Future C loss in mid-latitude mineral soils: climate change exceeds land use mitigation potential in France.

Many studies have highlighted significant interactions between soil C reservoir dynamics and global climate and environmental change. However, in order to estimate the future soil organic carbon sequestration potential and related ecosystem services well, more spatially detailed predictions are needed. The present study made detailed predictions of future spatial evolution (at 250 m resolution) of topsoil SOC driven by climate change and land use change for France up to the year 2100 by taking interactions between climate, land use and soil type into account. We conclude that climate change will have a much bigger influence on future SOC losses in mid-latitude mineral soils than land use change dynamics. Hence, reducing CO2 emissions will be crucial to prevent further loss of carbon from our soils.

[Is the availability of buprenorphine/naloxone therapy for opioid-dependent inmates a necessity? ]. / ¿Es necesario disponer de tratamientos con Buprenorfina/Naloxona para los presos dependientes de opiáceos?

Agonist therapy (OAT) programs in combination with a psychosocial approach are the most effective way to prevent relapse in opioid-dependent patients. These programs reduce morbidity and risk behaviours for HIV transmission and other infections, improve quality of life and retention in treatment, and have a positive impact on antisocial behaviour. They are therefore very useful for prisoners with a history of opiate use. OATs based on buprenorphine/naloxone (B/N), along with others using methadone, are currently available in Spain. Diversified treatment offers an alternative treatment for opioid dependence that is more personalized and tailored to the patient's characteristics. As regards effectiveness, both drugs are very similar, but B/N shows a better safety profile and fewer drug-drug interactions and can be dispensed in pharmacies once the patient is released, which can assist with the patient' social reintegration. B/N treatment is more expensive than methadone. It is advisable to have different modes of OAT. These should be prescribed according to the characteristics and needs of each case, without incarceration impeding the right to drug treatment, which should be similar to that performed outside prison.

Prevención y promoción de la salud en atención primaria: comparación entre la visión de los médicos españoles y los médicos europeos / Preventive care and health promotion in primary care: comparison between the views of spanish and european doctors

Objetivo. Describir y comparar los conocimientos y las actitudes de los médicos de familia (MF) europeos con los de los MF españoles en la implantación de actividades preventivas y de promoción de la salud en atención primaria, describir las barreras para su implementación y evaluar la relación entre los estilos de vida propios de los MF y su influencia en las actividades realizadas en sus pacientes. Diseño. Estudio postal multinacional a través de un cuestionario durante los meses de junio de 2000 a mayo de 2001. Emplazamiento. Muestra de MF a partir de las bases de datos de las sociedades científicas de cada país europeo participante. Participantes. En total participaron 2.082 MF de 11 países europeos. En España, el número total de MF participantes fue de 270. Resultados. Los MF españoles realizaban en un porcentaje superior la mayoría de las actividades de prevención y de promoción de la salud, y realizaban menos aquellas actividades de prevención de escasa o dudosa evidencia científica con respecto al conjunto de MF europeos. El conjunto de MF del estudio consideraba que la excesiva carga de trabajo/escaso tiempo era la primera barrera para el desarrollo de las actividades de prevención y promoción de la salud. Los MF fumadores del conjunto europeo se sienten menos efectivos para ayudar a sus pacientes a reducir o abandonar el consumo de tabaco con respecto a los MF no fumadores (el 39,34 frente al 48,18%; p < 0,01). Los MF europeos que realizan ejercicio se sienten más eficaces para ayudar a sus pacientes a practicar ejercicio regularmente que los MF sedentarios (el 59,14 frente al 49,70%; p < 0,01). No se observaron diferencias significativas al respecto en los MF españoles. Conclusiones. Globalmente existe aún un vacío en los conocimientos y las actitudes de los MF con relación a las recomendaciones sobre prevención y promoción de la salud. Los MF españoles realizan en mayor porcentaje las actividades de prevención y promoción de la salud por grupos de edad y sexo de mayor evidencia científica

Objective. Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European and Spanish GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs' perceived barriers to implementing these recommendations, and to assess how GPs' own health behaviors affect their work with their patients. Design. A postal multinational survey was carried out from June 2000 to May 2001. Setting. A random sample of GPs listed from national colleges of each country. Participants. A total of 2082 GPs from 11 European countries participated in the survey. In Spain a total of 270 GPs participated. Results. Spanish GPs carried out more frequently most of the health promotion or disease prevention activities than the European GPs. Spanish GPs carried out less often those no evidence-based activities. The most important barrier reported was heavy workload/lack of time. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% vs 48.18%; P< .01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% vs 49.70%;P<.01). No differences were observed for Spanish GPs. Conclusions. Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care. Spanish GPs carried out more frequently evidence-base recommendations for health promotion and disease prevention by age and sex

[Preventive care and health promotion in primary care: comparison between the views of Spanish and European doctors]. / Prevención y promoción de la salud en atención primaria: comparación entre la visión de los médicos españoles y los médicos europeos.

OBJECTIVE: Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European and Spanish GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs' perceived barriers to implementing these recommendations, and to assess how GPs' own health behaviors affect their work with their patients. DESIGN: A postal multinational survey was carried out from June 2000 to May 2001. SETTING: A random sample of GPs listed from national colleges of each country. Participants. A total of 2082 GPs from 11 European countries participated in the survey. In Spain a total of 270 GPs participated. RESULTS: Spanish GPs carried out more frequently most of the health promotion or disease prevention activities than the European GPs. Spanish GPs carried out less often those no evidence-based activities. The most important barrier reported was heavy workload/lack of time. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% vs 48.18%; P < .01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% vs 49.70%;P < .01). No differences were observed for Spanish GPs. CONCLUSIONS: Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care. Spanish GPs carried out more frequently evidence-base recommendations for health promotion and disease prevention by age and sex.

Estado clínico y psicosocial de reclusos en tratamiento con antirretrovirales / Clinical and psychosocial state of inmates in treatment with antiretrovirals

Introducción: La mayoría de los estudios realizados en prisiones se han centrado en el estudio de la infección por VIH, la adherencia o la TBC. Sin embargo, llama la atención la escasez de estudios sobre las características psicosociales de esta población, como son por ejemplo la morbilidad psíquica, el apoyo social o el consumo de drogas. Objetivos: Describir el estado clínico y psicosocial de los reclusos en tratamiento con antirretrovirales en tres prisiones andaluzas (Córdoba, Granada y Huelva). Material y métodos: Mediante una encuesta transversal, con un cuestionario administrado por entrevistador, se entrevistaron a todos los reclusos en tratamiento con antirretrovirales de los tres centros. Las variables estudiadas fueron: datos sociodemográficos, variables del medio penitenciario, variables sobre la adherencia al tratamiento, variables de salud y variables de apoyo. Resultados: La frecuencia de morbilidad psíquica fue del 42% y el 64,4% refirió tener algún tipo de enfermedad crónica; de éstos, el 12,7% afirmó padecer tuberculosis. El 46,6% afirmaron contar con apoyo social dentro de la prisión, recibiéndolo de otros internos el 45% y de los profesionales de la prisión el 36,6%. El 54,8% fueron considerados no adherentes al tratamiento con antirretrovirales. El 89% consideraba que la comida era mala, y sólo al 29,9% se le facilitaban suplementos de comida. Por último, el 33,8% refería no tener flexibilidad para que le abrieran la celda en caso de olvido del tratamiento. El 31% refería peor salud autopercibida (AU)

Introduction: Most studies conducted in prisons have focused on the study of HIV infection, adherence to treatment or TBC. However, there is a surprisingly small number of studies on the psychosocial characteristics of this population, such as psychic morbidity, social support or drug use. Objective: To describe the clinical and psychosocial status of inmates in treatment with antiretrovirals in three Andalusian prisons (Córdoba, Granada and Huelva). Materials and method: All inmates in treatment with antiretrovirals in the three correctional facilities were interviewed using a heteroadministered questionnaire, with a cross-sectional design. The sociodemographic data, penitentiary, adherence to treatment, health and social support variables were studied. Results: The frequency of psychic morbidity was 42%, and 64,4% of the interviewed sample mentioned having some kind of chronic disease; of these, 12,7% admitted to suffering from tuberculosis. 46,6% stated that they had social support within the prison, receiving it from other inmates in 45% of the cases and 36,6% from professionals of the prison. 54,8% were considered non-adherent to antiretroviral treatment. 89% of the sample considered that the food was of bad quality, and only 29,9% were provided with food supplements. Finally, 33,8% stated that they were not able to have their cells opened if their medication was forgotten. 31% mentioned worse self-perceived health when compared with the previous year (AU)

[Preventive treatment of nonrheumatic atrial fibrillation: from the efficacy of clinical trials to the effectiveness of clinical practice]. / Tratamiento preventivo de la fibrilación auricular no reumática: de la eficacia de los ensayos clínicos a la efectividad en la práctica clínica.

OBJECTIVES: To know the percentage of patients with nonrheumatic atrial fibrillation treated with anticoagulants as an approach to the effectiveness of the prophylactic treatment of stroke. DESIGN: Multicenter observational study. SETTING: Six primary health centers from Barcelona. PARTICIPANTS: 465 patients with the diagnosed of AF were selected during the second semester of 1996. Patients that had suffered a hemorrhagic stroke, or with mitral stenosis, or with a prosthetic valve, or had hyperthyroidism, or receiving anticoagulant therapy were excluded. MEASUREMENTS AND MAIN RESULTS: 299 patients (64%) were finally included for the analysis. 15.8% of the patients were treated with acenocoumarin, and 35.4% were treated with aspirin. The percentage of patients treated improved for high risk patients (higher than 50%). CONCLUSIONS: The percentage of patients with nonrheumatic AF treated with acenocoumarin or aspirin is low, and physicians might be reluctant to use them because of bleeding complications, compliance with the treatment, or problems of accessibility.

[Calibration and safety of sphygmomanometers in health centers of Murcia]. / Calibración y seguridad de los esfigmomanómetros en los centros de salud de Murcia.

OBJECTIVE: To find the levels of calibration, safety and physical faults in the sphygmomanometers used in Health Centres. DESIGN: A multi-centre, observational, descriptive and crossover study. SITE. 7 Health Centres in the urban zone of Murcia and nearby towns. All the sphygmomanometers in the 7 Health Centres, that is 80 aneroid and 62 mercury ones. MAIN MEASUREMENTS AND RESULTS: It needs high-lighting that 43.7% of the aneroid sphygmomanometers and 12.3% of the mercury ones were wrongly calibrated. We noted that 20% of the measurements made with wrongly calibrated aneroid sphygmomanometers had a margin of error above +/- 8 mmHg, with a tendency towards under-registering. We found very significant differences between the average arterial pressure measured by aneroid instruments as against mercury ones (p < 0.001). The number of sphygmomanometers which show a margin of error greater than +/- 3 mmHg at every level of pressure is significantly greater in aneroid instruments than in mercury ones (p < 0.001). We found physical faults in 23.9% of the instruments. CONCLUSIONS: We consider the number of wrongly calibrated aneroid sphygmomanometers to be excessively high. Therefore mercury ones should be used whenever possible and particularly during diagnosis and treatment. Both aneroid and mercury sphygmomanometers should be regularly checked, using a proper procedure. Mercury instruments set at zero are correctly calibrated and can be used as a model for checking aneroid ones.