Temperaturas extremas en verano. Implicaciones en salud

The increment that has been detected in summer temperatures in the last years joined to the trends expected to climate for the next century provide an increase in frequency and intensity of the extreme climate events, basically in heat waves. The undoubted relationship between temperature and mortality makes necessary a quantifying in order to characterize the expected effects of temperature over mortality particularly in heat waves.This study show a state-of-the-art review this problem, with a special emphasis in the heat wave that Europe suffered in summer of 2003 and how the heat waves has been characterized until now. Lastly, which are the characteristics that should have the preventive measures designed to minimized the effects of heat waves over population ́s health.El incremento que se ha detectado en las temperaturas estivales en los últimos años, unido las tendencias que se esperan para el clima durante el próximo siglo, hacen prever un aumento en la frecuencia e intensidad de los eventos térmicos extremos, fundamentalmente olas de calor. La clara relación existente entre la temperatura y la mortalidad, hace necesaria una cuantificación para la caracterización de los efectos esperados de la temperatura sobre la mortalidad en las denominadas olas de calor.En este trabajo se presenta una descripción del estado del conocimiento de este problema, haciendo especial referencia a la ola de calor que asoló Europa en el verano de 2003, de cómo se han caracterizado las olas de calor y en base a ello de cuáles son las características que han de tener los planes de alerta y prevención encaminados a minimizar los efectos del calor sobre la salud de la población

Influencia de los factores meteorológicos y geográficos en la difusión y transportes de sustancias contaminantes

In this paper we analysed how the stability and instability atmospheric situations influence the diffusion of air pollutants, as level of big areas and as level of restricted focus (e.g. a chimney). Moreover, the surface is considered, through the sea and valley breeze, because they can influence the wind direction and so, the transportation of pollutants when main winds do not exit. At last, the influence of orographic obstacles are considered in the generation of lee’s vortices.En este artículo se analiza como las situaciones de estabilidad e inestabilidad atmosférica influyen en los fenómenos de difusión de sustancias contaminantes en la atmósfera, tanto a nivel de grandes focos como de focos puntuales como penachos de chimeneas. Por otro lado, se consideran como la orografía, a través de las brisas de mar y de valle, pueden influir en la dirección del viento y, por tanto, del transporte de sustancias contaminantes en ausencia de vientos dominantes Por último, se analiza la influencia de los obstáculos orográficos en la formación de vórtices y remolinos a sotavento de dichos obstáculos

Impacto da contaminação atmosférica sobre a mortalidade diária a curto prazo em Espanha

There are no up-to-date papers in Spain about the impact of air pollution on daily mortality at the provincial level. Three papers on the effect of PM10, NO2 and O3 levels on daily mortality in the capitals of the 52 Spanish provinces have been recently published but there is no synthesis focusing on the joint effect of these three pollutants.Therefore, the purpose of this paper is to explain the joint methodology that has been followed in these studies, the main results obtained therein and the limitations of this type of paper and its implications for public health. The main conclusion is that the mortality rate that is ascribable to chemical air pollution in Spain stands at 9500 deaths per year. This figure represents one fifth the mortality associated with smoking and is 8 times greater than the number of road traffic deaths In other words, 3% of the mortality rate in Spain would be related to the short-term effects of chemical air pollution. Thus, it is essential to formulate structural action plans to lower the levels of chemical air pollution in Spanish large cities. In the particular case of ozone, the calculation of a threshold value at the provincial level could be useful in devising prevention plans similar to those already in place for preventing heat strokes.En España no existen trabajos actualizados sobre el impacto de la contaminación atmosférica sobre la mortalidad diaria a nivel provincial. Recientemente se han publicado tres artículos en relación al impacto que los niveles de PM10, NO2 y O3 tienen sobre la mortalidad diaria en las 52 capitales de provincia españolas, pero no existe una síntesis que englobe el efecto conjunto debido a estos contaminantes.El objetivo de este trabajo es, por tanto, explicar la metodología conjunta seguida en estos estudios, cuáles son los principales resultados obtenidos, así como las limitaciones y las implicaciones de este tipo de publicaciones en salud pública. El principal resultado es que la mortalidad por todas las causas atribuibles a la contaminación atmosférica química en España se relaciona con 9500 muertes/año. Este valor representa la quinta parte de la mortalidad debida al tabaco y 8 veces más que causada por los accidentes de tráfico. Es decir, el 3% de la mortalidad que se produce en España estaría relacionada con los efectos a corto plazo de la contaminación atmosférica química, por lo que la articulación de planes de actuación estructurales para bajar los niveles de contaminación química en las grandes ciudades se hacen imprescindibles. En caso especial del ozono con la determinación de un valor umbral a nivel provincial podría servir para la articulación de planes de prevención similares a los ya existentes para el caso del calor.Em Espanha não existem trabalhos atualizados sobre o impacto da contaminação atmosférica na mortalidade diária a nível provincial. Recentemente foram publicados três artigos relativos ao impacto dos níveis de PM10, NO2 e O3 sobre a mortalidade diária nas 52 capitais de província espanholas, contudo não existe uma síntese que englobe o efeito conjunto destes contaminantes.O objetivo deste trabalho é, portanto, explicar a metodologia conjunta seguida por estes estudos e quais os principais resultados obtidos, assim como, as limitações e as implicações deste tipo de publicações na saúda república. O principal resultado é que a mortalidade por todas as causas atribuível à contaminação atmosférica química em Espanha relaciona-se com 9500 mortes/ano. Este valor representa um quinto da mortalidade devida ao tabaco e é 8 vezes superior à mortalidade rodoviária. Ou seja, 3% da mortalidade ocorrida em Espanha estaria relacionada com os efeitos a curto prazo da contaminação atmosférica química, pelo que a articulação de planos de ação estruturais para reduzir os níveis de contaminação química nas grandes cidades é essencial. No caso particular do ozono a determinação de um valor limite a nível provincial poderia servir para a articulação de planos de prevenção similares aos já existentes para o caso do calor

Assessing the ability to perceive basic and complex emotions in deaf people with the PERVALE-S

Un aspecto poco conocido de las personas sordas es su manejo de las emociones como habilidad cognitiva. Software PERVALE-S es una herramienta para la evaluación de la percepción, la expresión y la evaluación de emociones básicas y complejas de las personas sordas, con diferente código de comunicación (verbal y gestual). PERVALE-S presenta imágenes visuales e instrucciones (a través de un intérprete), en el que el sujeto debe identificar lo que la imagen transmite tanto la percepción de la emoción correcta como su nivel de intensidad. A pesar de la pequeña muestra que tenemos, se han encontrado algunos resultados los cuales indicaron que la edad (.555**), el género (.438**) y el sordo no oralizante (.556**)- cuando nuestra hipótesis era lo contrario; rindieron significativamente en la prueba de emociones sociales. La explicación a éste último se debe a que los sordos oralizantes están más entrenador a fijarse en la boca de la otra persona que los de LSE, y por lo tanto no captan parte de la imagen visual que los de LSE, y por tanto no captan parte de la imagen visual para reconocer la emoción con la misma eficacia que los no oralizantes.A poorly understood aspect in deaf people is their cognitive emotion information processing abilities. Deaf people have more difficulties to distinguish the tone, intensity and rhythm of the language that listener people. When deaf people that they acquired deafness oral communication system, so they achieve a greater development of self and understanding of own and others’ emotions than deaf people who develop a gestural (LSE). PERVALE-S software is a tool for assessing perception, expression and evaluation both basic and complex emotions in deaf people with different communication codes (verbal and gestural). PERVALE-S presents visual images and instructions (by an interpreter), where the subject must identify what the image conveys both emotion and intensity level. Though the small simple, initial finding indicated that age (.556**), gender (.438**) and just gestural deaf people (.556**, 1: oral; 2: gestural)- last one, the assessment (all of them did not show interaction effect). An alternative explanation, for the better performance among gestural, in that oral deaf people he been training focus his visual perception in the mouth under social context situation, while just gestural spend more time paying attention on the rest of body when they need to accurate a social emotion. Eye tracking instrument will be used to test this hypothesis.peerReviewe

Spatial variability of COVID-19 first wave severity and transmission intensity in Spain: the influence of meteorological factors

Within the same country, Spain, with the same cultural aspects and containment policies (without lockdown), why in the initial moment of the COVID-19 first wave, given a significant number of infections, the disease prospered more intensely in some areas than in others? The hypothesis is that the meteorological factors, that is, the utbreak weather conditions are relevant factors which could be used as early indicators of the COVID-19 first wave severity and transmission intensity. This paper presents a model that allows predicting COVID-19 first wave severity and transmission intensity in Spain based on early weather informatio

Spatial variability in threshold temperatures of heat wave mortality: impact assessment on prevention plans

Spain’s current heat wave prevention plans are activated according to administrative areas. This study analyses the determination of threshold temperatures for triggering prevention-plan activation by reference to isoclimatic areas, and describes the public health benefits. We subdivided the study area – the Madrid Autonomous Region (MAR) – into three, distinct, isoclimatic areas: ‘North’, ‘Central’ and ‘South’, and grouped daily natural-cause mortality (ICD-10: A00-R99) in towns of over 10,000 inhabitants (2000–2009 period) accordingly. Using these three areas rather than the MAR as a whole would have resulted in a possible decrease in mortality of 73 persons (38– 108) in the North area, and in aborting unnecessary activation of the plan 153 times in the Central area and 417 times in the South area. Our results indicate that extrapolating this methodology would bring benefits associated with a reduction in attributable mortality and improved effectiveness of public health interventions.This study was funded by a ‘Miguel Servet type 1’ grant (SEPY 1037/14), as well as a Health Research Fund grant (Fondo de Investigaciones Sanitarias/FIS Project ENPY1133/16 from the Carlos III Institute of Health

Gender roles and aggressiveness in adolescence

La violencia entre adolescentes y jóvenes es un problema que repercute en su desarrollo biopsicosocial y viene determinado por diversos factores. El binomio sexo-género, ha mostrado una influencia considerable en las conductas agresivas adolescentes. Con el interés de profundizar nuestro conocimiento sobre estas variables, el presente estudio analiza la relación que las categorías de género (masculino, femenino, andrógino o indiferenciado) y sexo (hombre o mujer) tienen sobre la agresividad adolescente. Por este motivo, mediante la adaptación española de Inventario de Rol Sexual de Bem (García-Mina Freire, 2004) y el Cuestionario de Información, Actitudes y Comportamientos relacionados con la Salud (Ballester y Gil, 1999), se analiza la presencia de conductas violentas realizadas por 270 adolescentes de la Comunidad Valenciana, entre 13 y 17 años, así como su auto-identificación con el género. En general, los resultados ratifican la relación entre los rasgos masculinos y una mayor probabilidad de ejercer conductas agresivas. Este resultado, también se obtiene en la mayoría de personas identificadas con el “género indiferenciado”. Por el contrario, se reafirma la mayor preocupación por otras personas, de los y las adolescentes con más rasgos femeninos. Además, estos rasgos femeninos son los que muestran tener una mayor influencia en la realización de conductas agresivas, previniendo su aparición. Así pues, los hallazgos confirman la desigualdad de género en el comportamiento agresivo, asociado al universo masculino e indiferenciado, y proponen un amplio campo de acción para las intervenciones preventivas.Adolescent and Young violence remains a concern which damages their biopsychosocial development and involves several factors. The binomial sex-gender has revealed considerable influence on aggressive behavior among adolescents. In order to study in depth our knowledge about these variables, this study analyzes the relation between gender category (masculinity, feminity, adrogyny or undifferentiated) and sex (men or women) to adolescent aggressiveness. For this purpose, by the Spanish adaptation of Sexual Role Inventory by Bem (García-Mina Freire, 2004) and the Cuestionario de Información, Actitudes y Comportamientos relacionados con la Salud (Ballester y Gil, 1999), we analyze the existence of violent behaviors of 270 adolescents from Comunidad Valenciana, ranging from 13 and 17 years old, as well as their self-identification in gender. In general, the results support the relation between masculine traits and higher probability to develop aggressive behaviors. This result is also obtained by the majority of participants self identified as “undifferentiated gender”. However, participants who have more feminine traits are usually more worried about other people. In addition, these traits have shown more influence on aggressive behaviors, preventing their beginning. Therefore, our findings support the gender inequality about aggressive behavior, associated with masculine and undifferentiated universe, and suggest a broad range of actions for preventive interventions.peerReviewe

Variabilidad entre el ángulo de Clarke y el índice de Chippaux- Smirak para el diagnóstico de pie plano

[Abstract] Background: The measurements used in diagnosing biomechanical pathologies vary greatly. The aim of this study was to determine the concordance between Clarke's angle and Chippaux-Smirak index, and to determine the validity of Clarke's angle using the Chippaux-Smirak index as a reference. Methods: Observational study in a random population sample (n= 1,002) in A Coruña (Spain). After informed patient consent and ethical review approval, a study was conducted of anthropometric variables, Charlson comorbidity score, and podiatric examination (Clarke's angle and Chippaux-Smirak index). Descriptive analysis and multivariate logistic regression were performed. Results: The prevalence of flat feet, using a podoscope, was 19.0% for the left foot and 18.9% for the right foot, increasing with age. The prevalence of flat feet according to the Chippaux-Smirak index or Clarke's angle increases significantly, reaching 62.0% and 29.7% respectively. The concordance (kappa I) between the indices according to age groups varied between 0.25-0.33 (left foot) and 0.21-0.30 (right foot). The intraclass correlation coefficient (ICC) between the Chippaux-Smirak index and Clarke's angle was -0.445 (left foot) and -0.424 (right foot). After adjusting for age, body mass index (BMI), comorbidity score and gender, the only variable with an independent effect to predict discordance was the BMI (OR= 0.969; 95% CI: 0.940-0.998). Conclusion: There is little concordance between the indices studied for the purpose of diagnosing foot arch pathologies. In turn, Clarke's angle has a limited sensitivity in diagnosing flat feet, using the Chippaux-Smirak index as a reference. This discordance decreases with higher BMI values.[Resumen] Introducción: Existe una gran variabilidad en las mediciones para el diagnóstico de la patología biomecánica. El objetivo de este estudio fue determinar la concordancia entre el ángulo de Clarke y el índice de Chippaux-Smirak, para determinar la validez del ángulo de Clarke utilizando como referencia el índice de Chippaux-Smirak. Métodos: Se realizó un estudio observacional en una muestra aleatoriamente seleccionada (n= 1,002) en A Coruña (España). Tras el consentimiento informado del paciente y la aprobación del comité de ética, se estudiaron variables, antropométricas, índice de comorbilidad de Charlson y un examen podológico (ángulo de Clarke, índice de Chippaux-Smirak). Se realizó un estudio descriptivo y un análisis multivariado de regresión logística. Resultados: La prevalencia de pie plano utilizando el podoscopio fue de 19.0%(pie izquierdo) y 18.9%(pie derecho), incrementándose con la edad. La prevalencia de pie plano según el índice ChippauxSmirak o el ángulo de Clarke se incrementan considerablemente llegando a 62.0% y 29.7%. La concordancia (kappa I) entre los índices según grupos de edad oscila entre 0.25-0.33 (pie izquierdo) y 0.210.30 (pie derecho). El coeficiente de correlación intraclase (CCI) entre el índice de Chippaux-Smirak y el ángulo de Clarke es -0.445 (pie izquierdo) y 0.424 (pie derecho). Tras ajustar por edad, índice de masa corporal (IMC), score de comorbilidad y sexo la única variable con un efecto independiente para predecir discordancia es el IMC (OR= 0.969; IC 95%: 0.94-0.998). Conclusiones: La concordancia entre los índices estudiados para el diagnóstico de la patología del arco plantar es reducida. Existe a su vez una reducida sensibilidad del ángulo de Clarke para el diagnóstico de pie plano, utilizando como referencia el índice de Chippaux-Smirak. Esta discordancia disminuye con valores más altos de IMC

Analysis of health claims regarding creatine monohydrate present in commercial communications for a sample of European sports foods supplements

Objective: To analyse the information on health claims present in the labelling of creatine monohydrate (CM) products. Design: A descriptive study of a selection of products marketed as CM, with health claims, and that met the inclusion/exclusion criteria, was conducted using the Amazon and Google Shopping websites. The adequacy and compliance of the health claims were evaluated with the European legislative requirements (European Food Safety Authority and European Commission). The results were discussed with scientific evidence criteria from the Academy of Nutrition and Dietetics, International Olympic Committee, and International Society of Sports Nutrition, as well as the systematic review carried out by Mielgo-Ayuso in 2019. Setting: Health claims in the commercial communications of a sample of CM supplements, in relation to current legislation and scientific knowledge. Participant: A total of 554 CM products were obtained. Results: Of the total sample, only 167 met the inclusion/exclusion criteria. Of these, 30·5 % recommended a CM dose of 5·0–5·9 g/d, while 29·9 % recommended 3·0 to 3·9 g/d. As for the health claims, ‘Enhances physical performance’ appeared in 73·1 % of the supplements, in most cases referring to a dosage of 3·0 to 3·9 g/d for these products. The rest of the declarations were not adequate or needed to be modified. Conclusion: Only 25 % of the health claims complied with the criteria established by the scientific reference documents. Most of the declarations must be modified or eliminated, as they could be considered fraudulent and/or misleading for the consumer