Revista Espanola De Salud Publica最新文献

Despite the scientific development of this century, tuberculosis (TB) is the most prevalent infection worldwide. For many reasons, including the social stigma associated, it is an under-diagnosed disease. About a clinical case in our practice, the purpose of this work was to give relevance to this aspect of the disease, as well as to the role of chest radiography and Primary Care Medicine in detecting and treating cases.

The pandemic produced by COVID-19 has a significant impact on society and has also affected childhood and adolescence, which, in general, has been the most silenced group. This article addresses the contents that affect the mental health of children and adolescents in the heart of the COVID-19 pandemic, it is located in the "fourth wave of care" in category F54 of the ICD-10 ("Behavioral and psychological factors in disorders or diseases classified elsewhere"). The presentation mechanism is: reactive-adaptive to the pandemic; triggering factor, before a previous affective-emotional instability; decompensation of a pre-existing process. The clinical features have had their initial phase, fundamentally, in confinement: somatoform disorders, behavioral disorders, emotional symptoms, reactivation of child abuse and dysfunctional grief reactions. The most prevalent symptoms are of the anxious or anxious-depressive type. The response to chronic stress, including that of low profile and intensity but maintained over time, has significant repercussions for childhood and adolescence. Few percentage that present prominent mental disorders, but we must recognize that when projected to the whole the child-adolescent population, there could be a significant number that could be subsidiary of a more specific help. The return to schooling is going to represent another important moment, the repercussions of confinement being of capital importance, especially in terms of addictive behaviors with information and communication technologies. Intervention by professionals trained in childhood and adolescent mental health is a priority to avoid unwanted clinical evolutions or iatrogenesis.

Objective: Volcanic eruptions are a natural source of substances potentially dangerous to human health. The island of El Hierro (Canary Islands, Spain) suffered a marine volcanic eruption in 2012, making it necessary to monitor the levels of certain elements that can alter the quality of groundwater supply. The objective of this work was to determine the content of metals and trace elements in the groundwater supply of the Isla del Hierro and to check if they met the quality parameters established in Spanish legislation.

Methods: The content of metals and trace elements (aluminum, lead, cadmium, calcium, potassium, sodium, magnesium, boron, barium, cobalt, chromium, copper, iron, lithium, manganese, molybdenum, nickel, strontium, vanadium, zinc, fluorine) in a total of 60 samples of groundwater supply and agriculture from six different sampling points on the island. The determination was carried out by inductively coupled plasma optical emission spectrophotometry (ICP-OES) and by fluoride ion selective potentiometry. The data were statistically analyzed applying the Kolmogorov-Smirnov test, Levene's statistic, Kruskal-Wallis, Mann-Whitney U, ANOVA and Tukey's test. Significant differences were those that met p<0.05.

Results: The highest mean concentration of lead was recorded in the Tigaday samples (0.003±0.0005 mg/L), finding statistically significant differences (p<0.05) in the lead levels between the sampling points. The elements analyzed were below the parametric values set in Royal Decree 140/2003.

Conclusions: The results obtained reflect that, in all the samples analyzed, the quality parameters established in the Spanish legislation (RD 140/2003) are met, being, therefore, waters suitable for human consumption.

Between March and May 2020, the Spanish Ministry of Health and the Spanish Psychological Association created the Psychological First Care Service (Servicio de Primera Ayuda Psicológica-SPAP), a national helpline designed to provide early psychological intervention to those people affected by COVID-19. This service attended more than 15,000 calls and carried out more than 11,000 interventions and 9,500 follow-ups with the general population, healthcare and other essential professionals and the patients and relatives of the sick or deceased. Results show that the majority of calls (45.7%) came from the Autonomous Community of Madrid, that women significantly used this service in a higher proportion than men (73.5%) and that the commonest age range among users was 40-59. 75.9% of consultations were related to psychological problems linked to anxiety and depressive symptoms. However, grief symptoms also stood out among the patients or relatives of the sick and deceased and, to a lesser extent, stress symptoms were prevalent in the group of professionals. These data show the usefulness of this early psychological care service and the need for similar resources to be implemented in coordination with or within the National Health System.

Background: Covid-19 is a latent threat; a sector of the population with a labor obligation carries out its work not in person in an unplanned context due to the extraordinary social distancing expressed in remote work, without previous experience in many cases and with health exposure due to psychosocial risk factors conditioning stress. Our objective was to describe the fatigue and mental burden in teleworkers through a bibliographic review, of interest for occupational health, public health, clinical research, psychology and other areas of knowledge. We also intend to inform the community about these issues to promote safe telework and ensure a balanced quality of life.

Methods: Structured information on the topics of fatigue and mental load was presented, based on the analysis of international literature, mainly from recent years, obtained from the search engine reviews of scientific publications Ebsco, PubMed, and supplemented with Google Scholar, according to recognized thesauri, in English and Spanish.

Results: There are also psychosocial risks in teleworking; work-related stress can be linked to fatigue, which should also be addressed as a psychosocial risk. Fatigue, although multi-causal, can be occupational in origin and may be conditioned by various aspects of labour, such as the mental workload, which is pernicious at its extremes.

Conclusions: We conclude that both fatigue and mental workload must be watched, their extremes threaten the quality of work life.

Background: The 1918 influenza epidemic was an event of great social and health resonance, which caused high morbidity and mortality in the population. The rapidity in the development of symptoms, the extension to very large groups of the population and the lack of knowledge of the causative agent, were the factors that, added together, made the flu a major public health problem. The objective of this study was to review, through the Spanish written press, of the public health measures adopted as a consequence of the influenza epidemic of 1918.

Methods: A selection of the Spanish press was carried out through the Digital Newspaper Library of the National Library (HDBN) of Spain, from January 1, 1918 to December 31, 1920; and the concept "flu" was searched, selecting those units of analysis that made reference to the public health measures adopted during the flu epidemic of 1918.

Results: The newspapers analyzed reported the public health measures adopted by the health authorities of the different countries in order to reduce the spread of the epidemic, such as the closure of schools and the postponement of the opening of the academic year, disinfection of premises, quarantines, isolation, suspension, popular celebrations, disinfection and hygiene, border control, suspension of communications by train, as well as the creation and use of different vaccines and serums to immunize the population.

Conclusions: The poor management of the epidemic could be one of the causes of the great impact of influenza in the first half of October 1918, as the decisions of the administration to promote public health measures were adopted with some delay.

In the midst of the SARS-CoV-2 public-health pandemic emergency, it is important to understand its zoonotic origin and how an animal virus finally infects humans. Identifying the circumstances in which a virus jumps species boundaries to infect humans so productively is objective of this work and will help us to determine the epidemiology and pathogenisis of this agent. Nowadays, it is known that bats serve as reservoir hosts for virus progenitor, but determine the possibility of a potential intermediate host of SARS-CoV-2 is still a challenge. Scientific investigations stablish the natural selection theory as the most probable (natural selection in an animal host before zoonotic transfer or acquired mutations in humans following crossing species barrier). It is necessary to find out how SARS-CoV-2 emerged, its rapidly spreads within a community and the optimal context in which this virus binds to human receptor. One Health is a multisectoral, collaborative and transdisciplinary approach which allows a cooperative working between animal and human health that will help us to introduce some possible control measures that might reduce the spread of the virus; improving sanitary management, identifying new outbreaks and preventing future zoonotic and pandemic events.

Objective: Tuberculosis is a major public health problem and most cases are concentrated in vulnerable populations. The objective was to describe the incidence rates trend in native and foreign population (2009-2018) in Madrid Region.

Methods: Retrospective analysis of cases from the Tuberculosis Regional Registry of cases of Madrid Region 2009-2018. Annual incidence rates were calculated by country of birth (Spain, other), sex and age group (<15, 15-34, 35-44, 45-64, >64), using the annual January 1st continuous register population. The infection rate trend and the annual percentage change (APC) were calculated, along with the best jointpoint adjustment using Jointpoint regression.

Results: 7,696 cases were analyzed, 48.2% were foreign-born individuals. Average age in native population was 50 years old (SD: 23.96) and 35 (DS: 36.64) in foreign-born individuals (p<0.001). The overall incidence rate decreased from 17.30 in 2009 to 9.00 per 100,000 in 2018 and was higher in men. Pulmonary tuberculosis reduced from 11.90 to 6.55. Among native population, the incidence of TB fell from 10.29 to 5.24 with an APC of -7.3% (95%IC: -8.9; -5.7) (p<0.05), no jointpoint was identified. Among foreign-born individuals the incidence of tuberculosis declined from 46.54 to 25.49, a joint point was identified in 2013, observing an incidence decrease for the period 2009-2013 and APC of -13.8% (IC95%: -17.5; -10.0).

Conclusions: The global incidence rate in this period has decreased by approximately 7% per year. However, this reduction occurred mainly in native population. In foreign-born individuals the incidence decreased by approximately 14% during the 2009-2013 period, after this period there have been no significant incidence changes.

Objective: One of the fist lines of action of the National Plan against Antibiotic Resistance (PRAN) is to monitor the use of antibiotics as a fundamental basis for the fight against resistance. In order to know the antibiotic prescription habits, we pretended to describe the outpatient prescription of systemic antibiotics in the Balearic Islands through exploitation of ABPresclín database.

Methods: It was an ecological descriptive study of the electronic outpatient prescriptions of systemic antibiotics of the Health Service of the Balearic Islands from 2012 to 2018. Combining the prescription with population information data by year and geographical area, prescription rates were obtained per 1,000 person, distributed by professional, health centres, geographical areas: distribution per patient characteristics, type of antibiotics and associated diagnoses.

Results: 3,517,101 prescriptions are analyzed with an average prescription period (TPp) per 1,000 person-years of 472.1. A quarter of the population received at least one prescription of antibiotics. TPp was higher in over 80 years (899.0) and in women (553.4). 68.9% of the prescription was made in primary care (AP) and 17.9% in out-of-hours settings. TPp in AP was 333.1, varying from 192.3 to 527.0, according to basic health areas. The TPp of the most commonly used antibiotics was: amoxicillin/clavulanic (143), amoxicillin (95.9), azithromycin (54.5), fosfomycin (41.5) and ciprofloxacin (29.7). The main associated diagnoses were: lower respiratory infections (16.5%), urinary infections (15%), non-infectious (15%), tonsillitis (14.3%) and upper respiratory infections (13%).

Conclusions: Balearic Islands have a relatively low antibiotic prescription rate with a marked variability between prescribers. Amoxicillin/clavulanic was the most prescribed antibiotic, with an increase in azithromycin. Respiratory infections were the main reason for prescription. ABPresclín is useful to promote better use of antibiotics.