Sex and gender differences in acute stroke care: metrics, access to treatment and outcome. A territorial analysis of the Stroke Code System of Catalonia

Introduction: Previous studies have reported differences in the management and outcome of women stroke patients in comparison with men. We aim to analyze sex and gender differences in the medical assistance, access to treatment and outcome of acute stroke patients in Catalonia. Patients and methods: Data were obtained from a prospective population-based registry of stroke code activations in Catalonia (CICAT) from January/2016 to December/2019. The registry includes demographic data, stroke severity, stroke subtype, reperfusion therapy, and time workflow. Centralized clinical outcome at 90 days was assessed in patients receiving reperfusion therapy. Results: A total of 23,371 stroke code activations were registered (54% men, 46% women). No differences in prehospital time metrics were observed. Women more frequently had a final diagnosis of stroke mimic, were older and had a previous worse functional situation. Among ischemic stroke patients, women had higher stroke severity and more frequently presented proximal large vessel occlusion. Women received more frequently reperfusion therapy (48.2% vs 43.1%, p < 0.001). Women tended to present a worse outcome at 90 days, especially for the group receiving only IVT (good outcome 56.7% vs 63.8%; p < 0.001), but not for the group of patients treated with IVT + MT or MT alone, although sex was not independently associated with clinical outcome in logistic regression analysis (OR 1.07; 95% CI, 0.94–1.23; p = 0.27) nor in the analysis after matching using the propensity score (OR 1.09; 95% CI, 0.97–1.22). Discussion and conclusion: We found some differences by sex in that acute stroke was more frequent in older women and the stroke severity was higher. We found no differences in medical assistance times, access to reperfusion treatment and early complications. Worse clinical outcome at 90 days in women was conditioned by stroke severity and older age, but not by sex itself

Evaluación del crecimiento y de la producción de madera en plantaciones españolas de nogal realizadas con progenies híbridas. Resultados en fase semiadulta

El silvicultor debería ante todo conocer cuál es el producto que la industria valora y cuáles las características que se le exigen y dirigir sus esfuerzos de gestión a conseguirlas. Actualmente, la madera destinada a la producción de chapa a la plana es la más apreciada

Comportamiento en plantación de nueve genotipos del género Pistacia para su uso forestal en condiciones de sequía estricta

La introducción de varios materiales del género Pistacia procedentes de diferentes partes del mundo se efectuó, en un principio, en el marco de un programa de mejora del pistachero de orientación frutícola en el IRTA de Mas de Bover, para su utilización como patrones. Esta introducción permitió observar el interés medio ambiental y forestal de estas especies en condiciones mediterráneas e identificar algunos progenitores de familia con descendencias destacadas. Para conocer la bondad de estos materiales y evaluar las posibilidades de sus descendencias se diseñó un ensayo de genotipos de pistacea que se plantó en 2003, en Constantí (Tarragona), en condiciones de secano (P ± 500 mm anuales) y a un marco de 7 x 7 m. En el ensayo se incluyeron tres progenies híbridas, dos de P. integerrima x P. atlantica (PAI 0-268 y PAI 0-286) y una de ‘Tsikoudia’ (PTS 0-107), todas ellas producidas en el IRTA, y seis progenies de especies supuestamente puras, cuatro de P. atlantica, dos producidas en el IRTA (PA 0- 121 y PA 0-168) y dos procedente de Túnez, una de P. chinensis llegada de China y una de P. terebinthus, especie autóctona de la Península Ibérica, usada como referencia y procedente de un vivero de Castilla-La Mancha. Se estableció un diseño en bloques completos con 5 repeticiones de 8 árboles. Del 2º al 6º año de plantación se han registrado datos de crecimiento (diámetros y alturas) y de conformación de los árboles (dominancia, rectitud, ramificación, porte y forma de la punta). Los resultados muestran importantes crecimientos de la plantación en altura (incrementos anuales medios entre 50 y 70 cm/año) y en diámetro (incrementos anuales medios a 50 cm del suelo de 5 a 18 mm/año). Se presentan diferencias significativas en vigor entre materiales, destacando los crecimientos primario y secundario de ‘PTS 0-107’ y de ‘PA 0-121’

Nitrovinil indoles: estudio estructural

Trabajo presentado en la XXI Reunión bienal de la Real Sociedad española de Física, celebrada en Salamanca (España) del 04 al 10 de octubre de 1987.Peer reviewe

Prevalencia y carga de defectos visuales en Cataluña

El objetivo de este artículo es determinar la prevalencia de defectos visuales en Cataluña y analizar las desigualdades en visión. Estudio transversal en población ≥ 15 años de edad (7.881 hombres y 8.045 mujeres) a partir de los datos de la Encuesta de Salud de Cataluña de 2006. Se usaron modelos de regresión logística para calcular las odds ratio ajustadas por edad, estado civil, nivel de estudios, nivel de ingresos y situación laboral con un intervalo de confianza (IC) del 95%. El 4,7% (IC del 95%, 4,4-5,0) de la población de Cataluña,/nel 5,3% (IC del 95%, 4,8-5,8) de las mujeres y el 4,1% (IC del 95%, 3,7-4,5) de los hombres, declara tener mala visión. Las situaciones más desfavorables de mala visión autodeclarada por la población catalana corresponden a los ancianos y las mujeres con menores niveles tanto de estudios como de ingresosThe aim of this work is to determine the prevalence of visual impairment in Catalonia and analyze inequalities in vision. Cross sectional study in the population having ≥15 years of age (7,881 men and 8,045 women) based on data from the Encuesta de Salud de Cataluña 2006. Logistic regression models were used to calculate the adjusted odds ratio by age, civil state, level of studies, income and working situation with a confidence interval (CI) of 95%. A 4.7% (CI 95% 4.4-5.0) of the population of Catalonia, a 5.3% of female (CI 95% 4.8-5.8), and 4.1% of men (CI 95% 3.7-4.5) state that they have poor vision. The most unfavourable situations of self-reported poor vision by the Catalan population correspond to the elderly and women with lower levels of both studies and incom

Improving mental health and wellbeing in elderly people isolated at home due to architectural barriers: a community health intervention

Objectives: To explore the health effects of a community health intervention on older people who are isolated at home due to mobility problems or architectural barriers, to identify associated characteristics and to assess participants’ satisfaction. Design: Quasi-experimental before---after study. Setting: Five low-income neighbourhoods of Barcelona during 2010---15. Participants: 147 participants, aged ≥59, living in isolation due to mobility problems or architectural barriers were interviewed before the intervention and after 6 months. Intervention: Primary Health Care teams, public health and social workers, and other community agents carried out a community health intervention, consisting of weekly outings, facilitated by volunteers. Measurements: We assessed self-rated health, mental health using the General Health Questionnaire (GHQ-12), and quality of life through the EuroQol scale. Satisfaction with the programme was evaluated using a set of questions. We analysed pre and post data with McNemar tests and fitted lineal and Poisson regression models. Results: At 6 months, participants showed improvements in self-rated health and mental health and a reduction of anxiety. Improvements were greater among women, those who had not left home for ≥4 months, those with lower educational level, and those who had made ≥9 outings. Self-rated health [aRR: 1.29(1.04---1.62)] and mental health improvements [ˇ: 2.92(1.64---4.2)] remained significant in the multivariate models. Mean satisfaction was 9.3 out of 10. Conclusion: This community health intervention appears to improve several health outcomes in isolated elderly people, especially among the most vulnerable groups. Replications of this type of intervention could work in similar contexts

Developing performance audit in Spanish local government: an empirical study of a way forward

Like many developed countries, public services in Spain are facing a prolonged period of financial austerity. Consequently, most parts of the Spanish public sector have to give consideration to various aspects of public services, including the means for improving existing performance. Performance audit is seen as a key means for improving performance in Spanish local government but the approach is not as well developed as in many other countries. This paper is an empirically based study of the current situation regarding performance audit in the Spanish local government sector and provides pointers as to how this approach might be strengthened