Molecular Characterization of Peronospora variabilis Isolates Infecting Chenopodium quinoa and Chenopodium album in Spain.

Quinoa is an expanding crop in southern Spain. Downy mildew, caused by Peronospora variabilis, is the most important quinoa disease in Spain and worldwide. In Spain, this disease has also been observed on the weed Chenopodium album. The objectives of this study were to unravel the origin of the P. variabilis isolates currently infecting quinoa in southern Spain and to study their genetic diversity. We hypothesized that P. variabilis isolates infecting quinoa in Spain could have been introduced through the seeds of the quinoa varieties currently grown in the country or, alternatively, that these isolates are endemic isolates, originally infecting C. album, that jumped to quinoa. In order to test these hypotheses, we sequenced the internal transcribed spacer (ITS), cytochrome c oxidase subunit 1 (cox1), and cox2 regions of 33 P. variabilis isolates infecting C. quinoa and C. album in southern Spain and analyzed their phylogenetic relationship with isolates present in other countries infecting Chenopodium spp. cox1 gene sequences from all of the Spanish P. variabilis isolates were identical and exhibited nine single-nucleotide polymorphisms (SNPs) compared with a single P. variabilis cox1 sequence found at GenBank. Phylogenetic analyses based on the ITS ribosomal DNA region were not suitable to differentiate isolates according to their geographical origin or host. The cox2 sequences from P. variabilis Spanish isolates collected from C. quinoa and C. album were all identical and had a distinctive SNP in the last of four polymorphic sites that distinguished Spanish isolates from isolates from other countries. These results suggest that P. variabilis infecting quinoa in southern Spain could be native isolates that originally infected C. album.[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

La evaluación de impacto en protección de datos en los proyectos de investigación / Impact assessment on data protection in research projects

Los recientes cambios en la normativa europea de protección de datos de carácter personal siguen permitiendo el uso de los datos sanitarios con fines de investigación, pero establecen la evaluación de impacto en protección de datos como instrumento de reflexión y análisis de riesgos en el proceso de tratamiento de datos. La publicación de una guía facilita la realización de esta evaluación de impacto, aunque no es de aplicación directa para los proyectos de investigación. Se detalla la experiencia en un proyecto concreto, y se muestra cómo el contexto del tratamiento toma relevancia respecto a las características de los datos. La realización de una evaluación de impacto es una oportunidad para asegurar el cumplimiento de los principios de la protección de datos en un entorno cada vez más complejo y con mayores desafíos éticos

Recent changes in European regulations for personal data protection still allow the use of health data for research purposes, but they have set the Impact Assessment on Data Protection as an instrument for reflection and risk analysis in the process of data processing. The publication of a guide for facilitates this impact assessment, although it is not directly applicable to research projects. Experience in a specific project is detailed, showing how the context of the treatment becomes relevant with respect to the data characteristics. Carrying out an impact assessment is an opportunity to ensure compliance with the principles of data protection in an increasingly complex environment with greater ethical challenges

Conexión de registros sanitarios: base poblacional de salud de Andalucía / Health record linkage: Andalusian health population database

OBJETIVO: Describir el desarrollo de un sistema de información que conecta datos procedentes de múltiples registros, sanitarios y otros, para su uso con fines asistenciales, de administración, gestión, evaluación, inspección, investigación y salud pública. MÉTODO: Conexión determinística de datos pseudonimizados de una población de 8,5 millones de habitantes, procedentes de Base de datos de usuarios, Historia clínica electrónica DIRAYA, Conjunto mínimo básico de datos (hospitalización, cirugía mayor ambulatoria, urgencias hospitalarias y hospital de día médico) y sistemas de información de salud mental, pruebas de imagen, pruebas analíticas, vacunas, pacientes renales y farmacia. Se utilizó un codificador automático para los diagnósticos clínicos y se definieron 80 enfermedades crónicas para su seguimiento. La arquitectura del sistema de información constó de tres capas: datos (base de datos Oracle 11g), aplicaciones (MicroStrategy BI) y presentación (MicroStrategy Web, librerías JavaScript, HTML 5 y hojas de estilo CSS). Se implantaron medidas para la gobernanza del sistema. RESULTADOS: Se incluyeron datos de 12,5 millones de personas que fueron usuarias entre los años 2001 y 2017, con 435,5 millones de diagnósticos. El 88,7% de estos diagnósticos fueron generados por el codificador automático. Los datos se presentan mediante informes predefinidos o consultas dinámicas, ambos exportables a ficheros CSV para su tratamiento fuera del sistema. Analistas expertos pueden acceder directamente a las bases de datos y realizar extracciones mediante SQL o tratar directamente los datos con herramientas externas. CONCLUSIÓN: El trabajo ha mostrado cómo la conexión de registros sanitarios abre nuevas posibilidades en el análisis de datos

OBJECTIVE: To describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research. METHOD: Deterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented. RESULTS: Data from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools. CONCLUSION: The work has shown that the connection of health records opens new possibilities for data analysis

[Impact assessment on data protection in research projects]. / La evaluación de impacto en protección de datos en los proyectos de investigación.

Recent changes in European regulations for personal data protection still allow the use of health data for research purposes, but they have set the Impact Assessment on Data Protection as an instrument for reflection and risk analysis in the process of data processing. The publication of a guide for facilitates this impact assessment, although it is not directly applicable to research projects. Experience in a specific project is detailed, showing how the context of the treatment becomes relevant with respect to the data characteristics. Carrying out an impact assessment is an opportunity to ensure compliance with the principles of data protection in an increasingly complex environment with greater ethical challenges.

[Health record linkage: Andalusian health population database]. / Conexión de registros sanitarios: base poblacional de salud de Andalucía.

OBJECTIVE: To describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research. METHOD: Deterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented. RESULTS: Data from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools. CONCLUSION: The work has shown that the connection of health records opens new possibilities for data analysis.

Tratamiento del cáncer de laringe avanzado y calidad de vida. Revisión sistemática / Treatment of advanced laryngeal cancer and quality of life. Systematic review

Introducción y objetivos: El objetivo fue comparar la calidad de vida de los pacientes con cáncer de laringe en estadio avanzado tratados con preservación de órgano respecto a aquellos tratados quirúrgicamente. Métodos: Se realizó una revisión sistemática consultando MedLine, EMBASE, y PubMed (1991-2014) y Web of Science (2012-2014). Los términos de búsqueda fueron: cáncer de laringe, preservación de órgano, quimioterapia, laringectomía, resultados de tratamiento y calidad de vida. Se incluyeron revisiones sistemáticas, metaanálisis, informes de evaluación de tecnologías sanitarias y estudios comparativos con grupo control, publicados en idioma español, francés o inglés. La selección y evaluación de la calidad fue realizada por dos investigadores. Se usaron los criterios de la Colaboración Cochrane para evaluar el riesgo de sesgo y los del Scottish Intercollegiate Guidelines Network (SIGN) para el nivel de evidencia. Resultados: De los 208 estudios identificados en la búsqueda se incluyeron tres: un ensayo clínico y dos estudios observacionales, con un total de 211 pacientes. Su calidad y nivel de evidencia fueron bajos. Los resultados fueron contradictorios, en algunas ocasiones favorables a la cirugía y en otras, a la combinación de radioterapia y quimioterapia, pero en general, sin diferencias significativas entre los tratamientos. Se trataba de estudios heterogéneos, con metodología diferente, tamaño insuficiente, limitaciones en su calidad, con importante riesgo de sesgo y utilización de escalas de medida distintas. Conclusiones: Carecemos de estudios de calidad suficiente para establecer si la calidad de vida en los pacientes con cáncer de laringe en estadio avanzado es diferente en función del tratamiento recibido (AU)

Introduction and objectives: The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment. Methods: We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence. Results: Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales. Conclusions: There are not enough studies of quality to establish differences in the quality of life in patients with advanced laryngeal cancer according to the treatment received (AU)

Treatment of advanced laryngeal cancer and quality of life. Systematic review. / Tratamiento del cáncer de laringe avanzado y calidad de vida. Revisión sistemática.

INTRODUCTION AND OBJECTIVES: The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment. METHODS: We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence. RESULTS: Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales. CONCLUSIONS: There are not enough studies of quality to establish differences in the quality of life in patients with advanced laryngeal cancer according to the treatment received.

Place of death of people living with Parkinson's disease: a population-level study in 11 countries.

BACKGROUND: Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examines variation in place of death for people dying from Parkinson's disease (PD) across 11 European and non-European countries. METHODS: Using death certificate data of 2008 for Belgium, France, Italy, Hungary, Czech Republic, New Zealand, USA, Canada, Mexico, South Korea and Spain for all deaths with PD as an underlying cause (ICD-10 code: G20) cross-national differences in place of death were examined. Associations between place of death and patient socio-demographic and regional characteristics were evaluated using multivariable binary logistic regression analyses. RESULTS: The proportion of deaths in hospital ranged from 17% in the USA to 75% in South Korea. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea; nursing home in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%); home in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA). CONCLUSIONS: In several countries a substantial proportion of deaths from PD occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from PD occurring in hospital indicates a potential for many countries to reduce these proportions.

Desigualdades en mortalidad entre Andalucía y España desde 1990 hasta 2010 / Inequalities in mortality between Andalusia and Spain from 1990 to 2010

Objetivo: Describir las desigualdades en la mortalidad general entre Andalucía y España, por sexo y grupos de edad, entre 1990 y 2010. Métodos: Con las defunciones de Andalucía y España procedentes del Registro de Mortalidad de Andalucía y del Instituto Nacional de Estadística, y las poblaciones por sexo y grupo de edad correspondientes, se han calculado las tasas de mortalidad brutas y estandarizadas por edad y sexo, así como las tasas específicas por sexo y grupos de edad. Posteriormente se han estimado las razones de tasas estandarizadas entre Andalucía y España. Para valorar las tendencias se han construido modelos de regresión joinpoint. Resultados: Andalucía presentó una mayor mortalidad que España en todos los años, en hombres y mujeres. Las razones de tasas fueron superiores en Andalucía, pasando del 11% al 14% entre 1990 y 2010 en los hombres y del 9% al 11% en las mujeres. Por grupos de edad, los hombres y las mujeres de Andalucía tuvieron mayor mortalidad que la media española, excepto los menores de 45 años en los primeros años de la serie. Las tendencias fueron descendentes en Andalucía y España, en hombres y mujeres y en todos los grupos de edad. Conclusiones: Andalucía tiene una mayor mortalidad que la media española, con una tendencia que desciende a un ritmo ligeramente inferior a la de España, por lo que se han incrementado las desigualdades. De continuar esta situación, la convergencia de Andalucía con España no se producirá en un futuro próximo (AU)

Objectives: To describe inequalities in mortality between Andalusia and Spain as a whole by sex and age group between 1990 and 2010. Methods: Deaths in Andalusia and Spain were obtained from the Andalusian Mortality Registry and the National Institute of Statistics, respectively. Population data, classified by sex and age group, were obtained from the National Institute of Statistics. Crude and age- and sex-adjusted standardized mortality rates were calculated. Additionally, standardized rate ratios between Andalusia and Spain were estimated, and joinpoint regression models were built to assess trends. Results: In both sexes and in all the years studied, mortality was higher in Andalusia than in Spain as a whole. Rate ratios increased from 11% of men in Andalusia in 1990 to 14% in 2010 and from 9% of women in 1990 to 11% in 2010. By age group, mortality was higher than the Spanish average in Andalusian men and women, except in those aged less than 45 years in the first few years of the series. In both sexes and in all age groups, there were downward trends in Andalusia and Spain. Conclusion: Mortality in Andalusia is higher than the Spanish average with a tendency to decrease at a slightly slower rate than in Spain, indicating that inequalities have increased. If this tendency continues, mortality in Andalusia will not converge with the Spanish average in the near future (AU)

[Inequalities in mortality between Andalusia and Spain from 1990 to 2010]. / Desigualdades en mortalidad entre Andalucía y España desde 1990 hasta 2010.

OBJECTIVES: To describe inequalities in mortality between Andalusia and Spain as a whole by sex and age group between 1990 and 2010. METHODS: Deaths in Andalusia and Spain were obtained from the Andalusian Mortality Registry and the National Institute of Statistics, respectively. Population data, classified by sex and age group, were obtained from the National Institute of Statistics. Crude and age- and sex-adjusted standardized mortality rates were calculated. Additionally, standardized rate ratios between Andalusia and Spain were estimated, and joinpoint regression models were built to assess trends. RESULTS: In both sexes and in all the years studied, mortality was higher in Andalusia than in Spain as a whole. Rate ratios increased from 11% of men in Andalusia in 1990 to 14% in 2010 and from 9% of women in 1990 to 11% in 2010. By age group, mortality was higher than the Spanish average in Andalusian men and women, except in those aged less than 45 years in the first few years of the series. In both sexes and in all age groups, there were downward trends in Andalusia and Spain. CONCLUSION: Mortality in Andalusia is higher than the Spanish average with a tendency to decrease at a slightly slower rate than in Spain, indicating that inequalities have increased. If this tendency continues, mortality in Andalusia will not converge with the Spanish average in the near future.

Características sociodemográficas de la interrupción voluntaria del embarazo en Andalucía: diferencias entre población autóctona y extranjera / Sociodemographic characteristics of induced abortions in Andalusia (Spain): differences between native and foreign populations

ObjetivosDescribir las variables asociadas con la interrupción voluntaria del embarazo en Andalucía y las diferencias entre población autóctona y extranjera.Material y métodosEstudio poblacional transversal. Se ha unido el fichero de partos con el de interrupción voluntaria del embarazo y se ha creado un fichero único del periodo 2007-2010. Mediante modelos de regresión logística binaria, utilizando como variable dependiente si el embarazo terminó en parto o aborto voluntario y como independientes el año, la provincia de residencia, el número de hijos previo, el nivel de instrucción, la convivencia y la nacionalidad, se han calculado las odds ratios crudas y ajustadas con sus intervalos de confianza del 95%, para mujeres autóctonas y extranjeras. Con las poblaciones del padrón se calcularon las tasas correspondientes.ResultadosSe produjeron 460.715 embarazos, de los cuales un 17% terminó en aborto voluntario y un 83% en parto. Las variables que más influyeron en el riesgo de abortos voluntarios en las mujeres autóctonas y extranjeras fueron tener tres o más hijos (OR=23,06), ser menor de 25 años (OR=19,53), vivir sola (OR=10,04) y ser extranjera (OR=3,95), en especial africana. Las tasas de abortos voluntarios, de fecundidad y de fertilidad fueron mayores en las extranjeras que en las andaluzas, con un aumento de los abortos y un descenso de la fertilidad y de la fecundidad.ConclusionesEl mayor riesgo de abortar voluntariamente en Andalucía lo presentan mujeres jóvenes, con hijos, que no conviven en pareja, con estudios secundarios y extranjeras, en especial procedentes de África subsahariana y con residencia en la provincia de Huelva (AU)

Objectives: To describe the variables associated with induced abortions in Andalusia (Spain) and thedifferences between native and foreign populations.Material and methods: A cross-sectional population-based study was carried out. The files on deliveriesand induced abortions were combined to create a single file for the period 2007-2010. A binary logisticregression model was employed. The dependent variable was whether the pregnancy ended in deliveryor induced abortion. The independent variables were the year, province of residence, number of previouschildren, schooling, cohabitationandnationality. The rawandadjustedodds ratios andthe 95%confidenceintervals were calculated for native and foreign women.Results: Of 460,716 pregnancies, 17% ended in an induced abortion and 83% in delivery. The variablesmostclosely associated with the risk of an induced abortion among native and foreign women in Andalusiawere having three or more previous children (OR = 23.06), being under 25 years old (OR = 19.53), livingalone (OR = 10.04) and being animmigrant(OR = 3.95), especially inAfricanwomen. The rates of abortions,fecundity and fertility were higher in foreigners than in native women, with an increase in abortions anda decrease in fertility and fecundity.Conclusions: The women at greatest risk of having an abortion in Andalusia are young foreign women,especially those from Africa, who live alone, have previous children and secondary education and residein the province of Huelva (AU)

[Sociodemographic characteristics of induced abortions in Andalusia (Spain): differences between native and foreign populations]. / Características sociodemográficas de la interrupción voluntaria del embarazo en Andalucía: diferencias entre población autóctona y extranjera.

OBJECTIVES: To describe the variables associated with induced abortions in Andalusia (Spain) and the differences between native and foreign populations. MATERIAL AND METHODS: A cross-sectional population-based study was carried out. The files on deliveries and induced abortions were combined to create a single file for the period 2007-2010. A binary logistic regression model was employed. The dependent variable was whether the pregnancy ended in delivery or induced abortion. The independent variables were the year, province of residence, number of previous children, schooling, cohabitation and nationality. The raw and adjusted odds ratios and the 95% confidence intervals were calculated for native and foreign women. RESULTS: Of 460,716 pregnancies, 17% ended in an induced abortion and 83% in delivery. The variables most closely associated with the risk of an induced abortion among native and foreign women in Andalusia were having three or more previous children (OR=23.06), being under 25 years old (OR=19.53), living alone (OR=10.04) and being an immigrant (OR=3.95), especially in African women. The rates of abortions, fecundity and fertility were higher in foreigners than in native women, with an increase in abortions and a decrease in fertility and fecundity. CONCLUSIONS: The women at greatest risk of having an abortion in Andalusia are young foreign women, especially those from Africa, who live alone, have previous children and secondary education and reside in the province of Huelva.

Aportaciones al desarrollo de un sistema de información en salud pública. Informe SESPAS 2010 / Contributions to the development of a public health information system SESPAS Report 2010

Las leyes de salud pública aprobadas o en tramitación suponen una adecuación conceptual y metodológica de la salud pública a las necesidades sociales actuales, y tienen en común la incorporación de la salud en todas las políticas. Ello significa un nuevo enfoque estratégico que requerirá unos sistemas de información distintos, que además deberán incorporar los rápidos avances en el campo de las tecnologías de la información y la comunicación. El objetivo de este trabajo es identificar los aspectos más relevantes a tener en cuenta en los sistemas de información en salud pública desde la perspectiva tecnológica, tanto en su desarrollo como en los elementos que los componen. Para superar la fragmentación de los sistemas de información en salud pública es fundamental conseguir la integración de ellos entre sí y con los sistemas asistenciales y extrasanitarios, para lo que es preciso avanzar en la interoperabilidad técnica, semántica y organizativa. Habrá que tener en cuenta las tecnologías emergentes como apoyo a las nuevas estrategias, entre las que destacan las herramientas soporte a la Web 2.0. El desarrollo de los sistemas de información de apoyo a la nueva estrategia presentará dificultades añadidas por su tamaño y por la diversidad de organismos que intervendrán. Se propone que los sistemas de información, además de los ya tradicionales sistemas transaccionales, incluyan los elementos de la Web 2.0 y los sistemas de soporte a la toma de decisiones (AU)

New public health laws are a conceptual and methodological adaptation of public health to current social needs, their common link being the incorporation of health in all policies. This represents a new strategic approach that will require different information systems, which should incorporate the rapid advances made in the field of information technology and communication. The aim of this article was to identify the most important aspects to be taken into account in information systems in public health from a technological perspective, both in their development and in the elements that compose them. To overcome the fragmentation of information systems in public health, these systems must be successfully integrated among themselves and with other health and non-health systems. To achieve this task, technical, semantic and organizational interoperability must be ensured. Emerging technologies should be considered to support these new strategies, especially Web 2.0 tools. This new strategic development will pose additional challenges because of its size and the diversity of the departments involved. It is proposed that information systems will include the elements of Web 2.0 and support systems for decision-making technologies in addition to the traditional operational systems (AU)

[Contributions to the development of a public health information system. SESPAS Report 2010]. / Aportaciones al desarrollo de un sistema de información en salud pública. Informe SESPAS 2010.

New public health laws are a conceptual and methodological adaptation of public health to current social needs, their common link being the incorporation of health in all policies. This represents a new strategic approach that will require different information systems, which should incorporate the rapid advances made in the field of information technology and communication. The aim of this article was to identify the most important aspects to be taken into account in information systems in public health from a technological perspective, both in their development and in the elements that compose them. To overcome the fragmentation of information systems in public health, these systems must be successfully integrated among themselves and with other health and non-health systems. To achieve this task, technical, semantic and organizational interoperability must be ensured. Emerging technologies should be considered to support these new strategies, especially Web 2.0 tools. This new strategic development will pose additional challenges because of its size and the diversity of the departments involved. It is proposed that information systems will include the elements of Web 2.0 and support systems for decision-making technologies in addition to the traditional operational systems.

La industria tabaquera y la promoción del tabaquismo entre los menores y jóvenes: una revisión internacional / The tobacco industry and smoking promotion among minors and youths: an international review

ObjetivosRecopilar documentación científica que evidencia el interés histórico de las compañías tabaqueras por los menores y jóvenes.MétodosRevisión electrónica de la literatura en bases de datos científicas y búsqueda electrónica de informes técnicos y artículos científicos posteriores a 1999.ResultadosSe recopilaron y resumieron 13 informes y 30 artículos de revistas y publicaciones científicas de todo el mundo. La mayoría de los informes y artículos estaban centrados en las tácticas propagandísticas y de mercado.ConclusionesLa información recopilada evidencia los esfuerzos de las grandes tabaqueras para estimular el uso de tabaco entre los menores y jóvenes en todo el mundo e interferir con las políticas de regulación y control que positivamente repercuten en la iniciación al tabaquismo (AU)

ObjectivesTo compile scientific documentation of the historic interest of the tobacco industry in minors and youths.MethodsWe performed a literature review of electronic scientific databases and an electronic search of technical reports and scientific articles published after 1999.ResultsThirteen technical reports and 30 articles in international scientific journals and other publications were retrieved and summarized. Most reports and articles focused on advertisements and marketing.ConclusionsThis study compiled evidence of the interest of the tobacco industry in promoting tobacco use among minors and youths globally, as well as in interfering with tobacco control policies that prevent tobacco smoking initiation among youths (AU)

[The tobacco industry and smoking promotion among minors and youths: an international review]. / La industria tabaquera y la promoción del tabaquismo entre los menores y jóvenes: una revisión internacional.

OBJECTIVES: To compile scientific documentation of the historic interest of the tobacco industry in minors and youths. METHODS: We performed a literature review of electronic scientific databases and an electronic search of technical reports and scientific articles published after 1999. RESULTS: Thirteen technical reports and 30 articles in international scientific journals and other publications were retrieved and summarized. Most reports and articles focused on advertisements and marketing. CONCLUSIONS: This study compiled evidence of the interest of the tobacco industry in promoting tobacco use among minors and youths globally, as well as in interfering with tobacco control policies that prevent tobacco smoking initiation among youths.

[Opportunities for the 112 Emergency Service to collaborate in public health surveillance]. / Oportunidades de colaboración de los Servicios de Emergencias 112 en la vigilancia de la salud pública.

The Andalusian Regional Ministry of Health is implementing an Alert Integrated System (SIA) in order to improve the health protection of the population by means of the appropriate response to the sanitary alerts. <> is a service aimed both to catastrophic situations and to the other ones needing intervention and multisectorial coordination. Theses functions make possible their collaboration with the SIA, furnishing it with information about a series of environmental incidents. A study has been carried out in order to characterize the information received and to evaluate it systematic inclusion in the SIA, which include alerts from january to August 2003. The number of incidents communicated to 112 were 656, rank between months from 45 to 117. It is appropriate to underline the frequency of incidences related to Natural Hazards (50.15%) and Environmental Pollution (26.07%). The 67.55% of incidences happened between 15.00 p.m. and 8.00 a.m. hours of the following day. By provinces, Sevilla reported 24.5%, and the higher rate belongs to Huelva with 4.74 incidences/100 000 inhabitants. Incidents related to health care, environmental problems, risks to alimentary and occupational health, and epidemiological alerts are of great interest to the SIA; that is why it is necessary to consider the integration of the information systems of the emergency centres in the Public Health Surveillance.

Oportunidades de colaboración de los Servicios de Emergencias 112 en la vigilancia de la salud pública / Opportunities for the 112 Emergency Service to collaborate in public health surveillance

La Consejería de Salud de Andalucía está implantando un Sistema Integrado de Alertas (SIA) para mejorar la protección de la salud de la población mediante la respuesta adecuada a las alertas sanitarias. Emergencias 112 Andalucía es un servicio dirigido tanto a situaciones de carácter catastrófico como a otras que precisen intervención y coordinación multisectorial. Estas funciones hacen posible su colaboración con el SIA proporcionando información sobre una serie de incidencias medioambientales. Realizamos un estudio para caracterizar la información recibida y valorar su inclusión sistemática en el SIA, que incluyó alertas de enero a agosto de 2003. El número de incidencias comunicado al 112 fue de 656, intervalo entre meses de 45 a 117. Destaca la frecuencia de las referidas a riesgos naturales (50,15%) y contaminación ambiental (26,07%). El 67,55% de las incidencias ocurrieron entre las 15.00 y las 8.00 horas del día siguiente. Por provincias, Sevilla registró el 24,5% y la mayor tasa correspondió a Huelva, con 4,74 incidencias/100.000 habitantes. Tanto las incidencias relacionadas con la atención sanitaria como los problemas medioambientales, los riesgos para la salud alimentaria y ocupacional y las alertas epidemiológicas son de elevado interés para el SIA, por lo que es necesario considerar la integración de los sistemas de información de los centros de emergencias en la vigilancia de la salud pública

The Andalusian Regional Ministry of Health is implementing an Alert Integrated System (SIA) in order to improve the health protection of the population by means of the appropriate response to the sanitary alerts. «Emergencias 112 Andalucía» is a service aimed both to catastrophic situations and to the other ones needing intervention and multisectorial coordination. Theses functions make possible their collaboration with the SIA, furnishing it with information about a series of environmental incidents. A study has been carried out in order to characterize the information received and to evaluate it systematic inclusion in the SIA, which include alerts from january to August 2003. The number of incidents communicated to 112 were 656, rank betwen months from 45 to 117. It is appropriate to underline the frequency of incidences related to Natural Hazards (50.15%) and Environmental Pollution (26.07%). The 67.55% of incidences happened betwen 15.00 p.m. and 8.00 a.m. hours of the following day. By provinces, Sevilla reported 24.5%, and the higher rate belongs to Huelva with 4.74 incidences/100 000 inhabitants. Incidents related to halth care, environmental problems, risks to alimentary and occupational health, and epidemiological alerts are of great interest to the SIA; that is why it is necessary to consider the integration of the information systems of the emergency centres in the Public Health Surveillance