Epidemiological Situation of High-Prevalence Non-Communicable Diseases in Spain: A Systematic Review.

High-prevalence non-communicable diseases (HNCDs) are an ongoing global public health problem, posing a risk to the continuity of the 2030 Agenda for Sustainable Development. The aim of this study is to describe the current situation in Spain regarding certain HNCDs, namely, ischaemic heart disease, type 2 diabetes mellitus and colorectal cancer, including their prevalence and incidence in recent years. A systematic review was conducted between October 2022 and February 2023 using the MEDLINE, ProQuest and Scopus databases. After an exhaustive search, a total of thirty-four articles were included, comprising fourteen articles on colorectal cancer, seven on ischaemic heart disease and thirteen on diabetes mellitus type 2. The main topics included risk factors, lifestyles, mortality and incidence, the importance of screening and patient empowerment. On analysing each disease, it can be gleaned that risk factors and lifestyle impact the incidence, prevalence and mortality of the diseases studied. In addition, responsible human behaviour, associated with lifestyle factors, is related to the occurrence of these three diseases.

Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure.

Background: Among the clinical predictors of a heart failure (HF) prognosis, different personal factors have been established in previous research, mainly age, gender, anemia, renal insufficiency and diabetes, as well as mediators (pulmonary embolism, hypertension, chronic obstructive pulmonary disease (COPD), arrhythmias and dyslipidemia). We do not know the role played by contextual and individual factors in the prediction of in-hospital mortality. Methods: The present study has added hospital and management factors (year, type of hospital, length of stay, number of diagnoses and procedures, and readmissions) in predicting exitus to establish a structural predictive model. The project was approved by the Ethics Committee of the province of Almeria. Results: A total of 529,606 subjects participated, through databases of the Spanish National Health System. A predictive model was constructed using correlation analysis (SPSS 24.0) and structural equation models (SEM) analysis (AMOS 20.0) that met the appropriate statistical values (chi-square, usually fit indices and the root-mean-square error approximation) which met the criteria of statistical significance. Individual factors, such as age, gender and chronic obstructive pulmonary disease, were found to positively predict mortality risk. Isolated contextual factors (hospitals with a greater number of beds, especially, and also the number of procedures performed, which negatively predicted the risk of death. Conclusions: It was, therefore, possible to introduce contextual variables to explain the behavior of mortality in patients with HF. The size or level of large hospital complexes, as well as procedural effort, are key contextual variables in estimating the risk of mortality in HF.

Risk of Recurrence in Operated Parasagittal Meningiomas: A Logistic Binary Regression Model.

BACKGROUND: Parasagittal meningiomas arise from the arachnoid cells of the angle formed between the superior sagittal sinus (SSS) and the brain convexity. In this retrospective study, we focused on factors that predict early recurrence and recurrence times. METHODS: We reviewed 125 patients with parasagittal meningiomas operated from 1985 to 2014. We studied the following variables: age, sex, location, laterality, histology, surgeons, invasion of the SSS, Simpson removal grade, follow-up time, angiography, embolization, radiotherapy, recurrence and recurrence time, reoperation, neurologic deficit, degree of dependency, and patient status at the end of follow-up. RESULTS: Patients ranged in age from 26 to 81 years (mean 57.86 years; median 60 years). There were 44 men (35.2%) and 81 women (64.8%). There were 57 patients with neurologic deficits (45.2%). The most common presenting symptom was motor deficit. World Health Organization grade I tumors were identified in 104 patients (84.6%), and the majority were the meningothelial type. Recurrence was detected in 34 cases. Time of recurrence was 9 to 336 months (mean: 84.4 months; median: 79.5 months). Male sex was identified as an independent risk for recurrence with relative risk 2.7 (95% confidence interval 1.21-6.15), P = 0.014. Kaplan-Meier curves for recurrence had statistically significant differences depending on sex, age, histologic type, and World Health Organization histologic grade. A binary logistic regression was made with the Hosmer-Lemeshow test with P > 0.05; sex, tumor size, and histologic type were used in this model. CONCLUSIONS: Male sex is an independent risk factor for recurrence that, associated with other factors such tumor size and histologic type, explains 74.5% of all cases in a binary regression model.

Cognitive Profile of Zonisamide and Valproic Acid in the Treatment of Idiopathic Generalized Epilepsy: A Comparative Observational Study.

INTRODUCTION: Calls for an alternative to valproic acid (VPA) as drug of choice for idiopathic generalized epilepsies (IGEs) have intensified since the recent International League Against Epilepsy recommendation that the drug should not be administered to women of childbearing age. Zonisamide (ZNS), a third-generation antiepileptic drug, has proven effective in generalized seizures and could be considered an alternative to VPA in this population. OBJECTIVES: The present study was designed to examine possible differences in cognitive profile between ZNS and VPA as monotherapy in patients with IGE in real-life settings. METHODS: We conducted a comparative, descriptive, observational, retrospective cohort study in two groups of patients diagnosed with IGE treated with ZNS ≥200 mg/day or VPA ≥1000 mg/day as stable monotherapy for at least the previous 6 months. We used specific neuropsychological tests for short- and long-term mnemonic functions, working memory, visuospatial speed, attention and processing speed, verbal fluency, executive functions, visual perception, abstraction, anxiety, depression, and apathy. RESULTS: We included 16 patients in the study: eight in the VPA and eight in the ZNS group. Significantly superior mean scores were obtained by the VPA group in working memory (Forward Digits test) and by the ZNS group in execution time for the Rey-Osterrieth complex figure test. No statistically significant differences were found between the groups in the remaining tests. CONCLUSION: Zonisamide as monotherapy has a similar cognitive profile to that of VPA in patients with IGE. The final treatment selection setting should be individualized. ZNS may be a reasonable alternative to VPA in some cases in this population.

Characteristics of temporal lobe epilepsy with no ictal impairment of consciousness.

INTRODUCTION: The predominant manifestations of temporal lobe epilepsy (TLE) are partial seizures with impairment of consciousness (type I.B of ILAE classification), although consciousness impairment is not necessary in all seizures of patients with TLE. Nevertheless, there have been very few reports of TLE patients with exclusive seizures with no impairment of consciousness (i.e. isolated auras). The objective of this study was to determine any differential characteristics of this subgroup of TLE patients. MATERIAL AND METHODS: Retrospective case-control study in 163 consecutive TLE patients from our hospital database. The patients were divided between those with and without ictal impairment of consciousness, based on directed semi-structured questionnaire to the patient and relatives and on video-EEG records. Ten independent variables (8 clinical and 2 paraclinical) were compared between the groups. RESULTS: 14 patients (8.5%) formed the "TLE without ictal impairment of consciousness" group. This group was less refractory to medical treatment [Odds Ratio: 0.14 (0.03-0.64); p<0.01] and had frequent ictal motor behaviour [Odds ratio: 5.33 (1.65-17.14); p=0.008] and less frequent presence of automatisms [p<0.001]. Non-significant tendencies were observed for a higher frequency of lesional substrate and fewer generalization episodes. DISCUSSION: TLE without ictal impairment of consciousness appears to be more frequent than previously thought. This subgroup of TLE patients shows differential characteristics that may possibly result from a differential propagation of the original epileptic activity towards frontal areas rather than towards neocortical and diencephalic structures, which may be related to the more frequent presence of structural lesions.

[Factors linked to adhesion to treatment in patients with refractory and non-refractory epilepsy]. / Factores vinculados a la adhesión al tratamiento en pacientes con epilepsia refractaria y no refractaria.

INTRODUCTION: Non-compliance with therapy is a problem in clinical practice in chronic diseases. Nevertheless, there are important gaps in our knowledge on this subject and its associated factors in patients with epilepsy. Moreover, failure to comply could lead to poor classification of the patients according to the definition of refractory epilepsy. AIMS: To examine the behaviour in terms of therapy compliance and the clinical, psychosocial and developmental factors involved in a group of patients with epilepsy, and also to analyse the differences in the psychosocial variables depending on the degree of resistance. PATIENTS AND METHODS: The study involved 112 epileptic patients recruited consecutively in the epilepsy unit of a tertiary health care centre. Patients were administered a questionnaire designed to collect sociodemographic and clinical variables, together with data about treatment, adhesion, reasons for non-compliance, social support, health, welfare and degree of response to treatment. RESULTS: The levels of non-compliance with therapy agreed with those found in previous studies. No significant differences in the level of adhesion were found between patients with refractory epilepsy and pharmacologically-controlled epilepsy, although significant differences were observed in the level of health, welfare, social support and other associated variables. CONCLUSIONS: The level of compliance of epileptic patients is rather poor. Patients with refractory epilepsy are more aware of the severity of their disease, they are more critical with the health care system and with their social setting, and they tend to comply better with their treatment. Hence, there are no reasons to believe that therapy non-compliance can explain a high proportion of the resistance that exists in epilepsy.

Adherencia al tratamiento en trabajadores de la Administración Pública: factores relacionados conla salud y el bienestar / Adherence to treatment by public administration workers: factors related to health and well-being

Objetivos: a) Analizar los niveles de adherencia al tratamiento por parte de los trabajadores estudiados; b) determinar los factores relacionados con el incumplimiento terapéutico y, por ende, con la salud y el bienestar de los participantes en el estudio y c) sentar las bases para el diseño futuro de estrategias de intervención preventiva.Métodos: El estudio se llevó a cabo durante el año 2008 en el Servicio de Prevención de los Servicios Centrales del Instituto Nacional de la Seguridad Social. Para ello, se diseñó un cuestionario aplicado a cada paciente (trabajador) en el que se recogen, además de las variables sociodemográficas, el tipo de enfermedad, tipo de tratamiento, razones de incumplimiento, apoyo social, salud y bienestar subjetivo.Resultados: Los análisis muestran que la adherencia a la medicación se da en mayor medida que la relacionada con la dieta y/o ejercicio físico. Entre los motivos de incumplimiento se señala especialmente el olvido, seguido del temor a los efectos secundarios. Existen diferencias en salud y bienestar entre quienes siguen las recomendaciones y quienes no; aquélla son estadísticamente significativas en la dieta y el ejercicio físico. El apoyo social juega un papel importante en la adherencia, en la salud y el bienestar subjetivo.Conclusiones: El conocimiento de los factores relacionados con el incumplimiento terapéutico y su vinculación con la salud y el bienestar ayuda a planificar actuaciones encaminadas a la prevención de la enfermedad en el ámbito laboral (AU)

Objectives: a) to analyse the levels of adherence to treatment by the workers studied, b) to determine the factors related to therapeutic failure and thus to participants´ health and well-being and c) to make the design of future preventive strategies.Methods: The study was carried out during 2008 in the Prevention Service of Central Services, National Institute of Social Security. A questionnaire was designed and applied to each patient (employee). This instrument contains the type of disease, treatment, reasons for non-compliance, social support, health and subjective well-being, in addition to sociodemographic variables.Results: The analysis shows that adherence to medication is higher than adherence to diet and/or exercise. Among the reasons for non-compliance are oversight and the fear of side effects. There are differences in health and well-being between those who follow recommendations and those who don´t. These differences are significant statistically in diet and exercise. Social support plays an important role in adherence, health and subjective well-being.Conclusions: Knowledge of factors related to therapeutic failure and its relationship to health and well-being helps to plan actions to prevent the disease in the workplace (AU)

Factores vinculados a la adhesión al tratamiento en pacientes con epilepsia refractaria y no refractaria / Factors linked to adhesion to treatment in patients with refractory and non-refractory epilepsy

Introducción. El incumplimiento terapéutico representa un problema en la práctica clínica en enfermedades crónicas. Sin embargo, existen importantes lagunas en nuestro conocimiento de este tema y de sus factores asociados en pacientes con epilepsia. Además, la falta de cumplimiento podría ocasionar una mala clasificación de los pacientes según la definición de epilepsia refractaria. Objetivos. Examinar la conducta de adhesión terapéutica y los factores clínicos, psicosociales y evolutivos implicados en un grupo de pacientes con epilepsia, y analizar las diferencias en variables psicosociales en función de la refractariedad. Pacientes y métodos. Muestra compuesta de 112 pacientes epilépticos reclutados de forma consecutiva en la unidad de epilepsia de un centro terciario. Se aplicó un cuestionario en el que se recogen variables sociodemográficas, clínicas, del tratamiento, adhesión, razones de incumplimiento, apoyo social, salud, bienestar y grado de respuesta al tratamiento. Resultados. Se confirman los niveles de incumplimiento terapéutico hallados en estudios previos. No se han encontrado diferencias significativas en el nivel de adhesión entre pacientes con epilepsia refractaria frente a epilepsia controlada farmacológicamente, aunque sí en el nivel de salud, bienestar, apoyo social y otras variables asociadas. Conclusiones. El cumplimiento del paciente epiléptico es mediocre. Los pacientes con epilepsia refractaria tienen mayor conciencia de gravedad de su enfermedad, son más críticos con el sistema sanitario y con su entorno social y tienden a ser mejores cumplidores del tratamiento, por lo que no hay argumentos para pensar que el incumplimiento terapéutico pueda explicar una proporción elevada de la refractariedad en epilepsia (AU)

Introduction. Non-compliance with therapy is a problem in clinical practice in chronic diseases. Nevertheless, there are important gaps in our knowledge on this subject and its associated factors in patients with epilepsy. Moreover, failure to comply could lead to poor classification of the patients according to the definition of refractory epilepsy. Aims. To examine the behaviour in terms of therapy compliance and the clinical, psychosocial and developmental factors involved in a group of patients with epilepsy, and also to analyse the differences in the psychosocial variables depending on the degree of resistance. Patients and methods. The study involved 112 epileptic patients recruited consecutively in the epilepsy unit of a tertiary health care centre. Patients were administered a questionnaire designed to collect sociodemographic and clinical variables, together with data about treatment, adhesion, reasons for non-compliance, social support, health, welfare and degree of response to treatment. Results. The levels of non-compliance with therapy agreed with those found in previous studies. No significant differences in the level of adhesion were found between patients with refractory epilepsy and pharmacologically-controlled epilepsy, although significant differences were observed in the level of health, welfare, social support and other associated variables. Conclusions. The level of compliance of epileptic patients is rather poor. Patients with refractory epilepsy are more aware of the severity of their disease, they are more critical with the health care system and with their social setting, and they tend to comply better with their treatment. Hence, there are no reasons to believe that therapy non-compliance can explain a high proportion of the resistance that exists in epilepsy (AU)

Social support, burnout and well-being in teaching professionals. Contrast of a direct and buffer effect model

The main aim of this investigation is to determine whether social support has a direct impact n well-being or a buffer effect, reducing the negative consequences of burnout on teaching professionals´ health and well-being. The sample of the study was composed of 158 teachers. The instruments used for the measurement of social support, burnout and well-being were the Perceived Social Support Questionnaire (Herrero, Gracia & Musitu, 1996), adapted to the work context; the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981); and the Satisfaction with Life Scale (Diener, Emmons, Larsen, & Griffin, 1985), respectively. Overall social support showed a significant main effect on teacher´s well-being. Concerning the buffer effect model, significant interaction effects were verified between social support and burnout. Taking an applied perspective, the results obtained in the present study point out the relevance of interventions focused on social support and burnout coping strategies for teaching professionals (AU)

El objetivo principal de esta investigación es determinar si el apoyo social tiene un impacto directo en el bienestar o un efecto de amortiguación, reduciendo las consecuencias negativas del desgaste en la salud y el bienestar de los profesionales de la enseñanza. La muestra del estudio estuvo compuesta por 158 profesores. Los instrumentos utilizados para la medición del apoyo, el desgaste y el bienestar son el Cuestionario de Apoyo Social Percibido (Herrero, Gracia & Musitu, 1996), adaptado al contexto utilizado, el Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981) y la Escala de Satisfacción con la Vida (Diener, Emmons, Larsen & Griffin, 1985), respectivamente. En general, el apoyo social mostró9 un significativo efecto principal sobre el bienestar de los docentes. En cuanto al modelo de efectos de amortiguación, este efecto se verificó en la interacción significativa entre el apoyo social y el burnout. Adoptando una perspectiva aplicada, los resultados obtenidos en el presente estudio señalan la pertinencia de las intervenciones centradas en el apoyo social y las estrategias de afrontamiento del burnout para profesionales de la enseñanza (AU)

Estructura y funciones del apoyo social en un colectivo de inmigrantes marroquíes / Structure and functions of social support in a group of Moroccan immigrants

Los principales objetivos de la presente investigación son conocer las características estructurales y funcionales del sistema de apoyo social y analizar su relación con el bienestar subjetivo en un colectivo de inmigrantes. La muestra del estudio está formada por 100 marroquíes que cumplimentaron la entrevista de apoyo social ASSIS (Barrera, 1980), la escala de satisfacción con la vida (Diener et al., 1985), y una medida sobre percepción de prejuicio étnico. Los resultados obtenidos muestran una escasa presencia de autóctonos en las redes sociales de los marroquíes, siendo los vínculos con otros inmigrantes la principal fuente de apoyo informativo, material y emocional para este grupo de población. Las variables predictoras del bienestar subjetivo son la satisfacción con el apoyo emocional proporcionado por los autóctonos, la satisfacción con el apoyo informativo y la suficiencia de la ayuda facilitada por otros inmigrantes, y la percepción de prejuicio étnico. De este modo, se constata que las dimensiones del apoyo social que inciden de manera positiva sobre el bienestar subjetivo de este colectivo son las de carácter funcional, variando en función del origen, autóctono vs. extranjero, del proveedor de ayuda

The aim of the present investigation is to describe the structural and functional characteristics of the social support system in a group of Moroccan immigrants, and to analyze their relation with subjective well-being. The sample of the study is composed of 100 Moroccan immigrants who answered the ASSIS social support interview (Barrera, 1980), the satisfaction with life scale (Diener et al., 1985) and a measure of ethnic prejudice perception. Results show that relationships with natives are scarce in Moroccans’ social networks. Interpersonal ties with other immigrants are the main source of informative, material and emotional support for this group. Satisfaction with emotional support provided by autochtonous people, satisfaction with informative support and sufficiency of support given by other immigrants, as well as ethnic prejudice perception are the predictor variables of Moroccans’ subjective well-being. These results therefore confirm that the specific social support dimensions with a positive effect on immigrants’ subjective well-being are the funcional ones, and vary depending on the origin, autochtonous vs. foreigner, of the support provider

La percepción del riesgo en la prevención de accidentes laborales / Risk perception in occupational accidents prevention

En este trabajo intentamos realizar una aproximación de la percepción de riesgo en el contexto laboral. Para ello, hacemos una breve revisión del concepto de riesgo y la problemática que plantea la definición de este concepto. La percepción del riesgo en el ámbito laboral se convierte en un elemento crucial para entender la conducta del riesgo de los trabajadores. Se propone el estudio de varios modelos explicativos, ya que son aplicables al ámbito laboral, y de manera más concreta al contexto de la prevención de los riesgos laborales. Finalmente, se resalta la necesidad no sólo de tener en cuenta variables cognitivas, sino también factores psicosociales (AU)

La aproximación multimétodo en evaluación de necesidades / No disponible

La evaluación de necesidades es una modalidad de investigación social aplicada, de carácter evaluativo, que consiste en identificar y priorizar los problemas existentes en un contexto determinado, como base para la planificación de intervenciones que incidan sobre las principales carencias detectadas. A pesar de la amplia variedad de métodos de investigación disponibles para el desarrollo de este tipo de estudios, la práctica de la evaluación de necesidades suele caracterizarse por cierta pobreza metodológica, con un claro predominio de la encuesta como principal o único método de recogida de información. En el presente trabajo, tras realizar una breve revisión de las aproximaciones metodológicas alternativas que es posible adoptar en el ámbito general de la investigación social y la evaluación de programas, se propone un modelo multimétodo de evaluación de necesidades que plantea el uso combinado de técnicas de investigación tanto cuantitativas como cualitativas (AU)

Needs assessment is a type of applied social evaluative research, focused on the identification and prioritization of problems in a specific context, as a base for intervention planning oriented to solve the main identified needs. In spite of the huge availability of research methods for the development of this kind of studies, needs assessment practice is too often charaterized by certain methodological poverty, with a clear dominance of the survey as the main or only research method. In the present paper, after a brief revision of the methodological approaches that may be adopted in the general field of social research and programme evaluation, a multimethod needs assessment model is proposed, suggesting the combined use of both qualitative and quantitative research techniques (AU)