Revista de sanidad e higiene publica最新文献

Background: To establish the age at menopause in the Canary woman. To study the possible influence of habitat, socioeconomical status and other possible factors on it.

Methods: From an initial population of 742 women, we previously excluded those that were not menopausal at the moment of the study and those that suffered it as a result of a oophorectomy. We included 394 women that had a natural menopause in the study group.

Results: The mean age of menopause was 48.6 years old. There were no statistical differences between the natural or urban areas. Neither the age of menarche nor the number of pregnancies had any influence on the age of menopause. Women with high socioeconomical status had the menopause later (50.7 years old) than hose with medium or low socioeconomical status (48.6 and 48.4 years old respectively).

Discussion: Comparing the age of menopause found in our study (48.6 years) with the published in other papers, this is very similar to the age mean reported in other spanish studies but a little lower than the age of menopause established in some occidental countries.

Background: Antitobacco campaigns in industrialized countries (USA, Canada, United Kingdom, Sweden, Finland, Australia) have been less effective FOR low social classes, except for Australia. In order to attain further reductions of tobacco consumption, these countries have to pay attention to tobacco use amongst people of low socioeconomic status. This paper seeks to analyze the causes of it to summarize relevant lessons for our own country.

Methods: Literature review in relation to tobacco consumption, social status, mediating variables between these two elements, and variety of possible interventions.

Results: Low social classes bear higher tensions, more compelling economic, familiar, affective and social relations problems, with a lower capability to adapt, neutralize or change their situation; therefore making their emotional dependence on tobacco, stronger. Family physician's intervention and community participation appear as the recommended alternatives to mass-media public campaigns.

Conclusions: These two interventions should be fostered through the national Primary Health Care Network, as a complement to public campaigns, to guarantee in equity in reducing tobacco consumption and its consequences.

Background: To describe the general practitioners referral patterns. There is special emphasis in the delay between the referral and the first consultation with the specialist. Also we consider other aspects of the coordination between both levels of care.

Methods: Cross-sectional study upon 8.095 referrals from 242 spanish doctors.

Results: The referral rate was 6.63%, higher in the 15-44 age group and also for men. We find a huge variability in the referral rates among doctors. The referral rates are higher to surgical specialties. The mean delay between referral and specialist appointment was 11 days. The general practitioners didn't receive communication from the specialists in 23.5 of the referrals.

Conclusions: A considerable range of referral rates has been identified. There is a poor continuity and coordination in the patient care.

Background: This study was carried out in the Sportive Medical Evaluation Center at the Complutense University in Madrid. Its major objective was to assess the prevalence of the Depression Status among professional sport men and women.

Methods: The Tetradimensional structured Test for depression was used for psychometric evaluation to compare two groups of 52 high competition sport men and women, and 50 university as the reference group.

Results: Study results show a 25% prevalence of depression status for the high competition sport group compared to a 2% prevalence for the reference group (p = 0.00079).

Conclusions: These results seem to conform the association between high competition sport practice and the occurrence of depressive status.

Background: To describe the Public Health in Primary Health Care practice for medical students Program objectives, quality of training evaluation method, and implementation results.

Methods: 6 learning objectives were designed and training implemented in 3 Health Centers in the 90-91 academic course. Evaluation included the objectives level of difficulty, and homogeneity in achievement rates between objectives, within Centres and between Centres. Evaluation results were analyzed and used to design changes to increase homogeneity and achievement rates. Same evaluation was performed in the 91-92 academic course to document improvement.

Results: In the first evaluation there were highly significant differences in overall (p. < 0.00005) and by objectives (p. > 0.01) achievement rates between centers. Within centres between objectives difficulty was not homogeneous either (p. > 0.001). After implementing remedial actions, differences in difficulty and achievement rates within and between centres decreased. Increased homogeneity affected mostly to two previously less homogeneous objectives.

Conclusions: Quality assurance methods can be successfully applied to improve training of clearly defined and quantified Primary Health Care learning objectives.

Background: The study that we present is basically descriptive and contribute to try to characterize the morbidity of the insured working population of the city of Játiva.

Methods: The period studied is the year 1988. 2044 registers were analyzed for cause, sex and duration. The cases were classified according the CIE-9a. The results are expressed by proportions. The significant differences are valued by the Chi-square. The half duration of the process and his interval of confidence are studied.

Results: The respiratory diseases, with the 32.68%, the traumatisms and poisonings, with the 13.36% and the osteomuscular diseases with the 11.74% represent the first three causes of ILT. We found differences significant in the groups VI (Nervous system diseases) and XVII (Traumatisms and poisonings), more frequent for the men, and in the groups V (Mental disorders) and VIII (Respiratory diseases) more frequent for the women.

Conclusions: The results obtained from the ILT study are important for the knowledge of the of the health situation in the city of Játiva.

Medical and social services are confronted with the increasing demands that our ageing society presents. Some patients (specially geriatric, chronically disabled and oncologic patients) pose multiple needs of social and medical care that very often are not met in a coordinated and comprehensive way. In this work authors present case management as a tool to achieve a better organization of social and medical resources in accordance with the demands of this growing part of the population.

Background: The medical prescription increase for psychotropic drugs, and particularly by elderly, are the facts that have motivated this study: 1) elderly psychotropic consumption assessment, 2) identify risk factors consumption.

Methods: Descriptive and cross-sectional survey from individual questionnaires.

Results: The prevalence for psychotropic drugs was 24% in our sample, (72.1% women). 53.3% prescription were realized by family practitioners. 54.3% patients used them for more than three years. The biggest group consumed are the long term benzodiazepines (62.3%).

Conclusions: The high prevalence, the long time of consumption, the use of long-term benzodiazepines, and the fact of that family practitioners are the main prescribers, must make us think about the pertinence and accuracy of these medical prescriptions.

Background: To evaluate nursing practice in periodic health examination.

Methods: We make a retrospective evaluation of process data through 10 explicit criteria. We selected a random sample (in evaluation process) and a institutional based sample and population universe (re-evaluation process) of both male and female patients who underwent health examination in nursing consults of a urban health center.

Results: We found a substantial improvement in fulfilling degree in 8 out of criteria, although best standard only was reached in 3 criteria (blood pressure determination, somatometrics and tobacco smoking investigation). We also remark the high proportion of risk factors, tobacco smoking (51.6%), obesity (37.6%) and dyslipemia (25.5%).

Conclusions: We remark the importance of entering and developing evaluation and quality assurance methodology among common tasks of primary care teams and correct ubication of periodic health examination in nursing process.