Long-term impact of the 2008 economic crisis in Spain on road traffic collisions mortality by socioeconomic position.

We aimed to assess the effect of the 2008 crisis on road traffic collision (RTC) mortality in Spain, by socioeconomic position (SEP) and type of road use. This prospective, country-wide study covered all adults living in Spain and aged ≥30 years in November 2001. The long-term effect of the crisis was assessed by measuring the monthly percentage change (MPC) in RTC mortality between the pre-crisis (2002-2007) and crisis period (2008-2011). During the recession, RTC mortality fell more in people with low compared to high SEP, so MPCs difference between periods were of a higher magnitude in the low compared to high SEP groups, especially among men motorcyclists. RTC mortality trends were favorable following the 2008 crisis, particularly among low-SEP groups. In men motorcyclists, the upward trend of the pre-crisis period reversed course.

No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain.

The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %-25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %-27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.

Inicio y progresión en el consumo de sustancias en la población general de Cataluña, España / Onset and progression of drug use in the general population of Catalonia, Spain

Este estudio tuvo como finalidad realizar un análisis retrospectivo de la secuencia de inicio y progresión de las vías más comunes del inicio del consumo de sustancias en una muestra de la población general española. Recopilamos datos de la encuesta nacional de las viviendas del año 2011 sobre el consumo de sustancias en Cataluña, España, respecto de personas no-institucionalizadas de la población general con edades entre los 15-64 años. La muestra final estaba compuesta de 2.069 personas con la misma distribución de edad que la población general. Mostramos la progresión en el inicio de consumo de sustancias mediante la cuantificación de los cambios de un estado anterior, en términos de número de personas y porcentajes ponderados. Aplicamos análisis de supervivencia para valorar las vías más prevalentes halladas en el análisis descriptivo usando modelos de regresión aditivos. La edad media de inicio de consumo fue decreciendo en todas las cohortes desde 1965 hasta 1985-1996: de 17 a 15 para tabaco, de 20 a 16 para cannabis y de 21 a 18 para cocaína. En las personas que usaban las tres sustancias estudiadas, la vía más frecuente fue "tabaco-uso diario de tabaco-cannabis-cocaína". Dichos resultados requieren políticas de salud y estrategias de prevención para aumentar la percepción de los riesgos de las sustancias legales e ilegales. Esto, unido a intervenciones de compañeros bien diseñadas, podría reducir el riesgo de exposición de sustancias ilegales, como cannabis y cocaína, y, por tanto, reducir la probabilidad de un problema de consumo de sustancias en un futuro

The aim of the present study was to retrospectively study the onset and progression sequence of the most frequent pathways of drug use initiation in a sample of the Spanish general population. Data come from the 2011 household survey on drug use in Catalonia, Spain, on non-institutionalized individuals aged 15-64 in the general population. The final sample was of 2,069 individuals and had the same age distribution as the general population. Progressions of drug initiation were pictured by quantifying transitions from a previous state in terms of the number of individuals and weighted percentages. Survival analyses were employed to assess the most prevalent pathways found in the descriptive analysis using additive regression models. Median ages of onset were decreasing in every cohort from 1965 to 1985-1996: from 17 to 15 in tobacco, 20 to 16 in cannabis and 21 to 18 in cocaine. In people who consumed the three drugs studied, the most frequent pathway was "tobacco-daily tobacco-cannabis-cocaine". These results demand health policies and prevention strategies in order to increase perception of the risks of legal and illegal substances. This, together with well-designed peer interventions could reduce the risk of exposure to illegal drugs such as cannabis and cocaine, thus reducing the likelihood of future problem drug use

Successful Bendamustine Desensitization for a Delayed-Type Hypersensitivity Reaction

No disponible

Effect of country-of-origin contextual factors and length of stay on immigrants' substance use in Spain.

BACKGROUND: Factors explaining disparities in risk of substance use between immigrants and natives and between immigrant subgroups are poorly understood. We aimed to describe such disparities and identify some explanatory factors in Spain. METHODS: Participants were residents aged 15-64 years from 2005 to 07 nationally representative surveys. Outcomes were prevalences of alcohol, tobacco, sedative-hypnotics, cannabis and other illegal substance use. Immigrants were recent if <5 years of Spanish stay and long term if ≥10 years. Country-of-origin income per capita and population level of substance use were taken from international databases. Adjusted prevalence ratios (aPRs) and percent change from Poisson regression with robust variance were used to estimate risk disparities and effects of immigration variables. RESULTS: Most immigrants had lower substance use than natives, although it generally increased with increasing Spanish stay, especially for illegal substances. This lower risk could be partially explained by country-of-origin contextual factors as a lower level of income or substance use and religious or cultural factors such as Islam. By origin, recent immigrant aPRs and convergence-divergence risk patterns were, respectively, as follows: lower aPRs with upward convergence (often incomplete) toward natives' risk in immigrants from Muslim area, Eastern-Europe and Latin-America excluding South-Cone, lower/similar aPRs with upward overtaking or divergent patterns in South-Cone Americans and similar/higher aPRs with stable or upward divergent patterns in Non-Eastern-Europeans. CONCLUSION: Spain is a host context that seems to facilitate increased substance use among immigrants, even those from countries with prevalences close to Spain. However, country-of-origin context is important in explaining disparities in substance use among immigrants.

Computational investigations of the thermodynamic properties of size-selected water and Ar-water clusters: high-pressure transitions.

Classical parallel-tempering Monte Carlo simulations in the isothermal-isobaric ensemble were carried out for the (H2O)20 and Ar(H2O)20 clusters, over a wide range of temperatures (30-1000 K) and pressures (3 kPa-10 GPa) in order to study their thermodynamic properties and structural changes. The TIP4P/ice water model is employed for the water-water interactions, while both semiempirical and ab initio-based potentials are used to model the interaction between the rare-gas atoms and the water molecules. Temperature-pressure phase diagrams for these cluster systems were constructed by employing a two-dimensional multiple-histogram method. Structural changes were detected by analyzing the heat capacity landscape and the Pearson correlation coefficient profile for the interaction energy and volume. Those at high pressure correspond to solid-to-solid transitions and are found to be related to clathrate-like cages around the Ar atom. It is also shown that the formation and thermodynamic stability of such structures are determined by the intermolecular interaction between the rare-gas atoms and the host water molecules.

Cocaine use and risk of stroke: a systematic review.

BACKGROUND: Both cocaine use and strokes impact public health. Cocaine is a putative cause of strokes, but no systematic review of the scientific evidence has been published. METHODS: All relevant bibliographic-databases were searched until January 2014 for articles on the epidemiological association between cocaine use and strokes. Search strings were supervised by expert librarians. Three researchers independently reviewed studies for inclusion and data extraction following STROBE recommendations. Quality appraisal included study validity and bias. Both ischemic and hemorrhagic strokes were considered. RESULTS: Of 996 articles, 9 were selected: 7 case-control studies (CCS) and 2 cross-sectional (CSS) studies. One CCS (aOR=6.1; 95% CI: 3.3-11.8) and one CSS (aOR=2.33; 95% CI: 1.74-3.11) showed an association between cocaine and hemorrhagic strokes. The latter study also found a positive relationship with ischemic stroke (aOR=2.03; 95% CI: 1.48-2.79). Another CCS found the exposure to be associated with stroke without distinguishing between types (aOR=13.9; 95% CI: 2.8-69.4). One forensic CCS found that deaths with cocaine-positive toxicology presented a 14.3-fold (95% CI: 5.6-37) and 4.6-fold (95% CI: 2.5-8.5) increased risk of atherosclerosis compared to opioid-related deaths and hanging-deaths respectively. One CCS did not provide an aOR but found a statistically significant association between cocaine and hemorrhagic stroke. Three CCS and one CSS did not find any relationship between cocaine and strokes. Inadequate control for confounding was not uncommon. CONCLUSIONS: Epidemiological evidence suggests that cocaine use increases the risk of stroke. Larger, more rigorous observational studies, including cohort approaches, are needed to better quantify this risk, and should consider stroke type, hypertension variation, frequency/length of cocaine use, amphetamines co-use, and other factors.

A systematic review of evidence on the association between cocaine use and seizures.

BACKGROUND: Institutional monographs/medical textbooks mention seizures as a neurological complication of cocaine, but no systematic reviews (SRs) have been published on this issue. We aimed to conduct a SR of the literature on the relationship between cocaine use and seizures and to summarize the biological plausibility of that relationship. METHODS: The pathophysiological mechanisms that may underlie an association between cocaine and seizures were summarized; a SR was then performed using three databases (EMBASE, Medline, PsycINFO) and the Cochrane-library to search for published papers (1980-2012) aimed at quantifying the associations between cocaine use and seizures. The inclusion criteria for selection were: articles based on clinical trials, cohort, case-control (CC) or cross-sectional (CS) studies, participants ≥ 14 years old and not pregnant, and use of cocaine in the last 72 h. Information was extracted, evaluated and cross-checked independently by two researchers. RESULTS: Of the 1243 potentially relevant articles initially identified; one CC and 22 CS studies were finally selected. The CC study did not find cocaine use to be a risk-factor for seizures. In addition to the limitations of the CS design, these studies had important methodological weaknesses and biases. CONCLUSIONS: Despite its biological plausibility, no rigorous scientific evidence supports a causal relationship between cocaine use and seizures. The misinterpretation of the role of cocaine may have important implications in medical services. Well-conducted studies are urgently needed.

[Evolution of the need and coverage of syringe exchange programs in Spanish prisons, 1992-2009: A revised estimation]. / Evolución de la necesidad y cobertura de los programas de intercambio de jeringuillas en las prisiones españolas, 1992-2009: Una estimación corregida.

INTRODUCTION: The objective of this paper is to amend the bias included in our previous work, presenting a corrected estimation of the need and coverage of syringes/needles in Spanish prisons between 1992 and 2009. METHODS: Data on the provision of the needles exchange programs (NEPs) in prison is taken from official publications. The need was calculated by applying multiplicative methods to secondary data from several sources. Coverage was estimated as the quotient between provision and need and the difference between these magnitudes. The detected need estimate bias has been corrected. RESULTS: NEP's in prisons started in 1997. Their maximum coverage reached 36% in 2005, which is much higher than the initially estimated value. However, it decreased by half in the next four years, reaching 17.4% in 2009. CONCLUSION: The remarkable coverage reached by these programmes must be valued, but more recent evolution leads us to emphasize the need to be imaginative so that new epidemiological and economic circumstances do not lead to their disappearance.

[Evolution of the need and coverage of opioid substitution treatments and needle exchange programmes in Spanish prisons, 1992-2009]. / Evolución de la necesidad y cobertura de los programas de tratamiento con sustitutivos opioides e intercambio de jeringas en las prisiones españolas, 1992-2009.

INTRODUCTION: Spain is one of the few countries to have widely implemented opioid substitution treatments (OST) and needle exchange programmes (NEP) for drug users in prison. We analyze the evolution of the need, coverage and the timeliness of these interventions in Spain between 1992 and 2009. METHODS: Data on the provision of interventions is taken from official publications. The need was calculated by applying multiplicative methods to secondary data from several sources. Coverage was estimated as the quotient between provision and need. Temporal opportunity was estimated by observing the gap between the acme of the incidence of consumption, of HIV infection or need and the curve of provision. RESULTS: OST's began to be implemented in 1992. In 2002 they reached their maximum coverage (63.8%) and subsequently stabilized. NEP's started in 1997. Their maximum coverage reached 20.7% in 2006, but halved in a period of two years. The delay between the epidemic acme and the need and maximum intervention coverage was of 8-25 years. CONCLUSIONS: OST and NEP introduction in Spanish prisons was a great advance, but the delay in their implementation and the low level of NEP coverage could have limited their potential impact on the improvement of the health of incarcerated drug users. The decline of NEP coverage in recent years is a cause of major concern for the evolution of HIV and Hepatitis C epidemics.

Technetium-99m -- new production and processing strategies to provide adequate levels for SPECT imaging.

The most important radioisotope for use in Nuclear Medicine is (99m)Tc, supplied in the form of a (99)Mo/(99m)Tc generator. After the supply crisis of (99)Mo starting in 2008 the availability of (99)Mo became a worldwide concern. The purpose of this work is to do a brief story of the availability of (99)Mo in the world followed by an overview of the production routes of (99)Mo and the generators technology.

Weakly bound finite systems: (4He)N-Rb2(³Σu), clustering structures from a quantum Monte Carlo approach.

We report here ((4)He)(N)-Rb(2)((3)Σ(u)) complexes, 2 ≤ N ≤ 20, analysed through a quantum diffusion Monte Carlo stochastic approach. The calculations show that the spin stretched dimer molecule is bound outside the pure He sub-complex, due to the stronger He-He potential as compared with the He-Rb(2) interaction, while the rare gas atom moiety presents, in turn, a shell-like structure with ten He adatoms completing the first shell. Our results agree with previous findings on this and similarly weakly interacting systems.

Spin-polarized Rb2 interacting with bosonic He atoms: potential energy surface and quantum structures of small clusters.

A new full-dimension potential energy surface of the three-body He-Rb2(³Σ(u)(+)) complex and a quantum study of small (4He)(N)-Rb2(³Σ(u)(+)) clusters, 1 ≤ N ≤ 4, are presented. We have accurately fitted the ab initio points of the interaction to an analytical form and addressed the dopant's vibration, which is found to be negligible. A Variational approach and a Diffusion Monte Carlo technique have been applied to yield energy and geometric properties of the selected species. Our quantum structure calculations show a transition in the arrangements of the helium atoms from N = 2, where they tend to be separated across the diatomic bond, to N = 4, in which a closer packing of the rare gas particles is reached, guided by the dominance of the He-He potential over the weaker interaction of the latter adatoms with the doping dimer. The deepest well of the He-Rb2 interaction is placed at the T-shape configuration, a feature which causes the dopant to be located as parallel to the helium "minidroplet". Our results are shown to agree with previous findings on this and on similar systems.

Depression among regular heroin users: the influence of gender.

The aim of this study was to determine the prevalence of recent (last 12 months) depression in regular young heroin users and to ascertain factors associated with depression in this population, broken down by gender. A sample of 561 participants completed a cross-sectional survey. Eligibility criteria were: age 30 years or younger, and having used heroin for at least 12 days in the last 12 months and at least one day in the last 3 months. Participants were recruited outside of health-care facilities in the cities of Barcelona, Madrid and Seville by targeted sampling and chain referral methods. Depression was assessed using the World Mental Health Composite International Diagnostic Interview. The prevalence of recent depression was 22.3% (35.2% among women and 17.3% among men, p<0.001). In the multivariate analysis, the factors positively associated with recent depression in the whole sample were female gender, age 25 or less, inability to work due to health problems and high risk consumption of alcohol. Among woman, the related variables were age 25 or less, cocaine dependence in the last 12 months, and alcohol consumption in that period. Among men, employment status was the only related variable. Analysis of an overall sample without the gender breakdown may hide important differences in the factors associated with depression in men and women. Both prevention and treatment of depression should rely on specific gender analysis.

Evolución de la necesidad y cobertura de los programas de tratamiento con sustitutivos opioides e intercambio de jeringas en las prisiones españolas, 1992-2009 / Evolution of the need and coverage of opioid substitution treatments and needle exchange programmes in Spanish prisons, 1992-2009

Introducción: España es de los pocos países que ha implementado generalizadamente tratamientos con sustitutivos opioides (TSO) y programas de intercambio de jeringas (PIJ) para los consumidores de drogas en prisión. Se analiza la evolución de la necesidad, cobertura y oportunidad temporal de estas intervenciones en España durante 1992-2009. Material y métodos: La provisión de intervenciones procede de publicaciones oficiales. La necesidad se estimó aplicando métodos multiplicativos a datos secundarios de varias fuentes. La cobertura se estimó mediante el cociente entre provisión y necesidad, y la diferencia entre dichas magnitudes. La oportunidad temporal se estimó observando el decalaje entre el acmé de incidencia de consumo, de infección por VIH o de necesidad y las curvas de provisión. Resultados: Los TSO comenzaron en 1992. Su máxima cobertura se alcanzó en 2002 (63.8%), y posteriormente se estabilizó. Los PIJ comenzaron en 1997. Su máxima cobertura se alcanzó en 2006 (20.7%), pero disminuyó a la mitad en dos años. El retraso entre el acmé de las epidemias o de la necesidad y la máxima cobertura de las intervenciones fue de 8-25 años. Conclusiones: La implementación de TSO y PIJ en las prisiones españolas supuso un enorme avance de salud pública, pero el retraso en su implementación y la baja cobertura de los PIJ pueden haber limitado mucho su impacto potencial en la mejora de la salud de los consumidores de drogas en prisión. El descenso de la cobertura de los PIJ a la mitad en los últimos años es especialmente preocupante para la evolución de las epidemias de VIH y hepatitis C(AU)

Introduction: Spain is one of the few countries to have widely implemented opioid substitution treatments (OST) and needle exchange programmes (NEP) for drug users in prison. We analyze the evolution of the need, coverage and the timeliness of these interventions in Spain between 1992 and 2009. Methods: Data on the provision of interventions is taken from official publications. The need was calculated by applying multiplicative methods to secondary data from several sources. Coverage was estimated as the quotient between provision and need. Temporal opportunity was estimated by observing the gap between the acme of the incidence of consumption, of HIV infection or need and the curve of provision. Results: OST’s began to be implemented in 1992. In 2002 they reached their maximum coverage (63.8%) and subsequently stabilized. NEP’s started in 1997. Their maximum coverage reached 20.7% in 2006, but halved in a period of two years. The delay between the epidemic acme and the need and maximum intervention coverage was of 8-25 years. Conclusions: OST and NEP introduction in Spanish prisons was a great advance, but the delay in their implementation and the low level of NEP coverage could have limited their potential impact on the improvement of the health of incarcerated drug users. The decline of NEP coverage in recent years is a cause of major concern for the evolution of HIV and Hepatitis C epidemics(AU)

Evolución de la necesidad y cobertura de los programas de intercambio de jeringuillas en las prisiones españolas, 1992-2009. Una estimación corregida / Evolution of the need and coverage of syringe exchange programs in Spanish prisons, 1992-2009. A revised estimation

Introducción: El objetivo del presente artículo es subsanar el sesgo incluido en nuestro anterior original presentando una estimación corregida de la necesidad y cobertura de jeringuillas en las prisiones españolas en el período 1992-2009 Material y métodos: La provisión de jeringuillas procede de publicaciones oficiales. La necesidad se estimó aplicando métodos multiplicativos a datos secundarios de varias fuentes. La cobertura se estimó mediante el cociente entre provisión y necesidad, y la diferencia entre dichas magnitudes. Se corrigió el sesgo de estimación de necesidad detectado en el estudio original. Resultados: Los programas de intercambio de jeringuillas en prisión comenzaron en 1997. Su máxima cobertura se alcanzó en 2005, con un 36%, valor muy superior al estimado inicialmente, aunque disminuyó a la mitad en los cuatro años siguientes, con un 17.4% en 2009. Conclusiones: Debe valorarse la notable cobertura que se alcanzó con estos programas en España, pero su evolución más reciente nos lleva a enfatizar la necesidad de ser imaginativos para que las nuevas condiciones epidemiológicas y económicas no lleven a la desaparición de los mismos(AU)

Introduction: The objective of this paper is to amend the bias included in our previous work, presenting a corrected estimation of the need and coverage of syringes/needles in Spanish prisons between 1992 and 2009. Methods: Data on the provision of the needles exchange programs (NEPs) in prison is taken from official publications. The need was calculated by applying multiplicative methods to secondary data from several sources. Coverage was estimated as the quotient between provision and need and the difference between these magnitudes. The detected need estimate bias has been corrected. Results: NEP’s in prisons started in 1997. Their maximum coverage reached 36% in 2005, which is much higher than the initially estimated value. However, it decreased by half in the next four years, reaching 17.4% in 2009. Conclusion: The remarkable coverage reached by these programmes must be valued, but more recent evolution leads us to emphasize the need to be imaginative so that new epidemiological and economic circumstances do not lead to their disappearance(AU)

Frequency domain description of Kohlrausch response through a pair of Havriliak-Negami-type functions: an analysis of functional proximity.

An approximation to the Fourier transform (FT) of the Kohlrausch function (stretched exponential) with shape parameter 0 < ß ≤ 1 is presented by using Havriliak-Negami-like functions. Mathematical expressions to fit their parameters α, γ, and τ, as functions of ß (0 < ß ≤ 1 and 1 < ß < 2) are given, which allows a quick identification in the frequency domain of the corresponding shape factor ß. Reconstruction via fast Fourier transform of frequency approximants to time domain are shown as good substitutes in short times though biased in long ones (increasing discrepancies as ß â†’ 1). The method is proposed as a template to commute time and frequency domains when analyzing complex data. Such a strategy facilitates intensive algorithmic search of parameters while adjusting the data of one or several Kohlrausch-Williams-Watts relaxations.

A new accurate and full dimensional potential energy surface of H5(+) based on a triatomics-in-molecules analytic functional form.

In this work a reliable full nine-dimensional potential energy surface for studying the dynamics of H(5)(+) is constructed, which is completely symmetric under any permutation of the nuclei. For this purpose, we develop a triatoms-in-molecules method as an extension of the more common diatoms-in-molecules one, which allows a very accurate description of the asymptotic regions by including correctly the charge-induced dipole and quadrupole interactions. Moreover, this treatment provides a semiquantitative description of all the topological features of the global potential compared with coupled cluster results. In particular, the hop of the proton between two H(2) fragments produces a double well in the potential. This resonant structure involving the five atoms produces a stabilization, lowering the barrier, and the triatoms-in-molecules yields to a barrier significantly higher than the ab initio results. Therefore, to improve the triatomics-in-molecules potential surface, two five-body terms are added, which are fitted to more than 110,000 coupled-cluster ab initio points. The global potential energy surface thus obtained in this work has an overall root mean square error of 0.079 kcal/mol for energies below 27 kcal/mol above the global well. The features of the potential are described and compared with previous available surfaces.

A path-integral Monte Carlo study of a small cluster: The Ar trimer.

The Ar(3) system has been studied between T=0 K and T=40 K by means of a path-integral Monte Carlo (PIMC) method. The behavior of the average energy in terms of the temperature has been explained by comparison with results obtained with the thermal averaged rovibrational spectra estimated via: (i) a quantum mechanical method based on distributed Gaussian functions for the interparticle distances and (ii) an analytical model which precisely accounts for the participation of the dissociative continua Ar(2)+Ar and Ar+Ar+Ar. Beyond T approximately 20 K, the system explores floppier configurations than the rigid equilateral geometry, as linear and Ar-Ar(2)-like arrangements, and fragmentates around T approximately 40 K. A careful investigation of the specific heat in terms of a confining radius in the PIMC calculation seems to discard a proper phase transition as in larger clusters, in apparent contradiction with previous reports of precise values for a liquid-gas transition. The onset of this noticeable change in the dynamics of the trimer occurs, however, at a remarkably low value of the temperature in comparison with Ar(n) systems formed with more Ar atoms. Quantum mechanical effects are found of relevance at T