| 1. |
|
|
| 2. |
- Ferrando, Carlos, et al.
(författare)
-
Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy : a randomised controlled trial
- 2020
-
Ingår i: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:1, s. 110-120
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59-1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48-1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found.
|
|
| 3. |
- Andres Gimeno-Feliu, Luis, et al.
(författare)
-
Multimorbidity and immigrant status : associations with area of origin and length of residence in host country
- 2017
-
Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 34:6, s. 662-666
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. Multimorbidity is a growing phenomenon in primary care, and knowledge of the influence of social determinants on its evolution is vital. The aim of this study was to understand the relationship between multimorbidity and immigration, taking into account length of residence in the host country and area of origin of the immigrant population. Methods. Cross-sectional retrospective study of all adult patients registered within the public health service of Aragon, Spain (N = 1 092 279; 144 238 were foreign-born), based on data from the EpiChron Cohort. Age-standardized prevalence rates of multimorbidity were calculated. Different models of binary logistic regressions were conducted to study the association between multimorbidity, immigrant status and length of residence in the host country. Results. The risk of multimorbidity in foreign-borns was lower than that of native-borns [odds ratio (OR): 0.54, 95% confidence interval (CI): 0.53-0.55]. The probability of experiencing multimorbidity was lowest for Asians (OR: 0.34, 95% CI: 0.31-0.37) and Eastern Europeans (OR: 0.42, 95% CI: 0.40-0.43), and highest for Latin Americans (OR: 0.70, 95% CI: 0.68-0.72). Foreign-born immigrants residing in Aragon for >= 5 years had a higher multimorbidity risk than those residing for < 5 years (OR: 2.3, 95% CI: 2.2-2.4). Conclusion. Prevalence of multimorbidity is lower among foreign-borns as compared with native-borns, but increases rapidly with length of residence in the host country. However, the progressive development of multimorbidity among immigrants varies widely depending on area of origin. These findings provide important insight into the health care needs of specific population groups and may help minimize the negative impact of multimorbidity among the most vulnerable groups.
|
|
| 4. |
- Ares-Blanco, Sara, et al.
(författare)
-
Primary care indicators for disease burden, monitoring and surveillance of COVID-19 in 31 European countries: Eurodata Study
- 2024
-
Ingår i: EUROPEAN JOURNAL OF PUBLIC HEALTH. - 1101-1262 .- 1464-360X.
-
Tidskriftsartikel (refereegranskat)abstract
- Background During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19's impact in Europe.Methods Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Key-informants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity.Results Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP's COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy.Conclusions The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Fernández-Calviño, David, et al.
(författare)
-
Using pine bark and mussel shell amendments to reclaim microbial functions in a Cu polluted acid mine soil
- 2018
-
Ingår i: Applied Soil Ecology. - : Elsevier BV. - 0929-1393. ; 127, s. 102-111
-
Tidskriftsartikel (refereegranskat)abstract
- An extremely acid mine soil polluted with Cu was amended with pine bark, crushed mussel shell or a 1:1 mixture of these two by-products. The performance of the soil microbial community was measured as the bacterial and fungal community growth, which were monitored during 2 years following the amendments. Pine bark caused significant increases of microbial growth rates, but with distinct differences between fungal and bacterial groups. Bacterial growth increased transiently at intermediate rates of pine bark applications, but returned to control rates within 2 years of application. In contrast, pine bark applications consistently increased fungal growth with effects that were maintained throughout the study period. The addition of only crushed mussel shell to the mine soil caused very delayed positive effects on the bacterial growth and almost no significant effects on the fungal growth. However, the combination of pine bark with crushed mussel shells 1:1 mixtures caused positive growth responses of both bacteria and fungi that remained persistent throughout the 2 years of study. Fungal and bacterial growth were both suppressed in the mine soil by the lack of organic matter. In addition, bacterial growth was also secondarily suppressed by acidity, and hence, when organic matter (pine bark) additions were combined with pH increases (crushed mussel shell additions), bacterial growth was additionally stimulated. In conclusion, the proposed mixture of by-products (pine bark and crushed mussel shell) is suggested as a promising reclamation strategy for acid mine soils. These results also suggest that in soils like that studied here the organic matter limitation is a more important factor than the soil pH and Cu availability for fungal and bacterial performance.
|
|
| 8. |
- Gimeno-Feliu, Luis Andrés, et al.
(författare)
-
Multimorbidity and chronic diseases among undocumented migrants : evidence to contradict the myths
- 2020
-
Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the main chronic diseases and of multimorbidity in undocumented migrants, documented migrants, and Spanish nationals in a Spanish autonomous community.Methods: Retrospective observational study of all users of the public health system of the region of Aragon over 1 year (2011): 930,131 Spanish nationals; 123,432 documented migrants (DMs); and 17,152 UMs. Binary logistic regression was performed to examine the association between migrant status (Spanish nationals versus DMs and UMs) and both multimorbidity and individual chronic diseases, adjusting for age and sex.Results: The prevalence of individual chronic diseases in UMs was lower than in DMs and much lower than in Spanish nationals. Comparison with the corresponding group of Spanish nationals revealed odds ratios (OR) of 0.1-0.3 and 0.3-0.5 for male and female UMs, respectively (p < 0.05 in all cases). The risk of multimorbidity was lower for UMs than DMs, both for men (OR, 0.12; 95%CI 0.11-0.13 versus OR, 0.53; 95%CI 0.51-0.54) and women (OR, 0.18; 95%CI 0.16-0.20 versus OR, 0.74; 95%CI 0.72-0.75).Conclusions: Analysis of data from a health system that offers universal coverage to all immigrants, irrespective of legal status, reveals that the prevalence of chronic disease and multimorbidity is lower in UMs as compared with both DMs and Spanish nationals. These findings refute previous claims that the morbidity burden in UM populations is higher than that of the native population of the host country.
|
|
| 9. |
- Gimeno-Feliu, Luis Andrés, et al.
(författare)
-
Overuse or underuse? Use of healthcare services among irregular migrants in a north-eastern Spanish region
- 2021
-
Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is little verified information on global healthcare utilization by irregular migrants. Understanding how immigrants use healthcare services based on their needs is crucial to establish effective health policy. We compared healthcare utilization between irregular migrants, documented migrants, and Spanish nationals in a Spanish autonomous community.Methods: This retrospective, observational study included the total adult population of Aragon, Spain: 930,131 Spanish nationals; 123,432 documented migrants; and 17,152 irregular migrants. Healthcare utilization data were compared between irregular migrants, documented migrants and Spanish nationals for the year 2011. Multivariable standard or zero-inflated negative binomial regression models were generated, adjusting for age, sex, length of stay, and morbidity burden.Results: The average annual use of healthcare services was lower for irregular migrants than for documented migrants and Spanish nationals at all levels of care analyzed: primary care (0.5 vs 4 vs 6.7 visits); specialized care (0.2 vs 1.8 vs 2.9 visits); planned hospital admissions (0.3 vs 2 vs 4.23 per 100 individuals), unplanned hospital admissions (0.5 vs 3.5 vs 5.2 per 100 individuals), and emergency room visits (0.4 vs 2.8 vs 2.8 per 10 individuals). The average annual prescription drug expenditure was also lower for irregular migrants (euro9) than for documented migrants (euro77) and Spanish nationals (euro367). These differences were only partially attenuated after adjusting for age, sex, and morbidity burden.Conclusions: Under conditions of equal access, healthcare utilization is much lower among irregular migrants than Spanish nationals (and lower than that of documented migrants), regardless of country of origin or length of stay in Spain.
|
|
| 10. |
- Hallström, Lena, 1958-, et al.
(författare)
-
Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents : The HELENA Study
- 2011
-
Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 56:3, s. 649-657
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate factors associated with breakfast habits and influences on food choices at breakfast, within the framework of the EU-funded HELENA Study in 3528 adolescents from ten cities across Europe. The statement “I often skip breakfast” and personal and socio-environmental factors hypothesized to be related to food choice at breakfast were dichotomized. Logistic regression was used to investigate the association between behavioral (skipping versus consume breakfast) and individual, personal and socio-environmental factors. Half of the adolescents (fewer girls) indicated being regular breakfast consumers. Mothers’ education and family structure were associated with breakfast consumption. Adolescents with peers who gave little or no encouragement, and boys whose parents gave encouragement, were more likely to be regular breakfast consumers. Personal factors influenced the girls more than the boys in their choice of food for breakfast and socio-environmental factors influenced younger adolescents more than older adolescents. In conclusion, a broad range of (behavioral, individual, personal and socio-environmental) factors influence breakfast habits and food choices at breakfast among European adolescents. Breakfast habits were inappreciably influenced by socio-demographical factors. These factors need to be considered in discussions surrounding the development of nutritional intervention programs intended for adolescents.
|
|
