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Original Article
Knowledge of asthma and anaphylaxis among teachers in Spanish schools
J.C. Juliá-Benitoa,1,
Corresponding author
juancarlosjulia@hotmail.com

Corresponding author.
, M. Escarrer-Jaumeb,2, M.T. Guerra-Pérezc,2, J. Contreras-Portad,2, E. Tauler-Toroe,2, A. Madroñero-Tentorf,2, J.C. Cerdá-Mirg,2
a Centro Sanitario Integrado Alzira II, Valencia, Spain
b Centro de Salud San Agustín, Mallorca, Spain
c Centro de Salud San Telmo, Jerez de la Frontera, Cádiz, Spain
d Hospital Universitario La Paz, Madrid, Spain
e Hospital de Martorell, Barcelona, Spain
f Clínica Juaneda, Mallorca, Spain
g Consorcio Hospital General Universitario, Valencia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Allergic diseases affect 15&#8211;20&#37; of the paediatric population in the industrialised world&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> In fact&#44; asthma is the most frequent chronic illness in childhood&#44; with an estimated prevalence in the Spanish paediatric population of 7&#8211;10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a> Thus&#44; it can be deduced that there is an average of 1&#8211;2 pupils with asthma symptoms in each school class&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Asthma in school can manifest spontaneously in a previously asymptomatic child or can worsen in a child with mild symptoms&#46; A special case is asthma induced by exercise&#44; since physical exertion can induce exacerbation of the disease&#46; While not particularly frequent&#44; there have been reports of fatal episodes in physical education classes and team sports activities in school&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Food allergies are also common in schoolchildren&#44; with an estimated overall prevalence of 4&#8211;7&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a> In this regard&#44; it has been reported that 10&#8211;18&#37; of all allergic reactions to foods occur in the school setting&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Anaphylaxis is the most life-threatening expression of allergy&#46; It has been estimated that 5&#8211;22&#37; of all anaphylactic episodes in children occur in school&#44;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;7</span></a> and some of these reactions can prove fatal &#8211; particularly in the context of food allergy&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">According to the European Academy of Allergy and Clinical Immunology &#40;EAACI&#41;&#44; one out of every 300 Europeans suffers anaphylaxis at some point in life&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a> and most European schools have at least one child at risk of developing anaphylaxis in the context of food allergy&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Most educational centres in Spain do not have health professionals among their staff&#44; and the teachers are in charge of child care and supervision in school&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Making school a safer place for children with serious health risks is a pending objective in European countries&#44; and requires joint action on the part of parents&#44; physicians and school staff&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> The situation varies greatly from one country to another&#44; as well as between different school centres in one same country&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The Paediatric Section of the EAACI has launched initiatives to define uniform intervention protocols in these circumstances&#44; with general and specific objectives for the different allergic diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a> The Paediatric Section has drafted a document that aims to serve as a common guide to be adapted by each centre in accordance with its possibilities&#46; The recommended activities include the presence in schools of people trained in recognising alarm symptoms and in providing emergency treatment with adrenalin and bronchodilators if needed&#46; Furthermore&#44; the safety of children with life-threatening allergic disease requires the supervising physician to provide a personalised action plan describing the allergy of the patient&#44; the symptoms that may develop&#44; and the emergency treatment required if such symptoms appear&#46; The idea is not for the school&#39;s staff to diagnose and treat a reaction but to follow a clearly described series of concrete steps&#46; Registries containing the required information are therefore recommended&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The existence of such plans in schools increases the safety of the children&#44; although deaths have been reported<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">15&#44;16</span></a> despite emergency treatment&#46; Prevention is therefore essential&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In Spain&#44; pioneering programmes have been developed in the Autonomous Communities of Andaluc&#237;a<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> and Galicia&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> with coordination between the educational and emergency healthcare services&#46; In March 2007&#44; Galicia launched the School Alert &#40;<span class="elsevierStyleItalic">Alerta Escolar</span>&#41; programme with the main aim of ensuring immediate and efficient care of schoolchildren who suffer life-threatening emergencies due to anaphylaxis&#44; epileptic seizures or diabetes-related hypoglycaemia&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The School Alert programme was likewise introduced in the Balearic Islands in 2014&#46; This programme comes into effect when the parents enter a child with life-threatening chronic disease into the registry of the 061 emergency care service&#46; In the event of an emergency situation&#44; the school alerts 061&#44; where a physician provides instructions on what to do until the medical staff arrive&#46; The school teachers in turn receive prior training in the management of the life-threatening illnesses included in the programme&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Evaluation of the training needs constitutes the first step in planning an educational project&#46; In this regard&#44; the need for the teaching staff to have specific information and training&#44; with concrete intervention plans&#44; must be considered&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">With the purpose of exploring this need for information&#44; the Health Education Group of the Spanish Society of Clinical Immunology&#44; Allergology and Paediatric Asthma &#40;<span class="elsevierStyleItalic">Grupo de Educaci&#243;n Sanitaria de la Sociedad Espa&#241;ola de Inmunolog&#237;a Cl&#237;nica&#44; Alergolog&#237;a y Asma Pedi&#225;trica</span> &#91;SEICAAP&#93;&#41; evaluated knowledge about disorders such as asthma and anaphylaxis&#44; and their management&#44; among 2481 teachers in school centres in different Spanish Autonomous Communities&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="par0070" class="elsevierStylePara elsevierViewall">A self-administered questionnaire specifically developed for this study was distributed among nursery school&#44; primary school&#44; secondary school and high school teachers in five autonomous Communities &#40;Andaluc&#237;a&#44; the Balearic Islands&#44; Catalonia&#44; Madrid and Valencia&#41;&#46; The study covered the period between November 2013 and February 2014&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The directors of the schools were first contacted to explain the purpose of the study&#46; Teacher participation was voluntary and anonymous&#46; The questionnaires were completed in paper format or online&#44; according to personal preference&#46; Our aim was to obtain a sample representative of the provinces in which the study was made&#46; However&#44; given the voluntary nature of participation&#44; bias may have been introduced due to the inclusion of those teachers most interested in the subject of the study&#46; In any case&#44; the results obtained appear to reflect the true situation found in the educational centres of these provinces&#44; and possibly could be extrapolated to the rest of the country&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Due to the lack of a validated questionnaire&#44; we developed a new questionnaire for this study&#44; which was used in a pilot study to examine it for understanding and suitability&#46; The questionnaire comprised 25 questions addressing the following items&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Characteristics of the participating teachers and centres &#40;workplace&#44; age range&#44; sex&#44; academic training&#44; type of centre according to financing mode&#44; and educational grade&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Knowledge and attitudes referred to asthma&#44; anaphylaxis&#44; epilepsy&#44; diabetes and heart disease&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Interest in receiving training in such diseases and in having intervention protocols in the event of emergencies that may occur in the school&#46;</p></li></ul></p><p id="par0100" class="elsevierStylePara elsevierViewall">In this study we only analysed questions about knowledge and attitudes referred to asthma and anaphylaxis &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The study variables were of a categorical nature&#44; and the corresponding relative frequencies &#40;&#37;&#41; were calculated in each case&#46; The chi-squared test with a 95&#37; confidence interval &#40;95&#37;CI&#41; was used for the comparison of variables and the estimation of differences&#46; The data were analysed using the SPSS version 20&#46;0 statistical package&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0110" class="elsevierStylePara elsevierViewall">The questionnaire was answered by 2481 teachers &#40;29&#46;5&#37; males and 69&#46;5&#37; females&#41; in the Autonomous Communities of Andaluc&#237;a&#44; the Balearic Islands&#44; Catalonia&#44; Madrid and Valencia&#46; The majority &#40;60&#46;1&#37;&#41; were over 40 years of age&#46; Seventy-six percent worked in public schools and 23&#37; in private schools with public subvention&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Almost 73&#37; of the participants were primary and secondary school teachers&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The distribution of participants by Autonomous Communities was as follows&#58; Andaluc&#237;a 44&#46;8&#37;&#44; the Balearic Islands 30&#46;5&#37;&#44; Valencia 13&#46;7&#37;&#44; Catalonia 6&#46;8&#37; and Madrid 4&#46;2&#37;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> describes the characteristics of the study sample&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Knowledge and attitudes referred to asthma</span><p id="par0130" class="elsevierStylePara elsevierViewall">The immense majority of the teachers &#40;97&#37;&#41; claimed to know what asthma is &#8211; with no differences being observed in relation to the age of the teachers or of the schoolchildren&#46; In reference to the different educational grades&#44; over 30&#37; of the teachers in secondary education and high school did not know whether they had asthmatic students in class&#44; while 65&#46;2&#37; of the physical education teachers reported having some asthmatic student in class &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A total of 44&#46;5&#37; claimed to know what to do in the event of an asthma attack in class&#46; This percentage increased to 75&#46;8&#37; in the case of physical education teachers &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Knowing how to administer asthma medication in the event of an attack was found to depend on the age of the teacher&#44; since the proportion of teachers who knew how to administer treatment in the youngest group &#40;20&#8211;30 years&#41; and oldest group &#40;over 50 years&#41; was 36&#37;&#44; versus 45&#46;3&#37; among the teachers between 31 and 40 years of age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; Here again the physical education teachers yielded better results&#44; since 56&#46;1&#37; claimed to know how to administer asthma medication&#44; versus 29&#46;7&#37; of the high school teachers &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Knowledge and attitudes referred to anaphylaxis</span><p id="par0140" class="elsevierStylePara elsevierViewall">As regards knowledge of anaphylaxis&#44; the older teachers were seen to have more information on this clinical condition&#46; In effect&#44; 44&#46;6&#37; of those over 50 years of age knew what anaphylaxis is&#44; versus 28&#46;6&#37; of those under 30 years of age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; On the other hand&#44; according to 3&#46;5&#37; of the teachers&#44; some anaphylactic reaction had occurred in some student in their class&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The great majority &#40;82&#46;8&#37;&#41; would not know what to do in the event of an anaphylactic reaction in school&#44; and a full 87&#46;6&#37; would not know how to administer the medication required in such cases&#46; Knowing how to act in the event of anaphylaxis was again found to depend on the age of the teachers&#58; almost 17&#37; of those over 50 years of age claimed to know what to do&#44; versus 7&#46;7&#37; of those under 20 years of age&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Demand for information and intervention protocols</span><p id="par0150" class="elsevierStylePara elsevierViewall">A full 86&#46;6&#37; of the teachers expressed interest in attending courses on asthma and anaphylaxis&#44; and in learning the skills and techniques needed in the event of an emergency&#46; This percentage increased to 93&#46;5&#37; among the teachers between 20 and 30 years of age and dropped to 81&#46;5&#37; among those over 50 years of age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The high school teachers were those with the least interest in this respect &#40;77&#46;6&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Lastly&#44; 96&#46;8&#37; of the teachers claimed to be interested in having an intervention protocol on how to act in the case of a child with an asthma attack or anaphylactic reaction in school&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0160" class="elsevierStylePara elsevierViewall">Children spend about one-third of the day in school&#46; Because of the high prevalence of allergic diseases and asthma&#44; it is important to know the knowledge teachers have of these problems in order to allow them to intervene if necessary&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">There have been many studies in this field over the last decade&#44; evidencing the existing concern about the care of allergic children when in school&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The questionnaire used in our study evaluated teacher knowledge referred to management of the most common life-threatening chronic illnesses among their students&#46; No objective assessment of knowledge was made&#59; rather&#44; our aim was to gain an impression that could serve to establish a starting point&#46; On the other hand&#44; the study sample does not intend to be fully representative of the population of teachers in the study setting&#44; given the voluntary nature of participation&#46; Furthermore&#44; bias may have been introduced due to the inclusion of those teachers most motivated to answer the questionnaire&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The results obtained may give an idea of the true training needs&#44; with a view to developing intervention plans to deal with episodes that may occur in school&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In the case of knowledge on asthma&#44; a relevant finding is the fact that despite the high frequency of asthma in the paediatric population&#44; 19&#46;9&#37; of the teachers were unable to identify asthmatic children in their class&#46; A full 98&#37; claimed to know what asthma is&#44; but 54&#37; admitted that they would not know what to do or how to administer the required medication&#46; This does not seem consistent with the knowledge they claimed to have of the disease&#46; This aspect is particularly relevant considering the importance of being able to help the children to correctly perform the inhalation technique during management of an asthma attack&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Regarding anaphylaxis&#44; 82&#37; of the reactions have been shown to occur in schoolchildren &#8211; in some cases in the actual educational centre&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a> Anaphylaxis remains underdiagnosed and undertreated&#44; even in the healthcare setting&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a> and more so in schools&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">The results of the questionnaire point to a great lack of information&#46; In effect&#44; 59&#46;9&#37; of the teachers did not know what anaphylaxis is&#44; and 43&#46;5&#37; were unable to confirm whether any of their students had ever experienced such a reaction&#46; It is unfortunate that despite the seriousness of anaphylactic reactions&#44; the teachers were unable to identify those children at risk of suffering such problems&#46; Possibly even more worrisome is the fact that up to 85&#37; admitted that they would not know what to do in the event of an anaphylactic reaction&#44; and only 11&#37; claimed to know how to use adrenalin&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Teachers appear to recognise their lack of knowledge on how to deal with these diseases&#44; but are also interested in receiving training and in having protocols explaining how to act in emergency situations&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Most studies on the management of allergic disorders in school are recent&#46; The first Spanish study exploring knowledge about asthma among teaching staff was carried out by Cobos in 2001&#44; and involved 933 teachers from 27 schools in seven cities&#46; Twenty-five percent of the teachers reported having asthmatic children in their class&#44; and 91&#37; admitted having little knowledge on how to deal with possible asthmatic attacks&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Similar findings have been published in other countries&#46; A study of information on asthma among teachers in Turkey found the level of knowledge to be insufficient&#44; and underscored the need for educational programmes&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">Korta-Murua et al&#46; investigated the impact of an educational intervention referred to knowledge about asthma among school teachers in the Basque Country&#46; The authors concluded that the intervention significantly improved knowledge of asthma among the teachers&#44; although after three months this knowledge was partially lost&#8211;hence pointing to the need for sustained educational intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">In a studied conducted on the island of Tenerife&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a> 84&#37; of the teachers reported having at least one asthmatic child in class&#44; though 64&#37; admitted that they would not know what to do in the event of an asthma attack&#46; Fifty-eight percent considered themselves capable of helping with administration of the inhaled medication&#44; although 95&#37; considered that they needed further training&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Watson et al&#46; underscored the importance of standardised training protocols to improve teacher knowledge and self-confidence in dealing with emergencies in children with allergic diseases in school&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">In the United States&#44; Shah et al&#46; found that teacher training&#44; compared with a group of controls&#44; improved knowledge of food allergy as assessed by means of a questionnaire before and after training&#46; The number of positive responses increased significantly in the group that received training&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">In another study conducted among public school teachers in the city of New York&#44; the participants admitted having limited knowledge of food allergy and did not consider themselves to be prepared to deal with an anaphylactic reaction&#46; The authors concluded that counselling strategies and learning modules are needed to educate the teachers&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">The validation of the Spanish version of the New Castle Asthma Knowledge Questionnaire &#40;NAKQ&#41; in 537 teachers has recently been published&#46; While the results obtained were not available at the time of the present study&#44; they will make it possible to establish comparisons&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Based on the above&#44; it can be affirmed that the problem is of a global nature&#44; and that the results obtained using different methods show the situation in schools to be far from safe for children with asthma or food allergies&#46; Furthermore&#44; the deficiencies seen in our country are also found elsewhere&#46; The care of allergic children in school is a social problem that implicates the school staff&#44; health professionals and families&#44; as well as the pertinent government authorities&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">The fact that the problem is of a global nature is evidenced by the publication of studies in different geographical settings&#44; with results consistent with those of our own study&#44; and the drawing of common conclusions&#58; there are shortcomings in terms of the identification of these children&#44; and in the training of school staff&#46; Furthermore&#44; sustained training efforts are required&#44; with the adoption of protocols for the prevention of risks and intervention in the event of signs of disease&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">School teachers require knowledge of the signs and symptoms of allergic diseases and must be able to deal with clinical manifestations that may be mild but can also prove life-threatening&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Funding</span><p id="par0255" class="elsevierStylePara elsevierViewall">The authors declare that this study has received no funding&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflict of interest</span><p id="par0260" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Ethical disclosures</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Confidentiality of data</span><p id="par0265" class="elsevierStylePara elsevierViewall">The authors declare that there are no patient data in this article&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Right to privacy and informed consent</span><p id="par0270" class="elsevierStylePara elsevierViewall">The authors declare that there are no patient data in this article&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of human and animal subjects</span><p id="par0275" class="elsevierStylePara elsevierViewall">The authors declare that no experiments have been made involving either humans or animals in this study&#46;</p></span></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Allergic diseases affect 15&#8211;20&#37; of the paediatric population in the industrialised world&#46; Most educational centres in Spain do not have health professionals among their staff&#44; and the teachers are in charge of child care in school&#46; The advisability of specific training of the teaching staff should be considered&#44; with the introduction of concrete intervention plans in the event of life-threatening emergencies in schools&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evaluation of the training needs constitutes the first step in planning an educational project&#46; In this regard&#44; the Health Education Group of the Spanish Society of Clinical Immunology&#44; Allergology and Paediatric Asthma &#40;<span class="elsevierStyleItalic">Grupo de Educaci&#243;n Sanitaria de la Sociedad Espa&#241;ola de Inmunolog&#237;a Cl&#237;nica&#44; Alergolog&#237;a y Asma Pedi&#225;trica</span> &#91;SEICAAP&#93;&#41; assessed the knowledge of teachers in five Spanish Autonomous Communities&#44; using a self-administered questionnaire specifically developed for this study&#46; The data obtained were analysed using the SPSS statistical package&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 2479 teachers completed the questionnaire&#46; Most of them claimed to know what asthma is&#44; and almost one half considered that they would know how to act in the event of an asthma attack&#46; This proportion was higher among physical education teachers&#46; Most would not know how to act in the case of anaphylaxis or be able to administer the required medication&#46; In general&#44; the teachers expressed interest in receiving training and in having an interventional protocol applicable to situations of this kind&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">It is important to know what the training requirements are in order to develop plans for intervention in the event of an emergency in school&#46; Teachers admit a lack of knowledge on how to deal with these disorders&#44; but express a wish to receive training&#46;</p></span>"
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          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:28 [
            0 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worldwide time trends in the prevalence of symptoms of asthma&#44; allergic rhinoconjunctivitis&#44; and eczema in childhood&#58; ISAAC Phases One and Three repeat multicountry cross-sectional surveys"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;I&#46; Aser"
                            1 => "S&#46; Montefort"
                            2 => "B&#46; Bjorksten"
                            3 => "C&#46;K&#46; Lai"
                            4 => "D&#46;P&#46; Strachan"
                            5 => "S&#46;K&#46; Weiland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(06)69283-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2006"
                        "volumen" => "368"
                        "paginaInicial" => "733"
                        "paginaFinal" => "743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16935684"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents&#46; International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41; Phase 3"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Carvajal-Urue&#241;a I1"
                            1 => "L&#46; Garc&#237;a-Marcos"
                            2 => "R&#46; Busquets-Monge"
                            3 => "M&#46; Morales Su&#225;rez-Varela"
                            4 => "N&#46; Garc&#237;a de Andoin"
                            5 => "J&#46; Batlles-Garrido"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Spain J Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "659"
                        "paginaFinal" => "666"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "School attendance and school performance&#58; a population-based study of children with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;D&#46; Silverstein"
                            1 => "J&#46;E&#46; Mair"
                            2 => "S&#46;K&#46; Katusic"
                            3 => "P&#46;C&#46; Wollan"
                            4 => "E&#46;J&#46; O&#8217;Connell"
                            5 => "J&#46;W&#46; Yunginger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mpd.2001.115573"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2001"
                        "volumen" => "139"
                        "paginaInicial" => "278"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11487757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma deaths during sports&#58; report of a 7-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Becker"
                            1 => "J&#46; Rogers"
                            2 => "G&#46; Rossini"
                            3 => "H&#46; Mirchandani"
                            4 => "G&#46;E&#46; D&#8217;Alonzo Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2003.10.052"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2004"
                        "volumen" => "113"
                        "paginaInicial" => "264"
                        "paginaFinal" => "267"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14767440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A survey of sudden death among school children in Osaka Prefecture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Kitada"
                            1 => "T&#46; Nakagawa"
                            2 => "Y&#46; Yamaguchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Jpn Circ J"
                        "fecha" => "1990"
                        "volumen" => "54"
                        "paginaInicial" => "401"
                        "paginaFinal" => "411"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2398620"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anaphylaxis in children&#58; clinical and allergologic features"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Novembre"
                            1 => "A&#46; Cianferoni"
                            2 => "R&#46; Bernardini"
                            3 => "L&#46; Mugnaini"
                            4 => "C&#46; Caffarelli"
                            5 => "G&#46; Cavagni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1998"
                        "volumen" => "101"
                        "paginaInicial" => "E8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9606250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Food anaphylaxis in schools&#58; evaluation of the management plan and the efficiency of the emergency kit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;A&#46; Moneret-Vautrin"
                            1 => "G&#46; Kanny"
                            2 => "M&#46; Morisset"
                            3 => "J&#46; Flabbee"
                            4 => "L&#46; Gu&#233;nard"
                            5 => "E&#46; Beaudouin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "1071"
                        "paginaFinal" => "1076"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11703221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Further fatalities caused by anaphylactic reactions to food&#44; 2001&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;A&#46; Bock"
                            1 => "A&#46; Munoz-Furlong"
                            2 => "H&#46;A&#46; Sampson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2006.12.622"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2007"
                        "volumen" => "119"
                        "paginaInicial" => "1016"
                        "paginaFinal" => "1018"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17306354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Further fatal allergic reactions to food in the United Kingdom&#44; 1999&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;S&#46; Pumphrey"
                            1 => "M&#46;H&#46; Gowland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2007.01.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2007"
                        "volumen" => "119"
                        "paginaInicial" => "1018"
                        "paginaFinal" => "1019"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17349682"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0190"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anaphylaxis&#58; guidelines from the European Academy of Allergy and Clinical Immunology"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Muraro"
                            1 => "G&#46; Roberts"
                            2 => "M&#46; Worm"
                            3 => "M&#46;B&#46; Bil&#242;"
                            4 => "K&#46; Brockow"
                            5 => "M&#46; Fern&#225;ndez Rivas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.12437"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2014"
                        "volumen" => "69"
                        "paginaInicial" => "1026"
                        "paginaFinal" => "1045"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24909803"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0195"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EAACI food allergy and anaphylaxis guidelines&#58; managing patients with food allergy in the community"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Muraro"
                            1 => "I&#46; Agache"
                            2 => "A&#46; Clark"
                            3 => "A&#46; Sheikh"
                            4 => "G&#46; Roberts"
                            5 => "C&#46;A&#46; Akdis"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.12441"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2014 Aug"
                        "volumen" => "69"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1057"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24905609"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0200"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Food allergy in schools&#58; concerns for allergists&#44; pediatricians&#44; parents&#44; and school staff"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Munoz-Furlong"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2004"
                        "volumen" => "93"
                        "paginaInicial" => "S47"
                        "paginaFinal" => "S50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15562874"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0205"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The management of anaphylaxis in childhood&#58; position paper of the European academy of allergology and clinical immunology"
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                            3 => "P&#46;A&#46; Eigenmann"
                            4 => "S&#46; Halken"
                            5 => "G&#46; Lack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1398-9995.2007.01421.x"
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                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17590200"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The management of the allergic child at school"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1398-9995.2010.02343.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2010"
                        "volumen" => "65"
                        "paginaInicial" => "681"
                        "paginaFinal" => "689"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20345502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Further fatal allergic reactions to food in the United Kingdom&#44; 1999&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;S&#46; Pumphrey"
                            1 => "M&#46;H&#46; Gowland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allerg Clin Immunol"
                        "fecha" => "2007"
                        "volumen" => "119"
                        "paginaInicial" => "1018"
                        "paginaFinal" => "1019"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Life-threatening asthma and anaphylaxis in schools&#58; a treatment model for school-based programs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;R&#46; Murphy"
                            1 => "R&#46;J&#46; Hopp"
                            2 => "E&#46;B&#46; Kittelson"
                            3 => "G&#46; Hansen"
                            4 => "M&#46;L&#46; Windle"
                            5 => "J&#46;N&#46; Walburn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)60906-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2006"
                        "volumen" => "96"
                        "paginaInicial" => "398"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16597073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Programa Aire&#46; Consejer&#237;a de Salud&#46; Empresa p&#250;blica de emergencias sanitarias &#40;EPES&#41; Junta de Andaluc&#237;a &#40;<a href="http://www.epes.es/cocoon/epes-estatico-html?omv=/menuVertical/atencionAlCiudadano/%26omvh=/menuVertical/atencionAlCiudadano/programasEspeciales/%26language=%26c=programasEspeciales">http&#58;&#47;&#47;www&#46;epes&#46;es&#47;cocoon&#47;epes-estatico-html&#63;omv&#61;&#47;menuVertical&#47;atencionAlCiudadano&#47;&#38;omvh&#61;&#47;menuVertical&#47;atencionAlCiudadano&#47;programasEspeciales&#47;&#10216;uage&#61;&#38;c&#61;programasEspeciales</a>&#41;&#46;"
                ]
              ]
            ]
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              "identificador" => "bib0230"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Plan Alerta Escolar&#46; Conseller&#237;a de Cultura&#44; Educaci&#243;n e Ordenaci&#243;n Universitaria&#46; Xunta de Galicia &#40;<a href="http://www.edu.xunta.gal/portal/node/371">http&#58;&#47;&#47;www&#46;edu&#46;xunta&#46;gal&#47;portal&#47;node&#47;371</a>&#41;&#46;"
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary school teachers&#8217; knowledge about and attitudes toward anaphylaxis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Ercan"
                            1 => "A&#46; Ozen"
                            2 => "H&#46; Karatepe"
                            3 => "M&#46; Berber"
                            4 => "R&#46; Cengizlier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1399-3038.2012.01307.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Allergy Immunol"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "428"
                        "paginaFinal" => "432"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22554351"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;a de Actuaci&#243;n en Anafilaxia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Cardona"
                            1 => "N&#46; Caba&#241;es"
                            2 => "T&#46; Chivato"
                            3 => "P&#46; Guard&#237;a"
                            4 => "M&#46; Fern&#225;ndez"
                            5 => "C&#46; Freij&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2009"
                        "editorial" => "GALAXIA"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge about asthma by primary school Spanish teacher&#39;s&#58; a pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Cobos"
                            1 => "C&#46; Picado"
                            2 => "F&#46; Duce"
                            3 => "J&#46; Martinez"
                            4 => "G&#46; Del Rio"
                            5 => "M&#46; Perpi&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin"
                        "fecha" => "2001"
                        "volumen" => "117"
                        "paginaInicial" => "452"
                        "paginaFinal" => "453"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "22"
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                0 => array:3 [
                  "comentario" => "&#40;AB107&#41;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma knowledge level of teachers in child daycare center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Akcay"
                            1 => "Z&#46; Tamay"
                            2 => "S&#46;U&#46; Ones"
                            3 => "N&#46; Guler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2013"
                        "volumen" => "131"
                        "numero" => "2 Suppl&#46; 1"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of an asthma educational intervention programme on teachers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Korta Murua"
                            1 => "E&#46;G&#46; P&#233;rez-Yarza"
                            2 => "S&#46; P&#233;rtega D&#237;az"
                            3 => "A&#46; Aldasoro Ruiz"
                            4 => "O&#46; Sard&#243;n Prado"
                            5 => "A&#46; L&#243;pez-Silvarrey Varela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ana Pediat"
                        "fecha" => "2012"
                        "volumen" => "77"
                        "paginaInicial" => "236"
                        "paginaFinal" => "246"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge and attitudes of teachers on children with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;R&#46;R&#46; Fern&#225;ndez-Oliva"
                            1 => "M&#46;L&#46;T&#46;&#193;&#46; De Arcaya"
                            2 => "A&#46; Aguirre-Jaime"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ana Pediat"
                        "fecha" => "2010"
                        "volumen" => "72"
                        "paginaInicial" => "413"
                        "paginaFinal" => "419"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What are teachers&#8217; perspectives about dealing with allergy emergencies at school&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46; Watson"
                            1 => "A&#46; Woodrow"
                            2 => "A&#46; Bruce"
                            3 => "A&#46; Power"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Allergy&#58; Eur J Allergy Clin Immunol"
                        "fecha" => "2010"
                        "volumen" => "65"
                        "numero" => "Suppl&#46; 92"
                        "paginaInicial" => "320"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement of teacher food allergy knowledge in socioeconomically diverse schools after educational intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;S&#46; Shah"
                            1 => "C&#46;L&#46; Parker"
                            2 => "C&#46;M&#46; Davis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0009922813497425"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Pediat"
                        "fecha" => "2013"
                        "volumen" => "52"
                        "paginaInicial" => "812"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23899583"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
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              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of food allergy knowledge in NYC elementary school teachers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;S&#46; Agarwal"
                            1 => "J&#46;E&#46; Yu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2015"
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                        "numero" => "2 Suppl&#46; 1"
                        "paginaInicial" => "AB138"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0280"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of a questionnaire in spanish on asthma knowledge in teachers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; L&#243;pez-Silvarrey Varela"
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                            2 => "S&#46; Rueda Esteban"
                            3 => "J&#46; Korta Mur&#250;a"
                            4 => "B&#46; Iglesias L&#243;pez"
                            5 => "A&#46; Mart&#237;nez-Gimeno"
                          ]
                        ]
                      ]
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                    0 => array:2 [
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                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "115"
                        "paginaFinal" => "120"
                        "link" => array:1 [
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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