Razones de no asistencia a un programa de cribado mamográfico

Objetivo. El objetivo general de este trabajo es el estudio de los factores psicosociales asociados con la asistencia a un programa de cribado mamográfico. Método. Con un diseño retrospectivo se analizan las razones de no asistencia dadas por una muestra de mujeres que rechazaron participar en un programa de cribado (N=384). Además, se compararon algunas creencias específicas de salud mantenidas por estas mujeres con las de un grupo de mujeres que sí acudieron a dicho programa (N=715). Resultado. Las razones de no asistencia aducidas por las mujeres que no acudieron al programa tenían que ver con la invitación al mismo (no haber recibido la carta, pérdida u olvido), limitaciones personales (obligaciones familiares, enfermedad, trabajo), considerar que la mamografía es innecesaria en ausencia de síntomas y miedo a los resultados de la misma. El análisis de diferencias a nivel de creencias de salud entre asistentes y no asistentes confirmaron estos resultados y permitieron identificar diversas actitudes específicas asociadas con la participación en el programa. Cabe destacar la creencia en que es importante llevar a cabo actividades que mejoren la salud, que la mamografía permitiría empezar pronto un tratamiento si se tuviera algo malo, que este procedimiento no supone un pérdida de tiempo, y, sobre todo, que las personas significativas del entorno consideran importante para la propia mujer realizarse mamografías. Conclusiones. Los resultados clarifican algunos de los factores sobre los que hay que incidir a la hora de incrementar la participación de las mujeres en un programa de cribado mamográficoObjective. The present study analyses the psychosocial factors associated with participation in a mammography screening program. Methods. A retrospective design was used to analyze the reasons for non-attendance given by a sample of women who declined to participate in a mammography screening program (N=384). Some specific health beliefs held by the non-attendees were also compared with those of a group of women who accepted participating in the screening program (N=715). Results. Some important reasons stated by non-attendees referred to the invitation to the program (not receiving the letter, losing or forgetting it), personal restrictions (family obligations, illness, work), considering screening to be unnecessary in the absence of symptoms, and fear of the results of mammography. Analysis of the differences in health beliefs between participants and non participants confirmed these results, and identified a number of specific attitudes associated with participation in the mammography screening program. These include the belief that it is important to perform actions to improve health, that mammography screening would lead to early treatment if there was anything wrong, that this procedure is not a waste of time, and especially that salient others consider it important that women undergo breast screening. Conclusions. The results of our study clarify some beliefs and attitudes that should be stressed in order to increase participation in a mammography screening program

Razones de no asistencia a un programa de cribado mamográfico

Objetivo. El objetivo general de este trabajo es el estudio de los factores psicosociales asociados con la asistencia a un programa de cribado mamográfico. Método. Con un diseño retrospectivo se analizan las razones de no asistencia dadas por una muestra de mujeres que rechazaron participar en un programa de cribado (N=384). Además, se compararon algunas creencias específicas de salud mantenidas por estas mujeres con las de un grupo de mujeres que sí acudieron a dicho programa (N=715). Resultado. Las razones de no asistencia aducidas por las mujeres que no acudieron al programa tenían que ver con la invitación al mismo (no haber recibido la carta, pérdida u olvido), limitaciones personales (obligaciones familiares, enfermedad, trabajo), considerar que la mamografía es innecesaria en ausencia de síntomas y miedo a los resultados de la misma. El análisis de diferencias a nivel de creencias de salud entre asistentes y no asistentes confirmaron estos resultados y permitieron identificar diversas actitudes específicas asociadas con la participación en el programa. Cabe destacar la creencia en que es importante llevar a cabo actividades que mejoren la salud, que la mamografía permitiría empezar pronto un tratamiento si se tuviera algo malo, que este procedimiento no supone un pérdida de tiempo, y, sobre todo, que las personas significativas del entorno consideran importante para la propia mujer realizarse mamografías. Conclusiones. Los resultados clarifican algunos de los factores sobre los que hay que incidir a la hora de incrementar la participación de las mujeres en un programa de cribado mamográfic

Characterization of scintillator screens under irradiation of low energy 133Cs ions

An imaging heavy ion beam probe (i-HIBP) diagnostic, for the simultaneous measurement of plasma density, magnetic field and electrostatic potential in the plasma edge, has been installed at ASDEX Upgrade. Unlike standard heavy ion beam probes, in the i-HIBP the probing (heavy) ions are collected by a scintillator detector, creating a light pattern or strike-line, which is then imaged by a camera. Therefore, a good characterization of the scintillator response is needed. Previous works focused on the scintillator behaviour against irradiation with light ions such as hydrogen and alpha particles. In this work we present the characterization of several scintillator screens — TG-Green (SrGa2S4:Eu2+), YAG-Ce (Y3Al5O12:Ce3+) and P11 (ZnS:Ag) — against irradiation with 133Cs+ ions, in an energy range between 5 and 70 keV and ion currents between 105 and 107ions/(s·cm2). Three main properties of the scintillators have been studied: the ionolumenescence efficiency or yield, the linearity and the degradation as a function of the fluence. The highest yield was delivered by the TG-Green scintillator screen with > 8·103 photons/ion at 50 keV. All the samples showed a linear response with increasing incident ion flux. The degradation was quantified in terms of the fluence F1/2, which leads to a reduction of the emissivity by a factor of 2. TG-Green showed the lowest degradation with F1/2= 5.4·1014ions/cm2. After the irradiation the samples were analyzed by Scanning Electron Microscopy (SEM), Rutherford Backscattering Spectrometry (RBS) and Particle Induced X-ray Emission (PIXE). No trace of Cs was found in the irradiated regions. These results indicate that, among the tested materials, TG-Green is the best candidate for the i-HIBP detector.European Union’s Horizon 2020 (grant agreement No. 805162)Helmholtz Association VHNG-1350Spanish Ministry of Science and Innovation FJC2019-041092-I

Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry

Hypoandrogenemia, a frequent finding in men with obesity, is defined by low concentrations of serum testosterone. Although immunoassay (IA) is the most used method for the determination of this steroid in clinical practice, liquid chromatography-mass spectrometry (LC-MS/MS) is considered a more reliable method. In this study, we aimed to compare IA versus LC-MS/MS measurement for the diagnosis of hypoandrogenemia in a cohort of 273 nondiabetic young obese men. Mean total testosterone (TT) levels were 3.20 ± 1.24 ng/mL for IA and 3.78 ± 1.4 ng/mL for LC-MS/MS. 53.7% and 26.3% of patients were classified as presenting hypoandrogenemia with IA and LC-MS/MS, respectively. Considering LC-MS/MS as the reference method, sensitivity and specificity of IA were 91.4% (95% CI 82.3–96.8) and 61.1% (95% CI 54.0–67.8), respectively. IA presented an AUC of 0.879 (95% CI 0.83–0.928). Multivariate regression analysis indicated that sex hormone-binding globulin (SHBG) concentrations (p = 0.002) and insulin resistance (p = 0.008) were factors associated with discrepant IA values. In conclusion, the determination of TT by IA in nondiabetic young men with obesity yields lower concentrations of TT than LC-MS/MS, resulting in an equivocal increased diagnosis of hypoandrogenemia, which could lead to inaccurate diagnosis and unnecessary treatment

Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry.

Hypoandrogenemia, a frequent finding in men with obesity, is defined by low concentrations of serum testosterone. Although immunoassay (IA) is the most used method for the determination of this steroid in clinical practice, liquid chromatography-mass spectrometry (LC-MS/MS) is considered a more reliable method. In this study, we aimed to compare IA versus LC-MS/MS measurement for the diagnosis of hypoandrogenemia in a cohort of 273 nondiabetic young obese men. Mean total testosterone (TT) levels were 3.20 ± 1.24 ng/mL for IA and 3.78 ± 1.4 ng/mL for LC-MS/MS. 53.7% and 26.3% of patients were classified as presenting hypoandrogenemia with IA and LC-MS/MS, respectively. Considering LC-MS/MS as the reference method, sensitivity and specificity of IA were 91.4% (95% CI 82.3-96.8) and 61.1% (95% CI 54.0-67.8), respectively. IA presented an AUC of 0.879 (95% CI 0.83-0.928). Multivariate regression analysis indicated that sex hormone-binding globulin (SHBG) concentrations (p = 0.002) and insulin resistance (p = 0.008) were factors associated with discrepant IA values. In conclusion, the determination of TT by IA in nondiabetic young men with obesity yields lower concentrations of TT than LC-MS/MS, resulting in an equivocal increased diagnosis of hypoandrogenemia, which could lead to inaccurate diagnosis and unnecessary treatment

Diseño y validación de un cuestionario para la detección de depresión mayor en pacientes ancianos Design and validation of a questionnaire for the detection of major depression in elderly patients

Fundamento y objetivo: Elaborar y validar una escala para detectar trastornos depresivos mayores (TDM) en ancianos que utilizan las consultas de atención primaria (Escala para la Detección de Depresión en Ancianos [EDDA]). Métodos: Estudio observacional transversal para validar una escala, administrada mediante entrevista personal, en 259 pacientes de 65 o más años. Tras revisar los instrumentos disponibles y elaborar los ítems, se realizó una primera prueba piloto o pretest. En una segunda prueba piloto se analizó la reproducibilidad del instrumento. El estándar de oro fue el resultado de una entrevista psiquiátrica estandarizada realizada por psiquiatras (criterios DSM-IV y entrevista SCAN). Resultados: Los coeficientes de correlación intraclase (CCI) correspondientes a la fiabilidad intra e interobservador fueron, respectivamente, de 0,858 (intervalo de confianza [IC] del 95%, 0,634-0,946) y 0,908 (IC del 95%, 0,726-0,969). El número de sujetos válidos para el estudio fue de 216 ancianos, en quienes se realizó, de forma ciega, una valoración en consultas de atención primaria y de psiquiatría. En éstas se objetivó la existencia de un TDM en 81 de ellos (37,5%; IC del 95%, 31,1-44,4). La EDDA mostró una elevada coherencia interna (* de Cronbach = 0,79). El análisis factorial determinó que existían 8 factores capaces de explicar el 55,8% de la varianza total. Para una puntuación mayor o igual a 15, la EDDA presenta una sensibilidad del 90,1% (IC del 95%, 80,95-95,33), una especificidad del 74,8% (IC del 95%, 66,48-81,71) y un cociente de probabilidad positivo de 3,58 (IC del 95%, 2,65-4,83). Conclusiones: La EDDA es un instrumento clínicamente útil para la detectar los TDM de los ancianos en la atención primaria.Background and objective: The aim of this study was to design and validate a scale to detect major depressive disorders in elderly individuals in primary care (Detection of Depression in the Elderly Scale [DDES]). Methods: We performed an observational and cross-sectional study for the validation of a scale, administered by means of a personal interview, in 259 patients aged 65 years old or older. Available instruments were reviewed and the questions were designed. Subsequently, a first pilot study was performed. In a second pilot study the reproducibility of the instrument was analyzed. The gold standard was the result of a standardized psychiatric interview performed by psychiatrists (DSM-IV criteria and SCAN interviews). Results: The intraclass correlation coefficients corresponding to the test-retest and inter-rater reliability were 0.858 (95% confidence interval [CI], 0.634-0.946) and 0.908 (95% CI, 0.726-0.969) respectively. Two hundred sixteen subjects underwent an assessment, in which primary care and psychiatric evaluations were blinded. Major depression was diagnosed in 81 patients (37.5%; 95% CI, 31.1-44.4). The internal consistency of the DDES was good (Cronbach's alpha = 0.79). Exploratory factorial analysis revealed an 8-component structure (55.8% of explained variance). A cutoff score of 15 or more for the DDES showed sensitivity of 90.1% (95% CI, 80.95-95.33), specificity of 74.8% (95% CI, 66.48-81.71) and a likelihood ratio (+) of 3.58 (95% CI, 2.65-4.83). Conclusions: The DDES is a clinically useful instrument for the detection of major depression in elderly patients in primary care

Conceptual design of the ITER fast-ion loss detector

A conceptual design of a reciprocating fast-ion loss detector for ITER has been developed and is presented here. Fast-ion orbit simulations in a 3D magnetic equilibrium and up-to-date first wall have been carried out to revise the measurement requirements for the lost alpha monitor in ITER. In agreement with recent observations, the simulations presented here suggest that a pitch-angle resolution of ∼5° might be necessary to identify the loss mechanisms. Synthetic measurements including realistic lost alpha-particle as well as neutron and gamma fluxes predict scintillator signal-to-noise levels measurable with standard light acquisition systems with the detector aperture at ∼11 cm outside of the diagnostic first wall. At measurement position, heat load on detector head is comparable to that in present devices.Ministerio de Economía y Competitividad RYC- 2011-09152, FIS2015-69362-P, ENE2012- 31087Marie Curie FP7 Integration PCIG11-GA- 2012-32145