Association between Health Care Utilization with Asthma Control Levels among a Sample of Adult Patients in Puerto Rico.

OBJECTIVE: Asthma is an important and serious public health problem in Puerto Rico; however, very few studies measuring the association between health care utilization and asthma control levels in adult asthma patients in Puerto Rico have been done. METHODS: This study is secondary analysis of an observational and cross-sectional database generated by the Latin American Asthma Insights and Management (LA AIM) survey. Our sub-sample consisted of adults 18 years or older living with asthma, representing a total of 343 individuals. This study determined the numbers of ambulatory physician visits, emergency visits to a physician or an emergency room, and hospitalizations that took place the 12 months prior to the survey. Patients were characterized as having well-controlled, partly controlled, or uncontrolled asthma. Descriptive and inferential statistics were performed to detect differences in the mean and number of events for physician visits, emergency visits, and hospitalizations by asthma control groups. RESULTS: After adjusting for age, sex, and chronic health conditions (other than asthma), adult asthma patients with controlled asthma had 92.0% fewer physician visits, 82.5% fewer emergency visits, and 92.2% fewer hospitalizations than did those with uncontrolled asthma. CONCLUSION: Interventions geared toward controlling asthma symptoms and clinical manifestations in adults asthma patients-which interventions might include strategies for controlling environmental risk factors, increasing patient and family education with regard to asthma management, and boosting the use of appropriate and effective medications-may have significant potential in terms of reducing the direct and indirect costs of asthma, costs that have a critical impact on the whole health care system.

[Nursing accidents at the workplace and their relation with the security and occupational health status]. / Accidentes en el lugar de trabajo entre personal de enfermería y su relación con el clima de salud y seguridad ocupacional.

The purpose of this study was to examine the accidents and incidents that take place in the workplace and their relationship with the occupational health and safety climate. The sample for this study was chosen by convenience and was composed of 154 professional nurses. The Occupational Health and Safety Climate Scale. (Roduguez et al., 2000) was used for the research. The results of the study reveal that the variables that contribute to understanding the determinants of the occupational health and safety climate are the individual's relationships with peers and supervisors, the number of trainings in the area of occupational health and safety and the number of accidents that the individual has experienced.

Reducing quality-of-care disparities in childhood asthma: La Red de Asma Infantil intervention in San Juan, Puerto Rico.

BACKGROUND AND OBJECTIVE: Although children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions. METHODS: We describe our experience in adapting and implementing 2 previously tested asthma evidence-based interventions: the Yes We Can program and the Inner-City Asthma Study intervention. We assessed the feasibility of combining key components of the 2 interventions to reduce asthma symptoms and estimated the potential cost savings associated with reductions in asthma-related hospitalizations and emergency department visits. A total of 117 children with moderate and severe asthma participated in the 12-month intervention in 2 housing projects in San Juan, Puerto Rico. A community-academic team with the necessary technical and cultural competences adapted and implemented the intervention. RESULTS: Our case study revealed the feasibility of implementing the combined intervention, henceforth referred to as La Red intervention, in the selected Puerto Rican communities experiencing a disproportionately high level of asthma burden. After 1-year follow-up, La Red intervention significantly reduced asthma symptoms and exceeded reductions of the original interventions. Asthma-related hospitalizations and emergency department use, and their associated high costs, were also significantly reduced. CONCLUSIONS: Asthma evidence-based interventions can be adapted to improve quality of care for children with asthma in a different cultural community setting.

Reducing inequities among children with asthma in the island of Puerto Rico: experiences of a community-based, trans-sectoral effort.

Children living in the Commonwealth of Puerto Rico have the highest poverty and asthma prevalence rates of all U.S. children. Since 2000, a group of community, health care, education, housing, and academic representatives have been collaborating in a project to improve quality of life and reduce disparities among children with asthma in very poor communities in Puerto Rico. To date the project has implemented a successful intervention in the Luis Lloréns Torres Housing Project, aimed at adapting evidence-based interventions to improve the social and physical environment of children with asthma. The program has recently been extended to another San Juan housing area, the Manuel A. Pérez Housing Project. Using implementation theory, the authors report and reflect on the project's experience to date, provide recommendations, and discuss implications of lessons learned to address inequities in asthma care throughout other underserved areas in the U.S., Latin America, and the Caribbean.

La correlación de lo biológico y lo social en el manejo de la enfermedad periodontal / The correlation of the biological and the social in the periodontal disease handling

Se realizó un estudio comparativo en 80 niños de dos escuelas primarias de San Antonio de los Baños seleccionados por el método aleatorio simple con el objetivo de demostrar la correlación que tiene el factor biológico y el factor social en el manejo de la enfermedad periodontal. A un grupo de niños de una escuela se le aplicó un Programa de Educación para la Salud Bucal de un mes de duración y otra muestra igual de otra escuela fue tomada como grupo control. Al inicio y al final del estudio se les realizó a ambos grupos el Indice de Análisis de Higiene Bucal de Love. Los resultados mostraron que el grupo que recibió el programa educativo presentó al final una mejoría significativa en la higiene bucal, quedando demostrada la importante correlación que tiene el factor biológico y el factor social en el manejo de la enfermedad periodontal (AU)