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1.
Ramon Mir-Abellán Anna Falcó-Pegueroles María Luisa de la Puente-Martorell 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):145-149
Objective
To describe attitudes towards patient safety culture among workers in a hospital setting and determine the influence of socio-demographic and professional variables.Methods
The Hospital Survey on Patient Safety Culture was distributed among a sample of professionals and nursing assistants. A dimension was considered a strength if positive responses exceeded 75% and an opportunity for improvement if more than 50% of responses were negative.Results
59% (n = 123) of respondents rated safety between 7 and 8. 53% (n = 103) stated that they had not used the notification system to report any incidents in the previous twelve months. The strength identified was “teamwork in the unit/service” and the opportunity for improvement was “staffing”. A more positive attitude was observed in outpatient services and among nursing professionals and part-time staff.Conclusions
This study has allowed us to determine the rating of the hospital in patient safety culture. This is vital for developing improvement strategies. 相似文献2.
3.
Objective
To explore what hospitals and primary care (PC) are doing to reduce the negative social impact of a serious adverse event (AE).Methods
We surveyed 195 hospital (n = 113) and PC (n = 82) managers from eight autonomous communities to explore the level of implementation of five interventions recommended after an AE to protect the reputation of healthcare institutions.Results
Most institutions (70, 45.2% PC, and 85, 54.8% hospitals) did not have a crisis plan to protect their reputation after an AE. Internal (p = 0.0001) and external (p = 0.012) communications were addressed better in PC than in hospitals. Very few institutions had defined the managers’ role in case of an AE (10.7% hospitals versus 6.25% PC).Conclusion
A majority of healthcare institutions have not planned crisis intervention after an AE with severe consequences nor have they defined plans to recover citizens’ trust after an AE. 相似文献4.
5.
Seungho Lee Miyeon Shin Yun-Chul Hong Jin Hee Kim 《International journal of hygiene and environmental health》2017,220(2):407-414
Background
Biological measurements have been employed as useful biomarkers for exposure. Because of its property of reflecting toxicokinetic differences, however, within-subject variability leads to biased results in epidemiologic studies.Method
We examined the variability of lead (Pb), mercury (Hg), and cadmium (Cd) levels in blood samples from 1429 participants among 1677 elderly individuals aged over 60 years who lived in an urban area from August 2008 to April 2015.Results
The geometric means of blood Pb, Hg, Cd were 1.92 μg/dL, 2.48 μg/L, and 1.33 μg/L, and the intra-class correlations (ICCs) were 0.81, 0.71, and 0.83, respectively. The mean values of Pb and Hg levels in this study were lower than the results from single spot samples in other national biomonitoring surveys in Korea, with the exception of Cd was higher than those in other studies. Moreover, the predicted exceedances over the guidance levels for Pb, Hg, and Cd were 1.9%, 4.2%, and 0.3%, respectively.Conclusion
Korean elderly were exposed to high levels of Pb, Hg and Cd. Especially, those who had high levels of Cd were continuously exposed to Cd during study period with the 6 collection intervals. Therefore, factors affecting environmental Cd exposure should be further studied in the future. 相似文献6.
Xavier Continente Anna Pérez Albert Espelt Carles Ariza María José López 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):332-335
Objective
We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain.Methods
A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire.Results
More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR = 1.56; 95% confidence interval: 1.19-2.05).Conclusions
These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity. 相似文献7.
Carmen Franken Nathalie Lambrechts Eva Govarts Gudrun Koppen Elly Den Hond Daniëlla Ooms Stefan Voorspoels Liesbeth Bruckers Ilse Loots Vera Nelen Isabelle Sioen Tim S. Nawrot Willy Baeyens Nicolas Van Larebeke Greet Schoeters 《International journal of hygiene and environmental health》2017,220(2):468-477
Background
In Belgium, around 8.5% of the children have asthmatic symptoms. Increased asthma risk in children has been reported in relation to exposure to phthalate plasticizers but the underlying mechanisms are largely unknown.Aim
The aim of this study was to identify if oxidative stress, assessed by excision of 8-hydroxydeoxyguanosine (8-OHdG) from damaged DNA, is an intermediate marker for the association between phthalate exposure and doctor-diagnosed asthma.Material and methods
In 418 14–15-year-old youngsters, recruited as a representative sample of residents of Flanders (Belgium), personal exposure to phthalates was assessed by measuring phthalate metabolites in urine: mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), mono-isobutyl phthalate (MiBP) and mono-ethyl phthalate (MEP). Analysis of 8-OHdG in urine was used as a sensitive biomarker of oxidative stress at the level of DNA. The presence of doctor-diagnosed asthma was elicited by a self-administered questionnaire. Associations were assessed using multiple linear and logistic regression models. Mediation was tested using Baron and Kenny's regression approach.Results
A significant increased risk of a youngster being diagnosed with asthma was found for both urinary MnBP (metabolite of dibutyl phthalate (DBP)) and the sum of the three di(2-ethylhexyl) phthalate metabolites (ΣDEHP = MEHP + MEHHP + MEOHP), with respective odds ratio of 1.84 [95% CI: 1.02, 3.32] for MnBP and 1.94 [95% CI: 1.07, 3.51] for ΣDEHP. In addition, we observed significant associations between all urinary phthalate metabolites and increased urinary levels of 8-OHdG. The associations were stronger in girls than in boys. We did not found evidence that 8-OHdG was associated with doctor-diagnosed asthma.Conclusion
The results of our study are in line with other findings from epidemiological surveys and raise further concern about DEHP and DBP as risk factors for asthma, however, the underlying mechanisms are not yet well understood. 相似文献8.
9.
Xinyang Hua Guido Erreygers John Chalmers Tracey-Lea Laba Philip Clarke 《Health policy (Amsterdam, Netherlands)》2017,121(4):426-433
Objectives
Australia’s universal health insurance system Medicare generates very large amounts of data on out-of-pocket expenditure (OOPE), but only highly aggregated statistics are routinely published. Our primary purpose is to develop indices from the Medicare administrative data to quantify changes in the level and distribution of OOPE on out-of-hospital medical services over time.Methods
Data were obtained from the Australian Hypertension and Absolute Risk Study, which involved patients aged 55 years and over (n = 2653). Socio-economic and clinical information was collected and linked to Medicare records over a five-year period from March 2008. The Fisher price and quantity indices were used to evaluate year-to-year changes in OOPE. The relative concentration index was used to evaluate the distribution of OOPE across socio-economic strata.Results
Our price index indicates that overall OOPE were not rising faster than inflation, but there was considerable variation across different types of services (e.g. OOPE on professional attendances rose by 20% over a five-year period, while all other items fell by around 14%). Concentration indices, adjusted for demographic factors and clinical need, indicate that OOPE tends to be higher among those on higher incomes.Conclusions
A major challenge in utilizing large administrative data sets is to develop reliable and easily interpretable statistics for policy makers. Price, quantity and concentration indices represent statistics that move us beyond the average. 相似文献10.
Anna Maria Ingelido Vittorio Abate Annalisa Abballe Fulvia Lucia Albano Tatiana Battista Valter Carraro Michele Conversano Rosa Corvetti Silvia De Luca Silva Franchini Anna Rita Fulgenzi Laura Giambanco Nicola Iacovella Anna Laura Iamiceli Antonio Maiorana Francesco Maneschi Valentina Marra Flavia Pirola Elena De Felip 《International journal of hygiene and environmental health》2017,220(2):378-386
Background
Polychlorinated dibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs) are persistent organic pollutants that represent a major concern for women of reproductive age because of the neurodevelopmental effects associated to perinatal exposure.Objectives
This study was aimed at characterizing exposure of women of reproductive age to PCDDs, PCDFs, and PCBs as a function of residence in different Italian Regions, in areas at presumable different environmental contamination and human exposure to these pollutants.Methods
Study participants were enrolled in 2011–2012 in 6 Italian Regions representative of Northern, Central and Southern Italy; in each region, areas at presumed different exposure (rural, urban and industrial) were selected for enrolment. Each participant provided a serum sample for the analysis of PCDDs, PCDFs and PCBs.Results
Median concentrations of PCDDs + PCDFs, DL-PCBs, NDL6-PCBs and NDL9-PCBs in serum samples were respectively 6.0 and 3.5 pgWHO-TE05/g fat, and 75 and 93 ng/g fat.Age was the variable that most affected median serum concentrations.Age adjusted concentrations were found significantly different between geographical zones: women from Northern Italy showed the highest values, followed by Central and Southern Italy.PCDDs + PCDFs concentrations were significantly higher in the group of women residing in industrial areas compared to the group residing in rural areas.A clear diminishing temporal trend was observed compared to levels reported in previous studies.Conclusions
This study produced the largest dataset on serum concentrations of PCDDs, PCDFs and PCBs in women of childbearing age in Italy.Results
confirmed that environmental and lifestyle factors may influence exposure to these contaminants and thereby the body burden.The observed marked temporal decline in body burden during three decades is in agreement with the general trend observed worldwide. 相似文献11.
Steffen Andreas Schüle Katharina M.A. Gabriel Gabriele Bolte 《International journal of hygiene and environmental health》2017,220(4):711-718
Background
The environmental justice framework states that besides environmental burdens also resources may be social unequally distributed both on the individual and on the neighbourhood level. This ecological study investigated whether neighbourhood socioeconomic position (SEP) was associated with neighbourhood public green space availability in a large German city with more than 1 million inhabitants.Methods
Two different measures were defined for green space availability. Firstly, percentage of green space within neighbourhoods was calculated with the additional consideration of various buffers around the boundaries. Secondly, percentage of green space was calculated based on various radii around the neighbourhood centroid. An index of neighbourhood SEP was calculated with principal component analysis. Log-gamma regression from the group of generalized linear models was applied in order to consider the non-normal distribution of the response variable. All models were adjusted for population density.Results
Low neighbourhood SEP was associated with decreasing neighbourhood green space availability including 200 m up to 1000 m buffers around the neighbourhood boundaries. Low neighbourhood SEP was also associated with decreasing green space availability based on catchment areas measured from neighbourhood centroids with different radii (1000 m up to 3000 m). With an increasing radius the strength of the associations decreased.Conclusions
Social unequally distributed green space may amplify environmental health inequalities in an urban context. Thus, the identification of vulnerable neighbourhoods and population groups plays an important role for epidemiological research and healthy city planning. As a methodical aspect, log-gamma regression offers an adequate parametric modelling strategy for positively distributed environmental variables. 相似文献12.
Gabriela Barbaglia Núria D. Adroher Gemma Vilagut Ronny Bruffaerts Brentan Bunting José Miguel Caldas de Almeida Silvia Florescu Giovanni de Girolamo Ron de Graaf Josep Maria Haro Hristo Hinkov Vivianne Kovess-Masfety Herbert Matschinger Jordi Alonso 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(1):2-10
Objective
To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach.Methods
Representative samples of the adult general population (n = 13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated.Results
Health conditions explained a large proportion of full role limitation (PAF = 62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability.Conclusion
The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation. 相似文献13.
Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities
Elisabet Arribas-Ibar Josep Maria Suelves Albert Sanchez-Niubò Antònia Domingo-Salvany M. T. Brugal 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):292-298
Objective
We assessed prevalence of suicidal ideation and plans among illicit drug users and their association with contextual factors, by gender.Methods
Cross-sectional study. In a sample of 511 illicit drug users recruited during spring 2012 in drug treatment and prevention facilities in Catalonia (Spain), the prevalence of suicidal ideation/plans in the last 12 months was assessed. Poisson regression was used to examine associations between suicidal ideation/plans and various factors (socio-demographic, psychological, illegal drug market activities and marginal income generation activities, which included any reported sex work, stealing, peddling, begging or borrowing on credit from a dealer).Results
The average age was 37.9 years (standard deviation: 8.62); 76.3% were men. Suicidal ideation/plans were reported by 30.8% of men and 38.8% of women, with no significant differences by age or gender. Recent aggression (male prevalence ratio [PR] = 2.2; female PR = 1.4), psychological treatment (male PR = 1.2; female PR = 1.3) and illegal/marginal income generation activities (male PR = 1.5; female PR = 1.1) were associated with suicidal ideation/plans. Men who trafficked were more likely to have suicidal ideation/plans (PR = 1.3), while prison history was positive for women (PR = 1.8) and negative for men (PR = 0.7).Conclusions
Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated. 相似文献14.
15.
A.M. Holman J. Allyn G. Miltgen N. Lugagne N. Traversier S. Picot A. Lignereux C. Oudin O. Belmonte N. Allou 《Médecine et maladies infectieuses》2017,47(5):333-339
Background
The aim of this study was to trace the emergence of carbapenemase-producing Enterobacteriaceae (CPE) on Reunion Island, a French overseas territory well suited for the surveillance of CPE emergence in patients from the entire Indian Ocean Region.Methods
This retrospective multicenter study was conducted on Reunion Island between 2010 and 2015.Results
A total of 43 CPEs were isolated during the course of the study, in 36 patients (50% in the last year alone). Among these patients, 21 had a link with a foreign country (58%), mainly Mauritius (47.6%). Over the same period, CPEs were isolated from 13 of 1735 (0.7%) repatriated patients to Reunion Island from another country of the Indian Ocean Region. The incidence of isolation of CPEs in the repatriated patients treated in Mauritius was higher (9.2%) than in patients treated in Madagascar or the Comoros Islands (< 1%, P < 0.001). The most commonly isolated microorganism was Klebsiella pneumoniae (39.5%). The most frequently identified carbapenemase was NDM-1 (81.4%); 100% and 56% of the NDM-1 strains were susceptible to tigecycline and colistin, respectively. In-hospital mortality rate was higher in patients presenting with CPE infection than in patients without CPE infection (75% vs. 25%, P = 0.04).Conclusion
As elsewhere in the world, the number of CPE cases on Reunion Island is on the rise. Most cases involve patients from Mauritius, which justifies screening and isolating CPE in patients from that country. 相似文献16.
17.
José Manuel Terán Carlos Varea Cristina Bernis Barry Bogin Antonio González-González 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):116-122
Objective
Birthweight by gestational age charts enable fetal growth to be evaluated in a specific population. Given that maternal profile and obstetric practice have undergone a remarkable change over the past few decades in Spain, this paper presents new Spanish reference percentile charts stratified by gender, parity and type of delivery. They have been prepared with data from the 2010–2014 period of the Spanish Birth Statistics Bulletin.Methods
Reference charts have been prepared using the LMS method, corresponding to 1,428,769 single, live births born to Spanish mothers. Percentile values and mean birth weight are compared among newborns according to gender, parity and type of delivery.Results
Newborns to primiparous mothers show significantly lower birthweight than those born to multiparous mothers (p < 0.036). Caesarean section was associated with a substantially lower birthweight in preterm births (p < 0.048), and with a substantially higher birthweight for full-term deliveries (p < 0.030). Prevalence of small for gestational age is significantly higher in newborns born by Caesarean section, both in primiparous (p < 0.08) and multiparous mothers (p < 0.027) and, conversely, the prevalence of large for gestational age among full-term births is again greater both in primiparous (p < 0.035) and in multiparous mothers (p < 0.007).Conclusions
Results support the consideration of establishing parity and type of delivery-specific birthweight references. These new charts enable a better evaluation of the impact of the demographic, reproductive and obstetric trends currently in Spain on fetal growth. 相似文献18.
Riyadh Alshamsan Hannah Leslie Azeem Majeed Margaret Kruk 《Health policy (Amsterdam, Netherlands)》2017,121(3):315-320
Background
Countries globally are pursuing universal health coverage to ensure better healthcare for their populations and prevent households from catastrophic expenditure. The countries of the Gulf Cooperation Council (GCC) have and continue to implement reforms to strengthen their health systems. A common theme between the countries is their pursuit of universal health coverage to provide access to necessary health care without exposing people to financial hardship.Methods
Using nationally representative data from the Global Findex study, we sought to analyze the hardship faced by individuals from four high-income countries in the GCC. We estimated the weighted proportion of individuals borrowing for medical reasons and those who are not able to obtain emergency funds. We further examined variations in these outcomes by key socioeconomic factors.Results
We found up to 11% of respondents borrowed money for medical purposes, double of that reported in other high-income countries. In contrast to affluent respondents, we found that respondents from deprived background were more likely to borrow money for medical purposes (adjusted odds ratio: 1.81, P < 0.001) and expected to fail in obtaining emergency funds (adjusted odds ratio: 4.03, P < 0.001).Conclusion
In moving forward with their reforms, GCC countries should adopt a financing strategy that addresses the health needs of poorer groups in their pursuit of universal health coverage. 相似文献19.
Cristina Martínez Carlos Méndez María Sánchez José María Martínez-Sánchez 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):132-138
Objective
To assess attitudes towards the extension of outdoor smoke-free areas on university campuses.Methods
Cross-sectional study (n = 384) conducted using a questionnaire administered to medical and nursing students in Barcelona in 2014. Information was obtained pertaining to support for indoor and outdoor smoking bans on university campuses, and the importance of acting as role models. Logistic regression analyses were performed to examine agreement.Results
Most of the students agreed on the importance of health professionals and students as role models (74.9% and 64.1%, respectively) although there were statistically significant differences by smoking status and age. 90% of students reported exposure to smoke on campus. Students expressed strong support for indoor smoke-free policies (97.9%). However, only 39.3% of participants supported regulation of outdoor smoking for university campuses. Non-smokers (OR = 12.315; 95% CI: 5.377-28.204) and students ≥22 years old (OR = 3.001; 95% CI: 1.439-6.257) were the strongest supporters.Conclusions
The students supported indoor smoke-free policies for universities. However, support for extending smoke-free regulations to outdoor areas of university campuses was limited. It is necessary to educate students about tobacco control and emphasise their importance as role models before extending outdoor smoke-free legislation at university campuses. 相似文献20.
Alison Connolly Kate Jones Karen S. Galea Ioannis Basinas Laura Kenny Padraic McGowan Marie Coggins 《International journal of hygiene and environmental health》2017,220(6):1064-1073