An Integrative Screening Tool of Alcohol Exposure During Early Pregnancy: Combining of the CDT Biomarker with Green Page Questionnaire.

AIMS: In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy. METHODS: A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data. RESULTS: About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women's body mass index and European white race. CONCLUSION: Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.

[Economic recession (2006-2012) and changes in the health status of the Spanish population]. / Recesión económica (2006-2012) y cambios en el estado de salud de la población española.

OBJECTIVE: To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. MATERIALS AND METHODS: Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. RESULTS: In 2011/2012 the consumption of anti-anxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. CONCLUSIONS: The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety.

One or two faecal immunochemical tests in an organised population-based colorectal cancer screening programme in Murcia (Spain).

OBJECTIVE: Roll-out of population-based colorectal cancer (CRC) screening with faecal immunochemical test (FIT) is limited by availability of further investigations, particularly colonoscopy and examination of excised lesions. Our objective was to assess whether variation in number of faecal samples and threshold adjustment can optimise resource utilisation and CRC detection rate. METHODS: Three different screening strategies were compared for the same FIT threshold using a quantitative FIT system: one FIT, positive when >20 µg Hb/g faeces; two FIT, positive when either was >20 µg Hb/g faeces; and two FIT, positive when the mean was >20 µg Hb/g faeces. We calculated changes in the size of population the provider could invite to screening for an equal number of screening positive results, and CRC and adenoma detected. RESULTS: In our setting, Region of Murcia, south of Spain (not fully rolled out screening programme), changing the usual strategy of two FIT, positive when either to positive when the mean was >20 µg Hb/g faeces, would increase population invited by 37.81% with the same number of positive results (which would generate a CRC detection rate of 19.2%). In a fully rolled out programme, changing the strategy from one to two FIT (positive when the mean is >20 µg Hb/g faeces), would increase CRC detection rate by 4.64% with an increase of only 13.34% in positive FIT. CONCLUSIONS: In a population-based CRC screening programme, smart use of number of FITs and positivity threshold can increase population invited and CRC detection without increasing the number of colonoscopies and pathological examinations needed.

[Acceptability of self-sampling as a method for cervical cancer screening among women from the Region of Murcia (Spain).] / Aceptabilidad de la autotoma como método de cribado de cáncer de cérvix en mujeres de la Región de Murcia.

OBJECTIVE: Current literature is insufficient to determine the acceptability of self-sampling as a primary method for cervical cancer screening among women from a regular screening population. The aim of this study was to determine the acceptability of self-sampling among women in the Region of Murcia as a primary screening tool. METHODS: We performed a cross-sectional study between April-May 2021, in a regional sample of 247 women ages 35-65 years. All participants were contacted and completed a survey by telephone which included sociodemographic characteristics, knowledge and attitudes towards cancer screening, and self-sampling assessment. We conducted weighted statistical analysis including descriptive, bivariate and a multivariate logistic regression model to examine the associations between women's characteristics and their preference for self-sampling compared to clinician sampling. RESULTS: A total of 89.4% of participants reported at least one previous cytology in the last 5 years, 88.7% with a frequency equal to or less than 3 years. Eighty-one percent of women preferred self-sampling over clinical sampling as a primary screening method. Basal characteristics were unrelated to women's preference for self-sampling (P-adjusted≥0.05). Feasibility and reliability were the main concerns perceived in relation to self-sampling (23.3% and 14.8%, respectively). CONCLUSIONS: Acceptability of self-sampling was high among women in the Region of Murcia. Self-sampling in conjunction with an adequate educational strategy could be a suitable approach to consider in the cervical cancer screening program.

OBJETIVO: Actualmente existe poca evidencia publicada sobre la aceptabilidad de la autotoma como prueba inicial de cribado del cáncer de cérvix en una población de mujeres que acuden a cribado regularmente. El objetivo del estudio fue determinar la aceptabilidad de la autotoma en mujeres de la Región de Murcia (RM) como prueba primaria de cribado. METODOS: Estudio transversal mediante encuesta telefónica a una muestra de 247 mujeres entre 35-65 años de la RM entre abril-mayo de 2021. Se recogieron las características sociodemográficas, los conocimientos, actitudes frente a los cribados de cáncer y valoración de la autotoma. Se realizó un análisis ponderado descriptivo, bivariante y regresión logística multivariante para determinar las características de las participantes relacionadas con su preferencia por la autotoma frente a la toma realizada por un profesional sanitario. RESULTADOS: El 89,4% de las mujeres refirieron realizarse alguna citología en los últimos 5 años, el 88,7% de ellas con una frecuencia ≤3 años. El 81% de las mujeres prefirieron la autotoma como prueba primaria de cribado para la detección del cáncer de cérvix. No se detectaron características relacionadas con la preferencia de la autotoma frente a la toma por un profesional sanitario (P-ajustado≥0,05). Los principales inconvenientes valorados de la autotoma fueron la factibilidad (23,3%) y fiabilidad de la prueba (14,8%). CONCLUSIONES: La aceptabilidad de la autotoma fue elevada entre las mujeres encuestadas de la RM. Sería conveniente valorar este método junto a una estrategia adecuada de educación a las mujeres dentro del programa de prevención del cáncer de cérvix.

[Result's Evaluation of the educational project Alcohol: conciencia con ciencia of Programa ARGOS-Region de Murcia of alcohol consumption prevention for First Secondary School students.] / Evaluación de resultados del proyecto educativo Alcohol: Conciencia con ciencia del Programa ARGOS-Región de Murcia de prevención del consumo de alcohol en alumnado de 1º de Educación Secundaria Obligatoria.

OBJECTIVE: Alcohol: Conciencia con ciencia is an educational-community universal prevention project for 12-year-old students (1st of ESO) which consists of three sessions and it is being implemented every school year since 2012. The objective was to evaluate its effect on alcohol consumption, attitudes and knowledge in the subsequent courses (2nd and 3rd of ESO), in order to know its durability. METHODS: It is a cross-sectional observational study in different phases (applied in October and April), quasi-experimental with a comparison group. In the 2017/2018 academic year, all 2nd (n=2,892) and 3rd of ESO (n=2,601) students completed a questionnaire based on knowledge, opinions and consumption patterns in selected educational centers (18 centers in 13 municipalities). Statistical analysis: chi-square tests of contingency and difference of differences. RESULTS: The number of students who started drinking is less in the intervention group during the subsequent school year, with differences between groups (31.5% vs. 36.6% in October, and 35.9% vs. 43.4% in April) (October p=0.037, April p=0.006) and difference in negative differences in favour of the intervention (-2.6%), more pronounced in girls (-8.1%). Although the study includes alcohol, the greatest perception of risk extends to tobacco and cannabis. The effect on knowledge maintained the following year, being the differences statistically significant. The group pressure recognized by those who suffer it was significantly higher during 2nd of ESO in the comparison group (October p=0.002, April p=0.015), being its durability longer in girls. CONCLUSIONS: The intervention stops the beginning of consumption, drunkenness and every-week consumption the hole next school year (2nd ESO) after intervention, but in 3rd of ESO the effect of the intervention disappears, being therefore necessary to reinforce it with the implementation of the project Drogas: ALTACAN in 2nd of ESO.

OBJETIVO: Alcohol: Conciencia con ciencia es un proyecto educativo-comunitario de prevención universal para alumnado de 12 años (1º ESO) que consta de tres sesiones y se desarrolla desde 2012 cada curso escolar. El objetivo de este trabajo fue evaluar su efecto en el consumo de alcohol, actitudes y conocimientos en cursos posteriores (segundo y tercero), para conocer su durabilidad. METODOS: Estudio observacional transversal en distintas fases (octubre/abril), cuasiexperimental con grupo comparación. Se realizó en centros educativos seleccionados (18 centros, 13 municipios) el curso 2017/2018, completando todo el alumnado de 2º (2.892) y 3º ESO (2.601) un cuestionario de conocimientos, opiniones y consumos. Análisis estadístico: pruebas chi-cuadrado de contingencia y diferencia de las diferencias. RESULTADOS: Fue menor el alumnado que inició el consumo en el grupo intervención durante el curso escolar posterior, con diferencias entre grupos (31,5% frente a 36,6% en octubre y 35,9% frente al 43,4% en abril) (octubre p=0,037, abril p=0,006) y diferencia de las diferencias negativa a favor de la intervención (-2,6%), más acusada en chicas (-8,1%). Aunque trabajó el alcohol, se extendió esta mayor percepción de riesgo al tabaco y el cánnabis. El efecto en conocimientos se mantuvo el siguiente curso, con diferencias estadísticamente significativas. La presión de grupo reconocida por el que la sufrió, fue significativamente mayor durante 2º ESO en grupo comparación (octubre p=0,002, abril p=0,015), más duradera en chicas. CONCLUSIONES: La implementación de este proyecto frena el inicio del consumo de alcohol, borracheras y consumo todas las semanas, durante todo el siguiente curso escolar (2º ESO) a la intervención, en 3º ESO el efecto de la intervención desaparece siendo necesario reforzar con Drogas: ALTACAN en 2º.

[Tobacco use in Spain during COVID-19 lockdown: an evaluation through social media.] / Consumo de tabaco en España durante el estado de alarma por COVID-19: resultados de una evaluación a través de redes sociales.

OBJECTIVE: During the state of alarm and once the confinement decreed by the COVID-19 pandemic ended, a cross-sectorial study was carried out in Spain between May 4th and 22nd, 2020 by volunteers who completed a self-administered online survey. The objective of this study was to know how the confinement period affected the consumption of tobacco and other related products in the adult Spanish population. METHODS: The survey consisted of 18 questions concerning sociodemographic characteristics, the consumption of tobacco and other related products, exposure to secondhand smoke and perception of COVID-19 risk associated with consumption. Questions about tobacco and other related products were posed in order to compare consumption prior to and during confinement. The survey was completed by 17,017 people. The analysis of association of variables was carried out with T-student. Variable frequency analysis was performed with χ2. RESULTS: There was a reduction in the prevalence of daily tobacco smoking and no changes were observed in the products consumed in either period (6.73%). The prevalence of exposure to secondhand smoke at home during confinement among non-smokers decreased (61.83%). Most of survey respondents reported that tobacco and e-cigarette consumption increased the risk of contracting COVID-19 and suffering severe complications (39.09% and 31.80% respectively). CONCLUSIONS: During the COVID-19 lockdown in Spain, the tobacco consumption decreased. Also, secondhand smoke exposition reduces in Spain during this period.

OBJETIVO: Durante el estado de alarma y una vez finalizado el confinamiento decretado por la pandemia por COVID-19, en España se realizó, entre el 4 y el 22 de mayo de 2020, un estudio transversal en voluntarios aplicando una encuesta autocumplimentada online. El objetivo de este estudio fue conocer cómo afectó el periodo de confinamiento al consumo de tabaco y relacionados en la población adulta española. METODOS: El cuestionario constaba de 18 preguntas e incluía características sociodemográficas, el consumo de tabaco y otros productos relacionados, exposición al humo ambiental de tabaco y percepción del riesgo de enfermedad por COVID-19 asociada a su consumo. La encuesta fue completada por 17.017 personas. El análisis de la asociación entre variables cuantitativas, fue realizado mediante el test de la T de Student y el de frecuencias de las variables categóricas mediante el test de χ2. RESULTADOS: Se observó reducción en la prevalencia de fumadores diarios de tabaco (6,73%) y no se observaron cambios en los productos consumidos. La prevalencia de exposición al humo ambiental en casa durante el confinamiento entre personas no fumadoras disminuyó (61,83%). Los encuestados declararon que el consumo de tabaco y de cigarrillos electrónicos aumentaba el riesgo de contraer la enfermedad del COVID-19 y sufrir complicaciones (39,09% y 31,80% respectivamente). CONCLUSIONES: Durante el periodo de confinamiento en España debido al COVID-19, se produjo una reducción en el consumo de tabaco y similares. Además de observó una reducción a la exposición al humo ambiental.

["European Commission Initiative on Breast Cancer": Selected Breast Cancer Screening Recommendations from the European Guidelines.] / "European Commission Initiative on Breast Cancer": Recomendaciones seleccionadas de cribado de cáncer de mama de las guías europeas.

OBJECTIVE: The European Commission Initiative on Breast Cancer (ECIBC) has developed new recommendations on breast cancer screening and diagnosis. The objective of this work was to adapt these recommendations to Spanish in order to implement and guarantee the quality and success of breast cancer screening programmes (PCCM) throughout the Spanish territory. METHODS: The new European Guidelines on Screening and Diagnosis of Breast Cancer have been prepared by a multidisciplinary panel of experts and patients (Guidelines Development Group, GDG). The recommendations inclu-ded are supported by systematic reviews of the evidence conducted by a team of researchers from the Ibero-American Cochrane Center. For its preparation, the European Commission's conflict of interest management rules were applied and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used. The GRADE evidence-to-decision (EtD) frameworks were used to minimize potential influence of interests on the recommendations. RESULTS: As a result of the systematic reviews carried out, the GDG published on the ECIBC website a list of recommendations as part of the guidelines for the screening and diagnosis of breast cancer, which were translated into Spanish in this work. CONCLUSIONS: The adaptation to Spanish of the new recommendations helps their implementation and the creation of a uniform PCCM throughout the Spanish territory. All of this improves informed decision making and the success of PCCM.

OBJETIVO: La European Commission Initiative on Breast Cancer (ECIBC) ha desarrollado nuevas recomendaciones sobre cribado y diagnóstico de cáncer de mama. El objetivo de este trabajo fue adaptar dichas recomendaciones al castellano con el fin de implementar y garantizar la calidad y el éxito de los programas de cribado de cáncer de mama (PCCM) en todo el territorio español. METODOS: Las nuevas Guías Europeas sobre Cribado y Diagnóstico de Cáncer de Mama han sido elaboradas por un panel multidisciplinar de expertos y pacientes (Guidelines Development Group, GDG). Las recomendaciones que se incluyen se apoyan en revisiones sistemáticas de la evidencia realizadas por un equipo de investigadores del Centro Cochrane Iberoamericano. Para su elaboración se aplicaron las reglas de manejo de conflicto de intereses de la Comisión Europea y se utilizó la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation). Se utilizaron los marcos de la evidencia a la decisión (EtD) de GRADE para minimizar posibles influencias de intereses en las recomendaciones. RESULTADOS: Como resultado de las revisiones sistemáticas realizadas, el GDG publicó en la web de la ECIBC una lista de recomendaciones como parte de las guías para el cribado y diagnóstico del cáncer de mama, que fueron traducidas al castellano en este trabajo. CONCLUSIONES: La adaptación al castellano de las nuevas recomendaciones ayuda a su implementación y a crear un PCCM uniforme en todo el territorio español. Todo ello mejora la toma de decisiones informadas y el éxito de los PCCM.

[Impact of immigration on hospital care: utilization, case-mix, and economic effects]. / Impacto de la inmigración sobre la asistencia hospitalaria: frecuentación, casuística y repercusión económica.

OBJECTIVES: To identify the impact of immigration on health services by comparing hospital discharges, case-mix, and economic effects between immigrants and the native population. METHODS: We performed a retrospective longitudinal study of acute-care hospital admissions in Murcia (Spain) registered in the Minimum Data Set from 2004-2005. The groups to be compared, established on the basis of country of birth, were <>, <> and <>. Diagnoses were codified using the ICE-9-CM and were grouped by means of the All Patient-Diagnosis Related Groups (AP-DRG) version 18. Utilization rates were calculated by the time of medical insurance. Economic effects were calculated through DRG weights for 2004. RESULTS: There were 196,275 discharges, with 2,590,376 person-years of insurance. The frequency of discharges was 75.8 per thousand among Spaniards, 64.3 per thousand among immigrants from Europe-25 and 73.8 per thousand among immigrants from the remaining countries. The most frequent causes of admission were related to pregnancy, childbirth and the puerperium. Cost per admission was 3,529 euro in Spaniards, 3,231 euro in persons from Europe-25 and 2,423 euro in persons from the remaining countries. The average cost per year of insurance was 263 euro for Spaniards, 217 euro for immigrants from Europe-25 and 219 euro for those from the remaining countries. CONCLUSIONS: Hospital utilization and costs per admission and for person-year of insurance are higher in Spaniards than in immigrants, especially the group from <>. In this group, case-mix is also different.

[Evaluation of a public health program on early HIV diagnosis with quick test]. / Evaluación de un programa de salud pública sobre diagnostico precoz de VIH con prueba rápida.

OBJECTIVE: The use of HIV planned and structured, community-based rapid tests is one of the main strategies for the early detection of HIV infection. The objective of the study was to assess the HIV early diagnosis programme with rapid test in the Region of Murcia. METHODS: Descriptive analysis of the programme users' epidemiological data during the years 2016 to 2018. Variables related to sociodemographic characteristics, risk exposure, history of HIV test performance and its result were analyzed. All analyzes were performed with statistical software IBM SPSS25 and Microsoft Excel version 2013. Frequencies were calculated in absolute values and the variables of interest were crosshead. RESULTS: There were 1,023 people tested, of which 74% performed risky sexual practices in the last 12 months, both homosexual (50%) and heterosexual (45%), with an age between 18 and 40 years. 18.2% of the users were foreigners and 61.9% had been previously tested. Among the participants in the programme the percentage of reactive tests was 2.1% and the contribution to the diagnosis of new HIV cases in the Region was 4.3%. CONCLUSIONS: The results of the study show that the community-based programme is an effective tool for the diagnosis of HIV infection in vulnerable groups. In addition, several opportunities for improvement were identified in the process assessment, such as accessibility to the program and the collection of information.

OBJETIVO: Entre las principales estrategias para la detección precoz de la infección por VIH se encuentra la utilización planificada y estructurada de pruebas rápidas en entornos comunitarios especialmente vulnerables. El objetivo del presente estudio fue evaluar el programa de diagnóstico precoz de VIH con prueba rápida de la Región de Murcia. METODOS: Se realizó un análisis descriptivo de los datos epidemiológicos de la población participante en el programa durante los años 2016 a 2018. Se analizaron variables relacionadas con características sociodemográficas, exposición de riesgo, antecedentes de realización de la determinación de VIH y resultado de la prueba. Todos los análisis se realizaron con el software estadístico IBM SPSS25 y Microsoft Excel versión 2013. Se calcularon frecuencias en valores absolutos y los porcentajes correspondientes, y se cruzaron las variables de interés. RESULTADOS: Se caracterizaron 1.023 personas participantes, de las que el 74% realizaron prácticas sexuales de riesgo en los últimos 12 meses, tanto de carácter homosexual (50%) como heterosexual (45%), con una edad comprendida entre los 18 y los 40 años. El 18,2% eran extranjeros, y el 61,9% se había realizado la prueba anteriormente. Entre los participantes, el porcentaje de pruebas reactivas fue del 2,1%, y la contribución al diagnóstico de nuevos casos de VIH en la Región fue del 4,3%. CONCLUSIONES: Los resultados del estudio ponen de manifiesto que el programa es una herramienta eficaz para el diagnóstico de la infección por VIH en colectivos vulnerables. Además, en el proceso de evaluación se identifican varias oportunidades de mejora como son la accesibilidad al programa y la recogida de información.

[Relevance of the socioeconomic and health context in patient satisfaction]. / Relevancia del contexto socioeconómico y sanitario en la satisfacción del paciente.

OBJECTIVE: To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. METHODS: The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. RESULTS: The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04). CONCLUSIONS: The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside.

Cost Effectiveness and Economic Impact of the KineSpring Knee Implant System in the Treatment of Knee Osteoarthritis in Spain.

We investigated the efficacy and cost effectiveness of the KineSpring System in the Spanish healthcare system, as compared to other standard treatments methods. Cost-utility ratios were calculated using derived cost data and we calculated quality-adjusted life years (QALYs) gained for each method of treatment. Cost-utility ratios were calculated assuming lifetime and 10-year durability. Assuming lifetime durability, cost-utility ratios of total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), high tibial osteotomy (HTO), KineSpring System, and conservative treatments, compared to no treatment, are €2348 ± 70/QALYs, €2040 ± 61/QALYs, €2281 ± 68/ QALY, €1669 ± 268/QALYs, and €11,688 ± 2185/QALYs, respectively. Assuming a treatment durability of 10 years, the cost-utility ratio of TKA, UKA, HTO, KineSpring System, and conservative treatments, compared to no treatment, are €4884 ± 323/QALYs, €4243 ± 280/QALYs, €4744 ± 313/QALYs, €3757 ± 1353/QALYs, and €10,575 ± 4414/QALYs, respectively. In comparison to current standard-of-care treatments, the KineSpring System has a favorable cost-utility ratio, making it an effective treatment option and a suitable cost-saving alternative. The KineSpring System is associated with lower cost and increased QALYs.

[Response bias in a population postal survey on Health-Related Quality of Life (sf-12v2)]. / Sesgo de respuesta en una encuesta postal poblacional sobre calidad de vida relacionada con la salud (SF-12v2).

BACKGROUND: the bias associated with the low response rate may limit the economic advantage of population surveys by mail. The factors associated with non-response were estimated with an emphasis on Health-Related Quality of Life (HRQoL). METHODS: people who had answered to the Health Survey Murcia-2007 2007 (≥ 18 years), realized by telephone, were sent another postal questionnaire four months later. Both evaluations included information about HRQoL: SF-12v2 (by phone) and EQ-5D (postal). A logistic regression was realized to identify baseline factors (sociodemographic factors, health-related behaviors and HRQoL-physical component summary (PCS) and mental component summary (MCS) of the SF-12v2) associated with non-response to the postal survey. RESULTS: 2,078 individuals (61.5%) did not answer. Multivariate analysis: non-response was associated with marital status, more likely not to respond if it was not married: widower OR: 2,24; IC95% 0,61/0,88; separate/divorced 1,69; 1,10/2,59-; single 1,53; 1,23/1,90 ) and inversely with age (25-34 years OR: 0,95; IC95% 0,69/1,29; 35-44 years 0,60; 0,43/0,85; 45-54 years 0,42; 0,29/0,60; 55-64 years 0,29; 0,20/0,43; 65-74 years 0,17; 0,11/0,26-;≥75 years 0,15; 0,09/0,23) and educational level (low-OR: 0,65; IC95% 0,48/0,86; intermediate 0,41; 0,30/0,57; high-0,22; 0,16/0,30). It was also associated with HRQoL, but differentially for PCS (those with intermediate scores have less probability of not answering OR: 0.73; 95% CI: 0.61/0.88) than for the MCS (the persons in the highest tertile were more likely to not answering 1.47; 1.22/1.78. CONCLUSION: the HRQoL influences the non- response to the postal surveys, leading to an overrepresentation of individuals with middle physical health and low mental health, which it adds small magnitude bias in the estimation of population HRQoL.

Recesión económica (2006-2012) y cambios en el estado de salud de la población española / Economic recession (2006-2012) and changes in the health status of the Spanish population

Objetivo. Analizar la relación de los problemas de salud mental en población española con la recesión económica (2006-2012) y establecer en qué sentido afecta a la autopercepción del estado de salud. Material y métodos. Estudio transversal comparativo utilizando la Encuesta Nacional de Salud de España, 2006/2007 y 2011/2012. Mediante modelos de regresión logística, se analizaron tres indicadores relacionados con la salud mental y la salud percibida. Resultados. En 2011/2012 aumentó el consumo de medicamentos ansiolíticos y somníferos en hombres y mujeres. La disfunción mental aumentó durante el periodo de crisis económica en la población de varones. La percepción de una salud óptima no sufrió cambios significativos en hombres ni en mujeres. Conclusiones. La recesión económica mostró una relación variable con la salud mental y general de la población, y coincidió con un aumento de los trastornos de salud mental, como la ansiedad.

Objective. To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. Materials and methods. Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. Results. In 2011/2012 the consumption of anti-anxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. Conclusions. The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety.

[Population based norms of the Spanish version of the SF-12V2 for Murcia (Spain)]. / Normas poblacionales de referencia de la versión española del SF-12V2 para la Región de Murcia.

OBJECTIVE: Questionnaires on perceived health provide information on health results. Reference values are needed to assess these results. Previous studies have provided Spanish population-based norms for the SF-12v1. The aim of this study was to obtain the population-based norms for the Spanish version of the SF-12v2 for Murcia. METHODS: A cross-sectional telephone survey was carried out in 3,486 community-dwelling persons aged over 18 years old in the region of Murcia. The central tendency, dispersion and percentiles were calculated for each of the eight scales and the physical and mental summary components (PCS and MCS) of the SF-12v2. Known groups were compared to evaluate construct validity (Student's t-test and ANOVA). RESULTS: A total of 3, 381 persons took part in the study (50.5% men). The mean age was 43.6 years in men and 46.0 in women. The mean PSC was 48.6 (± 10.6) and the mean MCS was 53.6 (± 10.7). These scores were higher (more favorable) in men, the youngest age groups, in persons with higher education and in those no chronic illnesses (p=0.000). In all the dimensions and summary components, men had better scores than women. The dimension with the worst score in both men and women was general health and the PCS. CONCLUSIONS: These results should be considered as the population-based norms for the Spanish version of the SF-12v2 for Murcia but may also be useful to establish health aims in similar populations.

[Reference values of the Spanish version of the SF-12v2 for the diabetic population]. / Valores de referencia de la población diabética para la versión española del SF-12v2.

OBJECTIVE: Perceived health status questionnaires provide important information for health outcomes research. Reference measures are required to interpret the health-related quality of life questionnaires belonging to the short form (SF) health survey family. Previous studies have provided these reference measures for the Spanish general population, but not for specific disease conditions. The aim of the present study was to obtain diabetic population-based norms for the Spanish version of the 12-item short form health survey version II (SF-12v2) in the region of Murcia (Spain). METHODS: We performed a cross-sectional telephone survey in 1,500 non-institutionalized patients with type 1 or 2 diabetes, aged 18 years or older and representative of the region of Murcia. The central position, dispersion statistics and percentiles were calculated for each of the eight SF-12v2 scales and summary components (physical and mental). RESULTS: The mental component summary (MCS) (mean: 50.5+/-12.8) was higher than the physical component summary (PCS) (42.5+/-11.8). By sex, men had more favorable MCS (53.6+/-11.6) and PCS (44.9+/-11.2) scores than women (MCS: 47.7+/-13.2; PCS: 40.3+/-11.9). The dimension with the highest score was vitality (men: 57.2+/-11.1; women: 51.9+/-12.1), while that with the lowest score was general health (men: 39.0+/-9.7; women: 35.8+/-10.0). When the groups were stratified by age, scores continued to be higher in men than in women. CONCLUSIONS: The results of the present study should be taken as the diabetic population-based norms for the Spanish version of the SF-12v2 in the region of Murcia. These results may be useful to establish therapeutics targets, as well as for comparisons with the general, healthy and ill populations.