Revista Espanola De Salud Publica最新文献

Objective: Current literature is insufficient to determine the acceptability of self-sampling as a primary method for cervical cancer screening among women from a regular screening population. The aim of this study was to determine the acceptability of self-sampling among women in the Region of Murcia as a primary screening tool.

Methods: We performed a cross-sectional study between April-May 2021, in a regional sample of 247 women ages 35-65 years. All participants were contacted and completed a survey by telephone which included sociodemographic characteristics, knowledge and attitudes towards cancer screening, and self-sampling assessment. We conducted weighted statistical analysis including descriptive, bivariate and a multivariate logistic regression model to examine the associations between women's characteristics and their preference for self-sampling compared to clinician sampling.

Results: A total of 89.4% of participants reported at least one previous cytology in the last 5 years, 88.7% with a frequency equal to or less than 3 years. Eighty-one percent of women preferred self-sampling over clinical sampling as a primary screening method. Basal characteristics were unrelated to women's preference for self-sampling (P-adjusted≥0.05). Feasibility and reliability were the main concerns perceived in relation to self-sampling (23.3% and 14.8%, respectively).

Conclusions: Acceptability of self-sampling was high among women in the Region of Murcia. Self-sampling in conjunction with an adequate educational strategy could be a suitable approach to consider in the cervical cancer screening program.

Objective: Attention deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder characterised primarily by three core symptoms: inattention, hyperactivity and impulsivity. It is one of the most commonly diagnosed childhood psychiatric disorders, with a worldwide prevalence of between 3% and 5%, and between 6% and 7% in the Spanish population. The aim of the study is to analyse the trend in the consumption of drugs used for the treatment of ADHD between 2010-2019 in Castilla y León.

Methods: Epidemiological registry study of all dispensing in pharmacies in Castilla y León between 2010 and 2019 to patients under 19 years of age, of active substance N06BA04 (methylphenidate), N06BA09 (atomoxetine), N06BA12 (lisdexamfetamine), N06BA07 (modafinil) and C02AC02 (guanfacine). Data on drug use were obtained from the information system for the pharmaceutical provision of Castilla y León, CONCYLIA. Frequencies in absolute values and the corresponding percentages were calculated. Student's t-test was used to estimate differences between continuous variables and Pearson's Chi-square test for categorical variables, while the trend in consumption was analysed using the Cochran-Armitage test.

Results: ADHD medication was dispensed annually to 1.77% of the population, with consumption being more than three times higher in boys than in girls (2.69% vs 0.81%; p=0.001). The age group with the highest peak use was 10-14 years with 3.42%. Methylphenidate was the drug used by the highest percentage of the population (2.44%) followed by lisdexamfetamine (0.37%).

Conclusions: Approximately 2 out of every 100 people aged 0-19 years were treated with some ADHD medication, mainly methylphenidate, in Castilla y León between 2010 and 2019.

Pedro Felipe Monlau was a prominent Spanish hygienist and defender of the Miasmatic Theory of Diseases. By the nineteenth-century, Spain had not enough health infrastructure. Monlau's publications became a powerful source of transmission of the dominant scientific ideas of European hygienism. Levy, Londe, Villermé, Chadwick, Farr and Smith were personalities who influenced the thinking of the Spanish hygienist. The aim of this paper is to show whether the Florence Nightingale's hygienist doctrine influenced Spain through the work of Monlau. A review of primary documentary sources was carried out and the results were analysed from the hermeneutic perspective. The Digital Newspaper Library of the National Library of Spain was used as the main resource. Monlau referred to Nightingale eleven times. Nine fragments responded to Monlau's Hygienic Aphorisms. He recommended Nightingale's ideas regarding ventilation, lighting and housekeeping, among others. In addition, Monlau suggested the need for hospital statistics following Nightingale's proposal. In this sense, the surgeon Rubio y Galí was a clear example of its applicability in the Institute of Therapeutic Surgery. Monlau also recognized the work of Nightingale in the Crimean War. The results show the need to make women scientists visible in contemporary history, revisiting the biographies written so far.

Objective: This study presents information on the evolution of severe cases of SARS-CoV-2 infection that required hospitalization since the beginning of vaccination in Spain. The objective was to know the impact of vaccination against COVID-19 on the hospitalization of patients with SARS-CoV-2 infection, hospital mortality and readmissions for this cause, and to describe the characteristics of vaccinated patients who required admission.

Methods: A retrospective, observational epidemiological study was conducted of all patients admitted with SARS-CoV-2 infection confirmed by a diagnostic test for active infection (PDIA) in a tertiary hospital, from January 2021 to June 2021. The incidence of admissions was calculated based on the vaccination status of the patients and age groups at different times according to the progress of the strategy of vaccination COVID-19.

Results: Between December 27, 2020 and June 30, 2021, 1,308 patients with positive PDIA were admitted to the University Hospital of Salamanca, of which 1,167 (89.2%) were not vaccinated, 129 (9.9%) had received one dose of vaccine and 12 (0.9%) were fully vaccinated. Of the latter, none were admitted to the ICU and 2 died.

Conclusions: Vaccination against COVID-19 has contributed to the decrease in hospitalizations, since February 2021, of older and institutionalized people. Fully vaccinated people have a lower risk of admission to the ICU and death. These data, together with the information available on recent cases of new SARS-CoV-2 infections in unvaccinated young people, are in favor of achieving high vaccination coverage of the entire population in the shortest possible time.

On November 25, 2021, the European Medicines Agency (EMA) authorized the presentation of Comirnaty vaccine (Pfizer-Biontech) for children between 5 and 11 years of age. In our country, this vaccination began on December 15, after it was approved by the Public Health Commission. A mathematical model has been developed to evaluate the possible impact of this vaccination and contribute to assessing the risk-benefit balance. The model parameters were adjusted including all those characteristics that may influence the impact of childhood vaccination. The results indicate this vaccination involves a significant reduction in the number of infections, and to a lesser extent in the number of hospitalizations and deaths. This reduction will be more important in a future epidemic wave, when this population has been fully vaccinated. Mathematical models can be very powerful tools to predict the impact of vaccination in different epidemiological situations, and help to adjust vaccination programs to be more efficient.

Objective: Patients with Inflammatory Bowel Disease (IBD) are at increased risk of hepatitis B virus (HBV) infection as well as a lower response to vaccination. This study aimed to analyze the immune response after vaccination against HBV in patients diagnosed with IBD and its associated factors.

Methods: A retrospective observational study was conducted on patients with IBD treated at the vaccination clinic for at-risk patients at the Complejo Hospitalario Universitario de Albacete during the period 2011-2018. Immune response after vaccination and associated factors were determined using logistic regression models.

Results: 231 patients were included. HBV Vaccination had an optimal immune response in 82.7% of the patients. The likelihood of response to vaccination increased in those diagnosed with ulcerative colitis (OR 2.90; 95% CI 1.11-7.61) and decreased with age (80% lower in those aged 40-55 years (OR 0.20; 95% CI 0.05-0.83) and 88% lower in those over 55 years of age (OR 0.12; 95% CI 0.03-0.53) compared to those under 40 years of age) and pharmacological immunosuppression (OR 0.20; 95% CI 0.58-0.71).

Conclusions: The decrease in the immunogenicity of the vaccine against hepatitis B in patients with IBD after the beginning of immunosuppressive treatment, as well as with age, make early vaccination a priority in this kind of patients.

The Ministry of Health has coordinated three studies that have estimated the impact of the COVID-19 Vaccination Strategy in Spain. The models aim to help how to establish priority population groups for vaccination, in an initial context of dose limitation. With the same epidemiological and vaccine information, the results of this three different mathematical models point in the same direction: combined with physical distancing, staggered vaccination, starting with the high risk groups, would prevent 60% of infections, 42% of hospitalizations and 60% of mortality in the population. These models, which can be adapted to the new available scientific evidence, are dynamic and powerful tools for the evaluation and adjustment of immunization programs, promoting research on this field, and helping to achieve more efficient results in health.

Objective: Primary Care (PC) must attend and follow COVID-19 patients with mild and moderate symptoms, and identify severe cases. The aim of this study was to describe the characteristics of patients attended in PC with suspicious COVID-19 and health care provision by PC.

Methods: Retrospective longitudinal observational study of electronic health records (EHR) and agendas. Probabilistic sampling of suspicious COVID-19 patients' pathway in 5 health centers in Madrid between March 16 and 20, 2020. The variables used were sociodemographic, symptoms, examination, radiography, characteristics of schedules and professional sick leaves. Descriptive analysis and time to event (pneumonia).

Results: 240 EHR were reviewed. Average age 48 years, 60% women. Most frequent symptoms: cough (80%) and elevation of temperature (63%). Pneumonia appeared in 23%. 73% were bilateral. Age and male gender were related to pneumonia. 20% required admission. 7 patients died (2.9%). 19,027 COVID-19 appointments were scheduled in PC. 60% of patients were attended in PC without performing chest X-ray or assistance by other care level. 22.4% of GPs working days were absent because of sick leaves. Differences were found amongst facilities in chest X-ray requesting (max. 62%, min. 2%). The PC center with the fewest X-rays requested was the one with the major number of sick leaves.

Conclusions: Age and male gender were related to pneumonia onset in PC. Health care activity was intense, and variability was found amongst facilities. Professional sick leaves could affect the quality of care.

Objective: The characteristics of the residence environment seem to be closely related to the health status of its residents, and the infrastructure linked to the practice of physical activity may have a direct influence on health. The objective of the study was to analyze the physical activity practice environment, evaluating in adolescents their relationship with various lifestyle habits and indicators of physical and psychosocial health, academic performance, as well as the influence of various sociodemographic variables.

Methods: The study was carried out in a sample of 761 students (14.51±1.63 years) from 25 educational centers in a region of northern Spain. The environment for the practice of physical activity, physical activity engagement, the hours of night sleep, the adherence to the Mediterranean diet, the maximum oxygen uptake, the body mass index, the health-related quality of life were assessed, self-esteem, academic performance and various sociodemographic factors.

Results: The residence in more favorable environments for the realization of physical activity was associated with higher physical activity engagement, adherence to the Mediterranean diet, maximum oxygen uptake, self-esteem and health-related quality of life. In addition, the rates of residence in more favorable environments for the realization of physical activity were lower on the part of migrants and those with low/medium socioeconomic status.

Conclusions: The infrastructure linked to the practice of physical activity is associated with the well-being of its residents, so interventions aimed at child and adolescent health should take into account the promotion of residential spaces that facilitate access to said practice.