60 research outputs found
Schizophrenia and hospital admissions for cardiovascular events in a large population: the APNA study
(1) Background: patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: the APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. A total of 505,889 people over 18 years old were followed for five years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: schizophrenic patients had a Hazard Ratio (HR) of 1.414 (95% CI 1.031–1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, antecedents of cardiovascular disease, and smoking. In non-adherent to antipsychotic treatment schizophrenia patients, the HR was 2.232 (95% CI 1.267–3.933). (4) Conclusions: patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should monitor these patients and reduce cardiovascular risk factors.Menarini supported this study with an unconditional sponsored research grant. DM2-12-2017
Evaluating the Efficacy of ChatGPT in Navigating the Spanish Medical Residency Entrance Examination (MIR): Promising Horizons for AI in Clinical Medicine.
UNLABELLED: The rapid progress in artificial intelligence, machine learning, and natural language processing has led to increasingly sophisticated large language models (LLMs) for use in healthcare. This study assesses the performance of two LLMs, the GPT-3.5 and GPT-4 models, in passing the MIR medical examination for access to medical specialist training in Spain. Our objectives included gauging the model\u27s overall performance, analyzing discrepancies across different medical specialties, discerning between theoretical and practical questions, estimating error proportions, and assessing the hypothetical severity of errors committed by a physician.
MATERIAL AND METHODS: We studied the 2022 Spanish MIR examination results after excluding those questions requiring image evaluations or having acknowledged errors. The remaining 182 questions were presented to the LLM GPT-4 and GPT-3.5 in Spanish and English. Logistic regression models analyzed the relationships between question length, sequence, and performance. We also analyzed the 23 questions with images, using GPT-4\u27s new image analysis capability.
RESULTS: GPT-4 outperformed GPT-3.5, scoring 86.81% in Spanish (p \u3c 0.001). English translations had a slightly enhanced performance. GPT-4 scored 26.1% of the questions with images in English. The results were worse when the questions were in Spanish, 13.0%, although the differences were not statistically significant (p = 0.250). Among medical specialties, GPT-4 achieved a 100% correct response rate in several areas, and the Pharmacology, Critical Care, and Infectious Diseases specialties showed lower performance. The error analysis revealed that while a 13.2% error rate existed, the gravest categories, such as error requiring intervention to sustain life and error resulting in death , had a 0% rate.
CONCLUSIONS: GPT-4 performs robustly on the Spanish MIR examination, with varying capabilities to discriminate knowledge across specialties. While the model\u27s high success rate is commendable, understanding the error severity is critical, especially when considering AI\u27s potential role in real-world medical practice and its implications for patient safety
Influence of type of uniform and days of usage in microbiological contamination of nurses uniform in a university hospital
Presentación de un póster presentado al International Conference on Prevention & Infection Control (ICPIC 2011) Geneva, Switzerland. 29 June – 2 July 2011Nurse uniforms can act as a reservoir of infections, with
the areas around the pockets, cuffs and aprons the most
contaminated. The aim of this study is compare the contamination
of Standard nurse’s uniform consisted of a
dress, pinafore apron with the “scrub dress” type of uniform,
as well as to measure the influence of the number
of shifts as uniform was used in its contamination
Alimentación materna y desarrollo de alergias en menores de 6 y 7 años
Objetivo: Determinar la prevalencia de alergias en niños y niñas de 6 y 7 años y su relación con la nutrición materna Materiales y métodos: Estudio transversal descriptivo de prevalencia de alergias en niños y niñas de 6 y 7 años y su relación con la alimentación de la madre se recolecto la información a través del cuestionario del International Study of Asthma and Allergies in Childhood el cual es empleado para describir el comportamiento epidemiológico de las enfermedades como asma, rinitis y eccema en niños y jóvenes, este fue resuelto por los padres de los menores previa firma y entrega del consentimiento informado, el cuestionario arrojo una confiabilidad del 0,78 en el alfa de cronbach, a las categorías de interés de este estudio se les hizo análisis de proporción, el contraste de hipótesis se realizó mediante diferencia de proporciones con intervalo de confianza en un nivel del 95%, y cálculo de error aceptado Resultados: Teniendo en cuenta los resultados sobre el consumo de alimentos de la madre en etapa de gestación y la presencia de síntomas de alergia en los menores se concluye que: Valor-P= 0,0 Valor-Zα/2= -34,6241 No se acepta la H0 para un α/2= 0,025, se encontró en el estudio que aunque las madres refirieron haber consumido mayormente alimentos saludables, sus hijos presentaron síntomas de enfermedades alérgicas, asociados a asma, rinitis y eccema Conclusiones: No existe un consenso sobre si la dieta materna influye positivamente en la disminución de alergias en los neonatos, se sugiere continuar con las recomendaciones de los expertos en lo referente a una nutrición balanceada que culmine en un óptimo estado de salud de la gestante y el fet
Satisfacción laboral y factores de mejora en profesionales de atención primaria
Fundamento. La calidad de los servicios en un sistema sanitario está relacionada con el nivel de satisfacción de sus
profesionales. El objetivo de este trabajo es conocer la satisfacción laboral y jerarquizar aquellos factores capaces de
mejorarla, en profesionales de atención primaria.
Metodología. Estudio descriptivo realizado en 2010 en Navarra. Se remitió por correo un cuestionario validado a la
población de estudio: médicos, pediatras y enfermería de
atención primaria. Se recogen variables de datos sociodemográficos y autocalificación de su satisfacción laboral en
escala de 1 a 10. Se solicita la jerarquización de 10 factores
que puedan mejorar la satisfacción previa señalada.
Se realizó comparación de medias y análisis bivariante
mediante el test de la Chi cuadrado, estudiando la asociación entre variables mediante la Odds Ratio (OR). El análisis
ajustado se realizó mediante regresión logística no condicional.
Resultados. Se recogieron 432 cuestionarios (77,5%). La
satisfacción media fue 6,7 (escala 1 a 10), más alta en enfermería. Las mujeres presentaron una media superior a los
hombres (6,90: 6,34).
Los trabajadores de centros de salud urbanos (OR:1,71;
IC:1,10-2,65) presentaron un mayor riesgo de insatisfacción
respecto a los profesionales de centros rurales.
Las actividades formativas de los profesionales es el
ítem más valorado, seguido de razones económicas y de presión asistencial, no encontrándose diferencias por profesión.
Conclusión. La satisfacción laboral es una dimensión de
la gestión de calidad en atención primaria y su estudio
permite identificar problemas u oportunidades de mejora
con impacto en la calidad de los servicios que se ofertan.Background. The quality of services in a health system is
related to the level of satisfaction of its professionals. The
aim of this article is to determine job satisfaction in primary
care professionals and rank those factors capable of improving it.
Methodology. Descriptive study carried out in Navarre in
2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians
and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1
to 10. Respondents were asked to rank 10 factors that could
improve the previously mentioned satisfaction.
Averages were compared and bivariate analysis was
carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The
adjusted analysis was realized through unconditional logistic regression.
Results. We collected 432 questionnaires (77.5%). Average
satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34).
The workers at urban health centers (OR: 1.71; CI: 1.10-
2.65) showed a higher risk of dissatisfaction with respect to
professionals at rural centers.
The training activities of the professional is the most
highly valued item, followed by economic questions and
questions of care pressure, with no differences found by
profession.
Conclusion. Job satisfaction is a dimension of quality management in primary care and its study enables identification
of problems or opportunities for improvement with an impact on the quality of the services offered
Validación del Cuestionario de Orientación a la Vida (OLQ-13) de Antonovsky en una muestra de estudiantes universitarios en Navarra
Fundamento. El sentido de coherencia interna (SOC), concepto
central del modelo salutogénico descrito por Aaron
Antonovsky, se ha empleado como predictor de medidas
de salud percibida y objetiva, se relaciona fuerte y positivamente
con comportamientos saludables, y se desarrolla
principalmente en la juventud y en la época de estudiante.
Los universitarios son un grupo de jóvenes diana para aplicar
medidas promotoras de salud en función de su nivel SOC,
siendo necesario comprobar la calidad de la medición de la
escala. El objetivo es validar y estudiar las propiedades psicométricas
de la escala SOC en los estudiantes de la Universidad
de Navarra, y conocer su evolución temporal.
Sujetos y método. Se analizaron los estudiantes de nuevo
acceso de la Universidad de Navarra. Estudio de cohortes
con seguimiento a los tres años. Los instrumentos utilizados
fueron el cuestionario de orientación a la vida (OLQ-13), la
Escala del Estrés Percibido (EEP) y el Índice de malestar. Se
estudiaron la calidad de los datos y viabilidad, asunciones
escalares, estabilidad temporal, fiabilidad, validez de criterio
concomitante y clínica, y estructura factorial y análisis confirmatorio
de los datos obtenidos. Se utilizaron los paquetes
estadísticos SPSS v. 19 y Amos v.7.
Resultados. La muestra ha sido de 508 estudiantes, 33,5% varones
y el 65,9% mujeres. Fiabilidad alta (Alfa de Cronbach de
0,814). Adecuada validez convergente con la EEP. Inadecuada
validez clínica. Análisis de componentes principales con tres
factores que explican el 50,73% de la varianza.
Conclusiones. Instrumento válido que permite proponerlo
como herramienta para aplicar medidas promotoras de salud
en jóvenes.Background. The sense of coherence (SOC), the central
concept of the salutogenesis model described by Aaron Antonovsky,
has been employed as a predictor of measures of
perceived and objective health. It is strongly and positively
related to healthy behaviour and is mainly developed while
young and studying. University students are a target youth
group for applying measures promoting health according to
their SOC level; it is therefore necessary to check the quality
of the scale’s measurement. The goal is to validate and study
the psychometric properties of the SOC scale in students at
the University of Navarre and determine their temporal evolution.
Methods. Newly enrolled students at the University of Navarre
were analysed. Cohort study with a 3 year follow-up. The
instruments used were the Orientation to Life Questionnaire
(OLQ-13), Perceived Stress Scale (PSS) and the Discomfort
Index. The following were studied: the quality and viability
of the data, scale assumptions, temporal stability, reliability,
concurrent and clinical validity, as well as factorial structure
and confirmatory analysis of the data obtained. SPSS v. 19
and Amos v.7 statistical software were used.
Results. The study sample consisted of 508 students, 33.5%
male and 65.9% female. High reliability (Cronbach Alpha
0.814). Adequate validity converging with the PSS. Inadequate
clinical validity. Analysis of main components with three
factors that explain 50.73% of the variation.
Conclusions. A valid instrument that makes it possible to
propose it as a tool for applying measures promoting health
in young people
Validación de un cuestionario de mejora de la satisfacción laboral (CMSL) en profesionales de atención primaria
Fundamento. La satisfacción laboral de los profesionales
sanitarios se considera un indicador de calidad en la gestión del sistema, estando relacionado con la eficacia de los
servicios ofrecidos.
El objetivo del estudio es la validación de un cuestionario para evaluar la mejora de la satisfacción laboral
(CMSL) en una población de profesionales sanitarios de
atención primaria en Navarra.
Metodología. Se realizó un estudio descriptivo con cuestionarios autocumplimentados, siendo la población diana
todos los profesionales de atención primaria (médicos,
pediatras y personal de enfemería) de los centros de salud
de Navarra. Se utilizó la escala Lickert para la medición de
los ítems. Se recogieron datos descriptivos de sexo, años
de ejercicio profesional, satisfacción laboral, estamento
profesional, centro de salud y 47 ítems sobre mejora de
satisfacción laboral. Se calculó la fiabilidad mediante el
coeficiente alfa de Cronbach y se halló la validez de constructo mediante un análisis factorial con rotación varimax,
agrupando los ítems en 9 dimensiones.
Resultados. Se recogieron un total de 414 cuestionarios. Se
obtuvo el coeficiente alfa de Cronbach, con un valor global
de 0,933. Entre 5 dimensiones se explica el 41,287% de la
varianza total. La dimensión “relaciones con los pacientes”
presentó la media (4,087) más alta de mejora de la satisfacción laboral y el ítem “Si pudiera eliminar la demanda
injustificada” presentó una media de 4,21.
Conclusiones. El cuestionario diseñado es un instrumento
válido para la evaluación integral de la mejora de la satisfacción laboral de los profesionales de atención primaria.
Los resultados obtenidos pueden orientar sobre qué áreas
de mejora se deben implantar para mejorar la satisfacción
de los profesionales.Background. Job satisfaction of health professionals is
considered to be a quality indicator, as it is related to the
efficacy of the services.
The aim of the study is to validate a questionnaire for
evaluating job satisfaction improvement in a population of
health professionals in primary care in Navarre.
Methodology. Descriptive study with self-completed
questionnaires; the target population was all health care
professionals (family doctors, pediatricians and nurses)
of primary health centers of Navarre. A Lickert scale was
used for measuring the items. Other variables measured
were: sex, years in the profession, job satisfaction, professional status, health center, and 47 items on improving
job satisfaction. Cronbach’s alpha coefficient was used to
evaluate reliability, and to evaluate construct validity factor analysis with varimax rotation, grouping the items in 9
dimensions was used.
Results. A total of 414 questionnaires were collected.
Cronbach’s alpha coefficient was 0.933. Forty-one point
two eight seven percent (41.287%) of total variance was explained by five dimensions. The dimension “relations with
patients” presented the highest average (4.087) of improvement in job satisfaction, and the item “If it were possible to
eliminate unjustified demand” showed an average of 4.21.
Conclusions. The questionnaire designed is a valid instrument for a comprehensive evaluation of the improvement
in the job satisfaction of primary care professionals. The
results obtained can indicate which areas of improvement
should be implemented in order to improve the satisfaction of the professionals
Advancing science and policy through a coordinated international study of physical activity and built environments: IPEN Adult methods
Background: National and international strategies to increase physical activity emphasize environmental and policy changes that can have widespread and long-lasting impact. Evidence from multiple countries using comparable methods is required to strengthen the evidence base for such initiatives. Because some environment and policy changes could have generalizable effects and others may depend on each country’s context, only international studies using comparable methods can identify the relevant differences. Methods: Currently 12 countries are participating in the International Physical Activity and the Environment Network (IPEN) study. The IPEN Adult study design involves recruiting adult participants from neighborhoods with wide variations in environmental walkability attributes and socioeconomic status (SES). Results: Eleven of twelve countries are providing accelerometer data and 11 are providing GIS data. Current projections indicate that 14,119 participants will provide survey data on built environments and physical activity and 7145 are likely to provide objective data on both the independent and dependent variables. Though studies are highly comparable, some adaptations are required based on the local context. Conclusions: This study was designed to inform evidence-based international and country-specific physical activity policies and interventions to help prevent obesity and other chronic diseases that are high in developed countries and growing rapidly in developing countries
Personal and perceived peer use and attitudes towards use of non-prescribed prescription sedatives and sleeping pills among university students in seven European countries
Introduction
The use of non-prescribed prescription sedatives and sleeping pills (NPPSSP) among university students has been described as an important public health issue. However, the impact of perceived social norms on students' use and attitudes towards use of NPPSSP is still unclear. Our aim was to investigate whether perceptions of peer use and approval of use are associated with students' personal use and approval of NPPSSP use.
Methods
Cross-sectional data from the Social Norms Intervention for the prevention of Polydrug Use (SNIPE) project containing 4482 university students from seven European countries were analyzed to investigate self-other discrepancies regarding personal use and attitudes towards NPPSSP use. Associations between personal and perceived peer use and between personal and perceived approval of use were examined using multivariable logistic regression.
Results
The majority (51.0%) of students perceived their peers' NPPSSP use to be higher than their personal use. 92.6% of students perceived their peers' approval of NPPSSP use to be identical or higher than their personal approval. Students perceiving that the majority of peers had used NPPSSP at least once displayed higher odds for personal lifetime use (OR: 1.95, 95% CI: 1.49–2.55). Perceived peer approval of NPPSSP use was associated with higher odds for personal approval (OR: 5.49, 95% CI: 4.63–6.51).
Conclusions
Among European university students, perceiving NPPSSP use and approval of use to be the norm was positively associated with students' personal NPPSSP use and approval of use, respectively. Interventions addressing perceived social norms may prevent or reduce NPPSSP use among university students
Idiopathic non-histaminergic acquired angioedema: a case series and discussion of published clinical trials
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