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1.
Eur. j. psychol. appl. legal context (Internet) ; 11(2): 71-79, jul.-dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183601

RESUMO

Priority given to investigating the onset and maintenance of criminal behavior in the past is currently giving way to a new focus on the process of criminal desistance. Early narratives of future desistance are the first step in this process and, although they do not assure withdrawal from crime, they are the beginning of the personal change that precedes a progressive desistance from criminal activity. This study analyzes early desistance narratives of offenders still in prison and whether these narratives differed depending on their personal, criminal, and social characteristics. Participants were 44 imprisoned male offenders, aged between 20 and 50 years old at different stages of their sentence and in three different prison regimes. They were interviewed using Cid and Martí's protocol and their accounts were accordingly coded in three categories: early narratives towards a non-criminal identity, perceived self-efficacy to desist from crime, and will to desist. The results show that participants' early desistance narratives vary depending on their personal, criminal, and social variables. Results on the periods of sentence completion and prison regimes are discussed in terms of how prisons could contribute to enhancing the narratives of desistance from crime


La prioridad otorgada en el pasado a la investigación sobre el inicio y mantenimiento de la conducta delictiva está dando paso actualmente al análisis del proceso de desistimiento delictivo. Las narrativas tempranas del desistimiento futuro son el primer paso en este proceso y, aunque no aseguran dicho desistimiento, son el comienzo del cambio personal que precede al abandono progresivo de la actividad delictiva. Este estudio analiza las narrativas tempranas de desistimiento de delincuentes aún en prisión y si estas narrativas difieren según sus características personales, delictivas y sociales. Los participantes fueron 44 varones encarcelados, con edades comprendidas entre los 20 y los 50 años, en diferentes fases de su sentencia y en tres grados penitenciarios distintos. Fueron entrevistados utilizando el protocolo de Cid y Martí y sus relatos fueron codificados en tres categorías: narrativas tempranas sobre una identidad no delictiva, autoeficacia percibida para desistir del delito y voluntad para desistir. Los resultados muestran que las narrativas tempranas de desistimiento de los participantes difieren según sus características personales, delictivas y sociales. Los resultados relativos a la fase de la sentencia y a los grados penitenciarios se discuten en términos de cómo las prisiones pueden contribuir a potenciar las narrativas de desistimiento delictivo


Assuntos
Humanos , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Comportamento Criminoso , Criminosos/psicologia , Autoeficácia , Terapia Narrativa/métodos , Avaliação de Eficácia-Efetividade de Intervenções , Psicologia Criminal/métodos
2.
Interv. psicosoc. (Internet) ; 28(2): 57-65, ago. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-183646

RESUMO

This study examines the impact of the Building My Future program's implementation variables on attendance rate and on changes in personal, problem-solving, and community competencies. The program is run by local Social Services from Castile and Leon, Spain, and offers opportunities for adolescents to propose and carry out youth-led activities in their community. Data were accumulated from 356 participants, the majority experiencing negative psychosocial conditions, attending a total of 32 groups from 2013 to 2016. Using binary logistic regression and hierarchical linear regression analyses, results showed that having a facilitator with less professional experience, attending larger groups, having a high level of family involvement, and performing fewer modules and fewer extra activities predicted higher attendance rates and more positive task orientation, self-concept, social realization, and problem-solving competencies. Being younger, from an urban area, and having a facilitator with less professional experience predicted a higher score in community integration. These findings reveal that several program implementation components can contribute to the program's development and effectiveness and can also be considered across multiple programs in this field of practice


Este estudio examina la influencia de las variables de la aplicación del programa "Construyendo mi futuro" en el índice de asistencia y el cambio en competencias personales, de resolución de problemas y comunitarias. El programa se ofrece desde los Servicios Sociales de Castilla y León, España, brindando oportunidades para que adolescentes propongan y lleven a cabo actividades en su comunidad. Se recogieron datos de 356 participantes, la mayoría en situación de riesgo psicosocial, que asistieron a un total de 32 grupos desde el año 2013 hasta el año 2016. Mediante análisis de regresión logística binaria y regresión jerárquica lineal, los resultados indican que tener un facilitador con menos experiencia (más joven), asistir a grupos más grandes, disfrutar de un alto nivel de participación familiar y realizar menos módulos y menos actividades adicionales predecían un mayor índice de asistencia. Estas variables predijeron además una mayor orientación hacia la tarea y cambios positivos en autoconcepto, realización social y resolución de problemas. El hecho de ser joven, de zona urbana y tener un facilitador con menor experiencia profesional predecía una mayor puntuación en integración comunitaria. Estos resultados nos revelan cómo determinados componentes de la aplicación del programa pueden contribuir al desarrollo y a la eficacia del mismo, pudiendo igualmente ser considerados en otros muchos programas en este ámbito de intervención


Assuntos
Humanos , Adolescente , Avaliação de Eficácia-Efetividade de Intervenções , Carência Psicossocial , Grupos de Risco , Psicologia do Adolescente , Sistemas de Apoio Psicossocial , Comportamento do Adolescente/psicologia , Serviços de Saúde Comunitária , Medicina Baseada em Evidências
3.
Pediatr. aten. prim ; 21(82): 191-201, abr.-jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184599

RESUMO

La leche humana se reconoce como el alimento idóneo para todos los niños por sus probados beneficios en la salud de la madre y del niño. La Organización Mundial de la Salud recomienda la lactancia materna exclusiva durante los primeros seis meses de la vida y, al menos hasta los dos años, complementada con otros alimentos. Esta recomendación se extiende a los recién nacidos enfermos y prematuros, salvo raras excepciones. Las pruebas sobre el efecto protector de la lactancia materna en la salud del niño y de la madre son muy robustas en relación con catorce enfermedades, nueve infantiles y cinco maternas. El apoyo a la lactancia materna desde Atención Primaria tiene un efecto favorable y consistente, con un riesgo de efectos adversos mínimo y que precisa una disponibilidad de recursos asumibles. En los centros de salud se sugiere implantar las prácticas recomendadas por la Academia Americana de Pediatría o los siete pasos de la Iniciativa de Humanización de la Asistencia al Nacimiento y Lactancia para prolongar la lactancia materna. Se sugiere formar a los médicos en lactancia materna, implicar a enfermeras consultoras en lactancia y favorecer el apoyo entre pares para prolongar la lactancia materna


Human milk is recognized as the ideal nourishment for all children due to its proven health benefits for mother and child. World Health Organization recommends exclusive breastfeeding during the first six months of life and, at least until two years, complemented with other foods. This recommendation extends to sick and preterm newborns, with rare exceptions. Proofs on the protecting effect of breastfeeding for child and mother health are very robust relating to fourteen diseases: nine child diseases and five mother diseases. Support to breastfeeding in Primary Care has a favourable and consistent effect, with a minimum risk of adverse events and it requires affordable resources. It is suggested to implement in Primary Care Centers the recommended practices of the American Academy of Pediatrics or the 7 steps of Initiative Humanisation of Attendance to Birth and breastfeeding to prolong breastfeeding. It is suggested to train physicians in breastfeeding, involve breastfeeding consultant nurses and promote the peers' support to prolong breastfeeding


Assuntos
Humanos , Humanização da Assistência , Aleitamento Materno/tendências , Parto Humanizado , Atenção Primária à Saúde/organização & administração , Promoção da Saúde/organização & administração , Prevenção de Doenças , Avaliação de Eficácia-Efetividade de Intervenções
4.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184673

RESUMO

Objectives: To describe the drug therapy problems (DTPs) identified for patients enrolled in an Appointment Based Model (ABM) for medication synchronization, describe the pharmacist-delivered clinical interventions, and assess what patient characteristics are associated with the number of DTPs identified. Methods: A cross-sectional chart review of 1 month of pharmacist notes for telephone ABM encounters at one independent community pharmacy in the Midwest U.S. was performed for a systematic random sample of patients active in the program during September 2017. Included patients were 18 years and older and took one or more synchronized medications. Data included months in the program, gender, age, insurance type, refill interval, medications (synchronized and total), DTP category, and intervention category. Descriptive statistics were calculated, and a multiple linear regression tested the association between patient characteristics and the number of DTPs identified. Results: The study involved 209 subjects, 54% women, with a mean age of 69.5 years and. The average number of medications synchronized was 4.7, the mean total number of medications was 6.3, and mean length of time in the program was 20 months. The DTPs (n=334) identified included needs additional drug therapy (43.1%), inappropriate adherence (31.4%), unnecessary drug therapy (15.0%), and adverse drug reaction (9.6%). The regression showed age and number of medications was positively associated with number of DTPs identified, but months enrolled was not. Conclusions: This ABM approach identified several hundred DTPs with corresponding interventions within a one-month period, suggesting that ABMs have a significant potential to improve patient care. The data also suggest that pharmacist interventions within an ABM program are valuable beyond the first few fills as patients move into maintenance use of their medications, especially for patients of advancing age and polypharmacy


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Monitoramento de Medicamentos/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Adesão à Medicação/estatística & dados numéricos , Terapia Diretamente Observada/métodos , Estudos Retrospectivos , Avaliação de Eficácia-Efetividade de Intervenções , Papel Profissional , Serviços Comunitários de Farmácia/organização & administração
5.
Arch. prev. riesgos labor. (Ed. impr.) ; 22(2): 72-75, abr.-jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181178

RESUMO

Objetivos: Evaluar los cambios en la actividad física de los participantes de un programa de actividad física (Mueve-T) implantado en el medio laboral. Métodos: En marzo del 2014, se iniciaron las actividades del programa Mueve-T con los objetivos de sensibilizar a los trabajadores en la práctica de la actividad física y conseguir una mejora en el nivel de actividad. Para evaluar su efectividad se utilizó el Cuestionario IPAQ (International Physical Activity Questionnaire) antes de iniciarse el programa (2014) y a los dos años (2016). Se realiza la comparación entre años ajustando un modelo logístico de medidas repetidas de dos poblaciones de trabajadores de distintos centros de trabajo de la misma empresa con respuesta ordinal politómica para IPAQ (nivel bajo o inactivo, moderado y alto), para toda la población y estratificado por sexo, centro de trabajo y puesto de trabajo. Resultados: Se incluyen los 314 trabajadores que respondieron el cuestionario en los dos años. En 2014 un 35,35% de los encuestados reportaron un nivel bajo de actividad, un 39,50% moderado y un 25,15 un nivel alto. En 2016 un 36,30% reportaron nivel bajo de actividad, un 39,80% nivel moderado y un 23, 90% un nivel alto. El análisis de respuesta entre años no ha mostrado evidencia de cambio entre años (p=ns). No se han encontrado diferencias por sexo, pero sí una menor actividad en determinados centros y puestos de trabajo. Conclusiones: Si valoramos los resultados del programa y su efectividad con el cuestionario IPAQ, observamos que estadísticamente no muestran cambio en actividad física estadísticamente significativo; pero si hay cambios en el nivel de actividad manteniéndose y aumentando en un grupo de trabajadores, a su vez consideran el programa efectivo y desean continuar con las actividades. Para obtener un aumento del nivel de actividad física se precisaría de un periodo más largo de evaluación


Objective: To analyze the effectiveness of a company-based physical activity program using the International Physical Activity Questionnaire (IPAQ) questionnaire. Methods: In March 2014 we implemented a company-based physical activity program (Mueve-T, by its Spanish acronym) with the objective of increasing awareness of physical activity among employees, and measuring improvements in activity level. To evaluate the effectiveness of the program, we administered the IPAQ Questionnaire, before the program began in 2014 and two years later, in 2016. Descriptive summary statistics included frequencies, percentages and bar charts. To compare pre- and post-intervention results, we used a logistic repeated measures model, adjusted for two populations, with an ordinal polytomous response for IPAQ (low or inactive, moderate and high), applied to the overall study population and further examined by sex, workplace and job. Results: A total of 746 participants responded in 2014 and 563 in 2016. Only 314 respondents completed both surveys. In 2014, 35.4% of the respondents reported a low level of activity, moderate was 39.5% and highwas, 25.2%. In 2016, 36.3% reported a low level of activity, moderate was 39.8% and a high level was indicated by 23.9%. Overall, there were no significant differences in physical activity levels between the pre- and post-intervention period, among those who participated in both surveys. Likewise, there were no significant differences when this result was examined by sex, although employees sales or commercial tasks has lower levels of physical activity as compared to other centers or jobs. Conclusions: The results did not find this intervention program to be effective in increasing levels of physical activity. The differences found among the sales and commercial task employees could have been due to differences in the effect on awareness achieved by companywide information dissemination (e.g., newsletters, talks, intranet notes, etc.) as compared to specific individual activities (e.g., (yoga classes, zumba, cycling, walks, etc.). A longer evaluation period is needed to confirm these findings


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Atividade Motora , Promoção da Saúde/organização & administração , Eficácia/estatística & dados numéricos , Avaliação de Eficácia-Efetividade de Intervenções , Doenças Cardiovasculares/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Promoção da Saúde/tendências , Local de Trabalho/psicologia
6.
An. psicol ; 35(2): 300-313, mayo 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-181692

RESUMO

This study addressed the development and evaluation of the Smile Program whose main objective was the prevention of depression and the promotion of well-being in adolescents. The program is based on interventions that have been shown to be efficacious (a cognitive-behavioral approach). Participants were 89 adolescents (mean age = 13.88 years; SD = 0.95) recruited from a sample of 1212 students from seven schools. Results showed a significant reduction in self-reported depressive symptoms in the intervention group (n= 51) as compared to youth in the control group (n= 38). Based on parents' report (n=56), youth in the intervention group had significantly better self-esteem at post-test as compared to youth in the control group. At four months post intervention, youth in the intervention group had higher psychological well-being than those in the control group; at the 8-month follow-up, youth in the intervention condition reported better family self-concept


Este estudio consistió en describir el desarrollo y la evaluación del Programa Sonrisa cuyo principal objetivo fue la prevención de la depresión y la promoción del bienestar en adolescentes. El programa se basa en intervenciones que han demostrado ser eficaces (enfoque cognitivo-conductual). Los participantes fueron 89 adolescentes (edad media = 13,88 años, SD = 0,95) reclutados de una muestra de 1212 estudiantes de 7 escuelas. Los resultados de los autoinformes de los adolescentes mostraron una reducción significativa en los síntomas depresivos en el grupo de intervención (n = 51) en comparación con los adolescentes del grupo control (n = 38). Respecto a los cuestionarios de los padres (n = 56), se halló que los adolescentes en el grupo de intervención tuvieron una autoestima significativamente mejor en el postest en comparación con los del grupo control. Cuatro meses después del programa, los adolescentes del grupo de intervención tenían un mayor bienestar psicológico que los del grupo de control y , en el seguimiento de 8 meses, los adolescentes de la condición de intervención informaron de un mejor autoconcepto familiar


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Depressão/prevenção & controle , Promoção da Saúde/métodos , Comportamento do Adolescente/psicologia , Depressão/psicologia , Programas Gente Saudável/organização & administração , Avaliação de Programas e Projetos de Saúde , Programas Nacionais de Saúde/organização & administração , Estudos de Casos e Controles , Avaliação de Eficácia-Efetividade de Intervenções , Relações Pais-Filho , Pais/psicologia
7.
Cuad. psicol. deporte ; 19(2): 70-82, mayo 2019. tab
Artigo em Português | IBECS | ID: ibc-183270

RESUMO

Comportamentos antissociais tornaram-se recorrentes no ambiente escolar e se manifestado por meio de agressões físicas, verbais e simbólicas. O objetivo deste estudo foi verificar o efeito de uma intervenção, fundamentada no atendimento das necessidades psicológicas básicas (NPB), nos comportamentos pró e antissociais em aulas de Educação Física escolar. Participaram deste estudo 45 alunos e 2 professores de educação Física (PEF) divididos em Grupo Controle (GC) e Grupo Intervenção (GI). Os alunos responderam o Questionário de Atitudes no Esporte (QAE-23) e uma entrevista semiestruturada nos momentos pré e pós intervenção. A intervenção consistiu em uma orientação semanal com o PEF do GI durante 10 semanas, com objetivo de realizar adaptações na aula a fim de levar ao cumprimento das NPB. Para verificar diferença entre os grupos, em relação às respostas do QAE-23, nos momentos pré e pós, foi utilizado o teste T de Student e adotado nível de significância 5%. Na análise qualitativa, as entrevistas foram gravadas, transcritas e, posteriormente, categorizadas e analisadas. Mediante análise dos relatos obtidos pela entrevista foi possível observar percepção do atendimento das NPB e redução de comportamentos antissociais. Contudo, não foi observada diferença estatisticamente significativa entre os grupos para as respostas do QAE-2. Conclui-se, por meio dos relatos obtidos na entrevista, que a intervenção pautada no cumprimento das NPB possibilitou um efeito positivo em relação à redução dos comportamentos antissociais, porém, os dados quantitativos sugerem que a duração do estudo pode ter sido um fator limitante de maior efeito em relação à ausência internalização dos comportamentos


Los comportamientos antissociales se tornaron recurrentes en el ambiente escolar y se manifestaron por medio de agresiones físicas, verbales y simbólicas. El objetivo de este estudio fue verificar el efecto de una intervención, fundamentada en la atención de las necesidades psicológicas básicas (NPB), en los comportamientos pro y antisociales en clases de Educación Física escolar. En este estudio participaron 45 alumnos y 2 profesores de educación Física (PEF) divididos en Grupo Control (GC) y Grupo Intervención (GI). Los alumnos respondieron el Cuestionario de Actitudes en el Deporte (QAE-23) y una entrevista semiestructurada en los momentos pre y post intervención. La intervención consistió en una orientación semanal con el PEF del GI durante 10 semanas, con el objetivo de realizar adaptaciones en la clase a fin de llevar al cumplimiento de las NPB. Para verificar la diferencia entre los grupos, en relación a las respuestas del QAE-23, en los momentos pre y post, se utilizó la prueba T de Student y se adoptó un nivel de significancia del 5%. En el análisis cualitativo, las entrevistas fueron grabadas, transcritas y posteriormente clasificadas y analizadas. Mediante el análisis de los relatos obtenidos por la entrevista fue posible observar percepción de la atención de las NPB y reducción de comportamientos antisociales. Sin embargo, no se observó diferencia estadísticamente significativa entre los grupos para las respuestas del QAE-2. Se concluye, por medio de los relatos obtenidos en la entrevista, que la intervención pautada en el cumplimiento de las NPB posibilitó un efecto positivo en relación a la reducción de los comportamientos antisociales, sin embargo, los datos cuantitativos sugieren que la duración del estudio puede haber sido un factor limitante de mayor efecto en relación a la ausencia de internalización de los comportamientos


The objective was to verify the effect of an intervention, based on the attendance of the basic psychological needs (NPB) and pro and antisocial behaviors in school physical education classes. Thirty-five students and two teachers of Physical Education, divided into Control Group (CG) and Intervention (GI) participated in this study. The students answered the Attitudes Questionnaire in Sport (QAE-23) and participated in a semi-structured interview in the pre-and post-intervention moments. The intervention was performed with the GI teacher for 10 weeks, aiming to promote NPB during class. The Student's t-test was used and adopted p <0.05. The interviews were categorized and analyzed. It was observed perception of NPB care and reduction of antisocial behaviors. It was concluded that intervention based on NPB compliance enabled a reduction of antisocial behavior, but the duration of the study may have been a limiting factor of greater effect in relation to the internalization of these behaviors


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Comportamento Social , Habilidades Sociais , Educação Física e Treinamento/estatística & dados numéricos , Esportes/psicologia , Autonomia Pessoal , Retroalimentação Psicológica , Avaliação de Eficácia-Efetividade de Intervenções , Técnicas Psicológicas/estatística & dados numéricos
8.
Gac. sanit. (Barc., Ed. impr.) ; 33(2): 106-111, mar.-abr. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183671

RESUMO

Objective: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). Method: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure. Results: 490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (−14.3% vs.−7.7%; p=0.041). Total annual drug expenditure decreased 233.75 Euros/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 Euros would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 Euros per patient a year on average. Conclusions: The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment


Objetivo: Evaluar los ahorros monetarios resultantes de la intervención de un farmacéutico orientada a mejorar la adecuación de los fármacos prescritos en ancianos (≥70 años) polimedicados (≥8 medicamentos) de la comunidad. Método: Se evaluó la reducción del gasto farmacéutico en el marco de un ensayo clínico aleatorizado y multicéntrico. La intervención del estudio consistió en una evaluación de todos los fármacos prescritos a cada paciente utilizando el algoritmo Good Palliative-Geriatric Practice y los criterios Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START). El grupo control siguió la práctica clínica habitual. Se consideró un horizonte temporal de un año y los elementos de costes incluyeron los recursos humanos y el gasto en medicamentos. Resultados: Se analizaron 490 pacientes (245 por grupo). La disminución del gasto farmacéutico a los 12 meses fue significativamente mayor en el grupo de intervención que en el grupo control (−14,3% vs.−7,7%; p=0,041). El gasto anual en medicamentos disminuyó 233,75 Euros por paciente (intervalo de confianza del 95% [IC95%]: 169,83-297,67) en el grupo de intervención y 169,40 € por paciente (IC95%: 103,37-235,43) en el grupo control, indicando un ahorro farmacéutico de 64,30 Euros por paciente/año atribuible a la intervención del estudio. Se ha estimado un retorno de 2,38 Euros por cada euro invertido en el programa. Conclusiones: La intervención en estudio es una alternativa rentable a la atención estándar, que podría generar un retorno positivo de la inversión


Assuntos
Humanos , Idoso , Reconciliação de Medicamentos/organização & administração , Polimedicação , Assistência Farmacêutica/organização & administração , Prescrição Inadequada/prevenção & controle , Poupança para Cobertura de Despesas Médicas/organização & administração , Custos de Medicamentos/tendências , Avaliação de Eficácia-Efetividade de Intervenções , Estudos de Casos e Controles , Atenção Primária à Saúde/organização & administração
9.
Aten. prim. (Barc., Ed. impr.) ; 51(4): 236-244, abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-180864

RESUMO

Objetivo: Evaluar la efectividad de un Programa de actividad física (AF) supervisado, con actividades socioculturales y de 9 meses de duración, sobre la autoestima y su asociación sobre el control de las enfermedades crónicas en adultos usuarios de atención primaria. Diseño: Ensayo de intervención comunitaria, aleatorizado, controlado y multicéntrico. Emplazamiento: Cuatro centros de atención primaria de Reus-Tarragona, España. Participantes: Un total de 364 sujetos, aleatorizados al grupo control (GC = 104) y grupo intervención (GI = 260). Intervención: Programa supervisado de caminatas de 120 min/semana con actividades socioculturales mensuales. Mediciones principales: En los momentos basal y postintervención se valoró: AF (IPAQ-S), autoestima (escala de Rosenberg) e indicadores cardiovasculares: tabaquismo, presión arterial sistólica (PAS) y diastólica (PAD), colesterol LDL y HDL séricos, y glucosa sérica. Se registran características sociodemográficas y diagnósticos de enfermedades crónicas. Resultados: El Programa incrementó la AF en el GI (p = 0,001), mientras que disminuyó en el GC (p = 0,002), y también la autoestima en el conjunto de participantes (1,28 puntos; p = 0,006) y en los grupos con diagnósticos de hipertensión (1,60 puntos; p = 0,005), dislipidemia (1,62 puntos; p = 0,012), exceso de peso (1,24 puntos; p = 0,011) o ansiedad/depresión (1,53 puntos; p = 0,045), valorados mediante modelos estadísticos multivariantes. El incremento de la autoestima durante la intervención disminuyó la PAS -0,5 mmHg (p = 0,030) en el grupo de hipertensos, independientemente de la PAS basal y del efecto de la intervención. Conclusión: El Programa de AF realizado incrementó la AF y la autoestima en adultos usuarios de atención primaria. El incremento de la autoestima mejoró el control de la PAS en hipertensos


Aim: To evaluate the effectiveness of a 9 months of supervised Physical Activity (PA) Program with sociocultural activities, on self-esteem and its association on the control of chronic diseases in adult primary care users. Design: Multicenter, randomized, controlled community intervention. Location: 4 Primary care centers in Reus-Tarragona, Spain. Participants: 364 subjects, randomized to the Control Group (CG = 104) and Intervention Group (IG = 260). Intervention: Supervised walking program of 120min/week with sociocultural activities once a month. Main measurements: At baseline and at post-intervention we assessed: PA (IPAQ-S), self-esteem (Rosenberg scale) and cardiovascular indicators: smoking, systolic (SBP) and diastolic (DBP) blood pressure, serum LDL and HDL cholesterol, and serum glucose. Sociodemographic characteristics and diagnostic of chronic diseases are recorded. Results: The Program increased the PA in the IG (P = .001), while it decreased in the CG (P = .002), and also the self-esteem in the group of participants (1.28 points, P = .006) and in the groups with diagnoses of hypertension (1.60 points, P = .005), dyslipidemia (1.62 points, P = .012), excess weight (1.24 points, P = .011) or anxiety/depression (1.53 points, P = .045), assessed by multivariate statistical models. The increase in self-esteem during the intervention decreased SBP -0.5 mmHg (P = .030) in the hypertension group, regardless of baseline SBP and the effect of the intervention. Conclusion: The PA program increased the PA and self-esteem in adult primary care users. The increase of self-esteem improved the control of SBP in hypertensive patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Terapia por Exercício/psicologia , Múltiplas Afecções Crônicas/psicologia , Autoimagem , Avaliação de Eficácia-Efetividade de Intervenções , Programas Gente Saudável/organização & administração , Serviços de Saúde Comunitária/estatística & dados numéricos
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(3): 227-231, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-181713

RESUMO

Antecedentes; La dermatitis atópica (DA) es una enfermedad inflamatoria crónica de la piel típicamente infantil cuyas formas graves pueden afectar intensamente la calidad de vida del paciente. Existen formas refractarias al tratamiento convencional en las que es preciso emplear inmunosupresores sistémicos como la azatioprina (AZA) para alcanzar un buen control de la enfermedad. Objetivo: Evaluar la eficacia y la tolerancia de la AZA en niños con DA grave. Pacientes y métodos: Se realizó una revisión retrospectiva de niños con DA grave tratados con AZA entre enero de 2007 y mayo de 2017. Resultados: Se revisaron 11 pacientes (6 varones, 5 mujeres) con una edad promedio de 13 años (rango 8-18 años). La edad media ± DE al inicio del tratamiento fue de 10,9 ± 2,2 años (IC 95% 8,6-13,1). La media de la dosis inicial de AZA fue de 1,8 ± 0,2 mg/kg/d. Evaluamos la respuesta al tratamiento de nuestros pacientes a las 4 semanas, entre la semana 12 y la 16, y a partir de los 6 meses. La media del tratamiento fue de 10,8 ± 5,7 meses. Dos pacientes tuvieron que suspender el tratamiento por efectos adversos. Siete de los 9 pacientes restantes presentaron un aclaramiento completo o casi completo de la DA a los 6 meses de tratamiento. Conclusión: En nuestra experiencia, la AZA es bien tolerada y puede ser considerada como una opción terapéutica en los niños con DA grave refractaria a tratamientos convencionales


Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically affects children. Severe forms may have a profound effect on patients’ quality of life. Some forms are resistant to conventional treatment and require the use of systemic immunosuppressants such as azathioprine (AZA) to adequately manage the disease. Objective: To evaluate the effectiveness and tolerance of AZA in children with severe AD. Patients and methods: We performed a retrospective study of children with severe AD treated with AZA between January 2007 and May 2017. Results: We reviewed the cases of 11 patients (6 boys and 5 girls) with a mean age of 13 years (range, 8-18 years). The mean (SD) age at start of treatment was 10.9 (2.2) years (95% CI 8.6-13.1). The mean initial dosage of AZA was 1.8 (0.2) mg/kg/d. We evaluated treatment response after 4 weeks, 12 to 16 weeks, and 6 months. Mean treatment duration was 10.8 (5.7) months. Treatment had to be suspended in 2 patients because of adverse effects. Seven of the 9 remaining patients presented complete or almost complete clearance of the AD after 6 months of treatment. Conclusion: In our experience, AZA is well tolerated and may be considered as a treatment option in children with severe AD resistant to conventional treatment


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Dermatite Atópica/tratamento farmacológico , Azatioprina/efeitos adversos , Avaliação de Eficácia-Efetividade de Intervenções , Azatioprina/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Esteroides/administração & dosagem
11.
Enferm. glob ; 18(54): 63-70, abr. 2019.
Artigo em Espanhol | IBECS | ID: ibc-183477

RESUMO

Justificación: Existe una asociación entre tabaquismo y TUS, especialmente con alcohol y cannabis. Sin embargo, las intervenciones sanitarias parecen no ir encaminadas a su enfoque.Objetivo: Evaluar el grado de motivación para el abandono tabáquico tras realizar una intervención psicoeducativa breve sobre abordaje del tabaquismo.Metodología: Se trata de una investigación cuantitativa de tipo analítico cuasiexperimental que se lleva a cabo mediante dos cohortes experimentales, del tipo pre- y post-intervención. Se aplica una intervención breve educativa y se evalúan las diferencias en la motivación para el abandono tabáquico en un grupo antes de la intervención y en otro grupo después de la misma. Resultados: Existe una diferencia de 1,27 puntos en el grado de motivación encontrado en los individuos respecto a los grupos experimentales. Conclusiones: Las personas drogodependientes son fumadoras con altos grados de dependencia nicotínica por lo que es preciso diseñar estrategias de cesación adecuadas


Justification: There is a connection between smoking and substances use disorder, especially alcohol and cannabis. Nevertheless, health interventions seem not to be addressed to this approach. Objective: Evaluation of the motivation degree for the smoking quit after developing a brief psycho-educational intervention on smoking.Methodology: It is a quantitative research of analytical type, almost experimental, developed by means of two experimental series, of the types pre- and post- intervention. A brief educational intervention is applied and there is an evaluation of the differences in the motivation for the smoking quit in a group before the intervention and in another one after the intervention. Results: There is a difference of 1,27 points in the degree of motivation found in the individuals regarding the experimental groups. Conclusions: Drug addict people are smokers with a high degree of nicotinic dependence, so it is necessary to design suitable strategies of quitting


Assuntos
Humanos , Masculino , Feminino , Motivação/classificação , Tabagismo/enfermagem , Abandono do Uso de Tabaco/métodos , Transtornos Relacionados ao Uso de Substâncias/complicações , Comportamento Aditivo/terapia , Avaliação de Eficácia-Efetividade de Intervenções , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Planejamento de Assistência ao Paciente/organização & administração
12.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(1): 41-48, ene.-mar. 2019.
Artigo em Espanhol | IBECS | ID: ibc-176639

RESUMO

La evolución de la integración educativa hacia el paradigma de la inclusión representa un cambio radical en la perspectiva de análisis de la realidad de las escuelas, en cuanto a la diversidad del alumnado, y de las propuestas de intervención que se centran ahora no en los déficits y limitaciones del individuo, sino en las oportunidades y alternativas que les ofrece el contexto. La puesta en práctica del modelo inclusivo requiere la creación de equipos docentes, que incluyan al profesorado de apoyo como elemento clave para el desarrollo del proyecto. Miembros de este equipo de apoyo son los especialistas en comunicación y lenguaje, que plantean, en un modelo de educación inclusiva, una intervención no de carácter clínico ni terapéutico ni aislado, sino integral que considera el entorno natural del aula como clave para el proceso de adquisición y desarrollo de la capacidad lingüística y comunicativa de todos los alumnos. Este modelo de intervención tiene en el trabajo en equipo y la colaboración el elemento fundamental para garantizar el éxito en la implementación y desarrollo del modelo de la educación inclusiva, que plantea la necesidad de ofrecer propuestas coordinadas entre el apoyo y el tutor a partir de dimensiones y áreas curriculares comunes para trabajar la diversidad del alumnado en cuento a la comunicación y el lenguaje, que potencien y trabajen elementos válidos para todos e imprescindibles para algunos


The evolution of educational integration towards a paradigm of inclusiveness represents a radical change in the perspective of analysing school reality with regard to student diversity and intervention proposals, focused now not on individual shortcomings and limitations, but on the opportunities and alternatives offered to them in this context. Putting an inclusive model into practice requires setting up teaching teams, including support for teachers as a key element to implement the project. Members of this support team are specialists in communication and language which they suggest, in an inclusive education model, an intervention without a clinical, therapeutic or isolated nature, but rather as an integral part that takes into account the natural setting of the classroom as key for the process of acquiring and developing linguistic and communication skills amongst all students. Teamwork and collaboration are the key elements of this intervention model to ensure the inclusive education model is successfully implemented and rolled out. It includes the need to offer coordinated proposals between the support and tutor staff based on curricular dimensions and areas to work on student diversity regarding communication and language, which strengthen and work on elements that are valid for all students and which are essential for some


Assuntos
Humanos , Inclusão Educacional/tendências , Auxiliares de Comunicação para Pessoas com Deficiência/tendências , Transtornos da Comunicação/reabilitação , Avaliação de Eficácia-Efetividade de Intervenções , Disfonia/reabilitação , Transtornos da Articulação/reabilitação
13.
Int. j. psychol. psychol. ther. (Ed. impr.) ; 19(1): 89-100, mar. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183824

RESUMO

The primary concern of this study is to address parenting stress and adolescents' behavioral and emotional problems through an attachment based parenting intervention (Connect parents group) for parents of adolescents, in particular to test whether this intervention led to reduced levels of parenting stress, and adolescents' emotional and behavioral problems. 44 parents (33 mothers and 11 fathers; M= 50.4, SD= 4.9) of adolescents (M= 15 years, SD= 1.4) were randomly assigned to one of two groups: An attachment based intervention group (Connect), or a wait-list control group. They were assessed before and immediately after the ten-week intervention. Outcome measures were self-reported parenting stress, and multi-informant assessments of adolescents' emotional and behavioral problems. Compared to the control group, parents completing the Connect program reported significant reductions in their adolescents' externalizing behavior problems at treatment completion. Mediation model showed that, among parents completing the Connect program reductions in parental stress were mediated through decreases in adolescents' externalizing behavior problems. Decrease in adolescents' externalizing behavioral problems affected parental stress experienced in caring. These preliminary results underscore the importance of helping parents of adolescents to reduce levels of parenting stress through effective interventions able to curtail adolescents' emotional and behavioral problems. Furthermore, they provide additional evidence for the effectiveness of the Connect program and offer insights into the potential mechanisms that underlie change


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Transtornos do Comportamento Social/psicologia , Comportamento do Adolescente/psicologia , Estresse Psicológico/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Avaliação de Eficácia-Efetividade de Intervenções , Características da Família , Psicometria/instrumentação , Estudos de Casos e Controles
14.
Pharm. pract. (Granada, Internet) ; 17(1): 0-0, ene.-mar. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184603

RESUMO

Background: Training programs of various intensities and durations have been implemented to assist healthcare providers and students in leading smokers in a quit attempt. While some training programs have been developed to help community leaders provide these services, the focus for community leaders has been to assist with recruitment efforts. Objective: The objective of this study was to compare knowledge and confidence of students and community members before and after a smoking cessation educational intervention. Methods: After approval from the institutional review board, pharmacy students and community members were recruited for two-hour educational interventions. Topics covered included smoking health risks, benefits of quitting, behavioral, cognitive, and stress-management techniques, smoking cessation medications, and how to start a formal class. Pre- and post-intervention survey instruments were given to all participants with comparisons made via Student's or Paired T-tests, as appropriate. Results: Knowledge scores increased significantly (p<0.05) after the educational intervention for pharmacy students (n=30) and community members (n=8). Confidence scores increased significantly for pharmacy students (p<0.05), but not for community members. Pharmacy students had significantly greater knowledge score changes (53.7%, pre-intervention; 81.8%, post-intervention; p<0.05) versus community members (32.1%, pre-intervention; 50.1%, post-intervention; p<0.05). When comparing individual confidence questions, only scores evaluating the change in confidence for providing counseling were higher for students versus community members (2.13 vs. 1.8, respectively; p<0.05). Conclusions: Pharmacy students and community leaders exhibited increased knowledge after a smoking cessation educational intervention, and pharmacy students had increased confidence scores. All confidence scores did not change significantly for community members. Developing coalitions between healthcare providers and community leaders, focusing on the roles of each, may be productive in initiating smoking cessation programs


No disponible


Assuntos
Humanos , Abandono do Hábito de Fumar/estatística & dados numéricos , Educação em Saúde/organização & administração , Tabagismo/prevenção & controle , Avaliação de Eficácia-Efetividade de Intervenções , Estudantes de Farmácia/estatística & dados numéricos , Agentes Comunitários de Saúde/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
15.
Pharm. pract. (Granada, Internet) ; 17(1): 0-0, ene.-mar. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184605

RESUMO

Background: Diabetic retinopathy (DR) is a progressive, sight-threatening long-term complication of diabetes. Diabetes disease management reduces the risk of developing or progression to a severe form of DR. However, there are no reports of the potential role of pharmacists in DR progression. Objective: For this study, we performed a retrospective data analysis of patients with diabetes seen at cardiovascular risk reduction services provided by pharmacists with an objective to determine the potential role of pharmacists in the DR progression. These services involve pharmacists working in collaborative drug therapy management (CDTM), using a collaborative practice agreement (CPA) with primary care physicians. Methods: Patient records and ophthalmological notes were collected for 317 individuals seen by the pharmacists (intervention group) and 320 individuals seen only by a physician (control). Results: Statistical analysis was performed on 148 individuals in an intervention group and 120 individuals in the control group for which complete records were available. Retinopathy progression remained stable in 89.6 % of individuals in the intervention group compared to 87.9% in the control group. Moreover, the relative risk of retinopathy progressing to a severe form was 1.17 for the control group compared the intervention group. Conclusions: Our studies provide a proof-of-concept that pharmacists-managed care possesses a potential role in protection from DR, and paves a way for future pharmacists managed care with an emphasis on reducing diabetic complications


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doenças Cardiovasculares/prevenção & controle , Retinopatia Diabética/tratamento farmacológico , Conduta do Tratamento Medicamentoso/organização & administração , Fatores de Risco , Avaliação de Eficácia-Efetividade de Intervenções , Assistência Farmacêutica/organização & administração , Complicações do Diabetes/epidemiologia , Estudos Retrospectivos , Estudos de Casos e Controles , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
16.
Enferm. intensiva (Ed. impr.) ; 30(1): 4-12, ene.-mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-181636

RESUMO

Objetivo: Evaluar la efectividad de la implantación de un protocolo de control glucémico del paciente crítico liderado por enfermeras, en términos de mantenimiento de un rango preestablecido de glucemias, reducción de hiperglucemia y prevención de hipoglucemia severa. Método: Estudio cuasiexperimental prospectivo «pre-pos» realizado en una unidad de cuidados intensivos polivalente. Se incluyeron pacientes adultos en tratamiento con insulina endovenosa. Se registraron todas las determinaciones de glucemia desde noviembre de 2014 a agosto de 2015 (preintervención) y desde noviembre de 2015 a agosto de 2016 (pos). La intervención consistió en la implementación de un protocolo basado en la evidencia, para conseguir rangos de glucemia entre 140-180 mg/dl. Las variables principales incluyeron proporciones de glucemias dentro de rango, tasas de hipoglucemia severa (menos de 40 mg/dl) y tasas de hiperglucemia superior a 200 mg/dl. Resultados: Se evaluaron 7864 determinaciones de glucemia pertenecientes a 125 pacientes, 66 preintervención y 59 postintervención. La edad media fue de 66,24±13,99 años, el 64% eran hombres. La proporción de determinaciones dentro del rango fue superior en el grupo postintervención (38,82 vs. 44,34 p<0,001). Se identificó un caso de hipoglucemia severa, que sucedió en el grupo preintervención. La tasa de hiperglucemia severa resultó menor en el grupo postintervención (19,19 vs. 16,28 p=0,001). Conclusiones: Nuestra experiencia muestra que una implantación basada en la evidencia puede mejorar el control glucémico en pacientes críticos. Se observaron mayores tasas de glucemia dentro de rango. El protocolo resultó útil en la prevención de la hipoglucemia severa. El liderazgo del equipo de enfermería y la toma de decisiones autónomas basadas en datos clínicos permitió mejorar los resultados en salud de los pacientes


Aim: To assess the effectiveness of the implementation of a protocol for glycaemic control in critical care, in terms of maintenance of a pre-established target of blood glucose level, reduction of hyperglycaemia and prevention of severe hypoglycaemia. Method: Prospective "pre-post" quasi-experimental study carried out in a general critical care unit. Adult patients treated with intravenous insulin were included. We recorded all glycaemic tests performed from November 2014 to August 2015 (pre-intervention) and from November 2015 to August 2016 (post-intervention). The intervention consisted of the implementation of an evidence-based glycaemic control protocol to achieve glycaemic levels in a range of 140-180 mg/dl. Main variables analysed were: proportion of glycaemic tests in the target range, proportions of severe hypoglycaemia (under 40 mg/dl) and hyperglycaemia over 200 mg/dl. Results: We analysed 7864 glycaemic tests from 125 patients, 66 pre-intervention and 59 post-intervention. Average age was 66.24±13.99 years, 64% of patients were male. The proportion of tests within the target range was higher in the intervention group (38.82 vs. 44.34 p<.001). Only one case of severe hypoglycaemia was identified, which happened in the pre-intervention period. The rate of severe hyperglycaemia was lower in the post-intervention group (19.19 vs. 16.28 p=.001). Conclusions: Our experience shows that implementation of evidence-based interventions can improve glycaemic control during critical illness. We found higher glycaemia levels in the target range. The protocol proved useful in the prevention of severe hypoglycaemia. Nurse-led interventions based on clinical data improved health results in our patients


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Avaliação de Eficácia-Efetividade de Intervenções , Enfermagem Baseada em Evidências , Hiperglicemia/prevenção & controle , Estresse Psicológico/complicações , Enfermagem de Cuidados Críticos , Avaliação em Enfermagem , Estudos Prospectivos , Unidades de Terapia Intensiva , Liderança , Tomada de Decisões
18.
Gac. sanit. (Barc., Ed. impr.) ; 33(1): 10-16, ene.-feb. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-183621

RESUMO

Objective: We implemented and evaluated the Parenting Skills Program for families in Spain 1) to examine differences in parenting skills, social support, children's behaviours and parental stress pre, immediately post and six months post intervention and 2) to identify mechanisms by which the intervention is related to changes in the four outcomes examined. Methods: Quasi-experimental study design with pre (T0), post (T1), a follow-up (T2) and no control group, complemented by a qualitative study was used. The outcome variables were social support, parenting skills, parental stress and children's behaviours. 216 parents completed pre and post questionnaire and 130 parents the follow-up questionnaire. 39 professionals and 34 parents participated in 17 interviews and 5 discussion groups. Results: Compared with T0, all four outcomes improved significantly at T1. 76% of the participants improved parenting skills and 61% social support. 56% reduced children's negative behaviours and 66% parental stress. All outcomes maintained this significant improvement at T2. Parents and professionals describe different changes in parents' parenting skills, stress and social support after participation in the PSP, and in their children's behaviours. Some subcategories emerged after analysing parents' and professionals' discourses. Conclusions: This study describes positive parenting effects on participants of a parent-training program in Spain, which is a country where implementation and evaluation of these kind of interventions is an incipient issue


Objetivo: Se introdujo y evaluó el Programa de Habilidades Parentales para familias a fin de: 1) examinar las diferencias en cuanto a habilidades parentales, apoyo social, comportamientos infantiles y estrés parental preintervención, inmediatamente después y 6 meses después de la intervención, y 2) identificar los mecanismos que explican los cambios generados por la intervención para las cuatro variables examinadas. Método: Estudio cuasiexperimental con pre (T0), post (T1) y seguimiento (T2), sin grupo control, complementado con un estudio cualitativo. Variables: apoyo social, habilidades parentales, estrés parental y comportamientos infantiles. Completaron el cuestionario pre y post 216 padres/madres, y 130 el de seguimiento. Treinta y nueve profesionales y 34 padres/madres participaron en 17 entrevistas y cinco grupos de discusión. Resultados: Comparado con T0, las cuatro variables mejoraron significativamente en T1. El 76% de los participantes mejoraron las habilidades parentales y el 61% el apoyo social. El 56% redujo los comportamientos infantiles negativos y el 66% el estrés parental. Las variables mantuvieron significativa la mejora en T2. Padres/madres y profesionales describieron cambios en las cuatro variables tras participar en el Programa de Habilidades Parentales. Surgieron subcategorías tras el análisis discursivo. Conclusiones: Este estudio describe efectos positivos en la parentalidad de los participantes en un programa de educación parental español, siendo este un país donde la introducción y la evaluación de este tipo de programas son incipientes


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pais/educação , Poder Familiar , Educação Infantil/tendências , Transtornos do Comportamento Infantil/prevenção & controle , Avaliação de Eficácia-Efetividade de Intervenções , Apoio Social , Habilidades Sociais , Adaptação Psicológica
19.
Gac. sanit. (Barc., Ed. impr.) ; 33(1): 74-81, ene.-feb. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-183630

RESUMO

Objetivo: Evaluar el efecto de la Estrategia Forma Joven (EFJ) sobre las actitudes y los comportamientos del alumnado de 4° curso de Educación Secundaria Obligatoria de la provincia de Sevilla (España). Métodos: Se utilizó un diseño observacional longitudinal con dos grupos, uno que recibió la EFJ (grupo EFJ) y otro que no lo hizo (grupo no EFJ). En la evaluación inicial se contó con 402 participantes seleccionados aleatoriamente, y en el seguimiento, a los 6 meses, con 322 (161 por grupo). Se utilizaron instrumentos validados para la recogida de datos y se calcularon tablas de 2×2, odds ratio (OR) y ANOVA generales para diseños factoriales mixtos 2×2 (p<0,05). Resultados: Se encontraron efectos favorables de la EFJ. En el área de sexualidad, el porcentaje de participantes que iniciaron relaciones sexuales completas en la evaluación final fue menor en el grupo EFJ (14,9% vs. 23,4%; OR=0,57). También se observaron efectos contrarios: el inicio del consumo de tabaco fue estadísticamente superior en el grupo EFJ (19,5% vs. 9,1%; OR=2,43), si bien estas diferencias no llegaron a ser estadísticamente significativas. Conclusiones: La similitud del currículum de promoción de la salud escolar de los centros con la EFJ y sin la EFJ ha podido influir en la falta de resultados concluyentes. Las asesorías individuales o grupales en los centros, rasgo diferenciador de la EFJ, podrían haber retrasado las relaciones sexuales de sus participantes. Basándose en los estudios sobre intervenciones de promoción de la salud escolar, se recomiendan buenas prácticas que podrían ayudar a mejorar la efectividad de la EFJ


Objective: To evaluate the impact of the Youth Form Strategy (EFJ, Estrategia Forma Joven) on the attitudes and behaviours of students in the fourth year of compulsory secondary school in Seville, Spain. Methods: A longitudinal observational design was used with two groups; one received the EFJ (EFJ group) and other did not (non-EFJ group). In the initial evaluation, 402 participants were randomly selected and, in the follow-up at 6 months, 322 participants were evaluated (161 per group). Validated data collection tools were used, and 2×2 tables, odds ratio (OR) and general ANOVA for 2×2 mixed factorial design (p<0.05) were calculated. Results: Favourable effects of the EFJ were found: in the area of sexuality, the percentage of participants who had sexual intercourse in the final assessment was lower in the EFJ group (14.9% vs 23.4%; OR=0.57), as were counter-effects: start of tobacco use was higher in the EFJ group (19.5% vs 9.1%; OR=2.43). However, these differences were not statistically significant. Conclusions: The similarities in the school health promotion programme in centres with and without EFJ may have influenced the lack of conclusive results. Individual and/or group counselling at schools, a distinguishing feature of the EFJ, could have delayed sexual intercourse in the EFJ group. Based on the studies on school health promotion activities, good practices that could help to improve the effectiveness of the EFJ are recommended


Assuntos
Humanos , Masculino , Feminino , Adolescente , Serviços de Saúde Escolar/organização & administração , Promoção da Saúde/organização & administração , Educação em Saúde/organização & administração , Comportamento Sexual/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Tabaco/epidemiologia , Avaliação de Eficácia-Efetividade de Intervenções , Estratégias Locais , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável
20.
Med. clín (Ed. impr.) ; 152(3): 90-97, feb. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-181864

RESUMO

Antecedentes y objetivos: Los programas de ahorro de transfusión disminuyen el consumo de concentrados de hematíes en cirugía protésica. Se evalúa la efectividad de un protocolo basado en el Consenso de Sevilla en la disminución de la tasa transfusional y se propone una ecuación predictiva en cirugía de rodilla. Pacientes y métodos: Estudio de cohortes en pacientes sometidos a prótesis de rodilla y cadera en 2014 y 2015 en el Hospital Comarcal de l'Alt Penedès (HCAP). Pacientes con hemoglobina (Hb) entre 10 y 13g/dl se clasificaron en anemia con o sin déficit de hierro y recibieron hierro o combinación de hierro y eritropoyetina. El día de la cirugía se administró ácido tranexámico, al día siguiente se midió la caída de Hb y durante su estancia los requerimientos y el dintel transfusional. Resultados: El estudio incluyó 334 pacientes. El protocolo disminuyó la tasa de transfusión del 41,5 al 14,8%. En cirugía de cadera los pacientes transfundidos fueron mayores, con mayor porcentaje de comorbilidad y uso de anticoagulantes y menor Hb preoperatoria. El ácido tranexámico no se asoció a disminución del sangrado. En cirugía de rodilla, el análisis multivariante mostró que la administración de ácido tranexámico fue la variable que más disminuyó el riesgo de transfusión, seguido de valores de Hb preoperatoria más altos. La ecuación resultante predice la tasa transfusional, con una sensibilidad del 55% y una especificidad del 95,7%. Conclusión: La implantación del programa disminuyó la tasa transfusional. La efectividad de ácido tranexámico varía según la artroplastia. El uso conjunto de hierro y eritropoyetina recombinante humana es necesario para mejorar la Hb


Background and objectives: Patient blood management in orthopaedic surgery reduces transfusion risk. The best protocol is unknown. The effectiveness of a protocol based on the Seville Consensus on the reduction of transfusion risk is evaluated and a predictive transfusion equation is proposed in knee surgery. Patients and methods: Cohort study in patients undergoing knee and hip arthroplasty from January 2014 to December 2015 at a second level complexity hospital in Vilafranca del Penedès (Barcelona). Patients with Hb between 10 and 13g/dL were classified as anaemic with or without iron deficiency and received iron or combination of iron and erythropoietin. On the day of surgery, tranexamic acid was administered, the Hb drop was measured the next day and the requirements and the transfusion lintel were measured during the stay. Results: A total of 334 patients were included in the study. The implementation of the programme decreased the transfusion risk from 41.5% to 14.8% at the end of the study. In hip surgery, transfused patients were significantly older, sicker and with lower preoperative Hb. Tranexamic acid did not decrease bleeding. In knee surgery, the administration of tranexamic acid was the variable that most decreased the transfusion risk followed by a high preoperative Hb. The equation predicts transfusion risk with a sensitivity of 55% and specificity of 95.7%. Conclusion: The implementation of the programme reduces transfusion risk. The effectiveness of tranexamic acid varies according to surgery site. The use of iron and recombinant human erythropoietin is necessary to improve Hb


Assuntos
Humanos , Resultado do Tratamento , Transfusão de Eritrócitos , Estudos de Coortes , Prótese do Joelho , Prótese de Quadril , Avaliação de Eficácia-Efetividade de Intervenções , Anemia/complicações , Anemia/tratamento farmacológico , Ácido Tranexâmico/administração & dosagem , Enoxaparina/administração & dosagem
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