Revista Espanola De Salud Publica最新文献

Solidarity is part of the map of values and ethical principles of the COVID-19 pandemic that has devastated the world since the end of 2019. Solidarity has been behind the justification for public health measures such as confinement, quarantines, lockdowns, the mandatory use of masks, and the financing, distribution and inoculation of vaccines against the virus; it has also been used to economic compensation, intergenerational sacrifices, the importance of public health care and even mutual aid between citizens, institutions and countries to face the worst effects of the pandemic. However, solidarity has been used interchangeably as a descriptive and normative, motivational and justificatory, sentimental and political, moral and legal idea, thus increasing confusion about its meaning, use and scope. This article reviews the rhetorical use of solidarity during the pandemic, shows the contradictions derived from that use, and sheds light on the normative use it should have in order to more rigorously address responses to future pandemics.

Objective: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic.

Methods: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors.

Results: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of malnutrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01).

Conclusions: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.

Non-inferiority studies are increasingly more common for introducing new medicines in the market. Despite being situations where the use of this study design is justified, there is not a common analytical approach on how to conduct them. Pursuing a rigorous methodology, both in the study conduction and in its disseminations, is critical to ensure robust results to enable regulatory agencies and clinicians to reach valid conclusions and decisions which ultimately will benefit clinical practice. Most of the published reviews focus on the efficacy outcomes of non-inferiority clinical trials. We are unaware of other reviews that goes beyond and includes specific aspects for non-interventional designs and for studies focused on safety. Moreover, this review provides a simple and practical perspective with a minimum mathematical content on this complex type of studies.

Objective: Self-perception questionnaires are considered a useful alternative to assess the level of physical fitness (PF) of a specific population. However, very few questionnaires of this type have been validated in the Spanish population. The aim of this study was to identify the reliability and validity of the Perceived Physical Fitness Scale (PPFS) in Spanish students.

Methods: After a back-translation process, the PPFS questionnaire was administered twice to 722 students (primary school, n=207; secondary school, n=515) to determine its reliability. To identify its convergent validity, the International Fitness Scale (IFIS) was administered, as well as a set of PF field-based tests from the Eurofit battery. The questionnaire internal consistency, reliability and convergent validity of the questionnaire were assessed by means of the Cronbach's alpha, intraclass correlation coefficient and Pearson corelation coefficient.

Results: The internal consistency of the PPFS was accurate among Primary (α=0.702) and good among Secondary (α=0.888) students., Reliability was poor among Primary (ICC=0.490; 95% CI [0.298-0.665]) and good among Secondary (ICC=0.797; 95% CI [0.760-0.829]) students. The PPFS showed significant associations with PF levels assessed by means of the Eurofit (Primary; r=0.421; p<0.001 / Secondary; r=0.533; p<0.001) and with the IFIS scale (Primary; r=0.356; p<0.001 / Secondary r=0.792; p<0.001).

Conclusions: The Spanish adapted version of the PPFS questionnaire shows good reliability and acceptable convergent validity when used as a tool to assess PF among secondary school students. Its poor reliability, together with the weak association demonstrated against the IFIS scale among primary school students discourages the PPFS use at this educational level.

In these moments in which the pandemic seems to have granted a truce, hospitals are beginning to normalize their care activity and data on waiting lists have begun to regain their prominence as they are the object of attention by all interest groups: citizens, the media, politicians and health professionals themselves. An improvement is proposed in the treatment of the information on the surgical waiting list that is usually published based on the analysis of some relevant indicators of it. This proposal can contribute to a better understanding and interpretation of waiting list data at such an important time as the present.

Objective: Universities of the older population are centres of higher education where older people can acquire new knowledge, focusing on promoting the active participation of retired people. Participation in these universities enables learning and people who attend consider their health to be better because they are more active and motivated to learn, and have a positive self-image. This research aimed to explore on the one hand whether people attending this type of university have a good quality of life. On the other hand, what personality factors could be related to a good quality of life in these older adult students.

Methods: Quality of life was measured with the World Health Organization Quality of Lif-BREF (WHOQOL-BREF) questionnaire in 54 older university students in Spain. In addition, students' personality types were also assessed using Eysenck's Eysenck Personality Questionnaire-Revised EPQ-R questionnaire. Finally, the relationship between the different dimensions of personality and quality of life was studied. The statistical analyses performed were, in addition to the mean and standard deviation, the T-test to compare independent means as well as Pearson's correlations to correlate the dimensions of extraversion, neuroticism and psychoticism.

Results: This study showed that the University of the older population is an experience that is linked to a good quality of life with WHOQOL-BREF scores above 60. Also a high level of neuroticism and psychoticism are factors related to a poor quality of life (p<0.05).

Conclusions: From this study we can conclude that students at the University for Older Adults have, on the one hand, a high level of satisfaction with their overall quality of life, their general health, their physical health status, their psychological health status, their social relationships and their environment. On the other hand, they have a specific personal profile that scores relatively low in neuroticism and within the average population in extraversion and psychoticism.

Objective: Under the influence of climate change, environmental exposure to heat and pollution grows, exacerbated by extreme events, increasing the risk of mortality in vulnerable areas. We aimed to evaluate the present (2000-2019) and future effects of heat on the burden of cardiovascular (in people aged 45 years or older), respiratory (in people aged 60 years or older) and all-cause (in people aged 1 year or more) diseases in capitals of the Legal Amazon (Brazil).

Methods: An ecological study was conducted to initially estimate, for the period 2000-2019, the relative risk (RR) of exposure-response related to the effects of temperature on years of life potentially lost (YLL) using the generalized linear regression model (GLM), combined with the distributed non-linear lag model (DLNM); and the fractions of YLL attributable to heat from the prospective perspective (forward). Subsequently, the results were estimated in the baseline period (1970-2005) and projected into the future in the specific levels of warming and periods: 1.5 ºC (2010-2039), 2 ºC (2040-2069) and 4 ºC (2070-2099), considering the temperature data from the WCRP CORDEX regional climate model in RCP8.5 scenario.

Results: The RR of YLL increased significantly in the capitals due to exposure to heat and marked thermal amplitudes between 2000-2019, with the major effects on respiratory diseases in Río Blanco (14%), due to all causes in Manaus (12%) and cardiovascular in Cuiabá (9%). Compared with the baseline period, the period 2040-2069 showed the largest increase (10.40 times) in the fraction of the number of YLL attributable to heat in the region, with the predominance of cardiovascular diseases. The findings were not completely conclusive, the low precision of the estimated confidence intervals did not show the significance of the negative effect of heat.

Conclusions: Regardless of its significance, heat increases the risk of years of life lost in the short and medium term. The results support the need to include climate change mitigation and adaptation measures as public health protection policies.

Objective: Group B Streptococcus (GBS) infection remains to datey, without peripartum prophylaxis, the most common cause of vertically transmitted perinatal bacterial infection in the Western world. It is estimated that the prevalence of asymptomatic pregnant women with GBS in our country ranges between 10 and 20.5%, but there are few studies in this regard. With this research, we tried to establish the rate of pregnant women colonized by GBS at the recto-vaginal level at the time of delivery and to evaluate the validity of our strategy for the identification of pregnant women with GBS.

Methods: A 290 women sample representative of pregnant population from the province of Jaén was randomly selected and the presence or absence of GBS in the recto-vaginal microbiota was determined on the day of delivery. Subsequently, a retrospective analysis was made, case by case, in order to establish whether the screening techniques applied during pregnancy had been able to correctly identify the state of GBS colonization at the time of delivery. Statistical techniques were applied to perform a descriptive sample analysis, which was complemented with a case-by-case concordance analysis for the two GBS determinations made over time for each subject (repeated observations over time on individuals from the same cohort).

Results: The rate of pregnant women carrying GBS at the recto-vaginal level at the time of delivery was 23.10.

Conclusions: In our province, the rate of pregnant women with GBS at the time of delivery is higher than previously reported in the literature. Furthermore, our screening strategy during pregnancy could misclassify one of each eight women, causing one in sixteen GBS carriers to not be adequately identified.

After about a year and a half (at the moment these lines are being written) since the start of the massive vaccination campaign in which, thanks to the high coverage achieved in all groups eligible for vaccination, it has been possible to significantly reduce the morbidity and mortality due to COVID-19, it is important to review the scientific basics that have supported the recommendations implemented to date and those that could be adopted in the near future taking into consideration the epidemiological situation. The objective of this article is, therefore, to address the foundations of some of the technical decisions proposed by the Committee on Programme and Registry of Vaccinations (National Immunization Technical Advisory Group in Spain) and the Technical Working Group on Vaccination against COVID-19. Throughout the eleven updates of the Vaccination Strategy against COVID-19 in Spain, several issues pose intense debate as the vaccination intervals between doses, the convenience of using different types of vaccines, the use of heterologous schemes of vaccination, the benefits of hybrid immunity and the use of a fourth dose (second booster dose) for selected populations. All this without forgetting essential aspects of safety of vaccines. This article is divided into the following sections: Vaccination intervals; Heterologous or mixed scheme; Hybrid immunity (vaccination after infection and infection after vaccination [breakthrough]); Second booster dose.

In this paper we compared brand-specific COVID-19 vaccine effectiveness (VE) during August 2021 in persons born 1962-1971 and vaccinated during June. For SARS-CoV-2 symptomatic infection, protection was lower for Janssen (56%; CI95%: 53-59) or AstraZeneca [Vaxzevria] (68%; CI95%: 65-70), compared to Pfizer-BioNTech [Comirnaty] (78%; CI95%: 77-78), AstraZeneca/Pfizer (86%; CI95%: 80-90) or Moderna [Spikevax] (89%; CI95%: 88-90). VE against hospitalization was ranged 86% for Janssen to 97%-98% for other vaccines.