Influencia de la dinámica familiar y otros factores asociados al déficit en el estado nutricio de preescolares en guarderías del sistema Desarrollo Integral de la Familia (DIF) Jalisco

Introducción. Objetivo: identificar la influencia de factores asociados al estado nutricio de preescolares en Guarderías del sistema de Desarrollo Integral de la Familia, Jalisco. Material y métodos. En estudio transversal analítico se incluyeron 140 preescolares de 15–71 meses estimando el déficit en indicadores antropométricos a –1 y –2 desviaciones estándar (DE). Se obtuvieron variables socioeconómicas, demográficas y educacionales. Se calificó la dinámica familiar de los padres, explorando: la dinámica de pareja; identidad; comunicación y expresión; autoridad; conflicto; disciplina; valores; aislamiento. Con la razón de momios (RM) se estimó el riesgo de desnutrición y en modelo de regresión se exploraron factores que explicaran la variación en déficit antropométrico y dinámica familiar. Resultados. Asociados a déficit peso/talla: menor escolaridad del padre (RM 2.96); menor puntuación en la dinámica familiar (madre) (RM 2.72); ocupación de madre (RM 2.27) y mayor tabaquismo del padre (RM 2.50). A déficit talla/edad mayor número de miembros en familia (RM 2.16) y menor puntuación en la dinámica familiar (madre) (RM 8.6). Ingreso familiar mensual y escolaridad del padre explicaron la variación en el índice peso/talla (P <0.025). Conclusión. La disfunción de la dinámica familiar, menor ingreso económico, y mayor número de miembros fueron factores de riesgo del estado nutricio. Menor ingreso familiar y escolaridad del padre influyeron en la percepción de ambos padres sobre su dinámica familiar

Influencia de la dinámica familiar y otros factores asociados al déficit en el estado nutricio de preescolares en guarderías del sistema Desarrollo Integral de la Familia (DIF) Jalisco

Introducción. Objetivo: identificar la influencia de factores asociados al estado nutricio de preescolares en Guarderías del sistema de Desarrollo Integral de la Familia, Jalisco. Material y métodos. En estudio transversal analítico se incluyeron 140 preescolares de 15Zapotitlán71 meses estimando el déficit en indicadores antropomZapotitlántricos a Zapotitlán1 y Zapotitlán2 desviaciones esténdar (DE). Se obtuvieron variables socioeconómicas, demográficas y educacionales. Se calificó la dinámica familiar de los padres, explorando: la dinámica de pareja; identidad; comunicación y expresión; autoridad; conflicto; disciplina; valores; aislamiento. Con la razón de momios (RM) se estimó el riesgo de desnutrición y en modelo de regresión se exploraron factores que explicaran la variación en déficit antropomZapotitlántrico y dinámica familiar. Resultados. Asociados a déficit peso/talla: menor escolaridad del padre (RM 2.96); menor puntuación en la dinámica familiar (madre) (RM 2.72); ocupación de madre (RM 2.27) y mayor tabaquismo del padre (RM 2.50). A déficit talla/edad mayor número de miembros en familia (RM 2.16) y menor puntuación en la dinámica familiar (madre) (RM 8.6). Ingreso familiar mensual y escolaridad del padre explicaron la variación en el índice peso/talla (P <0.025). Conclusión. La disfunción de la dinámica familiar, menor ingreso económico, y mayor número de miembros fueron factores de riesgo del estado nutricio. Menor ingreso familiar y escolaridad del padre influyeron en la percepción de ambos padres sobre su dinámica familiar

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19).

The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p  Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situation

Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain.

To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain. A retrospective observational study was performed of the first consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox regression analyses were performed to identify factors associated with death. Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was 70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of 4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate. Our findings provide comprehensive information about characteristics and complications of severe COVID-19, and may help clinicians identify patients at a higher risk of death

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement

International Social Survey Programme: Environment II - ISSP 2000

Einstellung zum Umweltschutz. Präferierte staatliche Maßnahmenzum Umweltschutz. Themen: Privates Unternehmertum als beste Möglichkeit zur Lösung derökonomischen Probleme; Verantwortung der Regierung zur Verringerung derEinkommensdifferenzen bei den Bürgern; Postmaterialismus-Index;perzipierte Wissenschaftsgläubigkeit der Bevölkerung; Bewertung vonWissenschaft (Skala); erwartete Lösung der Umweltschutzprobleme durchdie Wissenschaft; Sorge um die Zukunft der Umwelt; Heiligkeit der Natur;Umweltzerstörung und modernes Leben; Einschätzung der Auswirkung desPopulationszuwachses auf der Erde; übertriebene Umweltempfindlichkeit;Beurteilung des Gegensatzes von Umweltschutz und ökonomischem Wachstum;Einstellung zu Tierversuchen in der Pharmazie; ökonomisches Wachstumgefährdet die Umwelt; Bereitschaft zu höheren Preisen bzw. höherenSteuern oder zur Akzeptanz von Einschnitten beim Lebensstandardzugunsten des Schutzes der Umwelt; Partizipation anumweltschutzrelevanten Aktivitäten; Selbsteinstufung der Beteiligung amUmweltschutz; Wichtigkeit von Umweltschutz; Einschätzung der Bedeutungeines eigenen Beitrags zum Umweltschutz; übertriebene Darstellung derUmweltgefährdung in der Öffentlichkeit; Kenntnis der Wirkungsweise vonAntibiotika auf Bakterien und Viren; Verständnis der Evolutionstheorie;Chemikalien als Ursache für Krebs; Kenntnisse der Gefährlichkeit vonRadioaktivität; Kenntnis der Ursache für den Treibhauseffekt; empfundeneGefährdung der Umwelt allgemein und für den Betroffenen selbst durchAutoabgase; Luftverschmutzung durch Industrieabgase; Einstufung derUmweltgefährdung durch Pestizide und Chemikalien in der Landwirtschaft,durch Wasserverschmutzung durch die Erwärmung der Atmosphäre(Treibhauseffekt) und durch Genmanipulation bei Nutzpflanzen; staatlicheIntervention und Rolle der Wirtschaft beim Umweltschutz; Bewertung desEinsatzes von Staat, Industrie und Bevölkerung für die Umwelt;Einstellung zu internationalen Abkommen und den Bemühungen ärmererLänder zum Schutz der Umwelt; Auswirkungen von Umweltschutz auf dieWirtschaftsentwicklung; Wahrscheinlichkeit eines Atomunfalls; Vertrauenin Glaubwürdigkeit von Umweltinformationen verschiedener Institutionen;eigene Beteiligung am Recycling; Häufigkeit des Verzichts auf das Autoaus Umweltgründen; Mitgliedschaft in einer Umweltschutzorganisation;eigene umweltpolitische Aktivitäten durch Beteiligung anUnterschriftslisten, Geldspenden sowie Beteiligung an Demonstrationen. Demographie: Alter; Geschlecht; Zusammenleben mit einem Partner;Familienstand; Bildung; Beschäftigungsstatus; Beruf (ISCO-Code);Beschäftigung im öffentlichen Sektor; Wochenarbeitszeit; Einkommen desBefragten; Haushaltseinkommen; Vorgesetztenfunktion;Haushaltsgröße; Haushaltstypologie; Ortsgröße; Region;Religionszugehörigkeit; Kirchgangshäufigkeit; Selbsteinschätzung derSchichtzugehörigkeit; Gewerkschaftsmitgliedschaft; Parteipräferenz; in einigen Ländern: ethnische Zugehörigkeit des Befragten