A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods: qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results: use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions: the results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat i

Characterization, Classification and Authentication of Honey by Non-Targeted UHPLC-HRMS Chromatographic Fingerprints and Chemometric Methods

Honey is a natural substance produced by bees of the genus Apis. Depending on the raw material used for its production, honey can be classified into two large groups: blossom honey, which results from the metabolization of nectar extracted from flowers; and honeydew honey, in which bees use plant or insect secretions for its production. The physicochemical characteristics are different between these two types of honey. For example, honeydew honey is darker and is characterized by a high content of phenolic acids. On the contrary, blossom honey stands out for its abundance of flavonoids. Blossom honey can be also classified based on the pollen origin. Thus, honey with more than 45% of the pollen coming from the same species can be considered monofloral; otherwise, it is considered multifloral. Honey is one of the food products with the highest level of fraudulent practices. Most of the adulterations consist of ingredient dilution, adding sweet substances, such as syrups, sugar cane, or corn syrup, among others. In the market, this was reflected in the dubious drop in prices for this product. In the last few years, several instance of honey fraud have come to light. This work aimed to develop a non-targeted ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS) fingerprinting method to address the characterization, classification, and authentication of Spanish honey samples considering their botanical and geographical origin. A total of 136 kinds of honey from different Spanish production regions belonging to different botanical varieties were analyzed, including: blossom honey (orange blossom, rosemary, thyme, eucalyptus, and heather) and honeydew honey (holm oak, forest, and mountain). A simple sample treatment was carried out, consisting of dissolving 1 g of honey in 10 mL of water, followed by a 1:1 dilution with methanol. The chromatographic separation of the obtained extracts was performed using a Kinetex® C-18 core-shell column (100 × 4.6 mm I.D., 2.6 μm), working under gradient elution, using an aqueous solution of 0.1% formic acid and acetonitrile as the mobile phase components. HRMS acquisition was performed using electrospray in negative ionization mode (−2500 V) in an LTQ-Orbitrap working in full scan MS (m/z 100-1000) at a resolution of 50,000 full-width at half maximum (FWHM). The obtained non-targeted UHPLC-HRMS fingerprints (peak signals as a function of retention time and m/z) were considered as chemical descriptors of the analyzed honey samples for principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). PLS-DA revealed good discrimination between blossom and honeydew honey. Furthermore, the obtained chemometric models allowed the achievement of very good classification among the different botanical varieties under study for both blossom and honeydew honey. The discrimination of honey regarding the different Spanish climate production regions was more limited, although some trends were observed. Thus, the non-targeted UHPLC-HRMS fingerprinting approach proved to be an appropriate methodology to address honey characterization, classification, and authentication based on their different botanical origin

Prevalencia de la obesidad en la población atendida en asistencia primaria de Girona, 1995–1999

ResumenObjetivosEstimar y comparar la prevalencia de la obesidad y el sobrepeso en la población de Girona, entre 1995 y 1999, estratificando geográficamente por sexo y edad.MétodosMedidas directas de talla y peso correspondientes a 24.554 usuarios mayores de 14 años (10.595 varones y 13.959 mujeres) atendidos en cuatro áreas básicas de salud (ABS): Girona 1, Girona 4, Salt y Camprodon, así como en un centro de atención primaria (CAP) de la provincia de Girona. Se calculó el índice de masa corporal (IMC) como el cociente entre el peso y la talla al cuadrado. La obesidad se define como los grados II y III del índice de Garrow (IMC ≥ 30 kg/m2) y el sobrepeso como el grado I (25 kg/m2 ≤ IMC < 30 kg/m2). Al no utilizarse una muestra aleatoria de sujetos, el cálculo de prevalencias y de sus errores estándar se corrigió mediante el uso de ponderaciones adecuadas. La comparación de las prevalencias entre dos ABS distintas para cada sexo se realizó utilizando un contraste paramétrico de diferencia de proporciones. La comparación entre las prevalencias de un determinado grado del índice de Garrow, controlando por sexo y edad, se llevó a cabo utilizando una regresión logística jerárquica.ResultadosLa prevalencia de la obesidad se estimó en 15,6% entre los varones de 20 a 74 años (desde el 14,0% en Girona 1 hasta el 22,4% en Camprodon) y en un 17,5% entre las mujeres (un 15,6% en Girona 1 y un 22,7% en Camprodon), un 16,7% de promedio ponderado. La prevalencia del sobrepeso se sitúa en el 44% en varones y en un 33% en mujeres, un 37,8% de promedio ponderado. Existe una gradación en las prevalencias de la obesidad, con diferencias estadísticamente significativas: Girona 1, Salt, Girona 4, Camprodon y Sils.ConclusionesLas estimaciones de la prevalencia de la obesidad y sobrepeso obtenidas en este trabajo no están tan alejadas como se creía de las estimadas en poblaciones de nuestro entorno. De hecho, podrían ser muy similares a las estimadas en la Unión Europea y, para algunos grupos de edad, incluso a las de Estados Unidos.AbstractObjectivesTo estimate the prevalence of obesity and overweight in the population of Girona (Spain) between 1995 and 1999 and to divide the prevalences in geographical areas according to age and sex.MethodsHeight and weight were directly measures in 24,554 health care consumers older than 14 years (10,595 men and 13,959 women) treated in four primary health care areas: Girona 1, Girona 4, Salt and Camprodon and in one primary health care center in the province of Girona. Body mas index (BMI) was calcuted by dividing weight in kilograms bye height in meters squared. Obesity was defined as grades II and III of Garrow's index (BMI ≥ 30 kg/m2) and overweight as degree I (25 kg/m2 ≥ BMI < 30 kg/m2). Because the sample was not randomized, the prevalences were adequately weighted. The comparison between prevalences in two different primary health care areas for each sex (in the same Garrow's index and age group) was carried out using a parametric test of differences in proportions (Student's t-test). A hierarchical logistic regression was used to compare prevalences in the same grade Garrow's index, controlling for age and sex.ResultsThe prevalence of obesity was estimated as 15.6% in men aged from 20-74 years (from 14.0% in Girona 1 to 22.4% in Camprodon) and 17.5% for women (15.6% in Girona 1, 22.7% in Camprodon). The weighted mean was 16.7%. The prevalence of overweight was 44% in men and 33% in women and the weighted mean was 37.8%. The prevalence of obesity was graduated with statistically significant differences between Girona 1, Salt, Girona 4, Camprodon and Sils.ConclusionsThe estimates of the prevalences of obesity and overweight obtained in this study were closer to those of other studies in similar populations than previously believed. Inde-ed, the prevalences may be similar to those of the European Union and, in some age groups, to those of the United States

Social Determinants of Community Health Services Utilization among the Users in China: A 4-Year Cross-Sectional Study

Background To identify social factors determining the frequency of community health service (CHS) utilization among CHS users in China. Methods Nationwide cross-sectional surveys were conducted in 2008, 2009, 2010, and 2011. A total of 86,116 CHS visitors selected from 35 cities were interviewed. Descriptive analysis and multinomial logistic regression analysis were employed to analyze characteristics of CHS users, frequency of CHS utilization, and the socio-demographic and socio-economic factors influencing frequency of CHS utilization. Results Female and senior CHS clients were more likely to make 3–5 and ≥6 CHS visits (as opposed to 1–2 visits) than male and young clients, respectively. CHS clients with higher education were less frequent users than individuals with primary education or less in 2008 and 2009; in later surveys, CHS clients with higher education were the more frequent users. The association between frequent CHS visits and family income has changed significantly between 2008 and 2011. In 2011, income status did not have a discernible effect on the likelihood of making ≥6 CHS visits, and it only had a slight effect on making 3–5 CHS visits. Conclusion CHS may play an important role in providing primary health care to meet the demands of vulnerable populations in China. Over time, individuals with higher education are increasingly likely to make frequent CHS visits than individuals with primary school education or below. The gap in frequency of CHS utilization among different economic income groups decreased from 2008 to 2011

Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission

Coexisting conditions and previous antimicrobial drug exposure predict colonization

The labor market effects of technology shocks

We analyze the effects of neutral and investment-specific technology shocks on hours worked and unemployment. We characterize the response of unemployment in terms of job separation and job finding rates. We find that job separation rates mainly account for the impact response of unemployment while job finding rates for movements along its adjustment path. Neutral shocks increase unemployment and explain a substantial portion of unemployment and output volatilityinvestment-specific shocks expand employment and hours worked and mostly contribute to hours worked volatility. We show that this evidence is consistent with the view that neutral technological progress prompts Schumpeterian creative destruction, while investment specific technological progress has standard neoclassical feature