Effectiveness of a Meningococcal Group B Vaccine (4CMenB) in Children.

BACKGROUND: In September 2015, the four-component, protein-based meningococcal serogroup B vaccine (4CMenB; Bexsero) became available for private purchase in Spain. METHODS: We conducted a nationwide matched case-control study to assess the effectiveness of 4CMenB in preventing invasive meningococcal disease in children. The study included all laboratory-confirmed cases of invasive meningococcal disease in children younger than 60 months of age between October 5, 2015, and October 6, 2019, in Spain. Each case patient was matched with four controls according to date of birth and province. 4CMenB vaccination status of the case patients and controls was compared with the use of multivariate conditional logistic regression. RESULTS: We compared 306 case patients (243 [79.4%] with serogroup B disease) with 1224 controls. A total of 35 case patients (11.4%) and 298 controls (24.3%) had received at least one dose of 4CMenB. The effectiveness of complete vaccination with 4CMenB (defined as receipt of at least 2 doses, administered in accordance with the manufacturer's recommendations) was 76% (95% confidence interval [CI], 57 to 87) against invasive meningococcal disease caused by any serogroup, and partial vaccination was 54% (95% CI, 18 to 74) effective. Complete vaccination resulted in an effectiveness of 71% (95% CI, 45 to 85) against meningococcal serogroup B disease. Vaccine effectiveness with at least one dose of 4CMenB was 64% (95% CI, 41 to 78) against serogroup B disease and 82% (95% CI, 21 to 96) against non-serogroup B disease. With the use of the genetic Meningococcal Antigen Typing System, serogroup B strains that were expected to be covered by 4CMenB were detected in 44 case patients, none of whom had been vaccinated. CONCLUSIONS: Complete vaccination with 4CMenB was found to be effective in preventing invasive disease by serogroup B and non-serogroup B meningococci in children younger than 5 years of age.

Trends in stroke mortality in La Rioja (Spain) from 1999 to 2022.

INTRODUCTION: Stroke mortality has declined in recent decades, but there appears to be a slowdown in the decline in recent years. We analyze the trends in stroke mortality in La Rioja (Spain) for the period 1999-2022. METHODS: We evaluated stroke mortality using statistical data from the mortality registry of La Rioja (Spain). We adjusted the rates by age and sex and analyzed both overall strokes and subtypes: hemorrhagic and ischemic. To analyze the trend in mortality rates we constructed joinpoint regression models, with associated annual percentage change (APC) RESULTS: Age-standardized stroke mortality declined between 1999 and 2022: females from 98.0 to 29.2 per 100 000; males, from 131.6 to 44.8 per 100 000. We found a decrease in overall stroke mortality in all age groups, except those under 65 years old. Ischemic stroke mortality showed declines in the first decade (APC: 7.3%, CI95%: 4.1-19.1%) and increases in the second decade (APC: 1.6%, CI95%: -1.6-11.7%) among men. In women, the rates declined between 2018 and 2022(APC: -6.6%, CI95%: -5.1-30.6%) after an increase between 2015 and 2017 (APC: 23.5%, CI95%: -20.2-38.3%). For hemorrhagic stroke, we found a consistent rate of decline throughout the entire time period in men (APC: 2.4%, CI95%: 0.9 a 4.0%). In women, rates increased during the period 1999-2009(APC: 1.9%, CI95%: -2.1-22.8%) and decreased 2010-2022 (APC: 6.5%, CI95%: 4.0-25.6%). CONCLUSIONS: Stroke mortality rates have decreased, more so for haemorrhagic than ischaemic strokes.

Epidemiologic Features and Control Measures during Monkeypox Outbreak, Spain, June 2022.

During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.

Vaccine effectiveness against symptomatic SARS-CoV-2 infection in adults aged 65 years and older in primary care: I-MOVE-COVID-19 project, Europe, December 2020 to May 2021.

We measured COVID-19 vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection at primary care/outpatient level among adults ≥ 65 years old using a multicentre test-negative design in eight European countries. We included 592 SARS-CoV-2 cases and 4,372 test-negative controls in the main analysis. The VE was 62% (95% CI: 45-74) for one dose only and 89% (95% CI: 79-94) for complete vaccination. COVID-19 vaccines provide good protection against COVID-19 presentation at primary care/outpatient level, particularly among fully vaccinated individuals.

Trends in Guillain-Barré syndrome mortality in Spain from 1999 to 2013.

BACKGROUND: Guillain-Barré syndrome (GBS) is a rare disease that consists of a group of neuropathic conditions. Very few epidemiological studies of GBS have been carried out in Spain. The aim of this study was to determine the trends in GBS mortality in the total population of Spain for the period 1999 to 2013. METHODS: Data on GBS deaths were drawn from the National Statistics Institute of Spain. Crude and overall age-standardised GBS mortality rates were calculated and joinpoint regression models were used to describe trend changes. Mean age of deceased by GBS each year was also assessed. RESULTS: The overall age-standardised GBS mortality rate was 0.71 per million in 1999 and 0.40 in 2013. It was higher in men, 1.08 vs. 0.42 in 1999 and 0.48 vs. 0.35 in 2013. There was a statistically significant decrease in mortality during the study period. All the age-standardised mortality rates decreased (overall and by gender) from 1999 to 2013. The mean age at death increased with time, from 73 years in 1999 to 77 years in 2013. CONCLUSIONS: GBS mortality has improved in Spain during the last 15 years. The age of death has risen and the mortality rate has decreased.

Trends in suicide mortality in Spain from 1998 to 2021 and its relationship with the COVID-19 pandemic: A joinpoint regression analysis.

In the European Union, a rate of 11.9 cases per 100,000 was estimated in 2019.In Spain, suicide is the leading cause of external death. Social crises can have an impact on suicide rates. We analyzed changes in suicide mortality trends in Spain following the COVID-19 pandemic. We used statistical data from the National Institute of Statistics of Spain (1998-2021). We calculated age-specific rates, age and sex-adjusted rates, and analyzed trends and changes using joinpoint-regression models. Rates decrease in both sexes at the ages of 65 and older. In women, they increase in the ages of 1-29 years and 45-59 years. In men, they decrease in the ages of 15-39 years. Among women, age-adjusted rates remained stable between 1998 and 2021, with a non-significant annual decrease of 0.4 %. Among men, there was a significant annual decrease of 0.7 %. The years 2020 and 2021 had 8 % higher mortality compared to the two years prior to the COVID-19 pandemic. Suicide mortality in Spain slightly decreased among men and remained stable among women between 1998 and 2021, but there seems to be an increase following the COVID-19 pandemic.

[Comparación de la vigilancia centinela de infecciones respiratorias agudas frente a la vigilancia universal en La Rioja en la temporada 2021-2022.] / Comparison of sentinel surveillance of acute respiratory infections versus universal surveillance in La Rioja in the 2021-2022 season.

OBJECTIVE: Sentinel surveillance is used to monitor health problems. The COVID detection strategy conducts universal surveillance of SARS-CoV-2 infection, which can be monitored by sentinel systems, through surveillance of mild acute respiratory infection (IRA) or severe respiratory infection (IRAG). The objective of this study was to compare incidence data obtained through sentinel surveillance against versus universal surveillance in acute respiratory infections. METHODS: A descriptive study of the incidences (cases/100,000 inhabitants) of acute respiratory infection (sudden onset of cough, sore throat, dyspnea or runny nose and clinical judgment of infection) was carried out in the entire population of La Rioja recorded in the primary care medical record, and in a sentinel cohort, by age and sex during the period from weeks 40-2021 to 06-2022. For SARI, the total number of hospitalized cases per 100,000 inhabitants with onset of symptoms in the previous ten days was calculated, as well as the incidence in a systematic selection of all SARI hospitalized one day a week. Weekly incidence rates were calculated in each cohort from week forty of 2021 to week six of 2022 by sex and age group. The characteristics of the population were expressed in their distribution by number and percentage. RESULTS: The data observed for ARI were similar in both systems by sex and age, except for the zero to four-year-old group and the group over seventy-nine years of age, where differences were observed, with the highest ARI figures in the first age group in sentinel surveillance, while in the older group they were superior in universal surveillance. SARIs showed a similar incidence, except in the fifteen/fourty-four age groups, which was higher in universal surveillance than in sentinel surveillance. CONCLUSIONS: There are no significant differences. Sentinel surveillance allows optimization of resources, being the most efficient methods for surveillance of high-incidence diseases.

OBJETIVO: La vigilancia centinela se emplea para monitorizar problemas de salud. En la Estrategia de detección de COVID se lleva a cabo vigilancia universal de infección por SARS-CoV-2, que puede pasar a monitorización mediante sistemas centinela, a través de vigilancia de infección respiratoria aguda leve (IRA) o grave (IRAG). El objetivo del presente trabajo fue comparar datos de incidencia obtenidos mediante vigilancia centinela frente a vigilancia universal en las infecciones respiratorias agudas. METODOS: Se realizó un estudio descriptivo de las incidencias (casos por cada 100.000 habitantes) de infección respiratoria aguda (comienzo súbito de tos, dolor de garganta, disnea o rinorrea y juicio clínico de infección) en toda la población de La Rioja, registrados en la historia clínica de Atención Primaria, y en una cohorte centinela, por edad y sexo durante el periodo que incluye la semana 40-2021 hasta la 06-2022. Para IRAG se calcularon los casos hospitalizados totales por cada 100.000 habitantes con inicio de síntomas en los diez días previos, así como la incidencia en una selección sistemática de todos los IRAG hospitalizados un día a la semana. Se calcularon las tasas de incidencia semanales en cada cohorte desde la semana cuarenta del año 2021 a la semana seis del año 2022 por sexo y grupo de edad. Las características de la población se expresaron en su distribución por número y porcentaje. RESULTADOS: Los datos observados para IRA fueron similares en ambos sistemas por sexo y edad, salvo para el grupo de cero a cuatro años y el de más de setenta y nueve años, donde se observaron diferencias, siendo las cifras de IRA más elevadas en el primer grupo de edad en la vigilancia centinela, mientras que en el grupo de mayores fueron superiores en la vigilancia universal. Las IRAG mostraron una incidencia similar, excepto en los grupos de edad de quince a cuarenta y cuatro años, que fue mayor en vigilancia universal que en el centinela. CONCLUSIONES: No se observan diferencias importantes. La vigilancia centinela permite optimización de recursos, siendo los métodos más eficientes para vigilancia de enfermedades de alta incidencia.

COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain.

BACKGROUND: With the emergence of SARS-CoV-2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. METHODS: Using a test-negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID-19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS-CoV-2 variant. RESULTS: VE was 89% (95% CI: 83-93) against COVID-19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS-CoV-2 variants, although variant-specific VE was slightly higher against Alpha. CONCLUSIONS: The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID-19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID-19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS-CoV-2 variants (Alpha vs. Delta).

[Assessment of the implementation of an unambiguous patient identification system in an acute care hospital]. / Evaluación de la implantación de un sistema de identificación inequívoca de pacientes en un hospital de agudos.

OBJECTIVE: To achieve implantation of unequivocal identification of all admitted patients, to ensure the identification of patients with an individual bracelet integrated into the clinical record, and to involve health professionals in this process. MATERIAL AND METHODS: A working group was created, which analyzed the current situation in the hospital, selected materials, and designed the patient identification procedure and support material for patients and health professionals. After the system was implemented, coverage was assessed through direct observation. Implementation and satisfaction among patients and health professionals was evaluated through specifically designed questionnaires. RESULTS: Coverage was 79.4%. Most (82.8%) professionals knew why the identification bracelet was used and 57.8% thought it helped to avoid patient identification errors. Twenty percent used the bracelet data when administering medication, 29.2% when taking blood samples and 25.6% on entry to the operating room. Nearly all (88.3%) patients reported that the bracelet was not uncomfortable and 62.8% reported they received no information when the bracelet was placed. CONCLUSIONS: Acceptable coverage of the patient identification bracelets was achieved. However, the involvement of health professionals in the identification process was low, since the bracelets were not routinely used in established procedures and patients were only infrequently provided with information when the bracelets were placed.

[Evolution of the virus pandemic flu (H1N1) 2009 in the autonomous community of La Rioja]. / Evolución de la pandemia por el virus de la gripe (H1N1) 2009 en la Comunidad Autónoma de la Rioja.

BACKGROUND. The aim of this study has been to analyze the development of pandemic influenza (H1N1) 2009 in La Rioja autonomous (cases in primary healthcare and cases hospitalized). METHODS. We have included all cases with 2009 H1N1 influenza from week 28-2009 to 3-2010. The main information was collected through Primary Healthcare databases (OMI), lists of Preventive Medicine Hospital Departments, reference laboratory and individual standardized forms. This information was analyzed and described according to week, sex, age, comorbidities, clinical development and medical complication. We explore the association of to antiviral treatment and risk factors. This association was assessed using odds ratios (OR) and 95% confidence interval (CI). Adjustment for confounders was performed using unconditional logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI). RESULTS. From 29-2009 week to 3-2010 week, a total of 7096 pandemic influenza A(H1N1) cases were notified from Primary Healthcare and 111 laboratory confirmed severe cases were admitted to hospital. Five cases were admitted to an ICU (4,5%) and 2 cases died. All this patients had comorbidities. None of children and pregnant female were admitted to an ICU. CONCLUSIONS. Children and young person have been population with more cases of pandemic influenza (H1N1) 2009. Clinical evolution of pandemic in the majority cases in La Rioja, has been mild.

Comparación de la vigilancia centinela de infecciones respiratorias agudas frente a la vigilancia universal en La Rioja en la temporada 2021-2022 / Comparison of sentinel surveillance of acute respiratory infections versus universal surveillance in La Rioja in the 2021-2022 season

Fundamentos: La vigilancia centinela se emplea para monitorizar problemas de salud. En laEstrategia de detección de COVID se lleva a cabo vigilancia universal de infección por SARS-CoV-2, que puede pasar a monitorización mediante sistemas centinela, a través de vigilancia de infección respiratoria aguda leve (IRA) o grave (IRAG). El objetivo del presente trabajo fue comparar datos de incidencia obtenidos mediante vigilancia centinela frente a vigilancia universal en las infecciones respiratorias agudas. Métodos: Se realizó un estudio descriptivo de las incidencias (casos por cada 100.000 habitantes) de infección respiratoria aguda (comienzo súbito de tos, dolor de garganta, disnea o rinorrea y juicio clínico de infección) en toda la población de La Rioja, registrados en la historia clínica de Atención Primaria, y en una cohorte centinela, por edad y sexo durante el periodo que incluye la semana 40-2021 hasta la 06-2022. Para IRAG se calcularon los casos hospitalizados totales por cada 100.000 habitantes con inicio de síntomas en los diez días previos, así como la incidencia en una selección sistemática de todos los IRAG hospitalizados un día a la semana. Se calcularon las tasas de incidencia semanales en cada cohorte desde la semana cuarenta del año 2021 a la semana seis del año 2022 por sexo y grupo de edad. Las características de la población se expresaron en su distribución por número y porcentaje. Resultados: Los datos observados para IRA fueron similares en ambos sistemas por sexo y edad, salvo para el grupo de cero a cuatro años y el de más de setenta y nueve años, donde se observaron diferencias, siendo las cifras de IRA más elevadas en el primer grupo de edad en la vigilancia centinela, mientras que en el grupo de mayores fueron superiores en la vigilancia universal. Las IRAG mostraron una incidencia similar, excepto en los grupos de edad de quince a cuarenta y cuatro años, que fue mayor en vigilancia universal que en el centinela.(AU)

Background: Sentinel surveillance is used to monitor health problems. The COVID detection strategy conducts universal surveillance of SARS-CoV-2 infection, which can be monitored by sentinel systems, through surveillance of mild acute respiratory infection (IRA) or severe respiratory infection (IRAG). The objective of this study was to compare incidence data obtained through sentinel surveillance against versus universal surveillance in acute respiratory infections. Methods: A descriptive study of the incidences (cases/100,000 inhabitants) of acute respiratory infection (sudden onset of cough, sore throat, dyspnea or runny nose and clinical judgment of infection) was carried out in the entire population of La Rioja recorded in the primary care medical record, and in a sentinel cohort, by age and sex during the period from weeks 40-2021 to 06-2022. For SARI, the total number of hospitalized cases per 100,000 inhabitants with onset of symptoms in the previous ten days was calculated, as well as the incidence in a systematic selection of all SARI hospitalized one day a week. Weekly incidence rates were calculated in each cohort from week forty of 2021 to week six of 2022 by sex and age group. The characteristics of the population were expressed in their distribution by number and percentage.Results: The data observed for ARI were similar in both systems by sex and age, except for the zero to four-year-old group and the group over seventy-nine years of age, where differences were observed, with the highest ARI figures in the first age group in sentinel surveillance, while in the older group they were superior in universal surveillance. SARIs showed a similar incidence, except in the fifteen/fourty-four age groups, which was higher in universal surveillance than in sentinel surveillance.(AU)

[Variables related to job satisfaction. Cross-sectional study using the European Foundation for Quality Management [EFQM] model]. / Variables relacionadas con la satisfacción laboral: un estudio transversal a partir del modelo EFQM.

OBJECTIVES: To identify the influence of the dimensions of people items and sociodemographic characteristics included in the EFQM model on high satisfaction of healthcare workers in a district hospital. METHODS: We performed a cross-sectional study in November 2003. The questionnaire used was the personal satisfaction survey of the Basque Country (Spain). The outcome measure was a high degree of satisfaction (75th percentile or higher). Independent variables were sociodemographic and organizational characteristics. The association among variables was assessed using odds ratios (OR) and their 95% confidence interval (CI). Adjustment for confounders was performed by unconditional logistic regression. RESULTS: On a scale from 0 to 10, the mean general satisfaction score was 5.95 (standard deviation, 2). Twenty-five percent of workers gave their general satisfaction with the organizational climate a score of 8 or more points. The most positively considered features were the environmental policy, hierarchical relations, promotion, and professional development. The most negatively viewed items were salary, knowledge and identification of objectives, and training. The variables most closely related to outcome were a favorable perception of training (adjusted OR = 5.04; 95% CI, 2.16-11.77) and recognition of the work performed (adjusted OR = 4.68; 95% CI, 2.20-10.08). Sociodemographic factors had less influence on satisfaction. CONCLUSIONS: Almost half of the staff surveyed in our hospital were satisfied or highly satisfied with the organizational climate. Satisfaction was strongly associated with positive evaluation of organizational characteristics.

[cycEVA study: case control study measuring influenza vaccine effectiveness in Spain, 2008-2013]. / Estudio cycEVA: casos y controles para la estimación de la efectividad de la vacuna antigripal en España, 2008-2013.

BACKGROUND: In Spain, influenza vaccine effectiveness (EV) is estimated since 2008-09 season through the cycEVA case-control study, the Spanish component of the European I-MOVE (Monitoring Influenza Vaccine Effectiveness in the EU/EEA) network. We aimed at describing cycEVA performance in its five consolidated editions 2008/09 -; 2012/13. METHODS: During the study period the following indicators were analysed: 1) the participation of sentinel general practitioners and pediatricians (MP), 2) the population studied and the study period, 3) the data quality and 4) the dissemination of the cycEVA results. Trend analysis of the indicators was done using the Cochran-Armitage test to compute the Annual Percentage Change (PCA). RESULTS: The number of participating MP increased from 164 in 2008-09 to 246 in the following editions. The percentage of MP recruiting at least one patient increased significantly annually (PCA = 15.33%). The percentage of recruited patients included into the analysis increased (PCA=5.91%) from 77% in 2008-09 to more than 95% in the following editions. The percentage of cycEVA patients contributing to the I-MOVE study ranged between 23% and 30% in the pilot and 2011-12 editions respectively.. Final results were disseminated in quartile 2 peer-reviewed journals and 2010-11 and 2011-12 preliminary EV estimates were published in quartile 1 journals. cycEVA publications received 97 citations. CONCLUSION: cycEVA study achieved more quality information, timely EV estimates and a higher impact of the results.

Influence of family history of colorectal cancer on health behavior and performance of early detection procedures: the SUN Project.

PURPOSE: The aim of this study is to explore the relationship between family history of colorectal cancer and both health behavior and screening procedures in a population cohort. METHODS: This study is a cross-sectional analysis of 15,169 participants belonging to a prospective cohort study (the SUN Project) based on two self-reported questionnaires: one of them related to lifestyle and the other a semiquantitative food frequency questionnaire. We explored the influence of family history of colorectal cancer in lifestyles (consumption of alcohol, weight, and diet) and medical management behaviors (screening of chronic diseases). RESULTS: People with family history of colorectal cancer increased their number of colorectal cancer screening tests (adjusted odds ratio for fecal occult blood test: 1.98, 95% confidence interval: 1.48-2.65; and adjusted odds ratio for colonoscopy/sigmoidoscopy: 3.42, 2.69-4.36); nevertheless, health behavior changes in diet of relatives of colorectal cancer patients were undetectable. CONCLUSIONS: We show that individuals with a family history of colorectal cancer increase their compliance with screening tests, although they exhibit no better health-related behaviors than people without family history of colorectal cancer. Further prospective studies are required to confirm these results and to identify tools to empower the subjects to change their risk profile.

Estudio cycEVA: caos y controles para la estimación de la efectividad de la vacuna antigripal en España, 2008-2013 / cycEVA study: case control study Measuring influenza vaccine effectiveness in Spain, 2008-2013

Fundamentos: Desde 2008-09 la efectividad de la vacuna (EV) antigripal en España se estima con el estudio de casos y controles para la evaluación de la EV antigripal (cycEVA), componente español de la red europea (Influenza- Monitoring Vaccine Effectiveness (I-MOVE). El objetivo es describir la evolución del estudio cycEVAdurante las cinco temporadas del período 2008/09-2012/13. Métodos: Se analizaron los siguientes indicadores: 1) participación de los médicos/pediatras centinela (MP); 2) población y periodo de estudio, 3) calidad de los datos y 4) difusión de los resultados mediantes publicaciones. Se calculó el porcentaje anual de cambio constante de los indicadores analizándose su tendencia mediante el test de Cochran-Armitage. Resultados: El número de MP participantes aumentó de 164 en 2008-09 hasta 246 en ediciones posteriores. El porcentaje de médicos que reclutaron al menos un paciente experimentó un cambio anual significativo (PCA) del 15,33%. El porcentaje de pacientes reclutados incluidos en el análisis aumentó del 77% en 2008-09 a más del 95% en las siguientes ediciones (PCA=5,91%). El porcentaje de casos y controles participantes en cycEVA sobre el total de pacientes que contribuyeron al estudio europeo I-MOVE osciló entre el 23% en la edición piloto y 30% en la temporada 2011-12. Los resultados finales se difundieron en revistas científicas con un factor de impacto situado en el cuartil 2 y en 2010-11 y 2011-12 se publicaron resultados preliminares en revistas con un factor de impacto situado en el cuartil 1 (97 citas). Conclusiones: La experiencia del estudio cycEVA se reflejó en una mejora en la oportunidad e impacto de sus resultados, cruciales para orientar las recomendaciones anuales de vacunación antigripal (AU)

Background: In Spain, influenza vaccine effectiveness (EV) is estimated since 2008-09 season through the cycEVAcase-control study, the Spanish component of the European I-MOVE (Monitoring Influenza Vaccine Effectiveness in the EU/EEA) network.We aimed at describing cycEVAperformance in its five consolidated editions 2008/09 - 2012/13. Methods: During the study period the following indicators were analysed: 1) the participation of sentinel general practitioners and pediatricians (MP), 2) the population studied and the study period, 3) the data quality and 4) the dissemination of the cycEVA results. Trend analysis of the indicators was done using the Cochran-Armitage test to compute theAnnual Percentage Change (PCA). Results: The number of participatingMP increased from 164 in 2008-09 to 246 in the following editions. The percentage of MP recruiting at least one patient increased significantly annually (PCA = 15.33%). The percentage of recruited patients included into the analysis increased (PCA=5.91%) from 77% in 2008-09 to more than 95% in the following editions. The percentage of cycEVA patients contributing to the I-MOVE study ranged between 23% and 30% in the pilot and 2011-12 editions respectively.. Final results were disseminated in quartile 2 peer-reviewed journals and 2010-11 and 2011-12 preliminary EV estimates were published in quartile 1 journals. cycEVA publications received 97 citations. Conclusion: cycEVA study achieved more quality information, timely EV estimates and a higher impact of the results (AU)

Evolución de la pandemia por el virus de la gripe (H1N1) 2009 en la comunidad autónoma de la Rioja / Evolution of the virus pandemic flu (H1N1) 2009 in the autonomous community of La Rioja

Fundamento: El objetivo de este estudio ha sido realizar un análisis de la evolución de la pandemia por el virus de la gripe (H1N1) 2009 en la Comunidad Autónoma de La Rioja tanto en atención primaria como en hospitalaria. Métodos: El periodo de estudio incluyó desde la semana 28-2009 hasta la 3-2010. La información de los casos de gripe se obtuvo de las bases informatizadas de atención primaria (OMI), de los listados remitidos por los servicios hospitalarios de medicina preventiva, del laboratorio de referencia de La Rioja y de los formularios de notificación individual. Se realizó una descripción de los casos según distribución por semana, sexo, edad, factores de riesgo, evolución y complicaciones. Se utilizó la regresión binaria logística para estimar las odds ratios ajustadas y su intervalo de confianza al 95%, de recibir tratamiento antiviral según factores de riesgo. Resultados: Hasta la semana epidemiológica 3 de 2010 se declararon a través del sistema OMI de atención primaria 7.096 casos de sospecha de gripe (H1N1) 2009, fueron hospitalizados 111 casos con diagnóstico confirmado por laboratorio. Requirieron atención en cuidados intensivos 5 (4,5%) y 2 fallecieron. Todos ellos presentaban factores de riesgo. Ninguno de los niños ni de las mujeres embarazadas hospitalizados precisaron ingreso en cuidados intensivos. Conclusiones: Durante la pandemia la gripe (H1N1) 2009 fue una enfermedad propia de la población pediátrica y joven, apareciendo con menor frecuencia en las personas mayores de 60 años. La evolución clínica en La Rioja cursó de forma leve en la mayoría de las personas diagnosticados(AU)

Background: The aim of this study has been to analyze the development of pandemic influenza (H1N1) 2009 in La Rioja autonomous (cases in primary healthcare and cases hospitalized). Methods: We have included all cases with 2009 H1N1 influen-za from week 28-2009 to 3-2010. The main information was collected through Primary Healthcare databases (OMI), lists of Preventive Medicine Hospital Departments, reference laboratory and individual standardized forms. This information was analyzed and described according to week, sex, age, comorbidities, clinical development and medical complication. We explore the association of to antiviral treatment and risk factors. This association was assessed using odds ratios (OR) and 95% confidence interval (CI). Adjustment for confounders was performed using unconditional logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI). Results: From 29-2009 week to 3-2010 week, a total of 7096 pandemic influenza A(H1N1) cases were notified from Primary Healthcare and 111 laboratory confirmed severe cases were admitted to hospital. Five cases were admitted to an ICU (4,5%) and 2 cases died. All this patients had comorbidities. None of children and pregnant female were admitted to an ICU. Conclusions: Children and young person have been population with more cases of pandemic influenza (H1N1) 2009. Clinical evolution of pandemic in the majority cases in La Rioja, has been mild(AU)

Evaluación de la implantación de un sistema de identificación inequívoca de pacientes en un hospital de agudos / Assessment of the implementation of an unambiguous patient identification system in an acute care hospita

Objetivos: Conseguir la implantación de un proceso de identificación inequívoca de todos los pacientes ingresados, asegurar la identificación mediante brazalete individual con datos del paciente integrado con la Historia Clínica Informatizada (SELENE) e implicar al personal sanitario en el proceso de identificación de pacientes. Material y métodos: Se creó un grupo de trabajo de profesionales, que realizó análisis de la situación, selección de materiales, elaboración del procedimiento de identificación de paciente y material de apoyo para pacientes y profesionales. Tras la implantación del proceso se evaluó la cobertura a través de observación directa. La implantación y la satisfacción del profesional y del paciente se evaluaron a través de encuestas diseñadas para tal fin. Resultados: La cobertura alcanzó el 79,4%. El 82,8% de los profesionales conocían por qué se utilizaba el brazalete de identificación y el 57,8% pensaba que evitaba los errores de identificación del paciente. El 20% de los encuestados revisan los datos del brazalete al administrar medicación, el 29,2% en extracciones sanguíneas y el 25,6% a la entrada a quirófano. El 88,3% de los pacientes manifestaron que el brazalete no les resulta nada incómodo y el 62,8% no recibieron información cuando les colocaron el brazalete de identificación Conclusiones: Aunque los brazaletes de identificación de pacientes presentan una cobertura aceptable, los profesionales no se sienten implicados en el proceso de identificación, ya que no los utilizan habitualmente en los procedimientos establecidos e informan con poca frecuencia al paciente en el momento de su colocación (AU)

Objective: To achieve implantation of unequivocal identification of all admitted patients, to ensure the identification of patients with an individual bracelet integrated into the clinical record, and to involve health professionals in this process. Material and methods: A working group was created, which analyzed the current situation in the hospital, selected materials, and designed the patient identification procedure and support material for patients and health professionals. After the system was implemented, coverage was assessed through direct observation. Implementation and satisfaction among patients and health professionals was evaluated through specifically designed questionnaires. Results: Coverage was 79.4%. Most (82.8%) professionals knew why the identification bracelet was used and 57.8% thought it helped to avoid patient identification errors. Twenty percent used the bracelet data when administering medication, 29.2% when taking blood samples and 25.6% on entry to the operating room. Nearly all (88.3%) patients reported that the bracelet was not uncomfortable and 62.8% reported they received no information when the bracelet was placed. Conclusions: Acceptable coverage of the patient identification bracelets was achieved. However, the involvement of health professionals in the identification process was low, since the bracelets were not routinely used in established procedures and patients were only infrequently provided with information when the bracelets were placed (AU)

Variables relacionadas con la satisfacción laboral: un estudio transversal a partir del modelo EFQM / Variables related to job satisfaction. Cross-sectional study using the European Foundation for Quality Management [EFQM] model

Objetivos: Identificar la influencia de las dimensiones del apartado personas y características sociodemográficas del modelo EFQM en la alta satisfacción de los trabajadores de un hospital comarcal. Métodos: Estudio transversal realizado en noviembre de 2003. Se ha utilizado la encuesta de satisfacción de las personas del País Vasco. Variable resultado: alto grado de satisfacción (percentil 75 o mayor). Variables independientes: características sociodemográficas de las personas y las organizacionales. Para cuantificar el grado de asociación se ha utilizado la odds ratio (OR) y su intervalo de confianza del 95% (IC del 95%). Los factores de confusión se ajustaron mediante regresión logística no condicional. Resultados: En una escala del 0 al 10, la satisfacción general obtuvo una puntuación media (desviación estándar) de 5,95 (2). El 25% de los trabajadores valoró su satisfacción general con el clima organizacional como >= 8. Los aspectos mejor considerados fueron: el plan medioambiental, la relación jerárquica, la promoción y el desarrollo profesional. Los apartados peor valorados han sido la retribución, el conocimiento y la identificación con los objetivos, y la formación. Las variables más relacionadas con el efecto fueron la percepción favorable de la formación (OR ajustada = 5,04; IC del 95%, 2,16-11,77), y el reconocimiento del trabajo realizado (OR ajustado = 4,68; IC del 95%, 2,20-10,08). Los factores sociodemográficos presentaron menor influencia sobre la satisfacción. Conclusiones: En nuestro hospital casi la mitad de las personas se consideran satisfechas/muy satisfechas con el clima organizacional. La satisfacción está fuertemente asociada a la valoración positiva de características propias de la organización

Objectives: To identify the influence of the dimensions of people items and sociodemographic characteristics included in the EFQM model on high satisfaction of healthcare workers in a district hospital. Methods: We performed a cross-sectional study in November 2003. The questionnaire used was the personal satisfaction survey of the Basque Country (Spain). The outcome measure was a high degree of satisfaction (75th percentile or higher). Independent variables were sociodemographic and organizational characteristics. The association among variables was assessed using odds ratios (OR) and their 95% confidence interval (CI). Adjustment for confounders was performed by unconditional logistic regression. Results: On a scale from 0 to 10, the mean general satisfaction score was 5.95 (standard deviation, 2). Twenty-five percent of workers gave their general satisfaction with the organizational climate a score of 8 or more points. The most positively considered features were the environmental policy, hierarchical relations, promotion, and professional development. The most negatively viewed items were salary, knowledge and identification of objectives, and training. The variables most closely related to outcome were a favorable perception of training (adjusted OR = 5.04; 95% CI, 2.16-11.77) and recognition of the work performed (adjusted OR = 4.68; 95% CI, 2.20-10.08). Sociodemographic factors had less influence on satisfaction. Conclusions: Almost half of the staff surveyed in our hospital were satisfied or highly satisfied with the organizational climate. Satisfaction was strongly associated with positive evaluation of organizational characteristics