Epidemiología del síndrome de burnout / Burnout syndrome epidemiology

El síndrome de burnout constituye un proceso de alta prevalencia e importantes consecuencias entre los profesionales sanitarios y especialmente en enfermería. Por ello nos hemos propuesto estudiar las tres dimensiones del síndrome (cansancio emocional, despersonalización y falta de realización) y la función que ciertos factores personales, laborales e institucionales tienen en el desarrollo del proceso. Se realizó un estudio transversal tras un muestreo aleatorio entre todo el personal adscrito al área de enfermería de un hospital de Madrid. Se aplicaron dos tipos de instrumentos de recogida de información: un cuestionario que recopilaba variables sociodemográficas, laborales e institucionales y el Maslach Burnout Inventory (MBI) en su versión validada en español, que estudiaba las tres dimensiones del síndrome de burnout. Se realizó un análisis de regresión logística múltiple, tomando como variables dependientes las tres escalas del síndrome y ajustando por todas las demás variables. Se mostraron como factores de riesgo claro las opiniones desfavorables de los profesionales de las variables institucionales, siendo especialmente importantes para la escala de cansancio emocional(AU)

The burnout syndrome constitutes a process which bears high prevalence and important consequences among sanitary professionals, particularly among nurses. Therefore, the authors have proposed to study the three dimensions of this syndrome, namely emotional tiredness, depersonalization and lack of a sense of achievement plus the function certain personal, labor, and institutional factors have in development of this process. The authors carried out a transversal study based on a random sample from among all the nursing staff at a Madrid hospital. Two methods to gather information were employed: one questionnaire gathered socio-demographic data, labor and institutional variables while the Maslach Burnout Inventory (MBI), in its verified Spanish version, studied the three burnout syndrome dimensions. The authors made a multiple logistical regression analysis, using as dependent variables the three syndrome scales and adjusting parameters for all the other variables. Clear risk factors were shown; these included unfavorable opinions professionals hold regarding institutional variables; the scale for emotional tiredness warrants special note(AU)

Psychotropics use in the Spanish elderly: predictors and evolution between years 1993 and 2003.

PURPOSE: This study mainly aimed at describing the prevalence of psychotropic medication consumption in the Spanish elderly population between the years 1993 and 2003. METHODS: Descriptive, cross-sectional study covering the Spanish population aged 65 years and over, using data drawn from the 1993 and 2003 Spanish National Health Surveys (ENSS). A total of 9570 interviews were analysed (3436 from 1993 and 6134 from 2003). The independent variables were sociodemographic and health-related, and the dependent variable was total consumption of psychotropic medication. Using logistic multivariate regression models, we have analysed the temporal evolution of psychotropic medication consumption between 1993 and 2003. RESULTS: The prevalence of consumption was significantly higher in women (6.7% from 1993 and 26.4 % from 2003) versus men (2.4% from 1993 and 10.6% from 2003) (p < 0.001). Multivariate analysis, highlighted the association between increased psychoactive drug intake and sex, nervous, depressive, sleep disorders and negative perception of health, displayed a strong association with consumption of psychoactive drugs across the 2 years. CONCLUSIONS: In Spain, the prevalence of psychoactive drug consumption is higher among elderly women than men, and increases with negative perception of health. The prevalence of consumption was significantly higher in the year 2003.

[Epidemiological characteristics of breast cancer development in pre and postmenopausal women]. / Características epidemiológicas relacionadas con el cáncer de mama en mujeres pre y posmenopáusicas.

BACKGROUND: To study the relation between breast cancer and different risk factors, personal, familial and demographic factors. An statistic and epidemiologic study was also carried on a whole population of women and then classified on pre and postmenopausal women. PATIENTS AND METHODS: A matched case-control study was performed based on age, urban area and hormonal activity. Total population was composed by 274 cases and same number of controls. Studied variables were obtained by a questionnaire asking for study level, reproductive and personal history, familial considerations and lifestyles. A multiples logistic regression model was made. RESULTS: Over total population, late menarcheal age, late first pregnancy, and familial history of breast cancer were shown as independent risk factors, but a low study level, and oral contraception were shown as protective factors. This risk model was confirmed on postmenopausal women but no over premenopausal women, so in this group, main risk factors were familial breast cancer history and a medical history of benign breast disease. Moreover, the low study level was also a protective factor. CONCLUSIONS: Familial history of breast cancer in mothers or sisters was the main risk factor for breast cancer, mainly in premenopausal women, and low study level showed as protective factor.

[Seroprevalence of antibodies against measles, rubella, mumps and varicella among school children in Madrid]. / Seroprevalencia de anticuerpos frente a sarampión, rubéola, parotiditis y varicela en escolares madrileños.

OBJECTIVE: The aim of this study was to assess the seroprevalence of antibodies against MMR and varicella in a population of children between 6 and 7 years of age vaccinated against measles, mumps and rubella at 15 months of age. PATIENTS AND METHODS: This cross-sectional study was carried out in a group of healthy children (6-7 years of age) of the Autonomous Community of Madrid, Spain. Vaccination against MMR at 15 months of age was documented for all children included in the study. Blood samples were drawn from all participants and sera were stored at -20C until they were tested at the end of the study. Measles, mumps, rubella and varicella antibody levels were measured by means of the enzyme linked immunosorbent assay (ELISA) method (IgG Genzyme Virotech GmbH). Positive values were defined as optical density values of > or = 0.20 for measles, > or = 0.30 for mumps, > or = 0.40 for rubella and > or = 0.36 for varicella. Prevalence (and the corresponding 95% confidence limits) assessed by the presence of anti-measles, anti-mumps, anti-rubella and anti-VZV antibodies on the study population were calculated. The Chi-squared test was used to evaluate differences in prevalence between sexes. The Chi-squared test was used to evaluate differences in prevalence between the sexes. RESULTS: A total of 174 children were recruited between October and November 1997. The mean age (SD) and male/female ratio were 6.4 (0.5) years and 0.8 (45.6%/54.5%), respectively. Prevalence of antibodies against measles, rubella, mumps and varicella were 92% (88-96%), 95% (92-98%), 81% (76-86%) and 85% (90-90%), respectively. There were no significant differences between the sexes in relationship to the prevalence of measles, mumps, rubella or varicella antibodies. CONCLUSIONS: Approximately 20% of these 6 to 7 year old children vaccinated at 15 months of age were unprotected against the mumps. Eight percent and 5% were sero-negative for measles and rubella, respectively. Administration of the second dose of MMR vaccine at 4 to 6 years of age instead of at 11 years would contribute to avoid the accumulation of non-immune children. Eighty-five percent of the study population was sero-positive for VZV. These data suggest that, in Spain, VZV infections commonly affect children younger than 5 years of age.

[The evaluation of the mutagenic activity of public drinking water by the Ames test]. / Evaluación de la actividad mutagénica de aguas de consumo público por medio del test de Ames.

BACKGROUND: The sources of potential mutagens in our environment are many, but the most important of these is water for public consumption. This is a result of the chlorinating process which is the main reason for the appearance of these mutagens. With this in mind, the aim of our study was to check a possible mutagenic activity, using the Ames test, in organic concentrates taken from water for public consumption in Madrid. METHODS: Several bacterial strains were used, namely Salmonella histidine dependent TA1535, TA1538, TA98 and TA100, taken originally from Salmonella typhimurium LT2. Each test was performed twice, with or without the introduction of the mammalian-microsome activation (S9 mix), as per the indications in Ames. The plate incorporation assay was used to test the mutagenicity. All samples of the water in question were processed and treated so as to create concentrates of organic chlorinated compounds. RESULTS: The highest levels of mutagenicity appeared in the TA1535 strain and in the tests where the microsome fraction was not used (IM = 1.94). CONCLUSIONS: With regard to mutagenic evaluation in organic concentrates taken from water for public consumption, no positive activity was found in any of the tester strains.

Spontaneous abortion in a hospital population: are tobacco and coffee intake risk factors?

The objective of this study was to examine the possible relationships between spontaneous abortion and caffeine, tobacco and alcohol intake in a well-controlled group of hospital workers. A retrospective cohort study design including 711 women, 20 to 41 years old, was used. All data regarding the purpose of this study were extracted from clinical histories registered at the Preventive Medicine Service. The dependent variable was spontaneous abortion and the independent variables were tobacco, coffee, and alcohol intake. Age, previous spontaneous abortion, menarcheal age and marital status were considered as potential confounders. The data were analyzed by multiple logistic regression. The following adjusted odds ratios of spontaneous abortion by caffeine consumption were calculated: 141-280 mg/day, 2.20 (1.22-3.96); 281-420 mg/day, 4.81 (2.28-10.14) and 421 or more, 15.43 (7.38-32.43); p < 0.05. The adjusted odds ratio for tobacco were 11 or more cigarettes/day, 3.35 (1.65-6.92); p < 0.05. It appears from this and other papers that tobacco and caffeine intake must be considered as clear risk factors for spontaneous abortion or miscarriage.

[Periodontal disease in juvenile diabetics and non-diabetics]. / Enfermedad periodontal en diabéticos juveniles y no diabéticos.

BACKGROUND: Knowing the prevalence of periodontal disease, to identify some associated variables in youth population. Insulin dependent diabetes mellitus (DMID) has been included as a common variable. METHODS: Cross-sectional study over 383 individuals, 11 to 18 years old. Chi square and Odds ratio (95% confidence limits) have been determined. RESULTS: Periodontal disease prevalence is 37.53%. An epidemiological and statistical association were found with: Insulin-dependent diabetes mellitus, low social class, poor dental hygiene and plaque index over 0.20. CONCLUSIONS: Juvenile diabetic population must be considered as a high risk group for periodontal disease.

Analysis of several risks factors involved in dental caries through multiple logistic regression.

Through multiple logistic regression an epidemiological study was undertaken of the following factors: age, gender, socio-economic status, dental care, toothbrushing, chewing gum, snacking, fluoride, and of their influence on the development of tooth decay. The factors are analysed individually and globally (global model). An initial model was constructed, establishing the interactions, and developing a final model. Risk factors shown to be involved were: low social class status, lack of dental care in the previous 12 months, absence of toothbrushing, and belonging to the age group 9-12 years old. An interaction was established between the following variables: socio-economic status and toothbrushing, and dental care and age.

[Dental caries: age, income level and dental care]. / Caries dental: edad, nivel de ingresos y atención odontológica.

We have studied a population of 527 school children between 6 and 17 years old, having as main characteristic to have free odontological care. The prevalence of caries found was 40.4%. The age appears as a risk factor. However, we have not found any influence in the social status. The odontological care is considered essential in the decrease of prevalence of dental caries.

[Dental care for 6 to 15-year old children]. / Atención odontológica en niños de 6 a 15 años.

It has been realized a descriptive study about odontological assistance in 883 schoolchildren, they are from Madrid, attending age, sex and social status. Equally we analyze the variable dental caries in relationship with social class and odontological assistance.

[Family background. Parity. Breast feeding and cancer of the breast]. / Antecedentes familiares. Paridad. Lactancia y cáncer de mama.

A study has been carried out of case-controls in a population of 482 women aged between 40 and 98. Of these, 194 had been diagnosed with breast cancer by means of a biopsy and the remaining 288 were controls whose lack of tumoral processes had been ensured by the usual diagnostic means. In the population under study we have found that the maternal family background in the first degree was a risk factor for breast cancer, while giving birth and breast-feeding, both one's own and one's children, acted as protective factor.

[Caries prevalence of a school population]. / Prevalencia de caries en una población escolar.

We have made a cross-sectional study about dental caries in 883 children between 6 and 15 years old, belonging to 3 public schools representing the municipal district of Tetuan (Madrid). The studied variables, that were related with presence/absence of caries were: age, sex, school, social class, number of meals per day, tooth brushing and use of fluor. We have also established the indexes DMFT, dmft, DMFM, together with the affection percentage of each tooth and its graphic representation.

[Prevalence of tooth discoloration from tetracycline in a school population]. / Prevalencia de tinciones dentales por tetraciclinas en una población escolar.

We have made a transversal study in a population of 910 scholars from Madrid with the purpose of knowing the prevalence to tetracycline-stained, and we have found a 3.11% of children affected. We have referred study by age, sex, socioeconomic level and dental caries.