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