Propiedades psicométricas de la Escala de Bienestar Psicológico para Adolescentes (BIEPS-J) en una muestra mexicana

Psychological well-being refers to the satisfaction that individuals generally have regarding their life. This concept has been related to mental health and to the detection of factors that favor human development. The interest in their study in adolescents has increased in recent years due to physical, mental and social changes at this stage of development, so it is necessary valid and reliable instruments that allow their evaluation. The objective of this study was to evaluate psychometric properties of the Psychological Wellbeing Scale for Adolescents (BIEPS-J) in a Mexican sample of late adolescents and obtain evidence of their convergent and criterion validity. The BIEPS-J scale and the Rosenberg Self-esteem Scale (RSS) were applied to 271 students of both sexes between 16 and 18 years old. A parallel analysis indicated two factors present in the BIEPS-J scale, which were structured by exploratory factor analysis (main components, oblique rotation) and that explained 54% of the variance. The factors were: 1) Relationship with self and with others, indicates satisfaction with their social relationships and self-acceptance; 2) Plans and personal control resources, indicates the sensation of the domain of their environment and self-competence as the presence of goals in their life. The global internal consistency (α > .80) and by factor (α > .70) was acceptable. The BIEPS-J scale showed convergent validity with the RSS (r = .44) and the level of psychological well-being was associated with the level of self-esteem (p < .001). The total score and by factor of the BIEPS-J scale did not differ between sexes (p > .05). The data indicate that the BIEPS-A scale is a valid and reliable instrument to assess psychological well-being in the Mexican adolescent population between 16 and 18 years of age.El bienestar psicológico se refiere a la satisfacción general que los individuos tienen respecto de su vida. Este concepto se ha relacionado con la salud mental y con la detección de factores favorables al desarrollo humano. El interés en su estudio en adolescentes se ha incrementado en los últimos años debido a los cambios físicos, mentales y sociales propios a esta etapa del desarrollo, por lo que son necesarios instrumentos válidos y confiables que permitan su evaluación. El objetivo de este estudio fue evaluar propiedades psicométricas de la Escala de Bienestar Psicológico para Adolescentes (BIEPS-J) en una muestra mexicana de adolescentes tardíos y obtener evidencia de su validez convergente y de criterio. Se aplicó la escala BIEPS-J y la Escala de Autoestima de Rosenberg (EAR) a 271 estudiantes de ambos sexos de entre 16 y 18 años. Un análisis paralelo indicó dos factores presentes en la escala BIEPS-J, estructurados mediante un análisis factorial exploratorio (componentes principales, rotación oblicua) y que explicaron el 54% de la varianza. Los factores fueron: 1) Relación con uno mismo y con terceros, satisfacción con sus relaciones sociales y la aceptación de sí mismo; 2) Planes y recursos personales de control, sensación del dominio de su entorno y auto-competencia, además de la presencia de metas en su vida. La consistencia interna global (α > .80) y por factor (α > .70) fue aceptable. La escala BIEPS-J mostró validez convergente con la EAR (r = .44) y el nivel de bienestar psicológico se asoció al nivel de autoestima (p < .001). El puntaje total y por factor de la escala BIEPS-J no difirió entre sexos (p > .05). Los datos indican que la escala BIEPS-A es un instrumento válido y confiable para evaluar el bienestar psicológico en población adolescente mexicana de entre 16 y 18 años

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Anafilaxia en niños y adultos: prevención, diagnóstico y tratamiento

La anafilaxia es una condición que requiere asistencia inmediata para su resolución, se puede presentar en diferentes entornos: consultorio, hospital, escuela, hogar o en algún otro espacio público. La información aquí contenida forma parte de lineamientos conocidos sobre prevención, diagnóstico y tratamiento. Se abordan aspectos epidemiológicos, desencadenantes, factores de riesgo y cofactores; se explican de una manera didáctica los mecanismos fisiopatológicos que se traducen en fenotipos de presentación. Se enfatiza el diagnóstico clínico con base en criterios ya establecidos, se mencionan clasificaciones para evaluar la gravedad de la reacción, así como el rol de las pruebas clínicas o de laboratorio. Como aspectos de relevancia, se abordan el tratamiento de primera elección con adrenalina, instrucciones sobre autoinyectores y diferentes elementos para el tratamiento complementario y de segunda elección. También se refieren aspectos a considerar al dar de alta a un paciente y medidas de seguimiento, con un énfasis preventivo en la comunidad. Finalmente, se menciona el abordaje en el consultorio de alergia para decidir sobre opciones de inmunomodulación. ABSTRACT Anaphylaxis is a condition that requires immediate assistance for its resolution, it can occur in different settings: office, hospital, school, home or some other public space. The information contained herein forms part of known guidelines on prevention, diagnosis and treatment. Epidemiological aspects, triggers, risk factors and co-factors are addressed; physiopathological mechanisms that are translated into presentation phenotypes are explained in a didactic way. Clinical diagnosis is emphasized based on established criteria, classifications are mentioned to evaluate the severity of the reaction, as well as the role of clinical or laboratory tests. As relevant aspects, the first choice treatment with adrenaline, instructions on auto-injectors and different elements for the complementary and second choice treatment are dealt with. They also refer to aspects to consider when discharging a patient and followup measures, with a preventive emphasis on the community. Finally, the allergy clinic approach to deciding on immunomodulation options is mentione

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multinational cohort

Background The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.Methods The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.Results During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.Conclusion Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.</p

Food allergy diagnosis in patients with elimination diet history. Preliminary report

Background: Food allergy diagnosis is performed by a double blind placebo controlled challenge; however, in a lot of patients, it is only based on clinical history, skin prick tests, or parents’ perception. There is a high frequency of elimination diets without an adequate approach. Objective: To analyze the results of diagnostic tests in a group of children with elimination diet-based on suspected food allergy and verify such studies with double blind placebo-controlled test challenge. Material and method: An observational, analytical and prospective study was done in a group of patients with elimination diet for suspected food allergy. We performed prick test, Prick-to-Prick test and patch test and the positive ones were verified by double-blind placebo-controlled challenge. Results: Fourty-three patients were included within a total of 1,935 tests. Both approach for immediate and late sensitivity had not statistically significant relationship between a positive test and the elimination of food. Until now, we had 4 (8%) positive challenges out of 50. Conclusion: The frequency of allergy proved by double-blind placebo-controlled test in 50 challenges was of 8% (4/50), thus, in the preliminary report we found a high frequency of elimination diets without adequate support. It is very important that food allergy diagnosis is accurate and based on an appropriate approach; since the implementation of an elimination diet in pediatric population can have a negative influence on their growth and development

Propiedades psicométricas de la Escala de Bienestar Psicológico para Adolescentes (BIEPS-J) en una muestra mexicana

Psychological well-being refers to the satisfaction that individuals generally have regarding their life. This concept has been related to mental health and to the detection of factors that favor human development. The interest in their study in adolescents has increased in recent years due to physical, mental and social changes at this stage of development, so it is necessary valid and reliable instruments that allow their evaluation. The objective of this study was to evaluate psychometric properties of the Psychological Wellbeing Scale for Adolescents (BIEPS-J) in a Mexican sample of late adolescents and obtain evidence of their convergent and criterion validity. The BIEPS-J scale and the Rosenberg Self-esteem Scale (RSS) were applied to 271 students of both sexes between 16 and 18 years old. A parallel analysis indicated two factors present in the BIEPS-J scale, which were structured by exploratory factor analysis (main components, oblique rotation) and that explained 54% of the variance. The factors were: 1) Relationship with self and with others, indicates satisfaction with their social relationships and self-acceptance; 2) Plans and personal control resources, indicates the sensation of the domain of their environment and self-competence as the presence of goals in their life. The global internal consistency (α > .80) and by factor (α > .70) was acceptable. The BIEPS-J scale showed convergent validity with the RSS (r = .44) and the level of psychological well-being was associated with the level of self-esteem (p .05). The data indicate that the BIEPS-A scale is a valid and reliable instrument to assess psychological well-being in the Mexican adolescent population between 16 and 18 years of age.El bienestar psicológico se refiere a la satisfacción general que los individuos tienen respecto de su vida. Este concepto se ha relacionado con la salud mental y con la detección de factores favorables al desarrollo humano. El interés en su estudio en adolescentes se ha incrementado en los últimos años debido a los cambios físicos, mentales y sociales propios a esta etapa del desarrollo, por lo que son necesarios instrumentos válidos y confiables que permitan su evaluación. El objetivo de este estudio fue evaluar propiedades psicométricas de la Escala de Bienestar Psicológico para Adolescentes (BIEPS-J) en una muestra mexicana de adolescentes tardíos y obtener evidencia de su validez convergente y de criterio. Se aplicó la escala BIEPS-J y la Escala de Autoestima de Rosenberg (EAR) a 271 estudiantes de ambos sexos de entre 16 y 18 años. Un análisis paralelo indicó dos factores presentes en la escala BIEPS-J, estructurados mediante un análisis factorial exploratorio (componentes principales, rotación oblicua) y que explicaron el 54% de la varianza. Los factores fueron: 1) Relación con uno mismo y con terceros, satisfacción con sus relaciones sociales y la aceptación de sí mismo; 2) Planes y recursos personales de control, sensación del dominio de su entorno y auto-competencia, además de la presencia de metas en su vida. La consistencia interna global (α > .80) y por factor (α > .70) fue aceptable. La escala BIEPS-J mostró validez convergente con la EAR (r = .44) y el nivel de bienestar psicológico se asoció al nivel de autoestima (p .05). Los datos indican que la escala BIEPS-A es un instrumento válido y confiable para evaluar el bienestar psicológico en población adolescente mexicana de entre 16 y 18 años

Knowledge of asthma: educational intervention with the 2014 GINA guide in primary care physicians

Background: Asthma is a public health problem in the world, so updating the guidelines for the diagnosis and treatment of asthma is based primarily on the practice of primary care physicians. Educational interventions are useful for increasing knowledge. Objective: To compare the level of knowledge of asthma before and after an educational intervention. Methods: A quasi-experimental prospective study was conducted in general and family practitioners and pediatricians who attended a training workshop on general aspects of asthma and current guidelines for diagnosis and treatment (GINA 2014). A questionnaire consisting of 11 multiple choice questions relating to fundamental aspects of the disease and diagnosis, classification, treatment and management of attacks, was used in two assessments, baseline and post-intervention.  Results: A total of 178 patients participated in the study, with knowledge pre-intervention at 25.5 points and post-intervention at 97.5 points on a scale of 100, with p < 0.05. Conclusion: Educational interventions are inexpensive and effective tools to increase the knowledge of health professionals, and they have an impact on improving patient care