Falsas creencias sobre las vacunas

Vaccines are an essential tool for the prevention of infectious diseases. However, false ideas and rumours with no scientific foundation about their possible negative effects may dissuade people from being vaccinated, with the consequent risks for the health of the population. The objective of this article is to evaluate the origin and the arguments of some of the most frequent mistaken ideas and rumours about the possible adverse effects of vaccines. Some clearly established adverse effects are presented, as well as false beliefs about various vaccines and potential harm to health. Vaccines, like any drug, can cause adverse effects, but the possible adverse effects of vaccination programs are clearly lower than their individual (vaccinated) and collective benefits (those vaccinated and those who cannot be vaccinated for medical reasons). The possible adverse effects attributable to vaccines should be detected by powerful and well-structured pharmacovigilance systems.     

Incentivos financieros en la mejora de la calidad asistencial. Informe SESPAS 2012

We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals.     

El estado de salud de las personas mayores que sufren insomnio

Objectives

To evaluate the perceived health status of elderly patients with insomnia, whether primary, secondary to a medical illness, or associated with another mental disorder.

Methods

We conducted a cross-sectional study in a representative sample of 926 persons aged over 65 years. A psychiatric interview was used to verify the presence of insomnia (DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth ed., revised text). Interviews were conducted by health professionals to assess perceived health status (EuroQol-5D), health problems, and socio-demographic characteristics.

Results

The prevalence of primary insomnia was 8.9% (95% CI: 7.1-11.0), that of insomnia associated with another mental disorder was 9.3% (95% CI: 7.5-11.4) and that of insomnia secondary to medical illness was 7.0% (95% CI: 5.4-8.9). Patients with insomnia who used hypnotics/sedatives scored lower in self-reported health (57.6; 95% CI: 53.7-61.4), significantly lower (p < 0.05) than participants with insomnia not taking these drugs (65.1; 95% CI: 53.7-61.4). The mean health status score in individuals without insomnia was 0.87 and was significantly lower (p < 0.05) in persons with any type of insomnia: 0.80 in primary insomnia, 0.73 in insomnia secondary to a mental disorder and 0.76 in insomnia associated with medical illness.

Conclusions

Health status was worse in older people with insomnia, whether primary, secondary to other mental illnesses or organic, and when the elderly patients consumed hypnotics/sedatives. Limitations were less severe in primary insomnia.     

El hábito de lectura como factor protector de deterioro cognitivo

Objective

To determine whether reading is a protective factor against cognitive decline in the population aged over 65 years.

Methods

We performed an unmatched case-control study in the Fuente de San Luis Health Center in Valencia, Spain. A total of 153 subjects aged more than 65 years old were studied, corresponding to 51 cases and 102 controls. Cognitive impairment was measured by the version of the Mini-Mental State Examination adapted and validated to Spanish. Reading habits were assessed with the scale of the Federación de Gremios y Editores de España.

Results

Logistic regression showed a significant association with the habit of frequent reading for more than 5 years, complete primary school education, and age lower than 75 years

Conclusions

Reading is a protective factor against cognitive impairment. This protection is greater in frequent readers with a history of reading of over 5 years     

El coste de la aplicación de la Ley de Dependencia a la enfermedad de Alzheimer

Aim

To calculate the formal cost of social care for people with Alzheimer disease according to the implementation of the dependency law in Gipuzkoa (Spain).

Method

A retrospective observational study was carried out of the database of the Dependency Care Services of Gipuzkoa from 2007 to 2012, using a prevalence-based bottom-up approach.

Results

The average annual formal cost per person was €11,730. The annual population cost was €34.7 million, representing 19% of the annual expenditure corresponding to the dependency law and 29% of the total cost of Alzheimer disease.

Conclusions

Despite the implementation of the new law, most of the burden of the disease is bourne by the family.