Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background: Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Methods: Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. Results: By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Conclusions: Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.

Trends in mortality due to motor vehicle traffic accident injuries between 1987 and 2011 in a Spanish region (Comunitat Valenciana)

Objective: To analyse the time evolution of the rates of mortality due to motor vehicle traffic accidents (MVTA) injuries that occurred among the general population of Comunitat Valenciana between 1987 and 2011, as well as to identify trend changes by sex and age group. Methods: An observational study of annual mortality trends between 1987 and 2011. We studied all deaths due to MVTA injuries that occurred during this period of time among the non-institutionalised population residing in Comunitat Valenciana (a Spanish Mediterranean region that had a population of 5,117,190 inhabitants in 2011). The rates of mortality due to MVTA injuries were calculated for each sex and year studied. These rates were standardised by age for the total population and for specific age groups using the direct method (age-standardised rate – ASR). Joinpoint regression models were used in order to detect significant trend changes. Additionally, the annual percentage change (APC) of the ASRs was calculated for each trend segment, which is reflected in statistically significant joinpoints. Results: For all ages, ASRs decrease greatly in both men and women (70% decrease between 1990 and 2011). In 1990 and 2011, men have rates of 36.5 and 5.2 per 100,000 men/year, respectively. In the same years, women have rates of 8.0 and 0.9 per 100,000 women/year, respectively. This decrease reaches up to 90% in the age group 15–34 years in both men and women. ASR ratios for men and women increased over time for all ages: this ratio was 3.9 in 1987; 4.6 in 1990; and 5.8 in 2011. For both men and women, there is a first significant segment (p < 0.05) with an increasing trend between 1987 and 1989–1990. After 1990, there are 3 segments with a significant decreasing APC (1990–1993, 1993–2005 and 2005–2011, in the case of men; and 1989–1996, 1999–2007 and 2007–2011, in the case of women). Conclusion: The risk of death due to motor vehicle traffic accidents injuries has decreased significantly, especially in the case of women, for the last 25 years in Comunitat Valenciana, mainly as of 2006. This may be a consequence of the road-safety measures that have been implemented in Spain and in Comunitat Valenciana since 2004. The economic crisis that this country has undergone since 2008 may have also been a contributing factor to this decrease. Despite the decrease, ASR ratios for men and women increased over time and it is still a high-risk cause of death among young men. It is thus important that the measures that helped decrease the risk of death are maintained and improved over time.

Trends and Disparities in Mortality Among Spanish-Born and Foreign-Born Populations Residing in Spain, 1999–2008

Spain’s immigrant population has increased 380 % in the last decade, accounting for 13.1 % of the total population. This fact has led her to become during 2009 the eighth recipient country of international immigrants in the world. The aim of this article is to describe the evolution of mortality and the main causes of death among the Spanish-born and foreign-born populations residing in Spain between 1999 and 2008. Age-standardised mortality rates (ASRs), average age and comparative mortality ratios among foreign-born and Spanish-born populations residing in Spain were computed for every year and sub-period by sex, cause of death and place of birth as well as by the ASR percentage change. During 1999–2008 the ASR showed a progressive decrease in the risk of death in the Spanish-born population (−17.8 % for men and −16.6 % for women) as well as in the foreign-born one (−45.9 % for men and −35.7 % for women). ASR also showed a progressive decrease for practically all the causes of death, in both populations. It has been observed that the risk of death due to neoplasms and respiratory diseases among immigrants is lower than that of their Spanish-born counterparts, but risk due to external causes is higher. Places of birth with the greater decreases are Northern Europe, Eastern Europe, Western Europe, Southern Europe, and Latin America and the Caribbean. The research shows the differences in the reduction of death risk between Spanish-born and immigrant inhabitants between 1999 and 2008. These results could contribute to the ability of central and local governments to create effective health policy. Further research is necessary to examine changes in mortality trends among immigrant populations as a consequence of the economic crisis and the reforms in the Spanish health system. Spanish data sources should incorporate into their records information that enables them to find out the immigrant duration of permanence and the possible impact of this on mortality indicators.

Advances in camera trap data management tools: Towards collaborative development and integration with GIS

Camera traps have become a widely used technique for conducting biological inventories, generating a large number of database records of great interest. The main aim of this paper is to describe a new free and open source software (FOSS), developed to facilitate the management of camera-trapped data which originated from a protected Mediterranean area (SE Spain). In the last decade, some other useful alternatives have been proposed, but ours focuses especially on a collaborative undertaking and on the importance of spatial information underpinning common camera trap studies. This FOSS application, namely, “Camera Trap Manager” (CTM), has been designed to expedite the processing of pictures on the .NET platform. CTM has a very intuitive user interface, automatic extraction of some image metadata (date, time, moon phase, location, temperature, atmospheric pressure, among others), analytical (Geographical Information Systems, statistics, charts, among others), and reporting capabilities (ESRI Shapefiles, Microsoft Excel Spreadsheets, PDF reports, among others). Using this application, we have achieved a very simple management, fast analysis, and a significant reduction of costs. While we were able to classify an average of 55 pictures per hour manually, CTM has made it possible to process over 1000 photographs per hour, consequently retrieving a greater amount of data.

Seguridad quirúrgica y cumplimentación del registro de información intraquirúrgica en España: Un análisis comparativo de dos instrumentos de registro

El objetivo del presente estudio es describir y comparar los porcentajes de no cumplimentación de dos instrumentos de registro: hoja circulante (HC) y lista de verificación quirúrgica (LVQ), en un mismo entorno quirúrgico para una muestra de pacientes de características similares. Metodología: Estudio descriptivo realizado sobre registros intraquirúrgicos de 3024 pacientes de Cirugía de Ortopedia y Traumatología. 1732 pacientes intervenidos en 2009 con modelo de hoja circulante, cumplimentada al finalizar la intervención y 1292 en 2010 intervenidos con modelo de registro lista de verificación quirúrgica (checklist) cumplimentado durante la intervención en tres tiempos. Se han calculado características descriptivas (media, desviación típica, mínimo y máximo) del porcentaje de no cumplimentación global en ambos registros y el porcentaje de no cumplimentación (intervalo de confianza al 95%) de cada ítem de los registros estudiados. Resultados: Se observa mayor porcentaje de cumplimentación global y, en general, también individual, en la hoja circulante que en la lista de verificación quirúrgica. Conclusiones: El registro intraquirúrgico que mayor porcentaje de cumplimentación ha tenido de manera global ha sido la hoja de circulante y se evidencia la necesidad de implantar estrategias para mejorar el grado de cumplimentación de la LVQ por su relación con la seguridad de pacientes.

Patient safety in the operating room and documentary quality related to infection and hospitalization

Objective: To describe the documentary quality of two records related to patient safety in the operating room and to identify differences between information related to infection and hospitalization. Methods: Comparative study based on two cross sections, conducted with 3,033 patients who had been hospitalized for more than 24 hours in an Orthopedics and Traumatology Center. Sociodemographic and clinical data, as well as information provided in forms were compared. Postoperative infection was identified as an adverse event. Results: There was a significant correlation between hospitalization days and the total number of diagnoses collected (Pearson=0.328; p<0.001). When diagnoses and infections were grouped together, a significant value was found between closed fractures and infection (p=0.001). Conclusion: Differences in the degree of completion were observed between the two records. There were no differences between adverse events.

Validation of the Spanish version of mackey childbirth satisfaction rating scale

Background: The “Mackey Childbirth Satisfaction Rating Scale” (MCSRS) is a complete non-validated scale which includes the most important factors associated with maternal satisfaction. Our primary purpose was to describe the internal structure of the scale and validate the reliability and validity of concept of its Spanish version MCSRS-E. Methods: The MCSRS was translated into Spanish, back-translated and adapted to the Spanish population. It was then administered following a pilot test with women who met the study participant requirements. The scale structure was obtained by performing an exploratory factorial analysis using a sample of 304 women. The structures obtained were tested by conducting a confirmatory factorial analysis using a sample of 159 women. To test the validity of concept, the structure factors were correlated with expectations prior to childbirth experiences. McDonald’s omegas were calculated for each model to establish the reliability of each factor. The study was carried out at four University Hospitals; Alicante, Elche, Torrevieja and Vinalopo Salud of Elche. The inclusion criteria were women aged 18–45 years old who had just delivered a singleton live baby at 38–42 weeks through vaginal delivery. Women who had difficulty speaking and understanding Spanish were excluded. Results: The process generated 5 different possible internal structures in a nested model more consistent with the theory than other internal structures of the MCSRS applied hitherto. All of them had good levels of validation and reliability. Conclusions: This nested model to explain internal structure of MCSRS-E can accommodate different clinical practice scenarios better than the other structures applied to date, and it is a flexible tool which can be used to identify the aspects that should be changed to improve maternal satisfaction and hence maternal health.

Memorias de licenciatura: resúmenes de las memorias de licenciatura leídas en el Dpto. de Historia Contemporánea de la Universidad de Alicante

Resúmenes de las memorias: ORS MONTENEGRO, Miguel: La prensa ilicitana: 1836-1980. Leída el 9 de noviembre de 1982. Director: Dr. Salvador Forner Muñoz; GARCIA ANDREU, Mariano: La Segunda República en la ciudad de Alicante: las elecciones. Leída el 10 de noviembre de 1982. Director: Dr. Salvador Forner Muñoz; VALERO IVAÑEZ, Manuel: Catálogo de la correspondencia consular y comercial del consulado francés en Alicante, 1808-1901. Leída el 14 de febrero de 1983. Director: Dr. Salvador Forner Muñoz.

Resúmenes de las tesis doctorales y memorias de licenciaturas leídas en el Departamento de Humanidades Contemporáneas, División Historia Contemporánea, de la Universidad de Alicante

Resumen de: GARCÍA ANDREU, Mariano: Crecimiento económico, burguesía y poder local en Alicante: 1902-1923. Tesis doctoral leída el 23 de marzo de 1987. Director: Dr. D. Salvador Forner Muñoz; GUTIÉRREZ LLORET, Rosa Ana: La República y el Orden: Burguesía y republicanismo en Alicante (1868-1893). Tesis doctoral leída el 16 de octubre de 1987. Director: Dr. D. Salvador Forner Muñoz; ESTEVE GONZÁLEZ, Miguel Ángel: La escuela y la enseñanza en Alicante durante el siglo XIX. Liberalismo y tradición. Tesis doctoral leída el 17 de septiembre de 1988. Director: Dr. D. Salvador Forner Muñoz; SANTACREU SOLER, José Miguel: Cambio económico y conflicto bélico: Transformaciones económicas en la retaguardia republicana (Alicante, 1936-1939). Tesis doctoral leída el 9 de diciembre de 1988. Director: Dr. D. Salvador Forner; PALAZÓN FERRANDO, Salvador: Los condicionamientos de la política exterior española durante la Segunda República. Memoria de licenciatura leída el 12 de noviembre de 1986. Director: Dr. D. Salvador Forner Muñoz; MORENO FONSERET, Roque: La crisis económica en la provincia de Alicante, 1973-1983. Memoria de licenciatura leída el día 13 de noviembre de 1986. Director: Dr. D. Salvador Forner Muñoz; COSTA VIDAL, Fernando: Villena durante la Segunda República. Vida política y elecciones. Memoria de licenciatura leída el 18 de diciembre de 1986. Director: Dr. D. Salvador Forner; BALLESTER ARTIGUES, Teresa: Les eleccions municipals de 1931 a la Marina Alta. Memoria de licenciatura leída el 23 de septiembre de 1987. Director: Dr. D. Glicerio Sánchez Recio; ZURITA ALDEGUER, Rafael: Alicante durante el Bienio Progresista. La actuación de la burguesía alicantina en una situación revolucionaria (1854-1856). Memoria de licenciatura leída el 3 de mayo de 1988. Director: Dr. D. Salvador Forner Muñoz.

¿Las plantas pueden revertir su sexo?

The sex determination is an event of great relevance in the life cycle of those plants that reproduce sexually. In recent years we have obtained substantial advances in elucidating the mechanisms involved, and in particular the role of epigenetic factors, in plant sex determination. Taking into account the relevance of this topic especially for dioecious species threatened as Cycads studies have been underwent to determine the basis of epigenetics of sex and to test whether compounds such as the de-metilating agent 5-azacytidine may be involved in sexual expression. This paper reviews the main progress made within this context obtained in Z. furfuraceae as well as cases of reversal of sex in cycads and different plant species.

Humanización de los cuidados en la Unidad de Quemados del Hospital General Universitario de Alicante

Introducción: Existen numerosos estudios que demuestran que la incidencia de muerte por quemaduras ha disminuido, por lo que la cuestión que debe preocuparnos en estos momentos es la calidad de vida de los supervivientes. La continuidad de los cuidados por parte de los profesionales de enfermería en las unidades de quemados es una pieza clave en la recuperación y rehabilitación del paciente en todos sus ámbitos. Objetivo: Identificar la humanización de los cuidados de enfermería en la Unidad de Quemados del Hospital General Universitario de Alicante. Método: Estudio cualitativo de carácter etnográfico mediante observación participante. Incluye una propuesta de cuestionario dirigido a estudiantes de enfermería en prácticas en unidades de quemados. Resultados: el cuidado observado no se centra en lo biológico, preocupándose por las necesidades de la persona e incorporando acompañamiento constante y apoyo emocional en las intervenciones. La política de visitas restrictiva constituye una barrera para la humanización, aunque el personal de enfermería muestra disposición para ampliar el horario establecido e incorporar a los familiares en el cuidado. Conclusiones: Las enfermeras aprovechan cualquier técnica para identificar necesidades insatisfechas y proporcionar apoyo emocional al paciente, personalizando cada intervención y centrando el cuidado en la persona mediante una visión holística de la misma.

Estudio de la implantación de los cuatro cursos del Grado en Ingeniería Civil

El objetivo de esta red de investigación se encuentra basado en el análisis de los resultados obtenidos en el Curso Académico 2013-14, correspondientes a las asignaturas de primer, segundo, tercer y cuarto curso del Grado de Ingeniería Civil, de forma que se pueda proceder a la mejora de los procedimientos de trabajo del profesorado implicado en el desarrollo de las asignaturas de los cursos indicados, dentro del marco creado por la implantación del EEES. Para ello se han analizado las metodologías empleadas en las distintas asignaturas analizadas, los calendarios y plazos asignados a cada una de ellas, los procedimientos de evaluación y los resultados de los mismos. Al mismo tiempo, se ha creado una comisión cuyo objetivo es el de analizar las necesidades de conocimiento de las distintas asignaturas, adecuando el contenido de las ofertadas en los primeros cursos a las exigencias de los posteriores, y ofreciendo de esta forma al alumno una formación homogénea a lo largo Grado de Ingeniería Civil.