Suboptimal Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients With Myocardial Infarction

Background: The incidence of cardiovascular events in HIV patients has fallen. Methods: We identified 81 patients with a history of coronary events from 2 hospitals in Spain to evaluate management of CVRF before and after the event. Results: The prevalence of coronary events was 2.15%. At the time of the coronary event, CVRF were highly prevalent. Decrease in total cholesterol (P=0.025) and LDLc(P=0.004) was observed. LDLc and HDLc were determined and the percentage of patients with LDLc &100 mg/dL remained stable at the last visit. Conclusions: The prevalence of coronary disease in our cohort was low. Although CVRF were highly.

Promoting rule compliance in daily-life: Evidence from a randomized field experiment in the public libraries of Barcelona

We study how to promote compliance with rules in everyday situations. Having access to unique data on the universe of users of all public libraries inBarcelona, we test the effect of sending email messages with dierent contents.We find that users return their items earlier if asked to do so in a simple email.Emails reminding users of the penalties associated with late returns are more effective than emails with only a generic reminder. We find differential treatmenteffects by user types. The characteristics we analyze are previous compliance,gender, age, and nationality.

Fuerza prensil de la mano asociada al grado de autonomía y riesgo de caída en ancianos

Objetivo: Determinación de la fuerza de prensión de la mano como indicador de la capacidad funcional y grado de autonomía para actividades cotidianas en personas de la tercera edad. Diseño: Se realizó un estudio observacional de diseño transversal. Emplazamiento: Medio comunitario. Centros cívicos, centros culturales y residencias de la tercera edad de la comarca del Bages (Barcelona). 2 Participantes: Se estudió a 61 personas, 40 mujeres y 21 hombres, con un rango de edad comprendido entre los 65 y 90 años, quienes no presentaban afecciones invalidantes graves. Se solicitó su colaboración y aceptación voluntaria tras informar del objetivo del estudio. Mediciones principales: El grado de autonomía funcional se valoró mediante el test de Barthel y el test de Lawton-Brody, y el riesgo de caída mediante el test de Tinetti. La fuerza muscular máxima voluntaria (FMMV) se determinó mediante el test de prensión de la mano (handgrip). Resultados: Los hombres mostraron una correlación positiva y estadísticamente significativa (p=0.001) entre la fuerza prensil de la mano y el grado de autonomía funcional y el menor riesgo de caída (p=0.037). Dicha correlación no fue observada en las mujeres respecto al grado de autonomía (p=0.232) y fue escasa para el riesgo de caída (p=0.048). Conclusiones: El test de handgrip es una herramienta potencialmente útil para estimar la autonomía funcional e instrumental y el riesgo de caídas, especialmente en varones que sobrepasan los 65 años.

The effect of scale in daily precipitation hazard assessment

Daily precipitation is recorded as the total amount of water collected by a rain-gauge in 24 h. Events are modelled as a Poisson process and the 24 h precipitation by a Generalised Pareto Distribution (GPD) of excesses. Hazard assessment is complete when estimates of the Poisson rate and the distribution parameters, together with a measure of their uncertainty, are obtained. The shape parameter of the GPD determines the support of the variable: Weibull domain of attraction (DA) corresponds to finite support variables as should be for natural phenomena. However, Fréchet DA has been reported for daily precipitation, which implies an infinite support and a heavy-tailed distribution. Bayesian techniques are used to estimate the parameters. The approach is illustrated with precipitation data from the Eastern coast of the Iberian Peninsula affected by severe convective precipitation. The estimated GPD is mainly in the Fréchet DA, something incompatible with the common sense assumption of that precipitation is a bounded phenomenon. The bounded character of precipitation is then taken as a priori hypothesis. Consistency of this hypothesis with the data is checked in two cases: using the raw-data (in mm) and using log-transformed data. As expected, a Bayesian model checking clearly rejects the model in the raw-data case. However, log-transformed data seem to be consistent with the model. This fact may be due to the adequacy of the log-scale to represent positive measurements for which differences are better relative than absolute

Salivary cotinine concentrations in daily smokers in Barcelona, Spain: a cross-sectional study

Background: Characterizing and comparing the determinant of cotinine concentrations in different populations should facilitate a better understanding of smoking patterns and addiction. This study describes and characterizes determinants of salivary cotinine concentration in a sample of Spanish adult daily smoker men and women. Methods: A cross-sectional study was carried out between March 2004 and December 2005 in a representative sample of 1245 people from the general population of Barcelona, Spain. A standard questionnaire was used to gather information on active tobacco smoking and passive exposure, and a saliva specimen was obtained to determine salivary cotinine concentration. Two hundred and eleven adult smokers (>16 years old) with complete data were included in the analysis. Determinants of cotinine concentrations were assessed using linear regression models. Results: Salivary cotinine concentration was associated with the reported number of cigarettes smoked in the previous 24 hours (R2 = 0.339; p < 0.05). The inclusion of a quadratic component for number of cigarettes smoked in the regression analyses resulted in an improvement of the fit (R2 = 0.386; p < 0.05). Cotinine concentration differed significantly by sex, with men having higher levels. Conclusion: This study shows that salivary cotinine concentration is significantly associated with the number of cigarettes smoked and sex, but not with other smoking-related variables.

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol ( � = 0.025) and LDLcholesterol ( � = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time ( � = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

Smoking behaviour, involuntary smoking, attitudes towards smoke-free legislations, and tobacco control activities in the European Union

The six most important cost-effective policies on tobacco control can be measured by the Tobacco Control Scale (TCS). The objective of our study was to describe the correlation between the TCS and smoking prevalence, self-reported exposure to secondhand smoke (SHS) and attitudes towards smoking restrictions in the 27 countries of the European Union (EU27).

Agglomeration vs. dispersion of economic activities in the districts of Paris

The spatial distribution of economic activity has often been analysed for wide geographical areas such as regions or metropolitan areas, but it has rarely been subject to microanalysis, especially outside the U.S. In this paper we focus on what happens within a large European city (Par is), and analyse how the industrial composition of its districts differs and how these districts evolve. We also analyse suburbanization process for both residents and the workforce and provide empirical evidence about the changing roles of the core and intramuros periphery. Keywords: agglomeration, suburbanization, Paris, micropolitan analysis

Learning in later life: participation in formal, non-formal and informal activities in a nationally representative Spanish sample

This article examines the participation of Spanish older people in formal, non-formal and informal learning activities and presents a profile of participants in each kind of learning activity. We used data from a nationally representative sample of Spanish people between 60 and 75 years old (n = 4,703). The data were extracted from the 2007 Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje (EADA, Survey on Adult Population Involvement in Learning Activities). Overall, only 22.8 % of the sample participated in a learning activity. However, there was wide variation in the participation rates for the different types of activity. Informal activities were far more common than formal ones. Multivariate logistic regression indicated that education level and involvement in social and cultural activities were associated with likelihood of participating, regardless of the type of learning activity. When these variables were taken into account, age did not predict decreasing participation, at least in non-formal and informal activities. Implications for further research, future trends and policies to promote older adult education are discussed.

Fuerza prensil de la mano asociada al grado de autonomía y riesgo de caída en ancianos

Objetivo: Determinación de la fuerza de prensión de la mano como indicador de la capacidad funcional y grado de autonomía para actividades cotidianas en personas de la tercera edad. Diseño: Se realizó un estudio observacional de diseño transversal. Emplazamiento: Medio comunitario. Centros cívicos, centros culturales y residencias de la tercera edad de la comarca del Bages (Barcelona). 2 Participantes: Se estudió a 61 personas, 40 mujeres y 21 hombres, con un rango de edad comprendido entre los 65 y 90 años, quienes no presentaban afecciones invalidantes graves. Se solicitó su colaboración y aceptación voluntaria tras informar del objetivo del estudio. Mediciones principales: El grado de autonomía funcional se valoró mediante el test de Barthel y el test de Lawton-Brody, y el riesgo de caída mediante el test de Tinetti. La fuerza muscular máxima voluntaria (FMMV) se determinó mediante el test de prensión de la mano (handgrip). Resultados: Los hombres mostraron una correlación positiva y estadísticamente significativa (p=0.001) entre la fuerza prensil de la mano y el grado de autonomía funcional y el menor riesgo de caída (p=0.037). Dicha correlación no fue observada en las mujeres respecto al grado de autonomía (p=0.232) y fue escasa para el riesgo de caída (p=0.048). Conclusiones: El test de handgrip es una herramienta potencialmente útil para estimar la autonomía funcional e instrumental y el riesgo de caídas, especialmente en varones que sobrepasan los 65 años.