Point process methods in epidemiology: application to the analysis of human immunodeficiency virus/acquired immunodeficiency syndrome mortality in urban areas

The analysis of spatio-temporal patterns of disease or death in urban areas has been developed mainly from the ecological studies approach. These designs may have some limitations like the ecological fallacy and instability with few cases. The objective of this study was to apply the point process methodology, as a complement to that of aggregated data, to study HIV/AIDS mortality in men in the city of Alicante (Spain). A case-control study in residents in the city during the period 2004-2011 was designed. Cases were men who died from HIV/AIDS and controls represented the general population, matched by age to cases. The risk surfaces of death over the city were estimated using the log-risk function of intensities, and we contrasted their temporal variations over the two periods. High risk significant areas of death by HIV/AIDS, which coincide with the most deprived areas in the city, were detected. Significant spatial change of the areas at risk between the periods studied was not detected. The point process methodology is a useful tool to analyse the patterns of death by HIV/AIDS in urban areas

Technological Factors That Influence the Mathematics Performance of Secondary School Students

Although the value of information and communication technology (ICT) is positive and its use is widespread, its potential as a teaching tool in mathematics is not optimized and its methodological integration is rare. In addition, the availability of ICT resources in schools is positively associated with the academic success of students, and the availability of ICT resources at home is negatively associated with their success. To determine the relationships among academic performance, uses, and available ICT resources, a total of 2018 secondary school students participated in the present study. The uses and available ICT resources, and the learning of mathematics and ICT, were evaluated using a validated 11-item questionnaire. Statistical analysis reveals that, of the secondary education levels, the lowest results are observed in the third year. A total of 64% of students affirm that they use ICT at home to study mathematics. In addition, 33.61% of the students affirm that they use their mobile phones frequently while studying at home. However, it should be noted that between 23.80% and 28.44% affirm that they dedicate more than 4 h per day to phone calls. Educational level is a predictor of academic performance in mathematics associated with students’ uses of ICT. The scores indicate that the computer is generally used for Internet searches, thus, limiting the use of ICT for educational purposes. Furthermore, there is a difference regarding gender

Escenaris i reptes pròxims

El patró de mortalitat de la població està determinat per les causes de mort de les persones majors: les malalties degeneratives n'han substituit d’altres històricament més importants. Hi ha una homogeneïtzació del procés de la mort, que es produeix més tard i es concentra en edats avançades i per causes semblants. És previsible que en els pròxims anys s'incrementen patologies, com ara les psicosis orgàniques senils i presenils, que ja vénen augmentant en les últimes décades

Augment reality and virtual reality for the improvement of spatial competences in Physical Education

Young and mobile are an intense combination in entertainment. Mobile phones can also be a powerful tool in improving some teaching parameters, also in Physical Education. This research aims to test if Augmented Reality and Virtual Reality with mobile phones can have an impact on Physical Education students and their abilities in spatial orientation and distance estimation. In the investigation we have created two virtual and augmented scenarios, and a quantitative methodology has been used to analyze and contrast the learning tests carried out. The results show that these augmented worlds improve spatial orientation and estimation capacity. The study shows that it is convenient to develop activities and digital scenarios to incorporate mobile augmented reality in the learning of spatial orientation, at the same time as teaching skills are improved

Technological Factors That Influence the Mathematics Performance of Secondary School Students

Although the value of information and communication technology (ICT) is positive and its use is widespread, its potential as a teaching tool in mathematics is not optimized and its methodological integration is rare. In addition, the availability of ICT resources in schools is positively associated with the academic success of students, and the availability of ICT resources at home is negatively associated with their success. To determine the relationships among academic performance, uses, and available ICT resources, a total of 2018 secondary school students participated in the present study. The uses and available ICT resources, and the learning of mathematics and ICT, were evaluated using a validated 11-item questionnaire. Statistical analysis reveals that, of the secondary education levels, the lowest results are observed in the third year. A total of 64% of students a rm that they use ICT at home to study mathematics. In addition, 33.61% of the students a rm that they use their mobile phones frequently while studying at home. However, it should be noted that between 23.80% and 28.44% a rm that they dedicate more than 4 h per day to phone calls. Educational level is a predictor of academic performance in mathematics associated with students’ uses of ICT. The scores indicate that the computer is generally used for Internet searches, thus, limiting the use of ICT for educational purposes. Furthermore, there is a di erence regarding gende

Análisis de la mortalidad en ciudades: resultados en Valencia y Alicante

ResumenObjetivosDescribir los patrones de mortalidad, general y por causas específicas seleccionadas, en Valencia y Alicante; establecer las diferencias internas por distritos, y evaluar los cambios en la magnitud de estas desigualdades en el tiempo.MétodosLas defunciones ocurridas en residentes en las ciudades de Valencia y Alicante durante los períodos 1990-1992 y 1996-1998 se asignaron a los distritos municipales de residencia. La comparación entre los períodos de estudio o entre ciudades se ha realizado a través del riesgo relativo estimado mediante regresión de Poisson. Se calculó la razón comparativa de mortalidad (RCM) según los 17 grandes grupos de la Clasificación Internacional de Enfermedades (9.a revisión). Por distritos se han calculado en cada período de estudio las tasas ajustadas por el método directo, la razón de mortalidad estandarizada (RME), la razón de años potenciales de vida perdida (RAPVP) y la esperanza de vida al nacimiento.ResultadosLos riesgos de muerte por todas las causas disminuyen del primer al segundo período tanto en varones, como en mujeres en ambas ciudades. La esperanza de vida aumenta significativamente en ambas ciudades en los varones, y en Valencia en las mujeres. La ciudad de Valencia presenta un mayor riesgo de muerte en ambos períodos. Algunos grupos de causas de muerte aumentan (grupos 5 y 6, que incluyen trastornos mentales y enfermedades del sistema nervioso y órganos de los sentidos). Por distritos, se observa una mayor variabilidad en Valencia —donde destacan los distritos 1 y 11 con un elevado riesgo de mortalidad— que en Alicante.ConclusionesEl proceso de vigilancia de la mortalidad interna, por distritos, es reproducible. En la ciudad de Valencia existen diferencias en la mortalidad que se mantienen en el tiempo. La ciudad de Alicante presenta una menor variabilidad interna en sus indicadores de mortalidad.AbstractObjectivesTo describe mortality patterns, in general and by selected specific causes in Valencia and Alicante, to establish internal inequalities by districts, and to evaluate changes in the magnitude of these inequalities over time.MethodsDeaths among residents of Valencia and Alicante in the periods 1990-1992 and 1996-1998 were assigned to residential municipal districts. Comparisons between the periods studied and between cities were carried out using the relative risk derived from a Poisson regression model. A comparative mortality figure was calculated using the 17 largest groups of the 9th International Classification of Diseases. Rates adjusted by the direct method, standardized mortality ratio, potential years of life lost (PYLL) ratio and life expectancy at birth were calculated by districts in each study period.ResultsThe risks of death from all causes decreased between the first and second periods in both men and women in both cities. Life expectancy significantly increased in both cities for men and in Valencia for women. The city of Valencia had the greatest risk of death in both periods. Some causes of death increased (groups 5 and 6, mental and nervous system disorders and sensory organ diseases). By districts, there was greater variability in Valencia than in Alicante, especially in districts 1 and 11 in Valencia, which showed a high risk of death.ConclusionsThe process of internal mortality surveillance by districts is reproducible. In the city of Valencia there were inequalities in mortality that were maintained over time. The city of Alicante showed less internal variability in its mortality indicators

Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background: Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Methods: Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. Results: By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Conclusions: Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996-2007

Background: While research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996–99, 2000–2003 and 2004–2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia). Methods: All deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson’s Regression models, adjusted for age and study period, and distinguishing between genders. Results: Amenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time. Conclusions: Although amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system, associated with areas of greater deprivation. Action must be taken in these areas of greater inequality in order to reduce the health inequalities detected. The causes behind socioeconomic inequalities in amenable mortality must be studied in depth.This work was partly supported by the FIS-FEDER projects PI040170 and PI080330

Anàlisi espacial de la mortalitat a la Comunitat Valenciana

L’anàlisi espacial pot contemplar-se, en el context epidemiològic, com una ferramenta per a l’estudi de la distribució geogràfica d’un determinat problema de salut. Els estudis geogràfics sobre resultats en salut de la població són importants perquè poden contribuir a detectar diferències entre distintes regions, a establir patrons de distribució al llarg de la geografia d’un determinat territori o a localitzar unitats geogràfiques en situació de risc extrem o altres resultats d’interés

Place of death of people with conditions needing palliative care in the different autonomous communities (regions) of Spain

Fundamento. Conocer el lugar de fallecimiento por causas susceptibles de cuidados paliativos de personas residentes en España de 15 o más años de edad según la comunidad autónoma (CA), y cómo influyen las causas (oncológicas y no oncológicas). Método. Estudio transversal de base poblacional con análisis de los certificados médicos de defunción entre 2012 y 2015. Los efectos ajustados de las variables sociodemográficas, la CA y las causas sobre el lugar de fallecimiento se estimaron mediante las odds de fallecimiento en hospital frente a domicilio (OH/D) y en residencia frente a domicilio (OR/D), y las odds ratio (ORH/D y ORR/D) obtenidas por regresión logística multinomial. Resultados. Se produjeron 1.611.767 muertes de las que 64,8% correspondieron a la población diana. La defunción en hospital fue un 77% más frecuente que en domicilio, y en residencia un 53% menor. Sexo masculino, menor edad, bajo nivel de estudios, lugar de nacimiento fuera de España, tamaño de municipio grande y estado civil no casado se asociaron a fallecimiento en hospital, y las mismas excepto sexo femenino y mayor edad a residencia. Las OH/D ajustadas fueron > 1 en todas las CA y las OR/D 1 and ON/H < 1 were observed in all AC, except Catalonia. Oncological causes made OH/H < 1 in almost 50% of AC, while ON/H continue to be < 1. Conclusions. Most deaths were in hospital and fewer at nursing homes, despite oncological causes increasing deaths at home (adjusted effect)