Publications (9)2.17 Total impact
-
Article: [Design and comparative analysis of an inventory of avoidable mortality indicators specific to health conditions in Colombia].
[show abstract] [hide abstract]
ABSTRACT: To develop a list of indicators of avoidable mortality (LIAM) in order to analyze failed efforts to control the mortality risks prevalent in Colombia, and to compare its results to those of two widely-used approaches. The official mortality records of Colombia for 1985-2001 were reviewed; the basic causes of death were classified according to the ICD-9. Indicators of avoidable mortality (AM) were selected using an algorithm that combined the lists of Holland and Taucher, the definition of Rutstein and colleagues, and the principle of Uemura. The proportions of avoidable deaths that resulted from applying the LIAM and the two AM lists were compared to a database containing Colombia's official death records from 1993-1996. Of the 680 617 deaths registered during the study period, 18.2% were classified as avoidable according to Holland's list, and 51.3%, by Taucher's list. According to the LIAM, avoidable mortality rose to 76.7%. This pattern remained relatively stable in 1993-1996. The differences observed between the proportions of avoidable deaths according to the LIAM and that of the two other lists were related to the local epidemiological profile and the conceptual approach of each list. The differences between the LIAM and the AM lists of Taucher and of Holland attest to the consequences of using one or another classification in the Colombian context. The LIAM can be a valuable resource for undergirding and evaluating health policies, but must be adjusted to the specific situation in which it is applied.Revista Panamericana de Salud Pública 11/2009; 26(5):385-97. · 0.85 Impact Factor -
Article: [Concordance among samples taken from a subcutaneous reservoir and a peripheral puncture].
[show abstract] [hide abstract]
ABSTRACT: Many patients who undergo phlebo-toxic treatment eventually require central vein access ways and of these accesses, the most common one used among oncology patients due to its advantages is a subcutaneous reservoir. The objective of this study was to verify the concordance among samples obtained from a subcutaneous reservoir using the rejection technique, and those obtained when using a direct puncture technique. This study included 22 patients who were carriers of a subcutaneous reservoir and who visited outpatient services during March and April in 2006. The study authors obtained simultaneous samples from subcutaneous reservoirs and from peripheral veins. These parameters were compared by means of an intra-class correlation coefficient. Only hematology parameters, that is leucocytes, hematocrits, hemoglobin and platelets, showed an adequate concordance.Revista de enfermeria (Barcelona, Spain) 07/2008; 31(6):36-8. -
Article: ["Auriga-04" study on the use of a range of Allevyn hydro-cellular dressings in the treatment of bed sores and leg ulcers by primary health care professionals].
[show abstract] [hide abstract]
ABSTRACT: The objective of this study was to analyze the application and usefulness of a range of Allevyn trademark hydro-cellular dressings during cicatrisation and in the control of exudation and other various characteristics of chronic lesions in real clinical conditions where patients were treated by primary health care professionals. In this study, 441 patients having chronic wounds, either bed sores or leg ulcers, were studied, health care professionals applied a planned program of measures repeated during 20 dressing changes or until cicatrisation was completed if this happened during this interval. The sample population was comprised of elderly patients, the majority of whom were women whose general health could be classified from medium to poor. These patients suffered from these types of wounds: 63% had bed sores, 27.2% had varicose ulcers and 9.8% had leg ulcers caused by another etiology such as mixed ulcers, arterial ulcers or diabetic foot. On average, these lesions were characterized by an evolutionary period of 6.1 months and had a 30.43 square centimetre surface area at the start of the study. 126 lesions, or 28.8%, cicatrized on average of 47.3 days. Among the 315 lesions which had not cicatrized by the end of 20 dressing changes, 90.5% showed evidence of improvement. During the study these lesions showed a significant reduction in their surface area, as well as a significant improvement at the edges of these lesions and the peri-ulceral skin. The health personnel which carried out the treatment using these dressings gave a very favorable evaluation for their use. At the end of this study, in comparison with other dressings previous used, this study showed that in 43.43% of the cases an Allevyn dressing was deemed better in terms of ease in application, in 51.79% of the cases an Allevyn dressing was better in terms of absorption and in 43.23% of the cases an Allevyn dressing was better during removal.Revista de enfermeria (Barcelona, Spain) 05/2006; 29(4):43-9. -
Article: [Making decisions. A conceptual approximation].
[show abstract] [hide abstract]
ABSTRACT: Decision making is constant in all aspects of the nursing field, including management, professional development, investigation and assistance. But, What can be stated about the mechanisms and procedures which lead us to adopt a decision? By means of the considerations taken into account, and bearing in mind that in our country there are no research articles which deal with decision making in nursing, the authors make a bibliographical review which contributes to a critical discussion about this topic and which brings to bear elements of reflection for decision making in daily nursing practice. First, the authors deal with the origins and the evolution of decision making models in clinical practice so that they may later analyze decision making in nursing.Revista de enfermeria (Barcelona, Spain) 01/2003; 25(12):22-30. -
Article: [Famine in the Spanish civil war and mortality from coronary heart disease: a perspective from Barker's hypothesis].
[show abstract] [hide abstract]
ABSTRACT: To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease (CHD) in persons born in this period, following the lines of Barker's hypothesis on fetal programming of chronic diseases in adult life. Using CHD mortality data by age and sex for 1990-2002, annual and age-adjusted rates were calculated by the direct method. Poisson regressions were used to estimate period, age and cohort effects by year of birth (1918-1957). During the study period, CHD mortality fell by a yearly average of -2.3% in both sexes and in all ages yearly. This trend was influenced by both cohort and period effects (p<0.001); an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense (1937, 1940, 1943 and 1945). The results obtained by studying yearly CHD mortality are compatible with those expected by Barker's hypothesis of the effect of nutritional stress during pregnancy. In addition to its human, economic and political costs, the Spanish civil war could also have had negative consequences for the health of persons born in this period.Gaceta Sanitaria 20(5):360-7. · 1.33 Impact Factor -
Article: Construcción de un índice de privación a partir de datos censales en grandes ciudades españolas: (Proyecto MEDEA)
[show abstract] [hide abstract]
ABSTRACT: Objetivos: a) Describir la metodología seguida en la construcción de un índice de privación por sección censal en ciudades, que permite identificar las secciones con situaciones socioeconómicas más desfavorables, y b) analizar la relación de este índice con la mortalidad general. Métodos: Se elaboraron diversos indicadores socioeconómicos (Censo 2001) correspondientes a las secciones censales de las ciudades de Barcelona, Bilbao, Madrid, Sevilla y Valencia. Se estudiaron sus correlaciones con la razón estandarizada de mortalidad (1996-2003), así como sus dimensiones conceptuales. Finalmente, mediante el análisis de componentes principales, se agregaron en un índice los indicadores seleccionados, usando como valores de peso las saturaciones correspondientes al primer eje. Resultados: Los indicadores que presentaron mayores correlaciones con la mortalidad general fueron los referidos a trabajo, educación, vivienda-entorno y hogares monoparentales. En el análisis dimensional de los indicadores aparece una primera dimensión que contiene los indicadores relati- vos a trabajo (desempleo, trabajadores manuales y eventuales) y educación (instrucción insuficiente total y en jóvenes). El índice elaborado con estos 5 indicadores recoge, en todas las ciudades estudiadas, más del 75% de la variabilidad de los indicadores que lo componen. Las correlaciones de este índice con la mortalidad muestran, en general, mayores valores que las obtenidas individualmente con cada indicador. Conclusiones: El índice de privación que se propone puede ser un instrumento útil para la planificación sanitaria al detectar áreas pequeñas de grandes ciudades con una situación socioeconómica desfavorable, que se relaciona con la mortalidad, y puede contribuir al estudio de las desigualdades sociales en salud en España.Gaceta sanitaria: Organo oficial de la Sociedad Española de Salud Pública y Administración Sanitaria, ISSN 0213-9111, Vol. 22, Nº. 3, 2008, pags. 179-187. -
Article: La mortalidad evitable: ¿cambios en el nuevo siglo?
[show abstract] [hide abstract]
ABSTRACT: Objetivos: Estudiar la evolución temporal y la distribución geográfica de la mortalidad evitable en la Comunidad Valenciana y en sus Departamentos de Salud por sexo, en los períodos 1990-1994, 1995-1999 y 2000-2004. Material y método: Se han analizado 21 causas de mortalidad evitable agrupándolas en tratables y prevenibles. Las defunciones analizadas corresponden a residentes en la Comunidad Valenciana durante el período 1990-2004. Se han calculado las tasas ajustadas por edad (método directo) y las razones de mortalidad comparativas para el estudio de la evolución temporal en los ámbitos geográficos indicados por período y sexo. Las razones de mortalidad estandarizadas (método indirecto) se han utilizado en el análisis de la distribución geográfica. Resultados: El total de defunciones evitables son 38.061 (un 7,1% de la mortalidad global), el 76,2% corresponden a varones y el 23,8% a mujeres. Por grupos, el 82,4% son prevenibles y el 17,6% tratables. En varones, las prevenibles representan un 86,5%, y en mujeres un 69,4%. En la Comunidad Valenciana se observan descensos significativos de la mortalidad evitable en ambos sexos, más acusados en las tratables, y en hombres. La mortalidad por cáncer de pulmón en mujeres presenta un aumento significativo. En 2000-2004 ningún departamento de salud presenta excesos de mortalidad estadísticamente significativos en las tratables. Conclusiones: La mortalidad evitable desciende más que la mortalidad general en la Comunidad Valenciana. Cabe destacar el aumento de la mortalidad por cáncer de pulmón en las mujeres.Gaceta sanitaria: Organo oficial de la Sociedad Española de Salud Pública y Administración Sanitaria, ISSN 0213-9111, Vol. 22, Nº. 3, 2008, pags. 200-209. -
Article: El hambre en la Guerra Civil española y la mortalidad por cardiopatía isquémica: una perspectiva desde la hipótesis de Barker
[show abstract] [hide abstract]
ABSTRACT: Objetivo: Analizar si el hambre durante la Guerra Civil española y la inmediata posguerra influyó sobre la mortalidad por cardiopatía isquémica de las personas que nacieron en este período, según lo planteado en la hipótesis de Barker acerca de la posible programación fetal de enfermedades de la edad adulta. Métodos: Con los datos de mortalidad por edad y sexo por cardiopatía isquémica en el período 1990-2002, se calcularon las tasas anuales de mortalidad específicas y las tasas ajustadas por edad, por el método directo. Mediante análisis de regresión de Poisson se analizó el efecto de la edad, el período y la cohorte anual de nacimiento (1918-1957). Resultados: Durante el período de estudio, la mortalidad por cardiopatía isquémica ha disminuido un promedio anual de –2,3% en ambos sexos y para todas las edades. En el descenso de mortalidad están presentes los efectos cohorte y período (p < 0,001); se observa un incremento del riesgo para todas las edades y ambos sexos en las muertes correspondientes a personas nacidas durante los años reconocidos como de mayor escasez alimentaria de la Guerra Civil y la inmediata posguerra (1937, 1940, 1943 y 1945). Conclusiones: Los resultados obtenidos al estudiar anualmente la mortalidad por cardiopatía isquémica son compatibles con la hipótesis de Barker sobre el efecto del estrés alimentario durante el embarazo en la génesis de diversas enfermedades en el adulto. La Guerra Civil española, además de costes humanos, económicos y políticos, puede haber tenido consecuencias negativas para la salud de los nacidos en esas cohortes. Objective: To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease (CHD) in persons born in this period, following the lines of Barker’s hypothesis on fetal programming of chronic diseases in adult life. Methods: Using CHD mortality data by age and sex for 1990- 2002, annual and age-adjusted rates were calculated by the direct method. Poisson regressions were used to estimate period, age and cohort effects by year of birth (1918-1957). Results: During the study period, CHD mortality fell by a yearly average of –2.3% in both sexes and in all ages yearly. This trend was influenced by both cohort and period effects (p < 0.001); an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense (1937, 1940, 1943 and 1945). Conclusions: The results obtained by studying yearly CHD mortality are compatible with those expected by Barker’s hypothesis of the effect of nutritional stress during pregnancy. In addition to its human, economic and political costs, the Spanish civil war could also have had negative consequences for the health of persons born in this period. -
Article: La recuperación de la información en ciencias de la salud: Medline vs. Medline
[show abstract] [hide abstract]
ABSTRACT: Medline has become the most used source of biomedical information. Sanitary personnel use Medline through PubMed due to its easiness and free access, although other database providers continue offering Medline for a fee (pay per use, subscription, etc.). Our objective has been to compare the search results using PubMed (free) versus ERLWebSPIRS-SilverPlatter® (paid subscription). We have searched for the publications on “Public Health” existing in this database between 1994 and 2003. Material and method: Descriptive and cross sectional study of the results of the bibliographical searches made in the database Medline. Results: Relative percentage differences obtained according to diverse search type: Maximum 99,86; Minimum -127,06; Mean 10,86; Median -1,84. Discussion and conclusion: Once seen the differences, an error in the election of the terminology or in the process of information search will alter the results. Therefore it is mandatory to write down the search strategies so that obtained results be consistent and can be reproduced.
