Citações de livros: influência do pensamento epidemiológico na comunidade acadêmica

Whilst their 'death' has often been certified, books remain highly important to most professions and academic disciplines. Analyses of citations received by epidemiologic texts may complement other views on epidemiology. The objective was to assess the number of citations received by some books of epidemiology and public health, as a first step towards studying the influence of epidemiological thought and thinking in academia. For this purpose, Institute for Scientific Information/ Thomson Scientific - Web of Science/ Web of Knowledgedatabase was consulted, in May 2006. The book by Rothman & Greenland appeared to have received the highest number of citations overall (over 8,000) and per year. The books by Kleinbaum et al, and by Breslow & Day received around 5,000 citations. In terms of citations per year the book by Sackett et al ranks 3rd, and the one by Rose, 4th of those included in this preliminary study. Other books which were influential in the classrooms collected comparatively less citations. Results offer a rich picture of the academic influences and trends of epidemiologic methods and reasoning on public health, clinical medicine and the other health, life and social sciences. They may contribute to assess epidemiologists' efforts to demarcate epidemiology and to assert epistemic authority, and to analyze some historical influences of economic, social and political forces on epidemiological research.Ainda que sua 'morte' tenha sido freqüentemente certificada, os livros continuam sendo relevantes para muitas profissões e disciplinas acadêmicas. Análises de citações recebidas por textos epidemiológicos podem complementar outras visões em epidemiologia. O objetivo do estudo foi avaliar o número de citações recebidas por alguns livros de epidemiologia e saúde pública, como um primeiro passo para estudar a influência do pensamento epidemiológico e o pensar da academia. Para este propósito, a base de dados do Institute for Scientific Information/ Thomson Scientific - Web of Science/ Web of Knowledge foi consultada em maio de 2006. O livro de Rothman & Greenland recebeu o maior número de citações no total (mais de 8.000) e por ano. Os livros de Kleinbaum et al, e de Breslow & Day tiveram em torno de 5.000 citações. Em termos de citações por ano, o livro de Sackett et al ocupou o terceiro lugar, e o de Rose, o quarto entre os incluídos no estudo. Outros livros que tiveram influência em salas de aula, comparativamente, tiveram menos citações. Os achados oferecem um rico retrato das influências acadêmicas e tendências de métodos epidemiológicos e interpretação em saúde pública, medicina clínica e outras ciências da saúde, da vida, e sociais. Eles podem contribuir para avaliar os esforços dos epidemiologistas para demarcar a epidemiologia e afirmar sua autoridade epistemológica, e para analisar algumas influências históricas de forças econômicas, sociais e políticas sobre as pesquisas epidemiológicas

Análisis de la relación volumen-resultado en la cirugía de cáncer digestivo

Cáncer digestivo; Mortalidad intrahospitalaria; Estancia hospitalariaDigestive cancer; Inpatient mortality; Hospital stayCàncer digestiu; Mortalitat intrahospitalària; Estada hospitalàriaL’objectiu general de l’anàlisi és conèixer el número d’intervencions anuals de càncer oncològic digestiu recomanable per centre que afavoreixi els resultats en salut (mortalitat intrahospitalària i reintervencions) i d’eficiència (estada hospitalària) per als pacients intervinguts en el període 2013-2016 als centres que formen part del Sistema Nacional de Salut (SNS).The general objective of this report is to know the number of recommended annual interventions of digestive cancer by center that favor health outcomes (inpatient mortality and reinterventions) and efficiency (hospital stay) for patients who underwent cancer surgery in the period 2013-2016 in the centres belonging to the National Health System (SNS in Spanish).El objeto general del análisis es conocer el número de intervenciones anuales de cáncer oncológico digestivo recomendable por centro que favorezcan los resultados en salud (mortalidad intrahospitalaria y reintervenciones) y de eficiencia (estancia hospitalaria) para los pacientes intervenidos en el periodo 2013-2016 en los centros pertenecientes al Sistema Nacional de Salud (SNS)

Hacia la concentración de la cirugía oncológica digestiva: cambios en la activad, las técnicas y los resultados

Objetivo: se examinaron los cambios en actividad, técnicas quirúrgicas y resultados del proceso de concentración de la cirugía oncológica digestiva compleja entre 2005-2012 en relación a 1996-2000. Material y métodos: se realizó un estudio de cohortes retrospectivo a partir del Conjunto Mínimo Básico de Datos (CMBD) al alta hospitalaria (1996-2012) de centros públicos de Catalunya. Población > 18 años intervenida de cáncer de: esófago, páncreas, hígado, estómago y recto. Los centros se clasificaron en: bajo, medio y alto volumen (≤ 5, 6-10 y > 10 procedimientos/año, respectivamente). Utilización del test tendencia Chi-cuadrado para valorar la concentración de pacientes en centros de alto volumen y la evolución de la mortalidad hospitalaria y regresión logística para estudiar la relación entre volumen y resultado en el periodo de concentración (2005-2012). Resultados: se ha producido una progresiva concentración de la cirugía oncológica digestiva compleja, mediante la reducción de entre un 10% (hígado) y 46% (esófago) del número de hospitales que realizan estas intervenciones y el aumento significativo del porcentaje de pacientes intervenidos en centros de alto volumen (todas las p tendencia < 0,0001, excepto esófago). También se observa una reducción significativa de la mortalidad, especialmente en esófago (de 15% en 1996/2000 a 7% en 2009/12, p tendencia = 0,003) y páncreas (de 12% en 1996/2000 a 6% en 2009/2012, p tendencia < 0,0001). Conclusiones: se ha producido una concentración efectiva de la cirugía oncológica digestiva en Cataluña en centros de alto volumen que se ha acompañado de una reducción de la mortalidad hospitalaria clara en esófago y páncreas, aunque sin cambios significativos en los otros cánceres estudiados

L’impacte de les noves tecnologies en la salut mental: depressió en adolescents i relació amb l’ús de tecnologies mòbils i xarxes socials

Noves tecnologies; Salut mental; AdolescentsNuevas tecnologías; Salud mental; AdolescentesNew technologies; Mental health; AdolescentsAquest treball ha tingut per objectiu identificar l'impacte que l'ús de les tecnologies mòbils i xarxes socials pot tenir sobre el desenvolupament o prevenció de trastorns depressius entre els adolescents. Es tracta d’un estudi desenvolupat a partir de la revisió sistemàtica de l'evidència disponible sobre el tema

Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review

Objective: The objective of the present review is to evaluate multicomponent/complex primary care (PC) interventions for their effectiveness in continuous smoking abstinence by adult smokers. Design: A systematic review of randomised and non-randomised controlled trials was undertaken. Eligibility criteria for included studies: Selected studies met the following criteria: evaluated effects of a multicomponent/complex intervention (with 2 or more intervention components) in achieving at least 6-month abstinence in adult smokers who visited a PC, biochemical confirmation of abstinence, intention-to-treat analysis and results published in English/Spanish. Methods: We followed PRISMA statement to report the review. We searched the following data sources: MEDLINE, Web of Science, Scopus (from inception to February 2014), 3 key journals and a tobacco research bulletin. The Scottish Intercollegiate Guidelines Network checklists were used to evaluate methodological quality. Data selection, evaluation and extraction were done independently, using a paired review approach. Owing to the heterogeneity of interventions in the studies included, a meta-analysis was not conducted. Results: Of 1147 references identified, 9 studies were selected (10,204 participants, up to 48 months of follow-up, acceptable methodological quality). Methodologies used were mainly individual or group sessions, telephone conversations, brochures or quit-smoking kits, medications and economic incentives for doctors and no-cost medications for smokers. Complex interventions achieved long-term continuous abstinence ranging from 7% to 40%. Behavioural interventions were effective and had a dose-response effect. Both nicotine replacement and bupropion therapy were safe and effective, with no observed differences. Conclusions: Multicomponent/complex interventions in PC are effective and safe, appearing to achieve greater long-term continuous smoking cessation than usual care and counselling alone. Selected studies were heterogeneous and some had significant losses to follow-up. Our results show that smoking interventions should include more than one component and a strong follow-up of the patient to maximise results

Effectiveness of an intensive E-mail based intervention in smoking cessation (TABATIC study) : study protocol for a randomized controlled trial

Background: Intensive interventions on smoking cessation increase abstinence rates. However, few electronic mail (E-mail) based intensive interventions have been tested in smokers and none in primary care (PC) setting. The aim of the present study is to evaluate the effectiveness of an intensive E-mail based intervention in smokers attending PC services. Methods/design: Randomized Controlled Multicentric Trial. Study population: 1060 smokers aged between 18-70 years from Catalonia, Salamanca and Aragón (Spain) who have and check regularly an E-mail account. Patients will be randomly assigned to control or intervention group. Intervention: Six phase intensive intervention with two face to face interviews and four automatically created and personal E-mail patients tracking, if needed other E-mail contacts will be made. Control group will receive a brief advice on smoking cessation. Outcome measures: Will be measured at 6 and 12 months after intervention: self reported continuous abstinence (confirmed by cooximetry), point prevalence abstinence, tobacco consumption, evolution of stage according to Prochaska and DiClemente's Stages of Change Model, length of visit, costs for the patient to access Primary Care Center. Statistical analysis: Descriptive and logistic and Poisson regression analysis under the intention to treat basis using SPSS v.17. Discussion: The proposed intervention is an E-mail based intensive intervention in smokers attending primary care. Positive results could be useful to demonstrate a higher percentage of short and long-term abstinence among smokers attended in PC in Spain who regularly use E-mail. Furthermore, this intervention could be helpful in all health services to help smokers to quit. Trial Registration: Clinical Trials.gov Identifier: NCT01494246

Information and communication technologies for approaching smokers : a descriptive study in primary healthcare

Background: Common interventions for smoking cessation are based on medical advice and pharmacological aid. Information and communication technologies may be helpful as interventions by themselves or as complementary tools to quit smoking. The objective of the study was to determine the use of information and communication technologies (ICTs) in the smoking population attended in primary care, and describe the major factors associated with its use. Methods: Descriptive observational study in 84 health centres in Cataluña, Aragon and Salamanca. We included by simple random sampling 1725 primary healthcare smokers (any amount of tobacco) aged 18-85. Through personal interview professionals collected Socio-demographic data and variables related with tobacco consumption and ICTs use were collected through face to face interviews Factors associated with the use of ICTs were analyzed by logistic regression. Results: Users of at least one ICT were predominantly male, young (18-45 years), from most favoured social classes and of higher education. Compared with non-ICTs users, users declared lower consumption of tobacco, younger onset age, and lower nicotine dependence. The percentages of use of email, text messages and web pages were 65.3%, 74.0% and 71.5%, respectively. Factors associated with the use of ICTs were age, social class, educational level and nicotine dependence level. The factor most closely associated with the use of all three ICTs was age; mainly individuals aged 18-24. Conclusions: The use of ICTs to quit smoking is promising, with the technology of mobile phones having a broader potential. Younger and more educated subjects are good targets for ICTs interventions on smoking cessation

Hacia la concentración de la cirugía oncológica digestiva: cambios en la actividad, las técnicas y los resultados

Digestive oncologic surgery; Hospital volume; MortalityCirurgia oncològica digestiva; Volum; MortalitatCirugía oncológica digestiva; Volumen; MortalidadEl objetivo de este estudio se ha centrado en examinar los cambios en la actividad, las técnicas quirúrgicas y los resultados del progresivo proceso de concentración de la cirugía oncológica digestiva de complejidad en el período 2005-2012 en los centros pertenecientes al Sistema Integral Sanitario de Catalunya (SISCAT), teniendo como referencia el estudio realizado en años anteriores (1996-2000)

Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

Average stay; Cross-sectional study; Hospital-at-home; MortalityEstancia media; Estudio transversal; Hospital en casa; MortalidadEstada mitjana; Estudi transversal; Hospital a casa; MortalitatHospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities