del conocimiento en las mujeres con nivel educativo alto respecto a las de menor nivel educativo. Entre las mujeres que recibieron la intervención, la elección informada fue casi tres veces superior en las de nivel educativo alto (27% vs. 11%). No se observaron diferencias entre niveles educativos en los grupos de intervención y control en cuanto a conflicto decisional, confianza en la decisión, ansiedad y preocupación por el cáncer de mama. Conclusiones: Una herramienta informativa para el cribado del cáncer de mama tuvo mucho más impacto sobre la elección informada en las mujeres con nivel educativo alto. En aquellas con nivel educativo bajo mejoró la actitud frente al cribado y produjo un aumento en la intención de participar en él. (AU)

Objective: To evaluate the effect of receiving information about the benefits and harms of breast cancer screening in informed choice, according to educational level. Method: Secondary analysis of a randomized, controlled study, in four screening programs, in Catalonia and the Canary Islands (Spain). We analyzed 400 women who were going to be invited to participate for the first time. The intervention group received a decision aid that showed the benefits and harms of screening. The control group received a standard brochure that recommended participating in the screening program. Educational level was grouped into two categories, low and high. The primary outcome was informed choice defined as adequate knowledge and consistency between attitudes and intentions. Results: The intervention produced a greater increase in knowledge in women with a high educational level compared to those with a lower educational level. Among women who received the intervention, informed choice was almost three times higher in those with a high educational level (27% versus 11%). No differences were observed between educational levels in decisional conflict, confidence in the decision, anxiety and worry about breast cancer, in the intervention and control groups. Conclusions: A decision aid for breast cancer screening had much more impact on informed choice among women with a high educational level. In women with low educational level, the attitude towards screening improved and there was an increase in the intention to be screened. (AU)

Asociación entre variables indicadoras del nivel socioeconómico del lugar de residencia en Sevilla y la incidencia y frecuentación hospitalaria pediátrica por tosferina / Association between indicators of neighbourhood socioeconomic status in Seville and the incidence of pertussis and related hospital admissions in children

Introducción: el objetivo de este estudio es analizar la asociación entre nivel socioeconómico del lugar de residencia y la incidencia y frecuentación hospitalaria infantil por tosferina.Material y método: estudio observacional, transversal, con dos unidades de observación de menores de 15 años residentes en Sevilla: 1) hospitalizaciones en los dos hospitales públicos de la ciudad por cualquier motivo (2013-2015): n = 7315; y 2) casos declarados confirmados de tosferina (2013-2017): n = 102. Las variables independientes fueron edad, sexo y residencia en zonas con necesidad de transformación social (ZNTS), en riesgo de pobreza (ZRP) y con educación insuficiente (EIZR). Las variables dependientes fueron hospitalizaciones y casos declarados confirmados de tosferina. Se realizaron análisis univariantes, bivariantes y multivariantes en la unidad Hospitalizaciones, mediante test χ2 y modelos de regresión logística, con el programa R. Se calcularon tasa y razón de incidencia por subdistritos en la unidad casos declarados. Resultados: el 1,12% de las hospitalizaciones fue por tosferina (n = 82). Entre el 2,0 y el 2,4% de las hospitalizaciones por tosferina procedieron de los subdistritos más desfavorecidos, en comparación con el 0,8 y 0,9% del resto de la ciudad (p <0,001). Las odds ratios, ajustadas por edad y sexo, y sus intervalos de confianza del 95%, fueron: ZNTS = 2,76 (1,74-4,32), ZRP = 2,48 (1,47-4,04) y EIZR = 2,17 (1,38-3,39). La razón de incidencia también fue superior en las zonas más desfavorecidas (2,50, 1,99 y 2,01, respectivamente). Conclusiones: el menor nivel socioeconómico de las áreas residenciales de Sevilla se asocia a la mayor frecuentación hospitalaria e incidencia de tosferina infantil (AU)

Introduction: the aim of our study was to analyse the association between the SES of the neighbourhood of residence and the incidence of pertussis and frequency of hospital visits associated with pertussis in the paediatric population.Material and methods: we conducted a cross-sectional observational study, with 2 sets of observations in children under 15 years living in Seville: 1) admissions for any reason to the 2 public hospitals of Seville (2013-2015; n = 7315) and 2) reported cases of pertussis (2013-2017; n = 102). The independent variables were age, sex and residence in areas in need of social transformation (ANSTs), areas at risk of poverty (ARPs) and areas with low educational attainment (ALEAs). In the analysis of the reported cases data set, we calculated the incidence and incidence ratio for each subdistrict.Results: of the total hospital admissions, 1.12% (n = 82) were due to pertussis. Between 2.0 and 2.4% of admissions in children that resided in disadvantaged subdistricts were due to pertussis, compared to 0.8 to 0.9% in children living in the rest of the city (p <0.001). The sex- and age-adjusted odds ratios (with their corresponding 95% confidence intervals) were: ANST 2.76 (1.74-4.32) for ANSTs, 2.48 (1.47-4.04) for ARPs and 2.17 (1.38-3.39) for ALEAs. The incidence ratios were also higher in these disadvantaged areas (2.50, 1.99 and 2.01, respectively).Conclusions: low neighbourhood socioeconomic status in Seville was associated with a higher incidence of pertussis and a higher frequency of related hospital admissions in the paediatric population. (AU)

Psychosocial factors associated with frailty in the community-dwelling aged population with depression. A cross-sectional study / Factores psicosociales asociados a fragilidad en ancianos de la comunidad con depresión: estudio observacional transversal

Objective: There is a two-way relationship between frailty and depression, but the mechanisms by which one may influence the other are not well understood. The objective of this study was to evaluate the relationship between psychosocial factors and frailty in community-dwelling aged populations with depression. Design:Observational cross-sectional study. Site: 5 primary care centres. Participants: Community-dwelling subjects with depression aged ≥70 years. Main measurements: Frailty status was established according to Fried criteria, depression and depression severity were evaluated by DSM-IV criteria and the Hamilton Depression Rating Scale, respectively, and psychosocial factors were assessed using the Gijón Social-Familial Evaluation Scale and ad hoc questionnaires. Results: Recruited were 338 subjects (mean age 77.2 years), 82% women and 36.1% rated as frail. A dose–response relationship was observed between depression severity and frailty risk. Widowhood was a risk factor for frailty, while a higher educational level, home internet, stairs in the home, and an active social life had a protective effect. A multivariate analysis showed that age, number of drugs, and depression severity were independent risk factors for frailty, while an active social life was a protective factor. The severity of depressive symptoms showed higher association with frailty than other clinical and socio-demographic characteristics. Conclusions: In depressed elderly subjects, frailty is associated with psychologiocal factors such as the intensity of depressive symptoms and with social factors such as education level, widowhood, loneliness, and limited social life. More research is required to better understand the modifiable psychological risk factors for frailty.(AU)

Objetivo: Existe una relación bidireccional entre la fragilidad y la depresión en la población anciana. El objetivo de este estudio fue evaluar la relación entre los factores psicosociales y la fragilidad en ancianos de la comunidad con depresión. Diseño: Estudio observacional transversal. Sitio: Cinco centros de atención primaria. Participantes: Ancianos ≥70años de la comunidad con depresión. Principales mediciones: La fragilidad se estableció de acuerdo con los criterios de Fried, la depresión y la gravedad de la depresión se evaluaron mediante los criterios DSM-IV y la Escala de Hamilton, respectivamente, y los factores psicosociales se evaluaron utilizando la Escala de Evaluación Social-Familiar de Gijón y cuestionarios ad hoc. Resultados: Se reclutaron 338 sujetos (edad media 77años), 82% mujeres y 36,1% frágiles. Se observó una relación dosis-respuesta entre la gravedad de la depresión y el riesgo de fragilidad. La viudez era un factor de riesgo para la fragilidad, mientras que un nivel educativo más alto, internet en el hogar, escaleras en el hogar y una vida social activa tenían un efecto protector. El análisis multivariado mostró que la edad, el número de medicamentos y la gravedad de la depresión eran factores de riesgo independientes para la fragilidad, mientras que una vida social activa era un factor protector. Conclusiones: En ancianos con depresión la fragilidad se asocia con factores psicológicos como la intensidad de los síntomas depresivos y con factores sociales como el nivel de estudios, la viudez, la soledad o la escasa vida social. Se requiere más investigación para comprender mejor los factores de riesgo psicológicos modificables de fragilidad.(AU)

Psychosocial factors associated with frailty in the community-dwelling aged population with depression. A cross-sectional study.

OBJECTIVE: There is a two-way relationship between frailty and depression, but the mechanisms by which one may influence the other are not well understood. The objective of this study was to evaluate the relationship between psychosocial factors and frailty in community-dwelling aged populations with depression. DESIGN: Observational cross-sectional study. SITE: 5 primary care centres. PARTICIPANTS: Community-dwelling subjects with depression aged ≥70 years. MAIN MEASUREMENTS: Frailty status was established according to Fried criteria, depression and depression severity were evaluated by DSM-IV criteria and the Hamilton Depression Rating Scale, respectively, and psychosocial factors were assessed using the Gijón Social-Familial Evaluation Scale and ad hoc questionnaires. RESULTS: Recruited were 338 subjects (mean age 77.2 years), 82% women and 36.1% rated as frail. A dose-response relationship was observed between depression severity and frailty risk. Widowhood was a risk factor for frailty, while a higher educational level, home internet, stairs in the home, and an active social life had a protective effect. A multivariate analysis showed that age, number of drugs, and depression severity were independent risk factors for frailty, while an active social life was a protective factor. The severity of depressive symptoms showed higher association with frailty than other clinical and socio-demographic characteristics. CONCLUSIONS: In depressed elderly subjects, frailty is associated with psychologiocal factors such as the intensity of depressive symptoms and with social factors such as education level, widowhood, loneliness, and limited social life. More research is required to better understand the modifiable psychological risk factors for frailty.

[Informed choice in breast cancer screening: the role of education]. / Elección informada en el cribado del cáncer de mama: el papel del nivel educativo.

OBJECTIVE: To evaluate the effect of receiving information about the benefits and harms of breast cancer screening in informed choice, according to educational level. METHOD: Secondary analysis of a randomized, controlled study, in four screening programs, in Catalonia and the Canary Islands (Spain). We analyzed 400 women who were going to be invited to participate for the first time. The intervention group received a decision aid that showed the benefits and harms of screening. The control group received a standard brochure that recommended participating in the screening program. Educational level was grouped into two categories, low and high. The primary outcome was informed choice defined as adequate knowledge and consistency between attitudes and intentions. RESULTS: The intervention produced a greater increase in knowledge in women with a high educational level compared to those with a lower educational level. Among women who received the intervention, informed choice was almost three times higher in those with a high educational level (27% versus 11%). No differences were observed between educational levels in decisional conflict, confidence in the decision, anxiety and worry about breast cancer, in the intervention and control groups. CONCLUSIONS: A decision aid for breast cancer screening had much more impact on informed choice among women with a high educational level. In women with low educational level, the attitude towards screening improved and there was an increase in the intention to be screened.

Evaluación cognitiva de niños: un estudio comparativo en San Luis, Argentina / Cognitive Evaluation of Children: a Comparative Study in San Luis, Argentina

Resumen En la provincia de San Luis (Argentina), se desarrollaron dos estudios con el propósito de conocer la incidencia de factores socioambientales en el desarrollo cognitivo de los niños. En la primera investigación se trabajó con una muestra de niños de alto riesgo entre 6 y 12 meses y, en la segunda, con una muestra de niños sanos de 6 a 9 años. Las evaluaciones cognitivas se llevaron a cabo mediante la aplicación de la Escala Argentina de Inteligencia Sensorio Motriz (EAIS) en la primera investigación y la versión argentina de la Escala de Inteligencia de Wechsler (WISC-IV) en la segunda. Los resultados reflejan que la variable ambiental nivel educativo materno incide en el rendimiento cognitivo alcanzado por los niños de 6 a 9 años, porque a medida en que aumenta la escolaridad materna mejoran los percentiles obtenidos por sus hijos. Sin embargo, no ocurre lo mismo en los bebés evaluados entre los 6 y los 12 meses de vida. Como conclusión, se remarca la importancia de los primeros años de vida en el crecimiento, la maduración y el desarrollo posterior del niño, así como el impacto que el medio familiar, cultural y social puede tener sobre los mismos. Además, se entiende al desarrollo cognitivo como un proceso multideterminado por aspectos subjetivos, ambientales, históricos-sociales y genéticos, entre otros.

Abstract Preliminary results are presented from two studies carried out in the province of San Luis, Argentina in which cognitive development in children was evaluated. A sample of high-risk children between 6 and 12 months of age was used in the first study, and in the second a sample of healthy children aged 6-9 years was used. Cognitive assessments were carried out by applying the Argentine Sensory-Motor Intelligence Scale (EAIS) in the first study and the Argentine version of the Wechsler Intelligence Scale (WISC-IV) in the second study. The aim of this work is to discern what factors can affect cognitive development in children. The results reflect that the environmental variable, maternal educational level, affects the cognitive performance achieved by children from 6 to 9 years of age, since as maternal schooling increases the percentiles obtained by their children also rise. However, this was not the case in those infants evaluated between 6 and 12 months of age. We conclude about the importance of early life in growth, maturation and subsequent child development and the impact that family, cultural and social environments may have on them. Cognitive development is understood as a multi-determined process with subjective, environmental, historical and social and genetic aspects, among others.

Food Security in Acajete, Veracruz / Seguridad alimentaria en Acajete, Veracruz / Segurança alimentar em Acajete, Veracruz / Sécurité alimentaire à Acajete, Veracruz

Abstract Objective: To determine the dietary diversity, the level of food security and its relationship with living conditions in families in Acajete, Veracruz. Materials and methods: Proportional stratified sampling, with 95% confidence, 5% error, and 50% response distribution. Household selection was made randomly, resulting in 211 dwellings as a sample. Results: Marginal food security with 40.3% (n = 85), followed by 32.7% of families with food security (n = 69). Regarding the nutritional status of surveyed people, the mode and median was normal weight (57.7%), overweight and obese 25.5% and underweight 16.8%. 33.6% of the people consume three food groups throughout the day, 27.5% four groups, 15.2% two groups, and the same percentage five food groups. There were significant differences (p=0.039) between the education level of the respondents in relation to their food security status, where 84.2% of the illiterate population has some degree of food insecurity, and 15.8% are in Food security. Conclusions: The housing characteristics considered in this study are not a determinant risk factor for Food Insecurity; no significant differences were found with overcrowding (p=0.239), housing ownership (p=0.987); and an unsafe source of drinking water (p = 0.973). The average scores of the Mexican Food Security Survey (EMSA) were statistically significant, therefore it is observed that lower food diversity results in lower food security. The inhabitants of Acajete who are in low or very low food security, only feed on two food groups: cereals or tubers; and legumes, nuts or seeds. When there is marginal food security add meat or fish.

Resumen Objetivo: Determinar la diversidad alimentaria, el nivel de la seguridad alimentaria y su relación con las condiciones de vida en familias en la localidad de Acajete, Veracruz. Materiales y métodos: Muestreo estratificado proporcional, con una confianza del 95%, un error del 5%, y un 50% de distribución de respuesta. La selección de los hogares se realizó de manera aleatoria, resultando 211 viviendas como muestra. Resultados: Inseguridad alimentaria leve con un 40.3% (n=85), seguido del 32.7% de las familias con seguridad alimentaria (n=69). Respecto al estado nutricio de las personas encuestadas, la moda y mediana fue de normopeso (57.7%), en sobrepeso y obesidad 25.5% y en bajo peso 16.8%. El 33.6% de los encuestados consume tres grupos de alimentos durante todo el día, 27.5% cuatro grupos, 15.2% dos grupos, y con el mismo porcentaje cinco grupos de alimentos. Se encontraron diferencias significativas (p=0.039) entre el nivel de educación de los encuestados en relación con su estado de seguridad alimentaria, donde el 84.2% de la población analfabeta cursa con algún grado de inseguridad alimentaria, y el 15.8% se encuentra en seguridad alimentaria. Conclusiones: Las características de la vivienda que se consideraron en este estudio no son un factor de riesgo determinante para la Inseguridad Alimentaria, no se encontraron diferencias significativas con el hacinamiento (p=0.239), propiedad de la vivienda (p=0.987); y fuente insegura de agua para beber (p=0.973). Los puntajes promedio de la Encuesta Mexicana para la Seguridad Alimentaria resultaron estadísticamente significativos, por consiguiente se observa que una menor diversidad de alimentos resulta en mayor inseguridad alimentaria. Las familias en Inseguridad Alimentaria Moderada o Severa, se alimentan únicamente de dos grupos de alimentos: cereales o tubérculos; y de legumbres. Cuando hay inseguridad alimentaria leve agregan la carne o el pescado.

Resumo Objetivo: Determinar a diversidade alimentar, o nivel de segurança alimentar e sua relação com as condições de vida das familias na cidade de Acajete, Veracruz. Materiais e métodos: Amostragem estratificada proporcional, com uma confiaba de 95%, um erro de 5%, e distribuição de resposta de 50%. A selecção dos agregados foi realizada de forma aleatória, resultando invólucro 211, como mostrado. Resultados: Insegurança aliemtar leve, com 40,3% (n = 85), seguido por 32,7% das familias com seguraba alimentar (n = 69). Com relação ao estado nutricional dos entrevistados, moda e mediana foi de peso normal (57,7%) em sobrepeso e obesidade de 25,5% e 16,8% abaixo do peso. 33,6% dos encuestados consumem três grupos de alimentos ao longo do dia, quatro grupos de 27,5%, 15,2% dois grupos, e a mesma percentagem de cinco grupos de alimentos. Diferenças significativas (p = 0,039) entre o nivel de escolaridade dos entrevistados sobre sua situação de segurança alimentar, onde 84,2% da população analfabeta apresenta com algum grau de insegurançã alimentar foram encontrados, e 15,8% estão em segurança alimentar. Conclusões: As características da habitação que foram considerados neste estudo não são um factor determinante para o risco de segurança alimentar, não há diferenças significativas com a superlotação (p = 0,239), a posse (p = 0,987) que foram encontrados; e a fonte de água não potável (p = 0,973). Os escores médios do Inquérito de Segurança Alimentar mexicano foram estatisticamente significativos, portanto, mostra que menos diversidade de alimentos resulta em maior insegurança alimentar. Familias insegura alimentar moderada ou grave, são alimentados apenas dois grupos de alimentos: cereais ou de tubérculos; e leguminosas. Quando há ligeira insegurança alimentar, eles adicionam carne ou peixe.

Résumé Objectif: Déterminer la diversité et le niveau de sécurité alimentaire, ainsi que leur relation avec les conditions de vie de familles résidant a Acajete, Veracruz. Matériaux et méthode: Échantillonnage stratifié proportionnel, avec un intervalle de confiance de 95%, une marge d'erreur de 5% et 50% de distribution des réponses. La sélection des ménages a été faite au hasard et a donné lieu a un échantillon de 211 logements. Résultats: 40.3% des familles (n=85) ont indiqué une insécurité alimentaire légére et 32.7% (n = 69) une sécurité alimentaire. En ce qui concerne l'état nutritionnel, 57% des personnes interrogées ont présenté un poids normal (valeur du mode et la médiane), 25,5% surpoids ou obésité 25,5% et 16,8% une insuffisance pondérale. 33,6% des personnes interrogées consomment trois groupes alimentaires dans la journée, 27,5% quatre groupes, 15,2% deux groupes, et 15,2% également cinq groupes. Des différences significatives (p = 0,039) de niveau d'éducation ont été trouvées en relation au statut de sécurité alimentaire: 84,2% des analphabétes expérimentent un certain degré d'insécurité alimentaire et 15,8% sont en sécurité alimentaire. Conclusions: Les caractéristiques du logement prises en compte dans cette étude ne sont pas un facteur de risque déterminant d'insécurité alimentaire. Aucune différence significative n'a été observée en fonction du surpeuplement (p = 0,239), de la propriété du logement (p = 0,987); et de l'existence d'une source non fiable d'eau pour boire (p = 0,973). Les valeurs moyennes de la Encuesta Mexicana para la Seguridad Alimentaria (EMSA) se sont révélés statistiquement significatifs ; on a ainsi observé qu'une moindre diversité alimentaire entrame une insécurité alimentaire majeure. Les familles en situation d'insécurité alimentaire modérée ou sévére ne se nourrissent que de deux groupes d'aliments: céréales et tubercules, et légumineuses. Dans les cas d'insécurité alimentaire légére, a cela s'ajoute de la viande ou du poisson.

Health Literacy and Health Outcomes in Very Old Patients With Heart Failure.

INTRODUCTION AND OBJECTIVES: Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level. METHODS: This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain. About 74% of patients had less than primary education and 71% had preserved systolic function. Health literacy was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults questionnaire, knowledge of HF with the DeWalt questionnaire, and HF self-care with the European Heart Failure Self-Care Behaviour Scale. RESULTS: Disease knowledge progressively increased with HL; compared with being in the lowest (worse) tertile of HL, the multivariable beta coefficient (95%CI) of the HF knowledge score was 0.60 (0.01-1.19) in the second tertile and 0.87 (0.24-1.50) in the highest tertile, P-trend = .008. However, no association was found between HL and HF self-care. During the 12 months of follow-up, there were 189 deaths. Compared with being in the lowest tertile of HL, the multivariable HR (95%CI) of mortality was 0.84 (0.56-1.27) in the second tertile and 0.99 (0.65-1.51) in the highest tertile, P-trend = .969. CONCLUSIONS: No association was found between HL and 12-month mortality. This could be partly due to the lack of a link between HL and self-care.