Atlas interactivo de mortalidad de Andalucía (AIMA)

Until now, mortality atlases have been static. Most of them describe the geographical distribution of mortality using count data aggregated over time and standardized mortality rates. However, this methodology has several limitations. Count data aggregated over time produce a bias in the estimation of death rates. Moreover, this practice difficult the study of temporal changes in geographical distribution of mortality. On the other hand, using standardized mortality hamper to check differences in mortality among groups. The Interactive Mortality Atlas in Andalusia (AIMA) is an alternative to conventional static atlases. It is a dynamic Geographical Information System that allows visualizing in web-site more than 12.000 maps and 338.00 graphics related to the spatio-temporal distribution of the main death causes in Andalusia by age and sex groups from 1981. The objective of this paper is to describe the methods used for AIMA development, to show technical specifications and to present their interactivity. The system is available from the link products in www.demap.es. AIMA is the first interactive GIS that have been developed in Spain with these characteristics. Spatio-temporal Hierarchical Bayesian Models were used for statistical data analysis. The results were integrated into web-site using a PHP environment and a dynamic cartography in Flash. Thematic maps in AIMA demonstrate that the geographical distribution of mortality is dynamic, with differences among year, age and sex groups. The information nowadays provided by AIMA and the future updating will contribute to reflect on the past, the present and the future of population health in Andalusia.

Validation of a new tool to assess health-related quality of life in psoriasis: the PSO-LIFE questionnaire.

BACKGROUND Several questionnaires have been used to measure health related quality of life (HRQoL) in patients with psoriasis, few have been adapted for use in Spain; none of them was developed specifically for the Spanish population. The purpose of the study was to validate and assess the sensitivity to change of a new questionnaire to measure HRQOL in patients with psoriasis (PSO-LIFE). METHODS Observational, prospective, multicenter study performed in centers around Spain. Patients with active or inactive psoriasis completed the PSO-LIFE together with other Dermatology Quality of Life Index (DLQI) and Psoriasis Disability Index (PDI). A control group of patients with urticaria or atopic dermatitis was also included. Internal consistency and test-retest reliability of the PSO-LIFE were assessed by calculating Cronbach's alpha and Intraclass Correlation Coefficient (ICC). Validity was assessed by examining factorial structure, the capacity to discriminate between groups, and correlations with other measures. Sensitivity to change was measured using effect sizes. RESULTS The final sample included for analysis consisted of 304 patients and 56 controls. Mean (SD) age of psoriasis patients was 45.3 (14.5) years compared to 38.8 (14) years for controls (p < 0.01). Cronbach's alpha for the PSO-LIFE was 0.95 and test-retest reliability using the ICC was 0.98. Factor analysis showed the questionnaire to be unidimensional. Mean (SD) PSO-LIFE scores differed between patients with psoriasis and controls (64.9 [22.5] vs 69.4 [17.3]; p < 0.05), between those with active and inactive disease (57.4 [20.4] vs 76.4 [20.6]; p < 0.01), and between those with visible and non-visible lesions (63.0 [21.9] vs. 74.8 [23.9]; p < 0.01). The correlation between PSO-LIFE and PASI scores was moderate (r = -0.43) while correlations with DLQI and PDI dimensions ranged from moderate to high (between 0.4 and 0.8). Effect size on the PSO-LIFE in patients reporting 'much improved' health status at study completion was 1.01 (large effect size). CONCLUSIONS The present results provide substantial support for the reliability, validity, and responsiveness of the PSO-LIFE questionnaire in the population for which it was designed.

Influence of gender on long-term prognosis of patients with chronic heart failure seen in heart failure clinics.

BACKGROUND Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available from specific heart failure clinics. HYPOTHESIS Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men. METHODS AND RESULTS We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patients with chronic heart failure seen in 62 specialized clinics forming part of a multicenter registry during a mean follow-up of 40 months. The mean age was 65 +/- 12 years and 71% were men. The men were younger than the women and more often had a history of hyperlipidemia and ischemic heart disease. The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) than the women and a greater frequency of systolic ventricular dysfunction. The men more often received treatment with beta-blockers, vasodilators, and antiplatelet aggregators as well as higher mean doses as compared with the women. The overall survival after the follow-up was similar for both genders, although the women had lower rates of survival free of admission for heart failure. CONCLUSIONS Despite the mortality of women and men with heart failure being similar, the rate of readmission for heart failure is greater in women in specialized heart failure clinics. These results may be associated with the pharmacological treatment differences observed.

Guía de indicadores par medir las desigualdades de género en salud y sus determinantes

Este proyecto ha recibido financiación de la Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía y del Fondo Europeo de Desarrollo Regional (Expediente P08-CTS-4321)

Mapa de indicadores para integrar la perspectiva de género en el Sistema Sanitario Público de Andalucía (SSPA)

Organizadores: AFOE (Asociación para la Formación, el Ocio y el Empleo)y Grupo MIDO (Métodos de Investigación y Diagnóstico en Orientación). Facultad de Ciencias de la Educación. Universidad de Sevilla. Web del Congreso: http://www.empleoeigualdad.es/congreso/

Análisis de la producción científica visible en internet de los técnicos de salud ambiental del Servicio Andaluz de Salud

Internet it is a powerful interactive communication channel with world scope, through which can be multiplied the visibility of the research of the professionals whose scientific production has a difficult diffusion by the conventionals media. It is presented an analysis of the scientific publications observed in the web in order to understand the different communication processes accomplished by the superior corps of environmental health technical of the Andalusian Health Service. Using the nominal relationship of the professionals, we used Google ‘search engine’ for all scientific publications located in the internet; we were made different bibliometric indicators as of the recovered records and was analyzed the time evolution of the scientific production, documental categories, geografic distribution, language, coauthors and institutional collaboration. It was identified a growing trend in the productivity of the publications in the last decade, mainly through communications to congresses (70.4%) and journals articles (16.9%). The publications mainly are located in spanish journals, that they are indexed on national and international databases. In all the Andalusian provinces was identified some published scientific communication. The indicator of coauthors is very high (95.77%) although the institutional participation is limited mainly to the primary attention districts, occupational centers of each professional (85.21%). The scientific publication patterns visualized in the web represent an important contribution for the knowledge of the characteristics of the environmental health professionals of the Andalusian health service, what provides avaluable information for the support of the information systems in public health.

Integración de la Biblioteca Virtual del Sistema Sanitario Público de Andalucía en la política científica de la Consejería de Salud y Bienestar Social

Capítulo incluido en parte III del Congreso: Indicadores cuantitativos y cualitativos para el análisis de la colaboración científica

Manual para la evaluación del impacto en salud de proyectos sometidos a instrumentos de prevención y control ambiental en Andalucía

Este Manual se complementa con los siguientes documentos de apoyo: 1. Actuaciones y requerimientos (Lista de actuaciones con indicación de los requerimientos que deben cumplir respecto a la EIS); 3. Indicadores (Batería de indicadores y estándares para la evaluación y la relevancia de los impactos); y 4. Análisis en profundidad (Resumen de las etapas de una evaluación de riesgos). Publicado en la página Web de la Consejería de Salud : www.juntadeandalucia.es/salud (Ciudadanía / Nuestra Salud / Evaluación de impacto en salud)

Manual para la evaluación del impacto en salud de los instrumentos de planeamiento urbanístico en Andalucía

Este Manual se complementa con varios documentos de apoyo: 1. Dimensiones y áreas que pueden verse afectadas por el planeamiento urbanístico; 3. Batería de indicadores y estándares para la evaluación de la relevancia de los impactos; y 4. Análisis en profundidad. Publicado en la página Web de la Consejería de Salud: www.juntadeandalucia.es/salud (Ciudadanía / Nuestra Salud / Evaluación de impacto en salud)

Elaboración de criterios e indicadores para desarrollar y evaluar programas de envejecimiento saludable en los lugares de trabajo

BACKGROUND In the actual context of population ageing and extension of working age, programs for health promotion at the workplace are a key and necessary tool to promote an active and healthy ageing. This work presents the methodological process followed to elaborate a checklist tool, within the framework of the European project Progress, that contributes to orientate planning, implementation and evaluation of good practices in this field, to be applicable to a variety of programs, countries and workplaces. METHODS A Delphi technique has been applied in three rounds in which experts in the area from five European countries participated. A questionnaire created from a list of criteria and indicators was adapted throughout the rounds, with the use of webmail, to the evaluation of interventions in the field of interest. Through processes of assessment and consensus, criteria and indicators most relevant were prioritized. RESULTS From the nine starting criteria and after the implementation of the technique, four key criteria were prioritized: relevance: 62, adequacy to objective: 57, innovation: 50 and guarantee of quality: 41. Using this group of criteria and indicators, a checklist was designed containing the key information that should be collected for planning, implementation and evaluation of good practices in interventions in this field. CONCLUSIONS The checklist tool helps to systematize the global methodology for the implementation of interventions which could be very useful for persons responsible of programmes to promote active and healthy ageing in the workplace.

Análisis de contenidos de páginas web sobre servicios de control de plagas en salud pública

Introduction: Our goal was to know the web contents and examine the technical information pest control services available to users through their webpages. Method: A total of 70 webpages from biocides services in the province of Málaga (Spain) were analyzed. We used 15 evaluation indicators grouped into 5 parameters relating to data of the service provider; information’s reliability and services; accuracy of content and writing style; technical resources and interaction with the users. As test instruments were used sectoral legislation, official records of products and deliveries, standards and technical guides. Results: Companies showed a remarkable degree of awareness with the implementation and use of new technologies. Aspects negative that they can have an impact on the confidence of users, relating to the reliability of the information and deficiencies associated with the description of the services portfolio and credentials of the companies were identified. The integration and use of collaborative platforms 2.0 was poorly developed and squandered. Discussion: It is possible to improve the trust of users intervening in those aspects that affect the reliability of the information provided on the web.

Entorno Colaborativo de Trabajo: La Intranet 2.0 de la Consejería de Salud de la Junta de Andalucía

The Department of Health of the Government of Andalusia provides professionals of the Andalusian Public Health Care System a collaborative working environment (Entorno colaborativo de trabajo [ECT]) based on the principles of web 2.0. The ECT is organized into communities, understood as sets of people with a common interest who share a space with its own information and collaboration tools. This space is managed and powered autonomously by the communities themselves. This paper analyzes the use and degree of implementation of the ECT, considering the user communities and activity statistics in 2009 and 2010. From the data obtained we deduce that instrumental services have easier acceptance than collaboration and knowledge management services; content generation is focused on a small number of users; and communities associated with organizational units have less development than those associated with work areas or projects.

Promoción de la salud en personas con trastorno mental grave : análisis de situación y recomendaciones sobre alimentación equilibrada y actividad física

Publicado en la página web de la Consejería de Salud y Bienestar social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / profesionales / Salud Pública / Promoción de la Salud / Actividad Física y Alimentación Equilibrada / Materiales) y (Consejería de Salud y Bienestar Social / Ciudadanía / Nuestra Salud / Vida sana)