[Association between the use of short-acting bronchodilators and the risk of hospitalization for asthma in a real-life clinical practice population cohort]. / Asociación entre la utilización de broncodilatadores de corta duración y el riesgo de hospitalización por asma en condiciones de práctica clínica habitual en una cohorte poblacional.

OBJECTIVE: To determine the number of short-acting beta-agonists (SABA) canisters dispensed in a pharmacy during one year that is associated with higher asthma hospitalization risk in the same period in patients with active asthma. Multi-centre cross-sectional descriptive design. LOCATION: Primary care, MAJORICA cohort including sociodemographic, clinical and electronic prescription system data coded during clinical practice from 68,578 patients with COPD and asthma in the Balearic Islands. PARTICIPANTS: A total of 7,648 patients older than 18 years with active asthma, who got any SABA canister from the pharmacy during the 2014-2015 period were included. COPD patients were excluded. MAIN MEASUREMENTS: Asthma hospitalization, respiratory medication, tobacco, co-morbidities, age and gender. RESULTS: Mean age 47 years, 38% women, 23.2% active smokers. Seventy-seven patients (1%) were admitted for asthma exacerbation in the study period. Patients who received more than 8 SABA containers per year increased the risk of hospitalization (OR 2.81; 95% CI 1.27-6.24). Severity by therapeutic step and amount of inhaled corticosteroids, as well as heart failure and sleep apnea were also significantly associated with hospitalization. CONCLUSIONS: There is a significant association between the risk of hospitalization and the higher number of SABA canisters dispensed from the pharmacy. The number of canisters/year that best defines a higher risk of hospitalization is≥8 and could be used to identify asthma at risk.

[Content validation of the spanish version of the Long-term Quality of Life Instrument for long-term female breast cancer survivors.] / Validación de contenido de la versión en castellano del instrumento Long-term Quality of Life Instrument para mujeres supervivientes de cáncer de mama de larga duración.

OBJECTIVE: The quality of life of women affected by breast cancer diagnosed 5 or more years ago has been relatively unexplored in Spain; there are no instruments for its measurement validated. The objective of the study is to translate into Spanish, culturally adapt and examine the content validity of the Spanish version of the Long-Term Quality of Life Instrument (LTQL). METHODS: The initial translation was performed by two translators with Spanish as their mother tongue carried out the translation of the questionnaire, obtaining two initial versions in Spanish (T1 and T2). An analysis of the results and elaboration of a single preliminary version in Spanish (T-1-2) were performed. The retro-translation was performed by two translators with English as their mother tongue not familiar with the original version translated the joint version (T-1-2) back into the original language (RT1 and RT2) to identify inconsistencies. Finally, a final version of the questionnaire was obtained. For content validation a committee of experts (seven women affected by breast cancer) assessed the degree of clarity, accuracy and understanding of each of the items in the questionnaire translated into Spanish, and calculated the content validity index (CVI) of the questionnaire according to Lawshe and Tristán. RESULTS: The LTQL questionnaire was translated into Spanish with a low discrepancy between translators. An adequate CVI higher than 0.58 was obtained in clarity (0.95), precision (0.93), comprehension (0.91) and relevance (0.72). CONCLUSIONS: The LTQL is a useful questionnaire in the health field for the assessment of quality of life of women survivors of long-term breast cancer.

OBJETIVO: La calidad de vida de mujeres afectadas de cáncer de mama diagnosticadas hace 5 o más años ha sido relativamente poco explorada en España, no existen instrumentos para su medida validados. El objetivo del estudio fue traducir al castellano, adaptar culturalmente y examinar la validez de contenido del cuestionario Long-Term Quality of Life Instrument (LTQL). METODOS: La traducción inicial fue realizada por dos traductores con castellano como lengua materna que tradujeron independientemente el cuestionario (versiones T1 y T2). Se realizó un análisis de los resultados y se elaboró una única versión preliminar en castellano (T-1-2). La retrotraducción se realizó por dos traductores con inglés como lengua materna que tradujeron independientemente la versión conjunta (T-1-2) al idioma original (RT1 y RT2) para identificar inconsistencias. Finalmente, se obtuvo una versión final del cuestionario. Para la validación de contenido se constituyó un comité de expertas (siete mujeres afectadas de cáncer de mama) que valoró el grado de claridad, precisión, comprensión y relevancia de cada uno de los ítems del cuestionario traducido al castellano y se calculó el índice de validez de contenido (CVI) del cuestionario según Lawshe y Tristán. RESULTADOS: Se tradujo el cuestionario LTQL al castellano con una baja discrepancia entre los traductores. Se obtuvo un CVI adecuado mayor de 0,58 en claridad (0,95), precisión (0,93), comprensión (0,91) y relevancia (0,72). CONCLUSIONES: El LTQL en un cuestionario de utilidad en el campo de la salud para la evaluación de la calidad de vida de mujeres supervivientes de cáncer de mama de larga duración.

[Clinical and managerial autonomy. Perception of the coordinators of the health centers in Mallorca, Spain]. / Autonomía clínica y de gestión. Percepción de los coordinadores de los centros de salud de Mallorca.

BACKGROUND: The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. DESIGN: cross-sectional study, application questionnaire. LOCATION: Primary Care, 2009. PARTICIPANTS: All the coordinators of the HC of Mallorca (N = 47). INTERVENTIONS AND MEASUREMENTS: 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a self-management. RESULTS: response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. CONCLUSIONS: The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects.