Alveolar nitric oxide and its role in pediatric asthma control assessment

Resumen Background: Nitric oxide can be measured at multiple flow rates to determine proximal (maximum airway nitric oxide flux; Jaw(NO)) and distal inflammation (alveolar nitric oxide concentration; CA(NO)). The main aim was to study the association among symptoms, lung function, proximal (maximum airway nitric oxide flux) and distal (alveolar nitric oxide concentration) airway inflammation in asthmatic children treated and not treated with inhaled glucocorticoids. Methods: A cross-sectional study with prospective data collection was carried out in a consecutive sample of girls and boys aged between 6 and 16 years with a medical diagnosis of asthma. Maximum airway nitric oxide flux and alveolar nitric oxide concentration were calculated according to the two-compartment model. In asthmatic patients, the asthma control questionnaire (CAN) was completed and forced spirometry was performed. In controls, differences between the sexes in alveolar nitric oxide concentration and maximum airway nitric oxide flux and their correlation with height were studied. The correlation among the fraction of exhaled NO at 50 ml/s (FENO50), CA(NO), Jaw(NO), forced expiratory volume in 1 second (FEV1) and the CAN questionnaire was measured and the degree of agreement regarding asthma control assessment was studied using Cohen's kappa. Results: We studied 162 children; 49 healthy (group 1), 23 asthmatic participants without treatment (group 2) and 80 asthmatic patients treated with inhaled corticosteroids (group 3). CA(NO) (ppb) was 2.2 (0.1-4.5), 3 (0.2-9.2) and 2.45 (0.1-24), respectively. Jaw(NO) (pl/s) was 516 (98.3-1470), 2356.67 (120-6110) and 1426 (156-11805), respectively. There was a strong association (r = 0.97) between FENO50 and Jaw(NO) and the degree of agreement was very good in group 2 and was good in group 3. There was no agreement or only slight agreement between the measures used to monitor asthma control (FEV1, CAN questionnaire, CA(NO) and Jaw(NO)). Conclusions: The results for CA(NO) and Jaw(NO) in controls were similar to those found in other reports. There was no agreement or only slight agreement among the three measure instruments analyzed to assess asthma control. In our sample, no additional information was provided by CA(NO) and Jaw(NO).

La supervisión de la práctica profesional socioeducativa

[Es] La supervisión es uno de los métodos de desarrollo profesional de las profesiones de ayuda, ya que se manifiesta particularmente funcional en las profesiones en las que es importante el manejo de las relaciones: se dirige hacia el desarrollo de profesionales altamente integrados y competentes. Tras la revisión crítica de los diferentes enfoques de supervisión que históricamente se han desarrollado, se presenta un modelo integrativo de supervisión en grupo, que se mueve en la perspectiva crítica de la formación, exponiendo las bases teóricas en que se fundamenta, el desarrollo del proceso y las funciones del supervisor, así como algunas estrategias y técnicas propias de esta supervisión.

Zientzien irakaskuntza

[eus] Gaur egun, konpetentzia zientifikoaren garapena Lehen Hezkuntzako eskolan gutxi garatu den gaia da. Ikasleak kultura zientifikoan murgiltzeko forma aurkitu eta ikerketa gaitasuna garatzen laguntzea, planteatutako arazoei erantzuna bilatzeko ikerketa propioak diseinatuz, ez da batere arrunta gure eskoletan. Esku hartze hau, egoera honi aurre egiteko eta arazoari irtenbide bat bilatzeko diseinatuta izan da. Honen bidez, Lehen Hezkuntzan, ikasleak ikerketen bitartez zientzietan konpetenteagoak izatea da helburu nagusia. Martxan jarritako ekimenean, ikasle gehienak ikerketaren diseinua eraiki dute, emaitza hobeak lortu dira taldean aritu direnean eta flotagarritasuna dentsitatearekin lotzeko gai izan dira.