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1.
Rev Esp Salud Publica ; 942020 01 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31942868

RESUMO

OBJECTIVE: There are few epidemiological studies on acute poisonings from pesticides, industrials and household products in Spain. The objective of this work is to describe the epidemiological and clinical profile of acute poisonings by chemical products in our country, and analyze their annual evolution. METHODS: The Spanish Toxicovigilance System (SETv) is a prospective registry that includes 32 Emergency Departments and Intensive Care Units in Spain. An observational descriptive study of acute poisoning by chemical agents (excluding pharmacological products and illicit drugs) was carried out, within 1999-2014. Statistical analysis was performed using Chi-square or exact Fisher's tests. Non-parametric continuous variables were compared using the Mann-Whitney U test. P-value less than 0.05 were considered significant. RESULTS: The 10,548 cases studied had a mean age of 38.41 (±22.07) years, being significantly higher in women (p=0.0001). 67.7% of the poisonings occurred at home, and the most frequent routes of exposure were respiratory (48.3%), digestive (35.3%) and ocular (13.1%). The most frequent toxic groups were toxic gases (31%), caustics (25.6%) and irritant gases (12.1%). Of the patients that required treatment (76.2%), antidotes were used in 27.2%. 20.6% of the patients were admitted at Hospital, with a median stay of 32 (±151.94) days, with significant differences for pesticides and solvents (p=0.02). Sequelae were presented at discharge in 2.1% of patients. Mortality was 1.4% (146 patients) with a mean age of 62.08 years (±19.58) (p=0.0001). CONCLUSIONS: The reduction of chemical poisonings should be prevented in the domestic environment, taking into account the sources of exposure to carbon monoxide and the handling of household cleaning products, both caustic liquids and the generation of irritating gases when mixed.

2.
Int J Surg ; 74: 5-10, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31874260

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study is to analyse prevalence and evolution of MetS in patients suffering from morbid obesity, before and after bariatric surgery, during a follow-up period of 5 years. METHODS: A before-after study was carried out including 156 patients with MetS. The definition of metabolic syndrome according to the Joint Interim Statement (JIS) definition was used. Demographic, as well as anthropometric, biochemical, and clinical analyses were assessed before, as well as 2 and 5 years after performing laparoscopic Roux-en-Y gastric bypass (RYGB). RESULTS: High BMI (100%), elevated blood pressure (78%) and low levels of high density lipoprotein (70%) were the most prevalent criteria for MetS. The percentage of people with MetS decreased significantly to 48.9% at 2 years and 24.1% at 5 years. The weight was also significantly reduced at 2 years, although at 5 years a rebound effect is already observed. Percentage of total weight loss (%TWL) and excess BMI loss (%EBMIL) were. 49.7 ± 19.4% and 68.2 ± 18.9%, respectively, at 2 years and 29.3 ± 11.6% and 62.0 ± 24.9 at 5 years, both presenting significant differences (p < 0.001). CONCLUSION: RYGB in obese patients is associated with a significant improvement of MetS and its comorbidities. Insufficient weight loss is the main factor related to the prevalence of MetS.

3.
Acta Vet Hung ; 67(3): 317-326, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31549546

RESUMO

The aim of this study was to determine the prevalence of methicillin-resistant Staphylococcus (MRS) in healthy goats on the Island of Tenerife, Spain, as well as to identify the phenotypic and genotypic characteristics of the strains found. A cross-sectional prevalence study was conducted. A total of 158 goats from 15 different farms were sampled between September 2017 and January 2018. The percentage of positive samples of methicillin-resistant Staphylococcus aureus (MRSA) was 15.8% (25/158) and that of methicillin-resistant coagulase-negative staphylococci (MRCoNS) was 6.9% (11/158). All MRSA isolates from goats belonged to one clonal group showing Multi-Locus Sequence type 398. All strains studied (n = 36) were resistant to non-carbapenem beta-lactam antibiotics and susceptible to teicoplanin, linezolid, vancomycin, rifampicin, quinupristin-dalfospristin and mupirocine. In MRSA isolates, the highest percentage of resistance obtained, besides beta-lactam non-carbapenem antibiotics, was to trimethoprim-sulphamethoxazole and, in the case of MRCoNS isolates, to phosphomycin and erythromycin. A total of 12 resistance patterns were obtained, presenting differences between patterns obtained for MRSA and MRCoNS, with 7 different patterns for MRSA and 5 for MRCoNS. We therefore consider it essential to expand the epidemiological study of these strains of animal origin, as well as to increase surveillance and control measures at all stages of the food chain.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31146341

RESUMO

The objective of the present study is to assess the model's impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002-2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators' tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p < 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients' clinical condition as well as in the quality and efficiency of care.


Assuntos
Administração de Caso , Serviços de Assistência Domiciliar/organização & administração , Enfermeiras e Enfermeiros , Feminino , Humanos , Avaliação de Resultados da Assistência ao Paciente , Atenção Primária à Saúde/organização & administração , Espanha
5.
Vet Sci ; 6(2)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30987334

RESUMO

The problem of emerging resistant microorganisms such as Methicillin-Resistant Staphylococcus aureus (MRSA) associated to livestock is closely linked to improper use of antimicrobial agents. The aim of this study is to find out the prevalence and characteristics of these strains, as well as their evolution in healthy pigs on the Island of Tenerife, Spain. Between October 2009 and December 2010, 300 pigs from 15 wean-to-finishing farms were screened. Between 1 September 2017 and 31 March 2018, a new sampling was performed collecting 125 nasal swabs from pigs belonging to the same farms and under the same conditions as the previous study. MRSA antibiotic resistant patterns were studied. Results: Prevalence of MRSA isolates was 89.6%. All isolates belonged to Sequence Type 398 (ST398), a livestock related strain. All strains studied were resistant to beta-lactamic non-carbapenemic antibiotics and sensitive to teicoplanin, linezolid, vancomycin, rifampicin, quinupristin-dalfospristin, and mupirocine. Between 2009/2010-2017/2018 a significant increase in resistance to gentamicin, tobramycin, trimethoprim-sulfomethoxazole, clindamycin, Fosfomycin, and tigecycline antibiotics was observed in isolated MRSA strains compared to the previous period. We consider a major control and surveillance program of antibiotic use in veterinary care is needed in order to reduce the presence of MRSA strains in livestock and control this significant multi-resistance increase.

6.
Emergencias (St. Vicenç dels Horts) ; 28(6): 381-386, dic. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-158778

RESUMO

Objetivos. Los residentes de centros de larga estancia (CLE) son población de riesgo para la colonización por Staphylococcus aureus resistente a meticilina (SARM) debido a la morbilidad asociada a la edad y la alta tasa de contactos hospitalarios, especialmente en el servicio de urgencias hospitalario (SUH). El objetivo del estudio fue determinar la prevalencia y los factores asociados a la colonización por SARM en los residentes de CLE. Método. Se realizó un estudio descriptivo transversal entre abril y junio de 2014. Como criterio de inclusión se consideró ser residente de un CLE del área norte de la isla de Tenerife. Se recogieron variables clínico-epidemiológicas y muestras nasales que se sembraron en agar chromID®MRSA, que discrimina entre colonizados por SARM o no. El tipado molecular se realizó mediante electroforesis en campo pulsante. Se realizó un análisis de regresión logística sobre la variable SARM como dependiente. Resultados. Se incluyeron 624 residentes. La prevalencia de SARM fue del 25,8%. Un total de 64 residentes necesitaron ser atendidos en el SUH en los tres meses previos al estudio. En el análisis multivariante se observó que ser atendido en el SUH en los tres meses previos [odss ratio (OR): 2,05 IC 95%: 1,29-3,26, p = 0,002] y la presencia de lesiones en la piel [OR: 1,65; IC 95% (1,11-2,44), p = 0,013] fueron las variables relacionadas con la colonización por SARM. El clon predominante fue ST–5 SARM-IVa (75,8%), estrechamente relacionado con la asistencia sanitaria. Conclusiones. Los CLE de nuestra área constituyen un importante reservorio de SARM. Haber sido atendido en el SUH se comportó como factor predictor de colonización por SARM, por lo que es necesario de reforzar las medidas preventivas de transmisión cruzada de microorganismos multirresistentes e implantar sistemas vigilancia activa de SARM en el SUH (AU)


Objectives. Residents of long-term care facilities (LTCFs) are at risk for methicillin-resistant Staphylococcus aureus (MRSA) colonization because of age-related illnesses and high rates of hospital use, in particular, of visits to the emergency department (ED). We aimed to determine the prevalence of and risk factors for MRSA colonization in LTCF residents. Methods. A descriptive cross-sectional study was carried out in 2014 (April–June). LTCF residents in the northern part of the island of Tenerife were eligible for enrolment. We collected clinical and epidemiologic data and took nasal swabs for culture (chromID MRSA agar) to screen for MRSA colonization. Molecular typing was established by pulsed field gel electrophoresis. MRSA colonization was the dependent variable in logistic regression analysis. Results. A total of 624 residents were enrolled. MRSA was detected in 25.8%. Sixty-four of the residents had received care in a hospital ED in the 3 months prior to enrolment. Multivariant regression analysis detected 2 risk factors for MRSA colonization: hospital ED care in the last 3 months (odds ratio [OR], 2.05; 95% CI, 1.29–3.26; P=.002) and the presence of skin lesions (OR, 1.65; 95% CI, 1.11–2.44); P=.013). The health-care-associated, ST5 MRSA-IVa, was the most prevalent (75.8%). Conclusions. LTCF residents in our area are a significant reservoir of MRSA colonization. Hospital ED care was a predictor of MRSA colonization. We believe that stronger measures to prevent cross-contamination of multidrug resistant microorganisms must be implemented, along with active vigilance systems to detect MRSA in hospitals (AU)


Assuntos
Humanos , Infecção Hospitalar/epidemiologia , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Infecções Estafilocócicas/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Fatores de Risco , Estudos Transversais , Tempo de Internação/estatística & dados numéricos , Resistência a Meticilina
7.
Int J Hyg Environ Health ; 219(1): 48-52, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26324115

RESUMO

BACKGROUND: Nontuberculous mycobacteria (NTM) are common bacteria in water and especially water supply distribution systems. Some species can cause infections, especially in immunocompromised patients and other risk groups. This study examined the frequency of occurrence of NTM in 135 household potable water samples collected from household water taps in Tenerife Island. METHODS: Mycobacteria species were identified by polymerase chain reaction targeting the 16S rRNA and 16S-23S rRNA regions, and by double-reverse hybridization on a dipstick using colloidal gold-bound and membrane-bound probes (Speed-Oligo(®) Mycobacteria). Some species were identified by sequencing the gene that encodes the 16S rRNA region. RESULTS: NTM were present in 47.4% of the samples. Mycobacterium fortuitum was the NTM isolated most frequently (70.3%), followed by Mycobacterium canariasense (6.3%) and Mycobacterium chelonae (6.3%). Other species were isolated at lower percentage frequencies. CONCLUSION: We isolated and identified the species M. canariasense in water supplies for public consumption. This species has previously been reported only in hospital settings. The elevated presence of NTM in the water supply indicates that it may be a reservoir for infections caused by recently described species of mycobacteria.


Assuntos
Água Potável/microbiologia , Infecções por Mycobacterium/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Microbiologia da Água , Abastecimento de Água , Técnicas de Tipagem Bacteriana/métodos , DNA Bacteriano/análise , Características da Família , Genes Bacterianos , Humanos , Ilhas , Sondas Moleculares , Mycobacterium , Micobactérias não Tuberculosas/genética , Micobactérias não Tuberculosas/crescimento & desenvolvimento , Reação em Cadeia da Polimerase , RNA Ribossômico 16S , Espanha , Abastecimento de Água/normas
8.
Emergencias ; 28(6): 381-386, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-29106082

RESUMO

OBJECTIVES: Residents of long-term care facilities (LTCFs) are at risk for methicillin-resistant Staphylococcus aureus (MRSA) colonization because of age-related illnesses and high rates of hospital use, in particular, of visits to the emergency department (ED). We aimed to determine the prevalence of and risk factors for MRSA colonization in LTCF residents. MATERIAL AND METHODS: A descriptive cross-sectional study was carried out in 2014 (April­June). LTCF residents in the northern part of the island of Tenerife were eligible for enrollment. We collected clinical and epidemiologic data and took nasal swabs for culture (chromID MRSA agar) to screen for MRSA colonization. Molecular typing was established by pulsedfield gel electrophoresis. MRSA colonization was the dependent variable in logistic regression analysis. RESULTS: A total of 624 residents were enrolled. MRSA was detected in 25.8%. Sixty-four of the residents had received care in a hospital ED in the 3 months prior to enrollment. Multivariant regression analysis detected 2 risk factors for MRSA colonization: hospital ED care in the last 3 months (odds ratio [OR], 2.05; 95% CI, 1.29­3.26; P=.002) and the presence of skin lesions (OR, 1.65; 95% CI, 1.11­2.44); P=.013). The health-care-associated, ST5 MRSA-IVa, was the most prevalent (75.8%). CONCLUSION: LTCF residents in our area are a significant reservoir of MRSA colonization. Hospital ED care was a predictor of MRSA colonization. We believe that stronger measures to prevent cross-contamination of multidrug resistant microorganisms must be implemented, along with active vigilance systems to detect MRSA in hospitals.

9.
Int J Environ Res Public Health ; 12(1): 611-22, 2015 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-25588155

RESUMO

BACKGROUND: Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) such as the MRSA ST398 strain has spread all over the world and the most worrying aspect of this fact appears to be its capacity to easily spread to humans. The excessive use of antibiotics has made swine a reservoir of MRSA. The aim of the present study was to determine the antibiotic resistance profile of MRSA samples isolated from healthy swine of the island of Tenerife (Spain). METHODS: A total of 256 MRSA isolates from swine samples and five MRSA isolates from pig worker samples were investigated for MRSA antibiotic resistant patterns. RESULTS: Analysis of the susceptibility status of MRSA pig isolates revealed that 39 isolates were resistant to one antibiotic, 71 isolates were resistant to two antibiotics and 96 isolates were resistant to three or more antibiotics. SCCmec typing revealed the presence of types IV and V. Isolates having SCCmec IV had an increased resistance to the antimicrobial agents tested than those having SCCmec V. We observed significant differences when comparing the most common resistance patterns and SCCmec type. CONCLUSIONS: MRSA isolated from humans showed similar resistance to those isolated from pigs, excepting erythromycin, since all the workers' isolates were sensitive to this antibiotic. The evolution of new MRSA clones has emphasized the need for infection control practices in animals and humans in close contact.


Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Meticilina/farmacologia , Sus scrofa/microbiologia , Animais , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Fazendeiros , Humanos , Testes de Sensibilidade Microbiana/veterinária , Espanha
10.
Foodborne Pathog Dis ; 11(11): 868-73, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25188670

RESUMO

The aim of the study was to detect the prevalence of CTX-M-type extended-spectrum ß-lactamases (ESBL) in Escherichia coli strains isolated in healthy chickens at poultry farms in Tenerife, Spain. From November 2012 to February 2013, 260 live chickens were screened. Samples were cultured in chromogenic media. Suspect strains were identified by Vitek 2 system and ESBL production was confirmed by the double-disk synergy test. Pulsed-field gel electrophoresis (PFGE) was performed with XbaI (Promega, Madison, WI) to ESBL-E. coli isolates. The presence of CTX-M-type was detected by real-time polymerase chain reaction. Of 260 rectal swabs, 237 (91.1%) were ESBL-E. coli, 196 (75.38%) strains were characterized by PFGE, and CTX-M-type was detected in 116 (59.1%) of these strains. With respect to the susceptibility patterns of E. coli blaCTX-M strains, 7.8% showed resistance to more than two non-ß-lactam antibiotics. In our area, the prevalence of CTX-M-type in E. coli isolated in chicken was even higher than those found in other countries. The impact of food animals as a possible reservoir for ESBL-E. coli, especially CTX-M-type ESBL, and the dissemination of such strains into the food production chain need to be assessed.


Assuntos
Galinhas/microbiologia , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , beta-Lactamases/análise , Animais , Eletroforese em Gel de Campo Pulsado , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Carne/microbiologia , Testes de Sensibilidade Microbiana , Produtos Avícolas , Espanha , beta-Lactamases/genética
11.
Nutr. clín. diet. hosp ; 34(2): 63-70, ago. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-130913

RESUMO

Introducción: El Síndrome Metabólico (SM) es una situación clínica muy prevalente implicada en los mecanismos de desarrollo de la diabetes mellitus, y a la vez un importante factor de riesgo de enfermedades cardiovasculares, especialmente en la población de mayor edad. Objetivo: Determinar la prevalencia de SM en la población mayor de 65 años y su relación con la mortalidad. Métodos: Se diseñó un estudio epidemiológico descriptivo en el que se incluyeron 455 personas (231 hombres y 228 mujeres) entre 65 y 94 años de la Isla de Tenerife (España). Se estudió la prevalencia de SM utilizando la definición armonizada de la Organización Mundial de la Salud (OMS) y se relacionó con la mortalidad y supervivencia de la misma. La recogida de datos se realizó en dos fases: Un primer período desde el 1 de octubre de 2007 hasta el 31 de junio de 2009 y posteriormente el 1 junio de 2011, se accedió a la base de datos interna del Servicio Canario de Salud (INTRANET) para revisar los datos de mortalidad y supervivencia de la población incluida en el estudio. Resultados: Los resultados mostraron que la prevalencia de SM en el total de la muestra fue 47,7%, superior en mujeres que en hombres. Los sujetos con SM presentaban mayor edad que los que no tenían SM. La mortalidad general de la población fue del 26,6% y la tasa de mortalidad de 11 por 100 personas/año: 1,1x103 personas/año. Conclusiones: La prevalencia de SM fue elevada. No obtuvimos diferencias significativas de mortalidad ni de supervivencia según la población tuviese o no SM (AU)


Introduction: Metabolic syndrome (MS) is a very prevalent clinical condition involved in diabetes mellitus mechanisms of development, being at once an important risk factor for cardiovascular disease, especially in the elderly population. Objetive: to determine the prevalence of the metabolic syndrome among 458 of the adults aged 65 years and over and its relation with mortality. Methods: A descriptive epidemiological study was designed, with 459 participants (231 males and 228 females) aged between 65 and 94; living in Tenerife (Spain). The prevalence of MS was studied using the harmonized definition of World Health Organization (WHO), related to its mortality and survival. Results: The results showed a prevalence of MS in the total sample of 47.7%, and this was higher in women than in men. There were also significant differences according to age. The overall mortality of the population was 26.6% and the mortality rate of 11 per 100 persons / year: 1.1 x103 person / year. Conclusion: This report on the metabolic syndrome shows a high prevalence of this disorder. We did not find significant differences in mortality or survival of the population, either with and without MS (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Síndrome Metabólica/epidemiologia , Mortalidade , Nutrição do Idoso , Saúde do Idoso , Comorbidade
12.
Metas enferm ; 16(4): 57-62, mayo 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-113764

RESUMO

Objetivo: determinar el uso de la espirometría diagnóstica en el Área de Salud de Tenerife y la disponibilidad de medios materiales y humanos para su realización. Método: se efectuó un estudio descriptivo transversal en el periodo de marzo a junio de 2011, en el Área de Salud de Tenerife, que abarca toda la isla, en el que se incluyeron los 38 centros de salud del área. La recogida de datos se llevó a cabo mediante un cuestionario elaborado y administrado por el equipo investigador, basado en el publicado por Naveran et al (1994) y que consta de 18 preguntas sobre la utilización de la espirometria. Los entrevistados fueron los profesionales encargados de la realización de las pruebas y los responsables de la subdirección del centro, en caso de que no se realizase esta técnica. Resultados: se cumplimentaron los cuestionarios de los 38 centros (100%).El 89,4% de los centros de salud disponen de espirómetro; realizan espirometrías el 71%; en el 85% de los centros las espirometrías las efectúa enfermeras/os; el 96% de las cuales ha recibido una formación básica sobre la utilización de esta técnica; se calibra el espirómetro y se limpia y desinfecta cada vez que se utiliza en el 84,6% de los centros; la media de espirometrías a la semana por centro es de siete y el tiempo medio de espera es de 36 días Conclusiones: aunque es alto el porcentaje de centros de salud que realizan la espirometría, la mejora de la formación enfermera y de los ratios enfermera/médico podría incrementar la media de pruebas semanales y hacerla más accesible a la población (AU)


Objective: to determine the use of Diagnostic Spirometry in the Tenerife Healthcare Area, and the availability of material and human resources in order to perform it. Method: a transversal descriptive study was conducted from March to June, 2011, in the Tenerife Healthcare Area, including the whole island and the 38 health centers in the area. Data collection was conducted through a questionnaire prepared and administered by the research team, based on the one published by Naveran et al (1994), consisting of 18 questions about the use of spirometry. The respondents were the healthcare professionals responsible for conducting tests, and the Healthcare Center Section Managers, in those centers where the test was not conducted. Results: the questionnaires were completed in all 38 centers (100%).There is a spirometer in 89.4% of health centers; spirometries are conducted in 71% of health centers; spirometries are performed by nurses in 85% of health centers; 96% of said nurses have received basic training on the use of this technique; the spirometer is readjusted, cleaned and disinfected after each use in 84.6% of health centers; the average number of spirometries per week is seven, and the average time of wait is of 36 days. Conclusions: even though the proportion of health centers performing spirometry is high, an improvement in nurse training and nursephysician ratio could increase the average number of weekly tests, so that it became more accessible to the population (AU)


Assuntos
Humanos , Espirometria , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Cuidados de Enfermagem/métodos , Atenção Primária à Saúde/métodos
13.
Enferm. clín. (Ed. impr.) ; 22(3): 126-134, mayo-jun. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-105192

RESUMO

Objetivo Construir un cuestionario válido, fiable y de fácil manejo para el diagnóstico enfermero psicosocial. Método El estudio se realizó en 2 fases: diseño-construcción del cuestionario y pruebas de validez-fiabilidad. Se construyó un banco de ítems con una escala tipo Likert y dicotómicas, empleando como marco de referencia la clasificación NANDA. La combinación de respuestas conformó reglas diagnósticas para asignar hasta 28 etiquetas. Las pruebas de validez de contenido las realizó un grupo de expertos. Para las pruebas de validez de criterio se emplearon otros instrumentos validados como patrones de referencia. Cuarenta y cinco enfermeras de Atención Primaria de Tenerife (España) administraron de forma independiente el cuestionario, en 3 ocasiones, y los otros instrumentos validados en una única ocasión a 188 pacientes en un intervalo de 3 semanas. Resultados Las pruebas de validez de constructo confirmaron las 6 dimensiones del cuestionario con un 91% de varianza total explicada. Las pruebas de validez de criterio indicaron una especificidad del 66-100% y mayores puntuaciones de los instrumentos de referencia cuando se asignaron etiquetas diagnósticas por nuestro cuestionario. Las pruebas de fiabilidad indicaron grados de acuerdo test-retest del 56%-91% (p<0,001) y una consistencia interna del 93%. El Cuestionario para el Diagnóstico Enfermero Psicosocial, denominado CdePS, quedó conformado por 61 ítems. Conclusiones El CdePS es un instrumento válido, fiable y de fácil empleo en Atención Primaria para facilitar el diagnóstico enfermero psicosocial (AU)


Aim To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. Method The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain).Results Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 ítems. Conclusions The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis (AU)


Assuntos
Humanos , Inquéritos e Questionários , Diagnóstico de Enfermagem/métodos , Atenção Primária à Saúde/métodos , Fatores Socioeconômicos , Condições Sociais/classificação
14.
Enferm Clin ; 22(3): 126-34, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22554419

RESUMO

AIM: To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. METHOD: The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain). RESULTS: Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 items. CONCLUSIONS: The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis.


Assuntos
Diagnóstico de Enfermagem , Atenção Primária à Saúde , Inquéritos e Questionários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicologia , Psicometria
15.
Rev Esp Salud Publica ; 83(2): 231-42, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19626250

RESUMO

BACKGROUND: Social class has commonly been defined by the type of employment and it is assessed as a categorical variable. However, this approach has a number of drawbacks. The objective of this article is to develop and validate a readily standardizable quantitative indicator of social class and to show its ability to measure the impact of social class as a health determinant. METHODS: In 6729 individuals we measured income, crowding index, education, occupation and employment status. Two models were adjusted to study the neighborhood, dietary pattern and health problems. RESULTS: The model that included only income, crowding index and education (ICE) yielded an indicator that correlated with age (r = -0.28; p < 0.001) and consumption of potatoes (r = -0.17; p < 0.001) and salads (r = 0.10; p < 0.001). This indicator estimated that poor social classes were at significant risk for unemployment (OR = 5,), blue collar jobs (OR = 40,9), residing in poor neighborhoods (OR = 30.2), low salad consumption (OR = 2.2) and high consumption of potatoes (OR = 4.5). They also had, especially in women, a higher risk of sedentarism (OR = 1.8), obesity (OR = 4.4), metabolic syndrome (OR = 3.4) and diabetes mellitus (OR = 2.0). CONCLUSIONS: The ICE index was valid, not based on occupation or employment status, readily standardizable, and suitable for measuring social class and its impact of on health.


Assuntos
Modelos Estatísticos , Classe Social , Adulto , Estudos Transversais , Aglomeração , Escolaridade , Emprego , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Ocupações , Espanha
16.
Rev. esp. salud pública ; 83(2): 231-242, mar.-abr. 2009. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-137993

RESUMO

Fundamento: La clase social generalmente se mide de manera categórica y basada en la ocupación laboral, lo cual tiene múltiples limitaciones. El objetivo de este trabajo es elaborar un indicador cuantitativo de clase social, fácilmente estandarizable, validarlo en población adulta y comprobar su aptitud para medir el impacto de la clase social como determinante de salud. Métodos: estudio transversal de 6.729 individuos para medir la clase social con las variables: Renta familiar per cápita, Índice de hacinamiento, Estudios realizados, Ocupación laboral y Situación laboral. Se crearon dos modelos y mediante curvas COR se seleccionó el mejor para validarlo analizando su capacidad de estimar los riesgos relativos de: residir en barrio pobre o rico, mantener un patrón dietético típico de clases sociales pobres y presentar problemas de salud actualmente asociados a la pobreza. Resultados: el modelo sólo incluyó las variables Renta, Estudios e Índice de hacinamiento (REI), produjo un indicador con rango de valores entre 4 y 21 y mostró correlación inversa con la edad (r= -0,28; p<0,001), con el consumo de papas (r= -0,17; p<0,001) y con el consumo de legumbres (r= -0,03; p=0,01), además de correlación directa con el consumo de ensalada (r = 0,10; p<0,001); su sensibilidad para detectar la residencia en barrio pobre alcanzó el 97% para valores menores a 10. REI estimó que las clases sociales pobres presentan riesgos significativos de situación laboral de desempleo (OR=5,4), ocupación laboral de baja cualificación (OR=40,9), habitar en barrios pobres (OR =30,2), bajo consumo de ensaladas (OR = 2,2), gran consumo de papas (OR = 4,5) y alto consumo de legumbres (OR = 1,6). En ambos sexos las clases pobres presentaron mayor riesgo de problemas de salud, con mayor fuerza en las mujeres: sedentarismo (OR = 1,8), obesidad (OR = 4,4), obesidad abdominal (OR = 5,4), síndrome metabólico (OR = 3,4) y diabetes mellitus (OR = 2,0). Conclusiones: REI es un indicador válido, no basado en la ocupación ni en la situación laboral, fácilmente estandarizable, apto para medir cuantitativamente la clase social en estudios que precisen analizar el impacto de la misma como determinante de salud (AU)


Background: Social class has commonly been defined by the type of employment and it is assessed as a categorical variable. However, this approach has a number of drawbacks. The objective of this article is to develop and validate a readily standardizable quantitative indicator of social class and to show its ability to measure the impact of social class as a health determinant. Methods: In 6729 individuals we measured income, crowding index, education, occupation and employment status. Two models were adjusted to study the neighborhood, dietary pattern and health problems. Results: The model that included only income, crowding index and education (ICE) yielded an indicator that correlated with age (r = –0.28; p < 0.001) and consumption of potatoes (r = –0.17; p < 0.001) and salads (r = 0.10; p < 0.001). This indicator estimated that poor social classes were at significant risk for unemployment (OR=5,), blue collar jobs (OR=40,9), residing in poor neighborhoods (OR = 30.2), low salad consumption (OR = 2.2) and high consumption of potatoes (OR = 4.5). They also had, especially in women, a higher risk of sedentarism (OR = 1.8), obesity (OR = 4.4), metabolic syndrome (OR = 3.4) and diabetes mellitus (OR = 2.0). Conclusions: The ICE index was valid, not based on occupation or employment status, readily standardizable, and suitable for measuring social class and its impact of on health (AU)


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Classe Social , Modelos Estatísticos , Escolaridade , Estudos Transversais , Ocupações , Emprego , Renda , Aglomeração
19.
Rev Esp Salud Publica ; 77(6): 749-60, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-14965066

RESUMO

BACKGROUND: School lunchrooms and catered meals are of major importance from the Public Health standpoint. This study is aimed at evaluating the microbiological quality of the meals served in school lunchrooms for the purpose of ascertaining whether it is suitable or, to the contrary, the intake thereof may involve a serious health problem for this high-risk group. METHODS: A transversal descriptive epidemiological study. An analysis was conducted of a total of 898 food samples collected from the lunchrooms at 101 schools in Tenerife, selected by a stratified random probabillistic sampling procedure, fifty-eight of which were prepared at the school proper (direct management) and 43 involving meals served by a catering firm (prepared under contract). RESULTS: No disease-causing Salmonella spp. or Listeria monocytogenes bacteria were isolated from any of the samples. A total 79% of the foods studies showed counts for this parameter, (91%) in salads and (85%) in main courses. A total 15% of the samples analyzed tested positive for total Enterobacteriaceae. Escherichia coli was isolated in 24% of the salads, in 4% of the side dishes and in 1% of the main dishes. Staphylococcus aureus having in isolated in three foods. The highest counts were found for the total aerobic mesophyllic microorganisms. A total 8.24% of the samples analyzed exceeded one or more of the limits stipulated for the parameters studies. CONCLUSIONS: The microbiological quality of the meals served in these school lunchrooms is acceptable, although due to a certain percentage of the foods having exceeded the stipulated limits for microorganisms indicative of and revealing a lack of hygiene, and school-children being a high-risk group, a revision of the surveillance related to critical checkpoints will be necessary.


Assuntos
Bactérias/isolamento & purificação , Microbiologia de Alimentos , Serviços de Alimentação/estatística & dados numéricos , Contagem de Colônia Microbiana , Estudos Transversais , Humanos , Serviços de Saúde Escolar , Instituições Acadêmicas/estatística & dados numéricos , Espanha
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