Revista espanola de salud publica最新文献

Objective: The experience of hospitalization in the Pediatric Intensive Care Unit (PICU) affects several dimensions of the quality of life of the pediatric patient at discharge. These effects may be related to factors such as diagnoses, invasive procedures and disruption of their family ties. The objective was to measure the quality of life of children discharged from the PICU area, using the Kidscreen self-reporting instrument 27.

Methods: A quantitative approach of the analytical observational type was carried out, the population was made up of children who were hospitalized in the PICU for more than forty-eight hours and who are in their home environment. The Kidscreen 27 instrument was applied, which evaluated five dimensions of quality of life to forty-seven children between eight and eighteen years old. The correlation analysis used was the Mann-Whitney U statistical test.

Results: The results showed statistical significant differences in quality of life between genders with a P value=0.002, with lower scores in physical activity in girls. Furthermore, respiratory pathologies were the main cause of admission to the PICU with 27.6%, highlighting the importance of family and social support. Finally, 89.9% of children underwent catheter and probe insertion procedures.

Conclusions: Multidisciplinary interventions and the need for a holistic approach in post-ICU care are required, with the aim of improving the quality of life of children and being able to reduce sequelae during their re-entry into society.

The epidemic emergence of poliomyelitis in Europe at the end of the 19^th century and its global epidemic progression in the following decades generated great social concern and prompted the international fight against the disease, especially after 1953, when the World Health Organization (WHO) considered it an important international Public Health problem. Spain recorded small outbreaks, which became more intense after the Spanish Civil War and, particularly after 1950. In the middle of that decade, the first vaccines became available in the USA and Europe, and became the main tools to control polio. In Spain, Florencio Pérez Gallardo, from the National School of Public Health, led the work to study the magnitude of the disease and produce his own vaccine, for which he required international support. Within the framework of the social history of medicine, and using varied sources, our work places the Spanish vaccination strategy in the European context, highlighting the delay in its initiation and the deficiencies in its materialization. In addition, it analyses the role played by the international research stays of Pérez Gallardo and his team in order to overcome some limitations and, in 1963, to carry out the first national immunization campaign with Sabin vaccine, packaged by IBYS laboratories, showing the weight carried by their international relations, particularly with Albert Sabin.

Objective: The disease generates cost in care and the cost of comprehensive care for the Human Immunodeficiency Virus (HIV) has an impact on the health budget. The objective of this paper was to determine the cost and percentage of health expenditure including medicines in the care of patients with HIV on antiretroviral treatment.

Methods: A cost study in patients diagnosed with HIV using information from the first and second level of care electronic clinical records was carried out. We worked with 246 patients that made up the total number of those existing at the time of the study. The profile of use of health services, fixed unit cost, variable unit cost, average unit cost, average annual cost per patient, annual cost for a population, and budget exercised by level of care were identified by level of care. The percentage of health spending was estimated based on spending on HIV and the budget spent at each level of care. Statistical analysis included averages percentages and projections.

Results: The average annual cost at the first level of care was €55.86, at the second level of care €628.30. The average annual cost per patient was €684.16 and the percentage of HIV health spending was 1.41%.

Conclusions: The cost of care for patients with human immunodeficiency virus is high and varies depending on the services used; in the same way the percentage of health expenditure shows the same trend if the percentage of the affected population is considered.

Artificial Intelligence (AI) is transforming Public Health by providing innovative tools to address complex global challenges. Its ability to analyze large volumes of data in real time enhances epidemiological surveillance, optimizes healthcare resource management, and personalizes preventive interventions. These applications have proven valuable in situations such as pandemics, where AI algorithms have contributed to outbreak prediction, efficient resource allocation, and the design of targeted strategies. However, the adoption of AI also raises significant ethical and regulatory challenges. Issues such as data privacy, algorithmic transparency, and biases in models highlight the need for robust regulatory frameworks to ensure its ethical and equitable use. Furthermore, the lack of training among Public Health professionals and the digital literacy of communities limit the potential impact of these technologies. This article examines the practical applications, ethical challenges, and strategies needed for the responsible adoption of AI in Public Health. It emphasizes the importance of training, interdisciplinary collaboration, and continuous research to ensure that AI becomes a transformative tool contributing to global well-being. If implemented ethically and sustainably, AI can play a crucial role in promoting equity and quality in Public Health systems.

The aim of this paper was to describe the activities carried out by the National Poliovirus Laboratory (LNP) and the Spanish Acute Flaccid Paralysis (AFP) Surveillance Network. The LNP coordinates the network since 1998 and is responsible for the characterization of polioviruses (PV) and other enteroviruses (EV) detected, using cell culture and molecular methods. It is annually accredited by WHO and represents Spain in the World Health Organization European Polio Laboratory Network. In addition to the reported AFP cases, the network has analyzed since its creation an average of 9,000 clinical samples annually for EV, with a 7% of positive results. Two surveillance periods can be distinguished in Spain: from 1998 to 2004, when vaccine PV could be detected due to the use of the oral polio vaccine, and from 2005 onwards, when only three cases of imported vaccine-derived poliovirus have been identified following the introduction of the inactivated polio vaccine. In addition, between 70% and 85% of the EV samples received at the LNP are successfully genotyped. The work carried out by the lab network has contributed to the epidemiological and clinical surveillance and research of these infections, as well as to the rapid detection and characterization of imported poliomyelitis cases. This has facilitated the timely implementation of appropriate measures to prevent PV transmission and circulation in our country, in alignment with the Global Polio Eradication Initiative.

Objective: Cardiorespiratory fitness reduces the risk of cardiometabolic diseases, cancer and mortality. The aim of this paper was to evaluate the relationship between equation-estimated cardiorespiratory fitness and all-cause mortality in the Chilean population of both genders according to data from the 2009-2010 National Health Survey (NHS).

Methods: Data from 4,749 participants from the 2009-2010 NHS were analysed after 10.9 years of follow-up. Fitness was estimated with the Myers et al. equation and classified into quintiles. All-cause mortality records were obtained from the Chilean Civil Registry and Identification until 2020. Cox regression models adjusted for confounding variables (demographics, nutritional status, lifestyle and comorbidities) were used to assess the association between fitness and mortality.

Results: During the 10.9 years (IQR: 10.8; 11.4) of follow-up 506 (10.6%) people died. Compared to the lowest fitness quintile (<7 METs) those classified in the highest quintile (>12 METs) had a 95% lower risk of mortality (HR: 0.05; 95% CI: 0.03, 0.09) and the risk of mortality was 28% lower for every 1-METs increase in fitness (HR: 0.72 95% CI: 0.69, 0.75). All these associations were independent of confounders.

Conclusions: We conclude that a higher level of fitness is associated with a lower risk of mortality independent of confounding factors in the Chilean population after 10.9 years of follow-up.

Objective: Physical activity (PA) may be key to reducing problematic Internet use (PIU) among adolescents. Given that Internet usage patterns and PA participation can vary significantly across genders and different age groups, this study aims to analyze the association between PIU and PA, mental health and other contextual factors, in students aged thirteen to nineteen in Barcelona, by sex and age.

Methods: A cross-sectional study using data from the 2021 FRESC Survey was carried out, which included 3,256 students in the city of Barcelona. The dependent variable was PIU, measured with the validated CIUS scale. Poisson regression was used to estimate crude and adjusted prevalence ratios (PRa) with 95% confidence intervals (IC95%).

Results: In the group over sixteen years old, lower PIU was associated with regular PA in girls (PRa=0.62, IC95%=0.39-0.97) and in boys (PRa=0.51, IC95%=0.35-0.74). Lower PIU in girls under sixteen was associated with higher frequency of sports activities (PRa=0.53, IC95%=0.31-0.88). Poor mental health was associated with higher PIU across all groups (boys under sixteen, PRa=3.31, IC95%=2.42-4.51).

Conclusions: PA is associated with lower PIU in all groups except boys under sixteen years old. Other factors associated with higher PIU includes poor mental health and poor family relationships. PA promotion programs with a gender perspective could be key to addressing PIU in adolescents.

This document aims to provide visibility and raise awareness of the vaccination campaign against influenza and COVID-19 for the 2024-2025 season in Spain. This manuscript may be of interest to the scientific community, healthcare professionals, and the general population, as it emphasizes the need for collaborative efforts among all health services and public-facing workers. Furthermore, it is important to consider that both diseases continue to pose a significant risk, especially to vulnerable populations, and vaccination is positioned as the most effective public health strategy to prevent the collapse of the healthcare system and the saturation of services.

Objective: Proton pump inhibitors (PPI) are one of the groups of drugs with the highest prevalence of use. However, in many cases they are used for the treatment of unapproved indications. For this reason, in Navarra a strategy was implemented to deprescribe PPI in those cases in which their use was not indicated. Subsequently, a project was designed in order to analyze the health outcomes of that PPI deprescription strategy.

Methods: A retrospective cohort study will be developed to evaluate health outcomes obtained after the implementation of the PPI deprescription strategy. The primary outcome will be the time until a serious adverse event, defined as one that causes hospital admission or death. We will analyze whether there are differences between patients who stopped PPI treatment and those who maintained it.

Conclusions: It is expected to obtain information on the health outcomes of the proton pump inhibitor deprescription strategy and information about the convenience of continuing it.