Revista Espanola De Salud Publica最新文献

In December 2019, an acute respiratory disease outbreak from zoonotic origin was detected in the city of Wuhan, China. The outbreak's infectious agent was a type of coronavirus never seen. Thenceforth, the Covid-19 disease has rapidly spread to more than 200 countries around the world. To minimize the devastating effects of the virus, the States have adopted epidemiological measures of various kinds that involved enormous economic expenses and the massive use of the media to explain the measures to the entire population. For the prediction and mitigation of infectious events, various epidemiological models, such as SIR, SEIR, MSIR and MSEIR, are used. Among them, the most widely used is the SIR model, which is based on the analysis of the transition of individuals susceptible to infection (S) to the state of infected individuals that infect (I) and, finally, to that of recovered (cured or deceased) (R), by using differential equations. The objective of this article was the mathematical development of the SIR model and its application to predict the course of the Covid-19 pandemic in the city of Santa Marta (Colombia), in order to understand the reason behind several of the measures of containment adopted by the States of the world in the fight against the pandemic.

Background: There are different scales in Spanish for cognitive and behavioral assessment of patients with severe dementia. The objective of this study was to select those scales that are more accessible, useful and with better psychometric properties, both for clinical practice and for research.

Methods: Literature review, by experts in the field, of scales of cognitive and behavioral assessment in dementia in the main scientific databases. Published in Spanish or English, excluding those not validated in Spanish.

Results: 11 bibliographical references were selected. Cognitive scales: Severe Impairment Battery was the one with the most cognitive areas, its abbreviated version (SIB-s) had the best internal consistency (α=0.96), Baylor Profound Mental Status Examination had very good psychometric properties with 0.99 reliability and excellent concurrent validity with Mini-Mental State Examination (r=-0.91). Severe Cognitive Impairment Profile was the only one that allowed establishing subgroups of cognitive impairment. Behavioral scales: Neuropsychiatric Inventory was the gold standard in dementias, but there was only one specific scale for severe Alzheimer's disease, the Baylor Profound Mental Status Examination behavioral subscale.

Conclusions: In Spanish severe dementia, Severe Cognitive Impairment Profile and the Neuropsychiatric Inventory are the gold standard tool for cognitive assessment for research studies, and the Baylor Profound Mental Status Examination is the most useful for daily clinical practice.

Objective: The Spanish registry of Covid-19 in Spanish pregnant women, made up of 100 centers, is created in response to the need to know the morbidity that Covid-19 generates in pregnant women and their newborns, to know the real incidence of the disease in this population group and to establish and monitor the package of measures to improve their care. The aim of this paper was the creation of a registry of pregnant women with Covid-19 infection in order to establish the interventions and measures necessary to improve the care of these patients during hospital admission.

Methods: To prepare the registry, the main researcher of each center collected weekly / biweekly the number of total pregnant women screened, as well as the total number of positive and negative, sending these data to the responsible researchers so that it could be available in real time of the percentage of infected asymptomatic pregnant population and the evolution by weeks in the centers of each participating province. The data were analyzed using the linear regression test and the Mantel test.

Results: As of May 31^stsup> 2020, 16,308 screening tests were carried out in these hospitals, in which 338 pregnant women were positive, which translates into 2.07% (95% Confidence Interval: 1.86-2.30) of the asymptomatic pregnant women we attended in our centers were carriers of the virus and could develop the disease in subsequent days.

Conclusions: The Spanish epidemiological registry allows us to know the incidence of infection in pregnant women attended in the Spanish delivery centers, as well as the weekly and / or fortnightly evolution of the same, observing a significant decrease in the proportion of positive pregnant women over the total of screenings throughout this period, with an average of 6.5% in early April 2020 to an average of 0.93% positive in late May 2020.

Objective: Social determinants and health inequalities have a huge impact on health of populations. It is important to study their role in the management of the Covid-19 epidemic, especially in cities, as certain variables like the number of tests and the access to health system cannot be assumed as equal. The aim of this work was to determine the relation of social determinants in the incidence of Covid-19 in the city of Barcelona.

Methods: An observational retrospective ecological study was performed, with the neighbourhood as the population unit, based on data of cumulative incidence published at May 14th, 2020 by the Public Health Agency of Barcelona. Covid-19 incidence disparities depending on the income of the neighbourhoods, the Pearson linear correlation of the variables selected (age, sex, net density, immigrants, comorbidities, smokers, Body Mass Index [BMI] and Available Income per Family Index [AIFI]) with the incidence and the correlation with a multivariant Generalized Linear Model (GLM) were estimated.

Results: It was found that neighbourhoods belonging to the lowest quintile of income had a 42% more incidence than those belonging to the highest quintile: 942 cases per 100,000 inhabitants versus 545 per 100,000 inhabitants of the highest quintile. The Pearson correlation was statistically significative between the incidence of Covid-19 and the percentage of population over 75 (r=0.487), the percentage of immigration of the neighbourhood and the origin of the immigrants (r=-0.257), the AIFI (r=-0.462), the percentage of smokers (r=0.243) and the percentage of people with BMI over 25 (r=0.483). The GLM showed that the most correlated variables with the incidence are the percentage of people over 75 (Z-score=0.258), the percentage of people from Maghreb (Z-score=-0.206) and Latin America (Z-score=0.19) and the percentage of people with BMI over 25 (Z-score=0.334). The results of the GLM were significative.

Conclusions: Social determinants are correlated with the modification of the incidence of Covid-19 in the neighbourhoods of Barcelona, with special relevance of the prevalence of BMI over 25 and the percentage of immigrants and its origin.

Objective: Pediatric hospital emergencies have increased hardly in the recent years, product of the irrational use and the over-massification. The objective of this study was to evaluate the relationship between anxiety and sociodemographic factors of the parents and mothers.

Methods: Descriptive cross-sectional study on parental anxiety and associated factors in a pediatric hospital emergency service with sample n=200 fathers and mothers who demand care in a level 3 hospital in Valencia. (Spain), during march, april and may of 2019. It was estimated the reliability of the Anxiety Scale E-7 (STAI-E7). The data was obtained with a self-administrated and desired document for the purpose. Data related to the level of anxiety and possible predictive variables were collected. The analysis of the data obtained was performed with the Statistical Package for the Social Sciences program (SPSS, version 20.0 for Windows) and ordinal regression with the R commander program.

Results: The results show that 75.5% of the people who went to the hospital with their children were mothers and 24.5% were fathers. The mean score obtained regarding the level of anxiety in the sample is moderate (9.18±4.92). Mothers present higher levels of anxiety than fathers (9.7±4.8 and 7.5±5.1, respectively). The probability of experiencing a higher level of anxiety in mothers is multiplied by two (OR=2.286; 95% CI: 1.212-4.353; P=0.01) compared to parents. The STAI-E7 scale presents a good internal consistency (Cronbach's α=0.847).

Conclusions: Mothers have higher levels of anxiety. It will be appreciated doing more studies to quantify the levels of parental anxiety, with the purpose of creating tools and programs to decrease it.

We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.

Objective: Suicide attempts have increased considerably in recent decades. They are multifactorial in nature with preventable biopsychosocial components. Suicide attempt constitutes a vital event that affects the family and socioeconomic systems with important repercussions on public health. It is important to identify and analyze the associated risk factors, so that health professionals can consider them in their clinical practice in order to prevent them. The objective of this study was to identify the risk and protection factors that were associated with suicide attempt in the hospital population of an area of the Community of Madrid.

Methods: An analytical study of paired case-controls of patients who attended the reference hospital in Area 6 of the Community of Madrid during 2016 was carried out. Percentages were calculated and chi-square tests were used to establish an association and calculation of odds ratio with its confidence intervals and for a statistical significance of p≤0.05.

Results: An association was identified between the suicide attempts of the following variables: depression, couple conflict, psychiatric history and high anxiety, among others. Influence of insufficient economic income and low educational level was found. Of the 67 cases, 59.7% were female, with a predominance of the age groups 21-30 and 31-40 years with 28.36% in both. 82.2% had low income. 35.8% used drugs. 62.7% had some chronic disease. 59.7% presented high anxiety, 53.7% major depression and 67.1% high impulsivity.

Conclusions: There are psychopathological and personal behavioral factors related to suicide attempts, as well as a high percentage of people who attempt to commit suicide by factors of socio-economic and cultural deprivation.

Background: Suicide ranks third among the teenager's death causes around the world. Recognizing the risk factors associated to suicide can serve as a base line to design timely and effective interventions. The objective of the study was to determine the prevalence and associated factors of ideation and suicide attempt in adolescents.

Methods: It was made Systematic review, through Search of bibliographic sources Cuiden, Lilacs, Pubmed/Medline, Scielo, Science direct, Scopus and Ebsco, of primary studies. The search was conducted in January between February 2019. The search terms were Suicide, Risk Factors, Adolescents and teenagers. The appraisal of the methodological quality was carried out using a specific guidance for observational epidemiological studies. A qualitative synthesis of the findings was made. Additionally, the vote counting and sign test technique was applied.

Results: 23 studies were selected. A variably prevalence of suicidal behavior in adolescents was found. Associated factors had to did with alcohol, tobacco and psychoactive substance that increased the risk in 30%, depression and anxiety, a family history of suicide 43%, poor relationships with parents 56%, physical and psychological abuse, hopelessness, poor school performance and previous thoughts of suicide.

Conclusions: The prevalence of suicidal behavior was variable in the adolescent population, however, in several studies there was a percentage considered high for ideas and suicide attempts that were directly related to some risk factors.

Objective: The use of bibliometric indicators to measure the quality of scientific journals is a general practice in all areas of science. The WoS and Scopus databases continue to be the reference sources to obtain bibliographic indicators. Others such as SciELO network offer indicators about Ibero-American science, which are scarcely collected in WoS and Scopus. The aim of this work was to analyze the association of the indicators proposed by SciELO for health sciences journals, with the most widely used impact and indicators and to study the complementarity of the existing prestige indicators.

Methods: Analytical correlational study between SciELO indicators, with impact and prestige indicators from Journal Citation Report, Scopus and Web of Science. The results refer to 2018, the most recent and complete data available. Association between the qualitative variables was analyzed using the chi-square test, and the analysis of variance (ANOVA) was performed for the quantitative variables using the Tukey method as a post hoc test. To obtain the relationship between quantitative variables, Pearson's correlation coefficient was used and Spearman's coefficient for ordinal variables. The level of significance used in all the hypothesis tests was α≤0.05.

Results: The SciELO Impact Factor showed a weak correlation both, with Journal Citation Report (R=0.36; p=0.003), and Scopus Cite Score (R=0.39; p=0.001). The association between the H index of the Web of Science andthe H index of Scopus with the H index of SciELO was weak in both cases (R=0.45; p<0.001 and R=0.340; p=0.003).

Conclusions: Indicators proposed by SciELO, for health journals, did not show an association with those of WoS or Scopus. The weak correlation between Impact Factor and Cite Score with SciELO Impact Factor, converts the latter into a necessary "metrics" to assess journals excluded from the "mainstream" and fundamentally those from the Latin American region. The need of using the prestige indicators to fill in the impact indicators, has not been proven in this study.