Order out of chaos: Sense of coherence and the mediating role of coping resources in explaining mental health during COVID-19 in 7 countries.

In the midst of the COVID-19 pandemic and the universal chaos created by it, this study explores the role of sense of coherence (Soc, Antonovsky, 1979) and how it enables coping with a stressful situation and staying well. SOC is a generalized orientation which allows one to perceive the world as comprehensible, manageable, and meaningful. In an attempt to understand 'how does the SOC work' we employed the salutogenic assumption that a strong SOC allows one to reach out in any given situation and find those resources appropriate to the specific stressor. Thus, we hypothesized that the positive impact of SOC on mental health outcomes would be mediated through coping resources that are particularly salient in times of crisis. One resource is related to the micro level (perceived family support) and the other concerns the macro level (trust in leaders and social-political institutions). Data collection was conducted in different countries during May-June 2020 via online platforms. The data included 7 samples of adult participants (age 18-90) from Israel (n â€‹= â€‹669), Italy (n â€‹= â€‹899), Spain (n â€‹= â€‹476), Germany (n â€‹= â€‹708), Austria (n â€‹= â€‹1026), Switzerland (n â€‹= â€‹147), and the U.S. (n â€‹= â€‹506). The questionnaires included standard tools (MHC-SF, SOC-13) as well as questionnaires of perceived family support and trust that were adapted to the pandemic context. As expected, SOC was associated with mental health in all the samples. Perceived family support and trust in leaders and social-political institutions mediated the relationships between SOC and mental health, controlling for age, gender, and level of financial risk. It appears that SOC has a universal meaning, not limited by cultural and situational characteristics. The discussion focuses on the theoretical, social, and political applications of the salutogenic model - and its core concept of SOC - in the context of coping with a global pandemic across different cultural contexts and countries.

Future directions for the concept of salutogenesis: a position article.

Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC) that helps to mobilize resources to cope with stressors and manage tension successfully (determining one's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensional SOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about the origin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in the international Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer, New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. To strengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal) of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis. During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky's original contribution and then present suggestions for future development. These ideas will help guide GWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.

Salutogenic health promotion program for migrant women at risk of social exclusion.

BACKGROUND: Migrant women at risk of social exclusion often experience health inequities based on gender, country of origin or socioeconomic status. Traditional health promotion programs designed for this population have focused on covering their basic needs or modifying lifestyle behaviors. The salutogenic model of health could offer a new perspective enabling health promotion programs to reduce the impact of health inequities. This study evaluated the effectiveness of a salutogenic health promotion program focused on the empowerment of migrant women at risk of social exclusion. METHODS: A four-session salutogenic health promotion program was conducted over a period of 6 months. In a quasi-experimental pre-test post-test design, an ad hoc questionnaire was administered to 26 women to collect sociodemographic data, together with 5 validated instruments: Antonovsky's Sense of Coherence (SOC-13), Duke-UNC-11 (perceived social support), Quality of Life Short Form-36 (SF-36), Rosenberg's Self-Esteem Scale, and the Cohen et al. Perceived Stress Scale (PSS-10). Descriptive analysis and multiple linear regression models were performed. Statistical tests were considered significant with a two-tailed p value < 0.05. RESULTS: Participants had a low initial SOC-13 score (60.36; SD 8.16), which did not show significant change after the health promotion program. Perceived social support (37.07; SD 6.28) and mental quality of life also remained unchanged, while physical quality of life increased from 50.84 (SD 4.60) to 53.08 (SD 5.31) (p = 0.049). Self-esteem showed an increasing trend from 30.14 (SD 4.21) to 31.92 (SD 4.38) (p = 0.120). Perceived stress decreased from 20.57 (SD 2.91) to 18.38 (SD 3.78) (p = 0.016). A greater effect was observed at the end of the program in women with lower initial scores for SOC-13 and quality of life and higher initial scores of perceived stress. CONCLUSIONS: The health promotion program reduced perceived stress, increased physical quality of life and showed a trend toward increased self-esteem, especially among migrant women with multiple vulnerability factors. The salutogenic model of health should be considered as a good practice to apply in health promotion programs and to be included in national policies to reduce health inequity in migrant populations.

Are nurses sufficiently well prepared to take on the detection of hypertension? / ¿Está el personal de enfermería lo suficientemente preparado para detectar la hipertensión?

The detection of arterial hypertension requires training and knowledge by the responsible health professional. The current guidelines recommend doctors and nurses to work together for the screening of hypertension. Objectives: To assess the level of knowledge among primary healthcare nurses’ in the screening of arterial hypertension. Methods: Descriptive, observational and transversal study. A random representative sample of 165 nurses working with adult patients in community-based primary healthcare centres were asked to complete an evaluation test of theoretical knowledge about hypertension. Higher scores indicated a greater knowledge about the detection of hypertension. Results: 32.1% of the participants obtained a score equal to or more than 72.7 which corresponded to the 75th percentile of correct answers. Nurses with lower scores were older, permanent employees with technical training studies. A higher age and technical training studies contributed independently to a lower score. In the multiple linear regression model, age and type of studies contributed independently to questionnaire's score variance. Conclusion: Currently, primary care nurses in the studied region do not have sufficient theoretical knowledge to detect hypertension. The results show the need to establish strategies to achieve the necessary knowledge for the implementation of a correct hypertension screening. For professional nurses, continuing education is essential to safe and effective nursing care

Antecedentes: La detección de la hipertensión arterial requiere formación y conocimientos por parte del profesional sanitario responsable. Las directrices actuales aconsejan a los doctores y enfermeros que trabajen juntos para diagnosticar la hipertensión. Objetivos: Evaluar el nivel de conocimiento entre el personal de enfermería de atención primaria para detectar la hipertensión arterial. Métodos: Estudio descriptivo, observacional y transversal. Se pidió a una muestra aleatoria de 165 enfermeros que trabajaban con adultos en centros de atención primaria que completaran una prueba de evaluación de sus conocimientos teóricos acerca de la hipertensión. Un resultado más alto indicaba un mayor conocimiento a la hora de detectar la hipertensión. Resultados: El 32,1% de los participantes obtuvo una puntuación igual o superior a 72,7, que se correspondía con el percentil 75 de respuestas correctas. El personal de enfermería con puntuación más baja fue el de los empleados más mayores, fijos y con estudios técnicos. La edad más avanzada y tener estudios de formación técnica contribuyeron de manera independiente a una menor puntuación. En el modelo de regresión lineal múltiple la edad y el tipo de formación contribuyeron de manera independiente a la variación del resultado. Conclusión: En la actualidad el personal de enfermería de atención primaria de la región estudiada no cuenta con suficientes conocimientos para detectar la hipertensión. Los resultados muestran la necesidad de establecer estrategias para alcanzar los conocimientos necesarios y poner en marcha un adecuado plan de diagnóstico de hipertensión. Para los enfermeros profesionales una formación continuada es clave para un cuidado seguro y eficaz

Are nurses sufficiently well prepared to take on the detection of hypertension?

BACKGROUND: The detection of arterial hypertension requires training and knowledge by the responsible health professional. The current guidelines recommend doctors and nurses to work together for the screening of hypertension. OBJECTIVES: To assess the level of knowledge among primary healthcare nurses' in the screening of arterial hypertension. METHODS: Descriptive, observational and transversal study. A random representative sample of 165 nurses working with adult patients in community-based primary healthcare centres were asked to complete an evaluation test of theoretical knowledge about hypertension. Higher scores indicated a greater knowledge about the detection of hypertension. RESULTS: 32.1% of the participants obtained a score equal to or more than 72.7 which corresponded to the 75th percentile of correct answers. Nurses with lower scores were older, permanent employees with technical training studies. A higher age and technical training studies contributed independently to a lower score. In the multiple linear regression model, age and type of studies contributed independently to questionnaire's score variance. CONCLUSION: Currently, primary care nurses in the studied region do not have sufficient theoretical knowledge to detect hypertension. The results show the need to establish strategies to achieve the necessary knowledge for the implementation of a correct hypertension screening. For professional nurses, continuing education is essential to safe and effective nursing care.

Las barreras percibidas en mujeres con incontinencia urinaria / No disponible

El objetivo de esta investigación es identificar las barreras que perciben mujeres con incontinencia urinaria (IU) para emprender una conducta encaminada a la resolución de su problema con la orina. Se trata de un estudio cualitativo con la participación de 34 mujeres de la provincia de Barcelona (España). Los datos se recogieron mediante entrevistas en profundidad y la técnica del grupo focal. La selección de la muestra fue intencional o de conveniencia y el análisis categorial temático se realizó a partir de las transcripciones de los discursos de las participantes. Los resultados muestran que entre las barreras percibidas respecto a la búsqueda de ayuda para su IU, están la falta de conciencia de la IU como enfermedad, unos conocimientos deficientes respecto a la misma y la propia actitud y práctica de algunos médicos. La falta de tiempo y el cansancio las impide autocuidarse. La pereza, la falta de voluntad o de constancia en la realización de los ejercicios del suelo pélvico obstaculizan su ejecución, así como el coste económico de los centros de rehabilitación privados. Se concluye que se debe empoderar a la mujer, apoyarla y ayudarla en la realización de las conductas promotoras de salud para su IU

The objective of this research is to identify the barriers they perceive women with urinary incontinence (UI) for preventing them from undertaking conduct aimed at solving your problem with urine. This is a qualitative study involving 34 women in the province of Barcelona (Spain). Data were collected through in-depth interviews and focus group technique. The sample selection was intentional or convenience categorical and thematic analysis was conducted from the transcripts of the speeches of the participants. The results show that perceived barriers regarding seeking help for UI, is the lack of awareness of the UI as a disease, a deficient knowledge about it and the right attitude and practice of some doctors. The lack of time and fatigue prevents them self-care. Laziness, lack of will or perseverance in performing pelvic floor exercises, impeding its implementation as well as the economic cost of private rehabilitation centers. It is concluded that should empower women, support and assist in the conduct of health promoting behaviors for IU

[Influence of waiting time on patient and companion satisfaction]. / Influencia del tiempo de espera en la satisfacción de pacientes y acompañantes.

OBJECTIVE: To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. METHODOLOGY: Prospective, observational study. SETTING: Hospital de Figueres Emergency Department (Girona, Spain). STUDY VARIABLES: sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. RESULTS: A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). CONCLUSIONS: Perceived waiting time and the information about estimated waiting time determined overall satisfaction.

Influencia del tiempo de espera en la satisfacción de pacientes y acompañantes / Influence of waiting time on patient and companion satisfaction

Objetivo: Evaluar la satisfacción de pacientes y acompañantes de un servicio de urgencias hospitalario y su relación con el tiempo de espera. Método: Estudio observacional transversal. Ámbito de estudio: Servicio de Urgencias del Hospital de Figueres (Girona). Variables estudiadas: características sociodemográficas, nivel de satisfacción, tiempo de espera real y percibido hasta el triaje y la visita médica. Resultados: Se recibieron 285 respuestas. La edad media (n = 257) fue de 54,6 años (DE = 18,3). La puntuación media de la satisfacción global con la visita (n = 273) fue de 7,6 (DE = 2,2) y la mediana, de 8 (rango intercuartílico [RIC] = 2). Se observó, a menor tiempo de espera percibido hasta ser atendidos por la enfermera de triaje, mayor satisfacción global (ρ = −0,242, p < 0,001), y a menor tiempo de espera percibido hasta la visita médica, mayor satisfacción global (ρ = −0,304; p < 0,001). Los usuarios que fueron informados sobre el tiempo de espera hasta la visita médica mostraron mayor satisfacción que los que no fueron informados (p = 0,001). Conclusiones: La satisfacción de los usuarios del servicio de urgencias es elevada. La percepción del tiempo de espera y la información sobre este tiempo influyó en la satisfacción de los usuarios (AU)

Objective: To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Methodology: Prospective, observational study. Setting: Hospital de Figueres Emergency Department (Girona, Spain). Study variables: sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. Results: A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n = 257) was 54.6 years (SD = 18.3). The mean overall satisfaction (n = 273) was 7.6 (SD = 2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ) = −0.242, P < .001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ = −0.304; P < .001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P = .001). Conclusions: Perceived waiting time and the information about estimated waiting time determined overall satisfaction (AU)

Intususcepción idiopática en el adulto: reporte de caso y revisión de la literatura / Idiopathic intussusception in an adult: case report and literature review

La intususcepción o invaginación intestinal es una rara causa de obstrucción intestinal en el adulto. Se reportan en la literatura aproximadamente 3 casos por millón de habitantes al año. Es una entidad poco frecuente y es más prevalente en la edad pediátrica. En el adulto, la mayoría de las veces se asocia a neoplasias, cicatrices postquirúrgicas, divertículo de Meckel, cuerpos extraños o enfermedad celiaca; pero hasta en 20% de los casos la causa es desconocida. Presentamos un caso y hacemos la revisión de la literatura correspondiente.

Intussusception is a rare cause of intestinal obstruction in adults. Only about 3 cases per million people are reported in the literature each year. It is an uncommon condition that is more prevalent in children. In adults, it is most often as sociated with neoplasms, postoperative scars, Meckel’s iverticulum, foreign bodies or celiac disease, but 20% of these cases have idiopathic causes. We present a case and review of the literature.

Lifetime fitness and age-related female ornament signalling: evidence for survival and fecundity selection in the pied flycatcher.

Ornaments displayed by females have often been denied evolutionary interest due to their frequently reduced expression relative to males, habitually attributed to a genetic correlation between the sexes. We estimated annual and lifetime reproductive success of female pied flycatchers (Ficedula hypoleuca) and applied capture-mark-recapture models to analyse annual survival rates in relation to the patterns of expression (absence/presence) of an ornament displayed by all males and a fraction of females. Overall, the likelihood of expressing the ornament increased nonlinearly with female age and was due to within-individual variation, not to the selective appearance or disappearance of ornament-related expression of phenotypes in the population. Accordingly, expressing the forehead patch in a given year did not influence survival probability. However, those females expressing the ornament at early ages (1-2 years old) enjoyed survival advantages throughout lifetime. Although ornamented females had higher lifetime fecundity and fledging success, their yearly reproductive performance, in terms of fledging productivity, decreased as they aged so that, late in life, ornamented females reared fewer offspring than nonexpressing females of the same age. In addition, both strategies (expressing vs. not expressing the trait) returned similar fitness payoffs in terms of recruited offspring. Our results support the hypothesis that fecundity and survival selection are involved in the displaying of this 'male' ornament by females.

Permanent genetic resources added to Molecular Ecology Resources Database 1 February 2012 - 31 March 2012.

This article documents the addition of 171 microsatellite marker loci and 27 pairs of single nucleotide polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Bombus pauloensis, Cephalorhynchus heavisidii, Cercospora sojina, Harpyhaliaetus coronatus, Hordeum vulgare, Lachnolaimus maximus, Oceanodroma monteiroi, Puccinia striiformis f. sp. tritici, Rhea americana, Salmo salar, Salmo trutta, Schistocephalus solidus, Sousa plumbea and Tursiops aduncus. These loci were cross-tested on the following species: Aquila heliaca, Bulweria bulwerii, Buteo buteo, Buteo swainsoni, Falco rusticolus, Haliaeetus albicilla, Halobaena caerulea, Hieraaetus fasciatus, Oceanodroma castro, Puccinia graminis f. sp. Tritici, Puccinia triticina, Rhea pennata and Schistocephalus pungitii. This article also documents the addition of 27 sequencing primer pairs for Puffinus baroli and Bulweria bulwerii and cross-testing of these loci in Oceanodroma castro, Pelagodroma marina, Pelecanoides georgicus, Pelecanoides urinatrix, Thalassarche chrysostoma and Thalassarche melanophrys.

Heritability and genetic correlation between the sexes in a songbird sexual ornament.

The genetic correlation between the sexes in the expression of secondary sex traits in wild vertebrate populations has attracted very few previous empirical efforts of field researchers. In southern European populations of pied flycatchers, a sexually selected male ornament is also expressed by a proportion of females. Additive genetic variances in ornament size and expression, transmission mechanisms (autosomal vs Z-linkage) and maternal effects are examined by looking at patterns of familial resemblance across three generations. Size of the secondary sex trait has a genetic basis common to both sexes, with estimated heritability being 0.5 under an autosomal model of inheritance. Significant additive genetic variance in males was also confirmed through a cross-fostering experiment. Heritability analyses were only partially consistent with previous molecular genetics evidence, as only two out of the three predictions supported Z-linkage and lack of significant mother-daughter resemblance could be due to small sample sizes caused by limited female trait expression. Therefore, the evidence was mixed as to the contribution of the Z chromosome and autosomal genes to trait size. The threshold heritability of trait expression in females was lower, around 0.3, supporting autosomal-based trait expression in females. Environmental (birth date) and parental effects on ornament size mediated by the mother's condition after accounting for maternal and paternal genetic influences are also highlighted. The genetic correlation between the sexes did not differ from one, indicating that selection on the character on either sex entails a correlated response in the opposite sex.

[Assessing the incidence of papillomavirus infections in France]. / Estimation de l'incidence des infections à papillomavirus en France.

High-risk oncogenic human papillomavirus (HR-HPV) are strongly associated with squamous cell carcinoma and adenocarcinoma of the uterine cervix. Relatively detailed data on prevalence of HR-HPV infections by age in France are available in several cytologically normal women populations but none on incidence. These latter data may be obtained according to the relationship between prevalence and incidence due to the spontaneous viral clearance over time. The study has shown that HR-HPV infections incidence changes slightly according to the selected hypotheses for the viral clearance and that a peak is reached at about 12% for the women aged 22. A relatively high incidence is observed at older age classes with about 4% at 60 years old. These results are close to that observed in other countries even if the incidence peak appears slightly lower and happens later. Nevertheless, the model did not include possible viral reactivation or reinfection that could modify the incidence curve angle. The incidence of the HR-HPV infections is essential to define vaccination strategies and to determine the women ages at which the vaccine could be optimally administered.

Permanent Genetic Resources added to Molecular Ecology Resources database 1 January 2009-30 April 2009.

This article documents the addition of 283 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Agalinis acuta; Ambrosia artemisiifolia; Berula erecta; Casuarius casuarius; Cercospora zeae-maydis; Chorthippus parallelus; Conyza canadensis; Cotesia sesamiae; Epinephelus acanthistius; Ficedula hypoleuca; Grindelia hirsutula; Guadua angustifolia; Leucadendron rubrum; Maritrema novaezealandensis; Meretrix meretrix; Nilaparvata lugens; Oxyeleotris marmoratus; Phoxinus neogaeus; Pristomyrmex punctatus; Pseudobagrus brevicorpus; Seiridium cardinale; Stenopsyche marmorata; Tetranychus evansi and Xerus inauris. These loci were cross-tested on the following species: Agalinis decemloba; Agalinis tenella; Agalinis obtusifolia; Agalinis setacea; Agalinis skinneriana; Cercospora zeina; Cercospora kikuchii; Cercospora sorghi; Mycosphaerella graminicola; Setosphaeria turcica; Magnaporthe oryzae; Cotesia flavipes; Cotesia marginiventris; Grindelia Xpaludosa; Grindelia chiloensis; Grindelia fastigiata; Grindelia lanceolata; Grindelia squarrosa; Leucadendron coniferum; Leucadendron salicifolium; Leucadendron tinctum; Leucadendron meridianum; Laodelphax striatellus; Sogatella furcifera; Phoxinus eos; Phoxinus rigidus; Phoxinus brevispinosus; Phoxinus bicolor; Tetranychus urticae; Tetranychus turkestani; Tetranychus ludeni; Tetranychus neocaledonicus; Tetranychus amicus; Amphitetranychus viennensis; Eotetranychus rubiphilus; Eotetranychus tiliarium; Oligonychus perseae; Panonychus citri; Bryobia rubrioculus; Schizonobia bundi; Petrobia harti; Xerus princeps; Spermophilus tridecemlineatus and Sciurus carolinensis.

[Nursing students voice their opinions regarding their profession]. / Los estudiantes de enfermería opinan sobre su profesión.

The authors research the opinions of first year nursing students about why the nursing profession does not receive the same degree of consideration which similar academic professionals receive. At the same time, the authors studied to see if this lower professional consideration is due to the predominant presence of females in the nursing profession. To collect data, the authors ran a transversal, descriptive, qualitative study by means of nominal group and discussion group techniques. Among the main results, the authors highlight that Nursing is considered a socially unknown profession and receives little acknowledgment inside the new health care model; furthermore, the fact that the majority of nurses are female does bear an influence on the vision of the nursing field and this female predominance harms competitiveness in the profession since nurses must conciliate their family lives with their professional lives.

Los estudiantes de enfermería opinan sobre su profesión / Nursing students voice their opinions regarding their profession

Se indaga la opinión de los estudiantes de primer curso de Enfermería sobre por qué el colectivo no está considerado al mismo nivel que otras profesiones académicamente similares. Así mismo, se ha estudiado si tiene que ver con la presencia mayoritaria de la mujer dentro de la profesión. Para recoger información se ha llevado a cabo un estudio transversal, descriptivo y cualitativo mediante las técnicas de grupo nominal y de discusión. Entre los principales resultados destacar que se considera la Enfermería una profesión socialmente desconocida y poco reconocida en su nuevo modelo asistencial; también, que la mayoría de los profesionales sean mujeres influye en la visión del entorno y dificulta la competitividad del colectivo al tener que conciliar la vida familiar con la laboral(AU)

The authors research the opinions of first year nursing students about why the nursing profession does not receive the same degree of consideration which similar academic professionals receive. At the same time, the authors studied to see if this lower professional consideration is due to the predominant presence of females in the nursing profession. To collect data, the authors ran a transversal, descriptive, qualitative study by means of nominal group and discussion group techniques. Among the main results, the authors highlight that Nursing is considered a socially unknown profession and receives little acknowledgment inside the new health care model; furthermore, the fact that the majority of nurses are female does bear an influence on the vision of the nursing field and this female predominance harms competitiveness in the profession since nurses must conciliate their family lives with their professional lives(AU)

Air pollution and respiratory hospital admissions in greater Paris: exploring sex differences.

The subject of sex and gender differences is relevant to the study of health effects of environmental exposures. In this study the authors aim at assessing the differences that may exist between males and females regarding short-term air pollution health effects. They studied the short-term relationships between air pollution levels and respiratory hospital admissions in greater Paris area for patients older than 15 years between 2000 and 2003. They also conducted time series analyses by using generalized additive models. For an increase of 10 microg/m3 in the air pollutant levels, the increase in relative risk of hospitalization was higher for males than for females and was significant only for males. These differences may not result solely from differences in biological susceptibility to air pollution because other factors related to gender (differences in individual exposures, in health care management, and so on) may play a role.

[Nutritional value of the diet in healthy pregnant women. Results of a nutrition survey of pregnant women]. / Valor nutricional de la dieta en embarazadas sanas. Resultados de una encuesta dietética en gestantes.

GOAL: The purpose of the present paper is to describe the level of nutritional adequacy of the regular diet of pregnant women belonging to our health-care area. SCOPE: Health-care area of Valme Hospital, Seville. DESIGN: Randomized transversal descriptive study. SUBJECTS: Forty-nine pregnant women during their first trimester. INTERVENTIONS: The daily intake was assessed by means of a 24-hour reminder sheet and a weekly consumption survey. The data obtained were compared with the recommended daily intake of nutrients and with the recommended daily allowances for various foods. At the same time, an anthropometric and basic analysis were also carried out. RESULTS: The calorie intake was as recommended (2,208 +/- 475 kcal/day). The diet contained excessive amounts of proteins (88 +/- 21 g/day) and fat (97 +/- 27 g/day), with a predominance of monounsaturated fats (46.9 +/- 5.5%) over saturated (36.6 +/- 7.2%) or polyunsaturated fats (15.1 +/- 7%), (p < 0.0005). Nonetheless, the diet was short on carbohydrates (44%), fibre (18 +/- 4.9 g/day), calcium (948 +/- 353 mg/day), iron (13.4 +/- 3.1 mg/day) and vitamin B6 (1.1 +/- 0.8 mg/day) (p < 0.0005), and extremely short on folic acid (172 +/- 101 micrograms/day), (p < 0.0005). In the assessment of the diet in terms of daily allowances, this was sufficient in fruit (2.3 +/- 1.8/day), but short on dairy products (1.9 +/- 1.1/day) and extremely short on vegetables (1 +/- 0.4/day), (p < 0.0005). Only 2% of the subjects fulfilled with the recommended daily intake for key vitamins and minerals. The prevalence of obesity (BMI > 30 kg/m2) was 18.4%. CONCLUSIONS: The normal diet of pregnant women in our health-care area is short on calcium, iron, folic acid and dietary fibre, although with an excess of animal protein and fat.

Valor nutricional de la dieta en embarazadas sanas. Resultados de una encuesta dietética en gestantes / Nutritional value of the diet in healthy pregnant women

Objetivo: El objetivo de este trabajo es describir el nivel de adecuación nutricional de la dieta habitual en gestantes pertenecientes a nuestra área sanitaria. Ámbito: Área Sanitaria Valme. Sevilla. Diseño: Estudio descriptivo aleatorio transversal. Sujetos: Cuarenta y nueve gestantes de primer trimestre. Intervenciones: Se valoró la ingesta diaria, por recordatorio de 24 horas y por encuesta de consumo semanal. Los datos obtenidos se comparan con las ingestas diarias recomendadas de nutrientes y con las raciones diarias recomendadas para determinados grupos de alimentos. Al mismo tiempo, se realizó una valoración antropométrica y analítica básica. Resultados: La ingesta calórica fue la recomendada (2.208 ñ 475 kcal/día). La dieta contenía un exceso de proteínas (88 ñ 21 g/día), de grasa (97 ñ 27 g/día), con predominio de grasas monoinsaturadas (46,9 ñ 5,5 por ciento) sobre las saturadas (36,6 ñ 7,2 por ciento) y poliinsaturadas (15,1 ñ 7 por ciento), (p 30 kg/m2) fue de un 18,4 por ciento. Conclusiones: La dieta habitual de las gestantes de nuestra área es deficitaria en calcio, hierro, ácido fólico, y fibra dietética, aunque excesiva en proteína animal y grasas (AU)

Goal: The purpose of the present paper is to describe the level of nutritional adequacy of the regular diet of pregnant women belonging to our health-care area. Scope: Health-care area of Valme Hospital, Seville. Design: Randomized transversal descriptive study. Subjects: Forty-nine pregnant women during their first trimester. Interventions: The daily intake was assessed by means of a 24-hour reminder sheet and a weekly consumption survey. The data obtained were compared with the recommended daily intake of nutrients and with the recommended daily allowances for various foods. At the same time, an anthropometric and basic analysis were also carried out. Results: The calorie intake was as recommended (2,208 ± 475 kcal/day). The diet contained excessive amounts of proteins (88 ± 21 g/day) and fat (97 ± 27 g/day), with a predominance of monounsaturated fats (46.9 ± 5.5%) over saturated (36.6 ± 7.2%) or polyunsaturated fats (15.1 ± 7%), (p < 0.0005). Nonetheless, the diet was short on carbohydrates (44%), fibre (18 ± 4.9 g/day), calcium (948 ± 353 mg/day), iron (13.4 ± 3.1 mg/day) and vitamin B6 (1.1 ± 0.8 mg/day) (p < 0.0005), and extremely short on folic acid (172 ± 101 µg/day), (p < 0.0005). In the assessment of the diet in terms of daily allowances, this was sufficient in fruit (2.3 ± 1.8/day), but short on dairy products (1.9 ± 1.1/day) and extremely short on vegetables (1 ± 0.4/day), (p < 0.0005). Only 2% of the subjects fulfilled with the recommended daily intake for key vitamins and minerals. The prevalence of obesity (BMI > 30 kg/m2) was 18.4%. Conclusions: The normal diet of pregnant women in our health-care area is short on calcium, iron, folic acid and dietary fibre, although with an excess of animal protein and fat (AU)