Putting health in all policies: The National Institute for Welfare Enhancement

Welfare is a rather vague term whose meaning depends on ideology, values andjudgments. Material resources are just means to enhance people s well-being, butgrowth of the Gross Domestic Production is still the standard measure of thesuccess of a society. Fortunately, recent advances in measuring social performanceinclude health, education and other social outcomes. Because what we measureaffects what we do it is hoped that social policies will change. The movementHealth in all policies and its associated Health Impact Assessment methodologywill contribute to it. The task consists of designing transversal policies thatconsider health and other welfare goals, the short term and long-term implicationsand intergenerational redistributions of resources. As long as marginalproductivity on health outside the healthcare system is higher than inside it,efficiency needs cross-sectoral policies. And fairness needs them even more,because in order to reduce social inequalities in health, a wide social and politicalresponse is needed.Unless we reduce the well-documented inefficiencies in our current health caresystems the welfare states will fail to consolidate and the overall economic wellbeingcould be in serious trouble. In this article we sketched some policy solutionssuch as pricing according to net benefits of innovation and public encouragementof radical innovation besides the small type incremental and market-ledinnovation. We proposed an independent agency, the National Institute forWelfare Enhancement to guarantee long term fair and efficient social policies inwhich health plays a central role.

Disparities in work, risk and health between immigrants and native-born Spaniards

We analyse the impact of working and contractual conditions, particularly exposure to job risks, on the probability of acquiring a permanent disability, controlling for other personal and firm characteristics. We postulate a model in which this impact is mediated by the choice of occupation, with a level of risk associated with it. We assume this choice is endogenous, and that it depends on preferences and opportunities in the labour market, both of which may differ between immigrants and natives. To test this hypothesis we apply a bivariate probit model to data for 2006 from the Continuous Sample of Working Lives provided by the Spanish Social Security system, containing records for over a million workers. We find that risk exposure increases the probability of permanent disability arising from any cause - by almost 5%.

Avaluació tecnològica de les tecnologies convergents : Les NBIC: sinergies entre nanotecnologia, biotecnologia, tecnologies d'informació i comunicació (TIC) i ciències del coneixement

Traducció al català de l’informe “Technology Assessment on Convergent Technologies” elaborat per l’STOA (Science and Technology Options Assessment) per a la Direcció General de Polítiques Interiors del Parlament Europeu, realitzada per la Fundació Catalana per a la Recerca i la Innovació (FCRI).

High-Resolution Mass Spectrometry applied to the identification of new metabolites and transformation products of quinolones in chicken muscle tissues

The aim of this work was the identification of new metabolites and transformation products (TPs) in chicken muscle from Enrofloxacin (ENR), Ciprofloxacin (CIP), Difloxacin (DIF) and Sarafloxacin (SAR), which are antibiotics that belong to the fluoroquinolones family. The stability of ENR, CIP, DIF and SAR standard solutions versus pH degradation process (from pH 1.5 to 8.0, simulating the pH since the drug is administered until its excretion) and freeze-thawing (F/T) cycles was tested. In addition, chicken muscle samples from medicated animals with ENR were analyzed in order to identify new metabolites and TPs. The identification of the different metabolites and TPs was accomplished by comparison of mass spectral data from samples and blanks, using liquid chromatography coupled to quadrupole time-of-flight (LC-QqToF) and Multiple Mass Defect Filter (MMDF) technique as a pre-filter to remove most of the background noise and endogenous components. Confirmation and structure elucidation was performed by liquid chromatography coupled to linear ion trap quadrupole Orbitrap (LC-LTQ-Orbitrap), due to its mass accuracy and MS/MS capacity for elemental composition determination. As a result, 21 TPs from ENR, 6 TPs from CIP, 14 TPs from DIF and 12 TPs from SAR were identified due to the pH shock and F/T cycles. On the other hand, 14 metabolites were identified from the medicated chicken muscle samples. Formation of CIP and SAR, from ENR and DIF, respectively, and the formation of desethylene-quinolone were the most remarkable identified compounds.

Aspectos socioculturales de la precariedad laboral y de su impacto

This essay analyzes the current work crisis, its individual and social influence and its implications on human development and health. It discusses the main cultural perspectives on the notion of work and presents the hypothesis of a possible influence of the cultural meaning of the concept of 'work' on diminishing self-esteem and mental health problems among unemployed people. The essay also highlights possible implications of the current situation in the future taking into consideration socioeconomic and political aspects as well as global demographic growth. Finally, the essay discusses the role that Public Health should have not only in the prevention and control of health problems among the unemployed, but also in the social, economic and cultural changes that are considered necessary to mitígate the serious social differences and to improve the current situation.

Aspectos socioculturales de la precariedad laboral y de su impacto

This essay analyzes the current work crisis, its individual and social influence and its implications on human development and health. It discusses the main cultural perspectives on the notion of work and presents the hypothesis of a possible influence of the cultural meaning of the concept of 'work' on diminishing self-esteem and mental health problems among unemployed people. The essay also highlights possible implications of the current situation in the future taking into consideration socioeconomic and political aspects as well as global demographic growth. Finally, the essay discusses the role that Public Health should have not only in the prevention and control of health problems among the unemployed, but also in the social, economic and cultural changes that are considered necessary to mitígate the serious social differences and to improve the current situation.

Verifique sus conocimientos sobre radioprotección

La protección radiológica en radiodiagnóstico merece una atención específica que abordaremos en esta entrega que forma parte de una serie sobre pruebas complementarias que se inició en el Nursing2007 de abril. La utilización de técnicas basadas en el uso de radiación ionizante es muy habitual en nuestro entorno laboral. En estas técnicas intervienen cada vez más profesionales de enfermería, tanto desde un punto de vista de la realización, como de supervisión y de apoyo del médico en su realización. Nuestro objetivo es familiarizar a los/as profesionales de enfermería con la protección radiológica y con el conocimiento de las herramientas y mecanismos de que disponemos, o deberíamos disponer, en nuestros centros asistenciales para aplicarlos desde el punto de vista de protección de la salud. Es importante aclarar que hay disciplinas médicas, diagnósticas o terapéuticas, que utilizan otras radiaciones ionizantes (alfa, beta y gamma), diferentes a las radiaciones X empleadas en radiodiagnóstico. En tal caso, aunque la base sea común, pueden estar sujetas a otras medidas de prevención. Finalmente creemos que de esta manera combatiremos posibles temores y prejuicios en torno a los rayos X; tendremos claras las principales precauciones que podemos tomar y cómo las gestionamos en el desempeño de nuestras funciones diarias como enfermeros/as desde un punto de vista de riesgo laboral.

Verifique sus conocimientos sobre radioprotección

La protección radiológica en radiodiagnóstico merece una atención específica que abordaremos en esta entrega que forma parte de una serie sobre pruebas complementarias que se inició en el Nursing2007 de abril. La utilización de técnicas basadas en el uso de radiación ionizante es muy habitual en nuestro entorno laboral. En estas técnicas intervienen cada vez más profesionales de enfermería, tanto desde un punto de vista de la realización, como de supervisión y de apoyo del médico en su realización. Nuestro objetivo es familiarizar a los/as profesionales de enfermería con la protección radiológica y con el conocimiento de las herramientas y mecanismos de que disponemos, o deberíamos disponer, en nuestros centros asistenciales para aplicarlos desde el punto de vista de protección de la salud. Es importante aclarar que hay disciplinas médicas, diagnósticas o terapéuticas, que utilizan otras radiaciones ionizantes (alfa, beta y gamma), diferentes a las radiaciones X empleadas en radiodiagnóstico. En tal caso, aunque la base sea común, pueden estar sujetas a otras medidas de prevención. Finalmente creemos que de esta manera combatiremos posibles temores y prejuicios en torno a los rayos X; tendremos claras las principales precauciones que podemos tomar y cómo las gestionamos en el desempeño de nuestras funciones diarias como enfermeros/as desde un punto de vista de riesgo laboral.

The use of non-animal alternatives in the safety evaluations of cosmetics ingredients by the Scientific Committee on Consumer Safety (SCCS)

In Europe, the safety evaluation of cosmetics is based on the safety evaluation of each individual ingredient. Article 3 of the Cosmetics Regulation specifies that a cosmetic product made available on the market is to be safe for human health when used normally or under reasonably foreseeable conditions. For substances that cause some concern with respect to human health (e.g. colorants, preservatives, UV-filters), safety is evaluated at the Commission level by a scientific committee, presently called the Scientific Committee on Consumer Safety (SCCS). According to the Cosmetics Regulations, in the EU, the marketing of cosmetics products and their ingredients that have been tested on animals for most of their human health effects, including acute toxicity, is prohibited. Nevertheless, any study dating from before this prohibition took effect is accepted for the safety assessment of cosmetics ingredients. The in vitro methods reported in the dossiers summited to the SCCS are here evaluated from the published reports issued by the scientific committee of the Directorate General of Health and Consumers (DG SANCO); responsible for the safety of cosmetics ingredients. The number of studies submitted to the SCCS that do not involve animals is still low and in general the safety of cosmetics ingredients is based on in vivo studies performed before the prohibition.

Los métodos alternativos en el estudio de la seguridad de cosméticos

El Reglamento 1223/2009 establece las normas que deben cumplir todos los productos cosméticos comercializados en Europa, con objeto de velar por el funcionamiento del mercado interior y lograr un elevado nivel de protección de la salud humana garantizando el uso de métodos alternativos que no impliquen la utilización de animales. El Laboratorio Europeo de Referencia para las Alternativas a la Experimentación con Animales (EURL-EURL- ECVAM) es el laboratorio de referencia en Europa encargado de validar los métodos alternativos. Posteriormente pueden ser homologados por la Organización de Cooperación y Desarrollo Económico (OCDE). Por otro lado, el Comité Científico de Seguridad de los Consumidores (SCCS) asesora a la Comisión sobre todos los temas relacionados con la seguridad de los cosméticos. En esta revisión se detalla una relación de métodos alternativos necesarios para evaluar la seguridad de los ingredientes cosméticos así como los métodos usados y sus limitaciones.

Improving interMediAte Risk management. MARK study

Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect

Los métodos alternativos en el estudio de la seguridad de cosméticos

El Reglamento 1223/2009 establece las normas que deben cumplir todos los productos cosméticos comercializados en Europa, con objeto de velar por el funcionamiento del mercado interior y lograr un elevado nivel de protección de la salud humana garantizando el uso de métodos alternativos que no impliquen la utilización de animales. El Laboratorio Europeo de Referencia para las Alternativas a la Experimentación con Animales (EURL-EURL- ECVAM) es el laboratorio de referencia en Europa encargado de validar los métodos alternativos. Posteriormente pueden ser homologados por la Organización de Cooperación y Desarrollo Económico (OCDE). Por otro lado, el Comité Científico de Seguridad de los Consumidores (SCCS) asesora a la Comisión sobre todos los temas relacionados con la seguridad de los cosméticos. En esta revisión se detalla una relación de métodos alternativos necesarios para evaluar la seguridad de los ingredientes cosméticos así como los métodos usados y sus limitaciones.

Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe)

Objectives: To measure the health-related quality of life (HRQoL) of multiple sclerosis (MS) patients and their caregivers, and to assess which factors can best describe HRQoL. Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL. Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS) and 551 caregivers (mean age 45.4 years) participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3). Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3). Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL. Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context