Impact of physical and psychosocial factors on disability caused by lumbar pain amongst fishing sector workers

[Abstract] Functional disability due to lumbar pain should be considered from the biopsychosocial model. There is inconclusive evidence as to whether the key determining factors in this form of disability are psychosocial or physical. Our aim is to identify variables that cause functional disability due to lumbar pain amongst shellfish gatherers in Galicia by means of a cross-sectional survey. Participants (N = 929) completed a self-administered, paper-based questionnaire including sociodemographic and lifestyle issues, as well as the nature of the lumbar pain, the presence of musculoskeletal pain in other regions of the body, the Roland-Morris Disability Questionnaire (RMDQ) and SF-36. Univariate examination, ROC curve and logistic regression analyses were performed. Most of these workers are women (98.7 %), with a mean age of 50.6 years. The point-prevalence of lumbar pain stands at 65.5 %. The RMDQ mean was 4.9 (SD = 4.7). In the logistic regression analysis, the variables associated with disability (RMDQ > median) were age (OR = 1.04), physical exercise (OR = 0.57), pain intensity (OR = 1.16), the number of regions of musculoskeletal pain (OR = 1.24) and mental health (SF-36) (OR = −0.95). Functional disability is determined by the physical nature of the pain and mental health attributes, although the former has a greater impact. In decreasing order of importance, functional disability is attributable to the presence of lower back pain, the number of regions of musculoskeletal pain, the intensity of that pain and age. Regular physical exercise and better mental health have a protective effect on disability

Impact of musculoskeletal pain on health-related quality of life among fishing sector workers

[Abstract] This study aims to determine the impact of musculoskeletal pain (in terms of intensity of the pain, location and functional disability due to back pain) and other factors (socio-demographic, lifestyle and co-morbidity) on the health-related quality of life on a group of shellfish gatherers. This observational transversal study included 929 shellfish gatherers (18–69 years, 98.7 % women) who completed a self-administered questionnaire, including socio-demographic and lifestyle questions, co-morbidity, intensity and location of musculoskeletal pain, and Roland-Morris Disability Questionnaire (RMDQ). Health-related quality of life was assessed using the 36-item Short Form Survey (SF-36). Physical component summary (PCS) and mental component summary (MCS) of the SF-36 were considered as outcome variables. The impact of the different factors on the PCS and MCS scores was evaluated using a stepwise linear regression analysis. Physical health was found to be independently associated to intensity of musculoskeletal pain (regression coefficient, B = −0.96), number of locations with musculoskeletal pain (MSP) (B = −0.77), presence of pain in the hip-knee (B = −2.26), self-reported rheumatic disorders (B = −2.79), lower back pain (B = −1.62) and age (B = −0.06). Mental health was associated with the presence of self-reported depressive syndrome (B = −1043.1) and RMDQ score (B = −42.2). The sample had significantly lower values than the reference population in all of the dimensions of the SF-36. Intensity of the pain, pain in the hip-knee, lower back pain, functional disability due to back pain and number of locations with musculoskeletal pain were found to have a detrimental impact on the physical health of the workers. Depressive syndrome and greater functional disability due to back pain, in turn, predict worse mental health

Prevalence, co-occurrence, and predictive factors for musculoskeletal pain among shellfish gatherers

[Abstract] The aims of this study are to determine prevalence and co-occurrence of musculoskeletal pain (MSP) among shellfish gatherers and its consequences for the use of medicine, health care, and sickness leave and to investigate predictive factors (sociodemographic, lifestyle, comorbidity) of MSP in five anatomical areas (neck/shoulder/higher back, lower back, elbow/wrist/hand, hip/knee, and leg/ankle/foot). Nine hundred twenty-nine shellfish gatherers (94% women) voluntarily took part in a physiotherapy workshop. A self-administered questionnaire was used to assess MSP and its consequences. Regression models were performed to determine the factors predicting the presence of MSP. The two most frequently self-reported forms of MSP were neck pain (70.9%) and lower back pain (65.5%). Sixty-four percent of respondents reported contact with their family doctor during the last 12 months due to MSP, and most subjects (88.1%) reported MSP in two or more locations. Hip/knee pain was associated with leg/ankle/foot pain (crude odds ratio = 3.14). Logistic regression analysis showed that being female and young is associated with lumbar pain, and being older is associated with pain in all areas of the lower limbs. The number of pain sites a person reported significantly predicted the presence of pain in all the anatomical areas studied. Prevalence of MSP and musculoskeletal comorbidity were high. The study shows that the presence of pain reported in one body area is highly dependent on the total number of painful areas. These findings are consistent with those of similar studies

Calidad de vida relacionada con la salud en trabajadoras del sector pesquero usando el cuestionario SF-36

[Resumen] Objetivo. Determinar la calidad de vida relacionada con la salud (CVRS) mediante el cuestionario SF-36 en trabajadoras del sector pesquero, y compararla con valores normalizados de población de referencia y con valores de otras muestras similares que presentan trastornos musculoesqueléticos. Método. Mediante un estudio transversal se midió la CVRS en 917 mariscadoras a pie seleccionadas a partir de la participación voluntaria en un taller de fisioterapia. Se utilizó un cuestionario autoadministrado que incluía variables sociodemográficas, de estilo de vida, de comorbilidad, de prevalencia de dolor musculoesquelético y de CVRS. Para el SF-36 se calcularon puntuaciones crudas, puntuaciones estandarizadas y puntuaciones z. Resultados. La edad media de las participantes es de 50,6 años (desviación estándar: 8,8). En todas las dimensiones del SF-36 la muestra tuvo valores inferiores que la población general de referencia. Las mayores diferencias se observaron en las personas más jóvenes. Las dimensiones más afectadas, superando la diferencia mínimamente importante, fueron dolor corporal, vitalidad y salud general. Su salud física está más afectada que su salud mental. Conclusiones. Se demuestra que este grupo de trabajadoras tiene peor CVRS que la población general y que otras muestras poblacionales, sobre todo en los componentes físicos.[Abstract] Objective. To determine health-related quality of life (HRQoL) measured with the 36-item Short-Form (SF-36) questionnaire in women workers in the fishing industry, compared with norm-based values in the reference population and other similar samples of persons with musculoskeletal disorders. Method. A cross-sectional study was performed to measure HRQoL in 917 shellfish gatherers. Women taking part in a physiotherapy workshop were invited to participate. We used a self-administered questionnaire, including questions on sociodemographic variables, lifestyle, comorbidity, the prevalence of musculoskeletal disorders, and HRQoL. For the SF-36 raw scores, norm-based scores and z-scores were calculated. Results. The mean age of participants was 50.6 years (standard deviation: 8.8). In all dimensions of the SF-36, values in the sample were lower than in the general reference population. The greatest differences were in younger people. The most affected dimensions were bodily pain, vitality and general health. Physical health was more affected than mental health. Conclusions. HRQoL, especially physical components, was worse in women shellfish gatherers than in the general population and other population samples

Identification of predictive factors of the degree of adherence to the Mediterranean diet through machine-learning techniques

[Abstract] Food consumption patterns have undergone changes that in recent years have resulted in serious health problems. Studies based on the evaluation of the nutritional status have determined that the adoption of a food pattern-based primarily on a Mediterranean diet (MD) has a preventive role, as well as the ability to mitigate the negative effects of certain pathologies. A group of more than 500 adults aged over 40 years from our cohort in Northwestern Spain was surveyed. Under our experimental design, 10 experiments were run with four different machine-learning algorithms and the predictive factors most relevant to the adherence of a MD were identified. A feature selection approach was explored and under a null hypothesis test, it was concluded that only 16 measures were of relevance, suggesting the strength of this observational study. Our findings indicate that the following factors have the highest predictive value in terms of the degree of adherence to the MD: basal metabolic rate, mini nutritional assessment questionnaire total score, weight, height, bone density, waist-hip ratio, smoking habits, age, EDI-OD, circumference of the arm, activity metabolism, subscapular skinfold, subscapular circumference in cm, circumference of the waist, circumference of the calf and brachial area.Instituto de Salud Carlos III; PI17/01826Xunta de Galicia; ED431G/01Xunta de Galicia; ED431D 2017/16Xunta de Galicia; ED431D 2017/23Xunta de Galicia; ED431C 2018/4

Cognitive impairment as predictor of functional dependence in an elderly sample

[Abstract] This retrospective study determines the role of cognitive decline as a predictor of functional dependence. In a representative 600 community-dwellers aged 65 or older, we examined using a logistic regression model, the association between cognitive status (taking into account age and educational level) and dependence on basic and instrumental activities of daily living (ADL and IADL, resp.), controlling for socio-demographic variables and health conditions. The Mini-Mental State Examination (MMSE) scores were compared in participants with functional disability to perform basic and instrumental activities. Cognitive status influenced functional dependence on activities of daily living, basic (OR = 4.1, 95%CI = 2.7–6.1) and instrumental (OR = 5.7, 95%CI = 3.5–9.3), independently of gender, age, educational level and health conditions. Besides, cognitive impairment was associated with the dependence on certain basic (e.g., bathing, toileting) and instrumental (e.g., using the telephone, taking medications, and handling finances) activities. This was a gradual relationship, the highest cognitive decline implied the highest loss of ability at carrying out activities, with a larger impact on basic activities. These findings suggest that cognitive decline can be a predictor for functional dependence, independently of other variables, and turn into a very useful tool indicating the need for support

The Maternal Education Programme in the Public Health System in Galicia

[Resumen] Objetivos. Los objetivos del presente estudio han sido conocer la presión asistencial de los cursos de Educación Maternal en los centros de salud gallegos, así como su temporalización y las actividades teóricas y prácticas realizadas. Material y métodos. Estudio observacional de prevalencia mediante cuestionario autoadministrado y autofranqueado de todos los Centros de Salud de la Comunidad Autónoma de Galicia que disponen de matrona. El análisis estadístico ha consistido en un estudio descriptivo de todas las variables incluidas en el estudio. En el 81,5 % de las encuestas recibidas se refiere la existencia del Programa de Educación Maternal. En el 93,4 % de los casos las mujeres que inician el programa lo finalizan. Los contenidos teóricos del programa más frecuentemente desarrollados han sido cuidados en el recién nacido, lactancia y cuidados en el puerperio que están presentes en el 100 % de los casos; y el menos frecuentemente abordado ha sido medicación y embarazo. Los contenidos prácticos del programa más frecuentemente desarrollados han sido las técnicas de respiración (100 %), seguida de la preparación física preparto (98,1 %); y el menos desarrollado ha sido la recuperación física posparto. El mes de gestación en el que se inició el programa tuvo como mediana 6,5. La duración del programa tuvo como mediana 10 semanas. En el 100 % de las encuestas recibidas se indica que el responsable del programa es la matrona. Según las respuestas recibidas, existe una buena implementación del Programa de Educación Maternal. En cuanto a los contenidos teóricos y prácticos abordados en el período preparto, se observa una gran homogeneidad entre las distintas Unidades, abarcando gran variedad de aspectos. Parece que se enfatiza el programa preparto respecto al posparto, que cuenta con un menor número de horas semanales y de semanas de duración.[Abstract] Aims of the study. The goals of this study have been to know the number of patients who participate in the Maternal Education Program in the Health Centers in Galicia. Timetable, theoretical and practical activities of the program have been analised. Subject and methods. transversal descriptive study. We have sent by post a survey to all the health centers of Galicia which have midwifes. The statistic analyses has been about a descriptive study of all the variables included in the questionnaire. The maternal Education Program exists in the 81.5 % of the replies we have received. In the 93.4 % of the cases, the women both started and finished the program. The theoretical contents more frequently developed have been the medical care for newborn, breast-feeding and medical care in the postpartum period, which are present in the 100 % of the cases. The less frequently developed has been the medication and pregnancy. The practical contents of the program more frequently developed have been the breathe technics (100 %) followed by physical training during pregnancy (98.1 %). The less developed topic has been the physical training after delivery. The month of pregnancy when the programme begun had as median 6.5. The lenght of the program had as median 10 weeks. The 100 % of the replies showed that the person in charge of the programme was the midwife. According to the replies we have received, there is a high development of the Maternal Education Program. Related to the theoretical and practical contents taught during the pregnancy, there is so much homogeneity about several aspects among the different centers. It seems to be more emphasis in the prepartum compared to the postpartum program, which has less number of hours per week, and also less weeks of length

Clinical-pathological characteristics and prognosis of a cohort of oesophageal cancer patients: a competing risks survival analysis

[Abstract] Background: To determine the clinical course, follow-up strategies, and survival of oesophageal cancer patients using a competing risks survival analysis. Methods: We conducted a retrospective and prospective follow-up study. The study included 180 patients with a pathological diagnosis of oesophageal cancer in A Coruña, Spain, between 2003 and 2008. The Kaplan-Meier methodology and competing risks survival analysis were used to calculate the specific survival rate. The study was approved by the Ethics Review Board (code 2011/372, CEIC Galicia). Results: The specific survival rate at the first, third, and fifth years was 40.2%, 18.1%, and 12.4%, respectively. Using the Kaplan-Meier methodology, the survival rate was slightly higher after the third year of follow-up. In the multivariate analysis, poor prognosis factors were female sex (hazard ratio [HR] 1.94; 95% confidence interval [CI], 1.24-3.03), Charlson's comorbidity index (HR 1.17; 95% CI, 1.02-1.33), and stage IV tumours (HR 1.70; 95% CI, 1.11-2.59). The probability of dying decreased with surgical and oncological treatment (chemotherapy and/or radiotherapy) (HR 0.23; 95% CI, 0.12-0.45). The number of hospital consultations per year during the follow-up period, from diagnosis to the appearance of a new event (local recurrences, newly appeared metastasis, and newly appeared neoplasias) did not affect the probability of survival (HR 1.03; 95% CI, 0.92-1.15). Conclusions: The Kaplan-Meier methodology overestimates the survival rate in comparison to competing risks analysis. The variables associated with a poor prognosis are female sex, Charlson's comorbidity score and extensive tumour invasion. Type of follow-up strategy employed after diagnosis does not affect the prognosis of the disease

Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality

[Abstract] The aim of this study is to establish the existing relationship among variables referred to the person, specifically age and gender, and the functional dependence in basic ADL and in IADL, as well as the possible relationship it has with the increase of morbidity and mortality in a random sample of 598 individuals older than 65 years. Of these individuals, 34.6% were categorized as dependent for at least one ADL, and 53.5% if we refer to IADL. Regarding the ADL, the risk of dependence increases (odds ratio = OR = 1.089) per year of age, (OR = 2.48) in women’s case; while there is an IADL correlation between age and the score (r = +- 0.527; p < 0.001). A relationship exists between dependence and the days of hospitalization (for ADL: r = +- 0.12, p = 0.018 and IADL: r = +- 0.97, p = 0.003), the number of visits to the doctor (ADL: r = +- 0.27, p < 0.001; IADL: r = +- 0.25, p < 0.001) or the presence of concomitant pathologies such as dementia (ADL: p < 0.001; IADL: p < 0.001). There is a significant association between age, gender and dependence, as well as between dependence and morbidity and mortality, so that dependence could be used as a predictor of both

Prevalence of cognitive impariment: effects of level of education, age, sex, and associated factors

[Abstract] Aims: To examine the prevalence of cognitive impairment in a Spanish elderly population and to analyse its association with some social and medical factors. Methods: We randomly selected a representative sample (n = 600) of people over 65 from Narón Council (A Coruña). Socio-demographic and biomedical data were collected and cognitive status was assessed using the Mini-Mental State Examination (MMSE). Results: We determined variations in the prevalence from 35.2%, when age or level of education distribution was not applied, to 22.2% when they were applied. Women showed a higher probability of cognitive impairment than men. Negative correlation was observed between the age of the subject and the MMSE secore (Spearman correlation p = -0.45, p < 0.001), with the possibility of developing cognitive impairment increasing each year. For our sample, cognitive impairment was associated with an increase of morbidity and mortality in the elderly population. This association was found with the presence of dementia. heart failure. anaemia, stroke and auditory deficits. Conclusions: Knowledge of the real prevalence rates, together with the establishment of adequate preventive and intervention measures, can be factors that may diminish the socio-sanitary impact of cognitive impairment