Risk factors control for primary prevention of cardiovascular disease in men: Evidence from the Aragon Workers Health Study (AWHS)

Benefits of cardiovascular disease (CVD) risk factors control are well known, but goals achievement remains low. The objective of this study is to evaluate the prevalence of CVD risk factors among men ina worker’s cohort with no previous CVD, to study control variations across time and the factors associated with poor control. To this end, we conducted a cohort reexamination (2010–2014) within the context of the Aragon Workers Health Study (AWHS). Data from working characteristics, analytical values and pharmacological prescription were included in the analysis. Prevalences of risk factor diagnosis and control were calculated, as well as factors associated with poor control. The prevalence of CVD risk factors was high. In 2014dyslipidaemia was the most prevalent (85.2%) followed by Hypertension (HT) (42.0%). People under treatment increased for the period analysed (p<0.001). The proportion of people treated varied from 72.2% in Diabetes Mellitus to 31.1% in dyslipidaemia in 2014. 46.2% of the workers with HT were controlled, decreasing to 21.9% in Diabetes and 11.0% in dyslipidaemia (2014). Working in a turn different to central shift was associated with poor control, especially for those working at night with HT (Odds Ratio in 2010: 3.6; Confidence Interval 95% 1.8–7.4) and dyslipidaemia (Odds Ratio 2010: 4.7; Confidence Interval 95% 1.3–16.4). We conclude that, although CVD control has increased significantly for the period studied, there are still many people that do not receive any treatment, and control goals are normally not achieved

Effectiveness of Statins for Primary Prevention of Cardiovascular Disease in Low- and Medium-Risk Males: A Causal Inference Approach with Observational Data

In this study, we analyzed the effectiveness of statin therapy for the primary prevention of cardiovascular disease (CVD) in low- and medium-risk patients. Using observational data, we estimated effectiveness by emulating a hypothetical randomized clinical trial comparing statin initiators with statin non-initiators. Two approaches were used to adjust for potential confounding factors: matching and inverse probability weighting in marginal structural models. The estimates of effectiveness were obtained by intention-to-treat and per-protocol analysis. The intention-to-treat analysis revealed an absolute risk reduction of 7.2 (95% confidence interval (CI95%), −6.6–21.0) events per 1000 subjects treated for 5 years in the matched design, and 2.2 (CI95%, −3.9–8.2) in the marginal structural model. The per-protocol analysis revealed an absolute risk reduction of 16.7 (CI95%, −3.0–36) events per 1000 subjects treated for 5 years in the matched design and 5.8 (CI95%, 0.3–11.4) in the marginal structural model. The indication for statin treatment for primary prevention in individuals with low and medium cardiovascular risk appears to be inefficient, but improves with better adherence and in subjectvs with higher risk

Políticas e iniciativas para el abordaje de las pérdidas y el desperdicio alimentario en España. Red sin desperdicio

En los Objetivos de Desarrollo Sostenible se recoge la necesidad de reducir las pérdidas y el desperdicio alimentario (PDA) en un 50% para el año 2030. Desde la UE se insta a todos los Estados miembros a conocer sus cifras y a que realicen acciones que contribuyan a dicha meta. En España, cada Comunidad Autónoma está implantando su propia agenda y los enfoques son múltiples. En una primera parte del presente trabajo se repasan y se valoran las principales políticas regionales que están realizándose para el abordaje de las PDA. Se comprueba que las iniciativas sobre las PDA las están desarrollando numerosas personas que trabajan en diversas administraciones y entidades. La evidente necesidad de avanzar en red ha incentivado la creación de la Red Sin Desperdicio, un foro en el que se buscan sinergias e intercambio de aprendizajes colectivos. En su primera iniciativa conjunta se realizó un sondeo durante el primer gran confinamiento por COVID-19, y se recabó información de más de 6.250 hogares. Se muestran los principales resultados del comportamiento que han tenido las familias.Las autoras agradecen el apoyo de sus entidades y organismos. También al “Plan contra el desperdicio alimentario en la Comunitat Valenciana, Plan BonProfit” (con fondos FEDER), por el soporte dado

Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were studied over the two-year period 2010–2012 according to their ownership structure—public hospitals, private hospitals and public–private partnership (PPP)—data envelopment analysis orientated to inputs was used to measure the overall technical efficiency, pure efficiency and efficiency of scale. A generalised linear mixed model (GLMM) with binomial distribution and logit link function was used to analyse the hospital and regional variables associated with positioning on the frontier. Results: There are substantial differences between the average pure technical efficiency of public, private and PPP hospitals, as well as a greater number of PPP models being positioned on the efficiency frontier (91.67% in 2012). The odds of being positioned on the frontier are 41.7 times higher in PPP models than in public hospitals. The average annual household income per region is related to the greater odds of hospitals being positioned on the frontier of efficiency. Conclusions: During the most acute period of recession in the Spanish economy, PPP formulas favoured hospital efficiency, by increasing the odds of being positioned on the frontier of efficiency when compared to private and public hospitals. The position on the frontier of efficiency of a hospital is related to the wealth of its region.EUROPEAN REGIONAL DEVELOPMENT FUND (Operative Program: Andalusia 2014-2020. Ministry of Economy, Knowledge, Business and University. Junta de Andalucia. Spain) B-SEJ-266-UGR1