Risk of suicide in households threatened with eviction: the role of banks and social support

Background: One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate the risk of suicide among victims of eviction and investigate whether it is associated with specific characteristics of households and interviewees, the eviction process and social support, and health needs. Results: Almost half of the sample (46.7%) were at low (11.8%), moderate (16.9%), or high suicide risk (17.9%). Household and interviewee features had a limited association with suicide risk. On the contrary, the risk of suicide is greater with a longer exposure to the eviction process. In addition, threatening phone calls from banks increased significantly the risk of suicide, especially among men. Suicide risk was also associated with low social support, especially among women. Interviewees at risk of suicide received more help from nongovernmental organizations than those who were not at risk. In interviewees at risk, the main unmet needs were emotional and psychological help, especially in men. A high percentage of those at risk of suicide declare having large unmeet health needs. Finally, there was a tendency among the evicted at risk of suicide to visit emergency room and primary care more often than those not at risk, especially among women. Conclusions: To our knowledge, this is the first study showing that when banks adopt a threatening attitude, suicide risk increases among the evicted. As hypothesized, when the evicted felt socially supported, suicide risk decreased. Emotional help was the main mediator of suicide risk and the main unmet need, especially among me

Influence of individual characteristics and working conditions in the level of injury accident at work by registered in Andalusia, Spain, in 2003

Background. The study of the severity of occupational injuries is very important for the establishment of prevention plans. The aim of this paper is to analyze the distribution of occupational injuries by a) individual factors b) work place characteristics and c) working conditions and to analyze the severity of occupational injuries by this characteristics in men and women in Andalusia. Methods. Injury data came from the accident registry of the Ministry of Labor and Social Issues in 2003. Dependent variable: the severity of the injury: slight, serious, very serious and fatal; the independent variables: the characteristics of the worker, company data, and the accident itself. Bivariate and multivariate analysis were done to estimate the probability of serious, very serious and fatal injury, related to other variables, through odds ratio (OR), and using a 95% confidence interval (CI 95%). Results. The 82,4% of the records were men and 17,6% were women, of whom the 78,1% are unskilled manual workers, compared to 44,9% of men. The men belonging to class I have a higher probability of more severe lesions (OR = 1,67, 95% CI = 1,17 – 2,38). Conclusions. The severity of the injury is associated with sex, age and type of injury. In men it is also related with the professional situation, the place where the accident happened, an unusual job, the size and the characteristics of the company and the social class, and in women with the sectorYesFundamento. El estudio de la gravedad de las lesiones por accidente de trabajo es clave para el establecimiento de planes de prevención. El objetivo de este trabajo es conocer la distribución de las lesiones registradas por accidente de trabajo con baja según: a) las características del trabajador/ora; b) las del centro de trabajo y; c) las condiciones de empleo y del puesto de trabajo; y analizar la gravedad de las lesiones registradas según estas características en hombres y mujeres en Andalucía. Métodos. Se utilizaron los datos del registro de lesiones por accidente de trabajo con incapacidad laboral durante 2003 en Andalucía. Variable dependiente: grado real de la lesión; variables independientes: las características del/a trabajador/a, de la empresa y las del propio accidente. Se realizó un análisis bivariante y multivariante para estimar la probabilidad de lesión grave, muy grave o mortal asociada al resto de variables mediante la razón de odds (OR) y su intervalo de confianza. Resultados. El 82,4% de las lesiones se produjeron en hombres y el 17,6% en mujeres, de las cuales el 78,1% eran trabajadoras manuales no cualificadas, frente al 44,9% de los hombres. En hombres de clase I se encontró una probabilidad mayor de presentar lesiones más graves (OR = 1,67; IC 95% = 1,17-2,38). Conclusiones. La gravedad de las lesiones se relaciona con el sexo, la edad y el tipo de lesión. En los hombres también se asocia con la situación profesional, la clase social, el lugar del accidente, la plantilla del centro y el realizar un trabajo que no es el suyo y en las mujeres con el sector de actividad

Nursing care for the adult diabetic experiencing hypoglycemia: an integrative review

Introducción: La hipoglucemia es la complicación más frecuente del tratamiento con insulina en adultos. Los eventos de hipoglucemia severa se asocian con complicaciones a corto, mediano y largo plazo en  pacientes con diabetes ellmitus. Una de las estrategias para reducir  la frecuencia de hipoglucemia son las intervenciones de enfermería y  aunque hay pocos estudios que las enuncian de manera explícita, se ha publicado respecto a las necesidades de dichos pacientes, que permiten determinar características definitorias de  diagnósticos enfermeros y a partir de ellos establecer metas e intervenciones enfermeras, para el cuidado de dichos pacientes.  Objetivo: identificar los cuidados de enfermería para prevenir y controlar los eventos de hipoglucemia en pacientes adultos diagnosticados con diabetes mellitus. Metodología: revisión integrativa, se realizó en seis fases: planteamiento de la pregunta PICO; búsqueda en bases de datos y metabuscadores; lectura crítica; análisis, clasificación, validación por nivel de evidencia y grado de recomendación, y presentación de la información. Resultados: la revisión reportó cinco categorías: factores de riesgo y protectores, miedo a la hipoglucemia, atención brindada al paciente, disminución de la hipoglucemia y descripción del impacto de la hipoglucemia en los pacientes. Conclusiones: a partir de las necesidades reportadas en las 5 categorías de los resultados se determinaron características definitorias y factores relacionados que permitieron formular diagnósticos de enfermería y determinar como principales intervenciones: enseñanza del proceso de enfermedad, medicamentos prescritos, entrenamiento de asertividad, manejo de la hipoglicemia, nutricional y de la medicación, mejorar el afrontamiento, enseñanza individual, facilitar el aprendizaje y potenciación de la disposición de aprendizaje

Psychometric properties of the Brazilian version of the Cognitive Emotion Regulation Questionnaire

Abstract Introduction: The Cognitive Emotion Regulation Questionnaire (CERQ) was developed to measure nine cognitive strategies referring to what someone thinks after the experience of threatening or stressful events. The main purpose of this study was to evaluate the validity of the Brazilian version of the CERQ. Methods: The adaptation process included translation, backtranslation, expert committee evaluation, and test on 30 participants from the target population. A sample of 445 university students completed the Portuguese version of the CERQ, a sociodemographic questionnaire, the Life Events Checklist (LEC-5), and the Positive and Negative Affect Schedule (PANAS) on an on-line research platform. Validity was assessed through confirmatory factor analysis of two models - a nine-factor model and a second-order model. Internal consistency was assessed through Cronbach's alpha analysis and correlations with affective variables measured by the PANAS. Results: The analyses showed that the nine-factor model of the CERQ has good factorial validity and high reliability, with Cronbach's alpha values ranging between 0.71 and 0.88. The second-order model did not have a good fit to the data. Conclusion: The results obtained in this study are similar to the ones found previously, indicating that the Brazilian version of the CERQ is a valid and reliable tool for assessing cognitive emotion regulation strategies, but that grouping them according to their adaptability is not recommended

Introducción al estudio del biodeterioro de la resina de acetato de polivinilo Mowilith 50 usando la espectroscopia FTIR y la pirolisis-cromatografía de gases-espectrometría de masas

Evaluation of the alteration produced by microbiological attack on the poly(vinyl) acetate (PVA) resin Mowilith 50 has been carried out using FTIR spectroscopy and Pyrolysis-Gas Chromatography/Mass Spectrometry (Py-GC/MS). The latter proposed method includes the on-line derivatization of vinyl resins using hexamethyldisilazane during pyrolysis. Specimens consisting of thin films formed on glass slides from drying of an acetone solution of this PVA resin have been used. Analyses performed on the specimens on which different genera of bacteria and fungi were inoculated and allowed to grow, indicate that attack of microorganisms promotes the formation of acidic compounds. IR bands ascribed to carboxylic acids appearing in samples from inoculated specimens as well as an increase in the content of ethanoic acid detected by Py-GC/MS from specimens inoculated with fungi suggest that the effects of metabolic processes in these microorganisms are more significant than those of bacteria.La evaluación de la alteración producida por el ataque microbiológico en la resina de acetato de polivinilo (PVA) Mowilith 50 ha sido llevada a cabo usando un espectroscopio (FTIR) y Cromatografía de gases y pirólisis/espectrometría de masas (Py-GC/MS). El último método propuesto incluye la derivatización en linea de las resinas de vinilo usando hexametil-disilazano durante la pirólisis. Se han utilizado muestras consistentes en películas delgadas formadas sobre láminas de vidrio procedentes del secado de una solución de acetona de esta resina de acetato de polivinilo. Los análisis realizados sobre las muestras en los cuales fueron inoculados y guiados para crecer diferentes géneros de bacteria y hongo, indican que el ataque de microorganismos promueve la formación de componentes ácidos. Las bandas infrarrojas atribuidas a los ácidos carboxílicos que aparecen en las muestras de las probetas inoculadas así como el incremento del contenido de ácido etanoico detectado por Py-GC/MS de las probetas inoculadas con hongos sugiere que los efectos de los procesos metabólicos en estos microorganismos son mas significativos que los correspondientes a bacterias.Domenech Carbo, MT.; Bitossi, G.; Osete Cortina, L.; Yusa Marco, DJ.; Bolivar Galiano, F.; López Miras, MDM.; Fernández Vivas, MA.... (2007). Introduction to the study on the biodeterioration of the poly(vinyl) acetate resin mowilith 50 using ftir spectroscopy and pyrolysis-gas chromatography-mass spectrometry. Arché. (2):109-114. http://hdl.handle.net/10251/32240109114

The PACARDO research project: Youthful drug involvement in Central America and the Dominican Republic

Objective. To estimate the occurrence and school-level clustering of drug involvement among school-attending adolescent youths in each of seven countries in Latin America, drawing upon evidence from the PACARDO research project, a multinational collaborative epidemiological research study. Methods. During 1999-2000, anonymous self-administered questionnaires on drug involvement and related behaviors were administered to a cross-sectional, nationally representative sample that included a total of 12 797 students in the following seven countries: Costa Rica (n = 1 702), the Dominican Republic (n = 2 023), El Salvador (n = 1 628), Guatemala (n = 2 530), Honduras (n = 1 752), Nicaragua (n = 1 419), and Panama (n = 1 743). (The PACARDO name concatenates PA for Panamá, CA for Centroamérica, and RDO for República Dominicana). Estimates for exposure opportunity and actual use of alcohol, tobacco, inhalants, marijuana, cocaine (crack/coca paste), amphetamines and methamphetamines, tranquilizer

Bottom-Up Policy Risk Assessment

Otorepec P, Martin-Olmedo P, Bolivar J, et al. Bottom-Up Policy Risk Assessment. In: Guliš G, Mekel O, Ádám B, Cori L, eds. Assessment of Population Health Risks of Policies. New York, NY: Springer New York; 2014: 131-198.The top-down risk assessment that fits the classical HIA method and its application on policy was in depth presented in the previous chapter. Many public health experts find large policies difficult to assess as for their impact on health. People knowing health outcome and its societal burden well may find it easier to find proper policies starting from the bottom line—from health outcome. The use of complex causal process diagrams for analyzing health impacts of policy interventions was already described. The RAPID guidance based on bottom-up approach might be helpful to act more efficiently in reducing prevalence of health outcomes by identification and selection of proper policies for structural intervention. The health outcome was taken as a starting point and assessment through levels of risk factors and determinants of health lead to identification of policies needed to reduce burden of health outcome. The present chapter illustrates through eight case studies conducted in seven different countries a bottom-up policy risk assessment model aiming to describe casual pathways upstream, from a single health outcome (effect) up through risk factors and health determinants leading to a list of policies. The purpose of this approach is to emphasize that results in health outcomes are related to many different policies at the same time, bringing up the need to adopt proactive inter-sectoral negotiations and putting health in the agenda of non-health sectors. Special interest was put on identifying the type of information needed for the description of the full-chain, possible discrepancies in defining health outcomes, risk factors or health determinants, the availability of data, the designation of possible scenarios related to political options, and the characterization of uncertainties

The PACARDO research project: youthful drug involvement in Central America and the Dominican Republic Proyecto de investigación PACARDO: el consumo de drogas entre la juventud en Centroamérica y la República Dominicana

OBJECTIVE: To estimate the occurrence and school-level clustering of drug involvement among school-attending adolescent youths in each of seven countries in Latin America, drawing upon evidence from the PACARDO research project, a multinational collaborative epidemiological research study. METHODS: During 1999-2000, anonymous self-administered questionnaires on drug involvement and related behaviors were administered to a cross-sectional, nationally representative sample that included a total of 12 797 students in the following seven countries: Costa Rica (n= 1 702), the Dominican Republic (n= 2 023), El Salvador (n= 1 628), Guatemala (n= 2 530), Honduras (n= 1 752), Nicaragua (n= 1 419), and Panama (n= 1 743). (The PACARDO name concatenates PA for Panamá,CA for Centroamérica,and RDO for República Dominicana). Estimates for exposure opportunity and actual use of alcohol, tobacco, inhalants, marijuana, cocaine (crack/coca paste), amphetamines and methamphetamines, tranquilizers, ecstasy, and heroin were assessed via responses about questions on age of first chance to try each drug, and first use. Logistic regression models accounting for the complex survey design were used to estimate the associations of interest. RESULTS: Cumulative occurrence estimates for alcohol, tobacco, inhalants, marijuana, and illegal drug use for the overall sample were, respectively: 52%, 29%, 5%, 4%, and 5%. In comparison to females, males were more likely to use alcohol, tobacco, inhalants, marijuana, and illegal drugs; the odds ratio estimates were 1.3, 2.1, 1.6, 4.1, and 3.2, respectively. School-level clustering was noted in all countries for alcohol and tobacco use; it was also noted in Costa Rica, El Salvador, Guatemala, and Panama for illegal drug use. CONCLUSIONS: This report sheds new light on adolescent drug experiences in Panama, the five Spanish-heritage countries of Central America, and the Dominican Republic, and presents the first estimates of school-level clustering of youthful drug involvement in these seven countries. Placed in relation to school survey findings from North America and Europe, these estimates indicate lower levels of drug involvement in these seven countries of the Americas. For example, in the United States of America 70% of surveyed youths had tried alcohol and 59% had smoked tobacco. By comparison, in these seven countries, only 51% have tried alcohol and only 29% have smoked tobacco. Future research will help to clarify explanations for the observed variations across different countries of the world. In the meantime, strengthening of school-based and other prevention efforts in the seven-country PACARDO area may help these countries slow the spread of youthful drug involvement, reduce school-level clustering, and avoid the periodic epidemics of illegal drug use that have been experienced in North America.<br>OBJETIVO: Estimar el grado en que el consumo de drogas se produce y muestra una concentración en el nivel escolar entre adolescentes que asisten a la escuela en siete países de América Latina. Los datos presentados provienen del proyecto de investigación PACARDO, estudio epidemiológico conjunto multinacional. MÉTODOS: En el período de 1999­2000, se aplicaron cuestionarios anónimos autoadministrados sobre el consumo de drogas y conductas afines a una muestra transversal, representativa de la población nacional, que se compuso de un total de 12 797 estudiantes en los siguientes siete países: Costa Rica (n = 1 702), El Salvador (n = 1 628), Guatemala (n = 2 530), Honduras (n = 1 752), Nicaragua (n = 1 419), República Dominicana (n = 2 023) y Panamá (n = 1 743). (El nombre de PACARDO combina la PA de Panamá, la CA de Centroamérica y la RDO de República Dominicana). Se calcularon las oportunidades de exposición y el consumo de alcohol, tabaco, sustancias inhaladas, marijuana, cocaína (crack/pasta de cocaína), anfetaminas y metaanfetaminas, tranquilizantes, éxtasis y heroína sobre la base de las respuestas dadas a preguntas acerca de la edad en que se tuvo la oportunidad de probar cada una de las drogas, y en que se probó cada una de ellas, por primera vez. Para estimar las asociaciones de interés se aplicaron modelos de regresión logística con arreglo a la complejidad de la encuesta. RESULTADOS: Las siguientes fueron las frecuencias estimadas acumulativas del consumo de alcohol, tabaco, sustancias inhaladas, marijuana y drogas, respectivamente, en toda la muestra: 52%, 29%, 5%, 4% y 5%. Comparados con las mujeres, los varones fueron más propensos a consumir alcohol, tabaco, sustancias inhaladas, marijuana y drogas; las razones de posibilidades estimadas fueron, respectivamente, 1,3; 2,1; 1,6; 4,1 y 3,2. En todos los países se observó una concentración del consumo de alcohol y tabaco en el nivel escolar; el consumo ilegal de drogas también mostró una concentración escolar en Costa Rica, El Salvador, Guatemala y Panamá. CONCLUSIONES: Este informe arroja nueva luz sobre las experiencias de los adolescentes con la droga en Panamá, en los cinco países centroamericanos de tradición española, y en la República Dominicana. En él se presentan las primeras estimaciones del grado en que se concentra en las escuelas el consumo de drogas entre la juventud de estos siete países. Cuando se examinan a la luz de los resultados de encuestas escolares en América del Norte y en Europa, estas estimaciones apuntan a que el grado de consumo de drogas es más bajo en estos siete países americanos. Por ejemplo, en los Estados Unidos de América, 70% de los jóvenes encuestados habían consumido alcohol y 59% habían fumado tabaco. En cambio, en estos siete países, solamente 51% habían probado bebidas alcohólicas y solo 29% habían fumado tabaco. Futuras investigaciones ayudarán a explicar las variaciones observadas en los distintos países del mundo. En el entretiempo, el fortalecimiento de las iniciativas preventivas en las escuelas y otros ámbitos en el territorio de los siete países donde se lleva a cabo el proyecto PACARDO podría ayudar a estos países a frenar la diseminación del consumo de drogas entre la juventud, a reducir su concentración en las escuelas y a evitar las epidemias periódicas del consumo de drogas que se han producido en América del Norte