ABSTRACT
This study aimed to analyse the existence of an association between social class (categorized by type of occupation) and the occurrence of A(H1N1)pmd09 infection and hospitalization for two seasons (2009-2010 and 2010-2011). This multicentre study compared ambulatory A(H1N1)pmd09 confirmed cases with ambulatory controls to measure risk of infection, and with hospitalized A(H1N1)pmd09 confirmed cases to asses hospitalization risk. Study variables were: age, marital status, tobacco and alcohol use, pregnancy, chronic obstructive pulmonary disease, chronic respiratory failure, cardiovascular disease, diabetes, chronic liver disease, body mass index >40, systemic corticosteroid treatment and influenza vaccination status. Occupation was registered literally and coded into manual and non-manual worker occupational social class groups. A conditional logistic regression analysis was performed. There were 720 hospitalized cases, 996 ambulatory cases and 1062 ambulatory controls included in the study. No relationship between occupational social class and A(H1N1)pmd09 infection was found [adjusted odds ratio (aOR) 0·97, 95% confidence interval (CI) 0·74-1·27], but an association (aOR 1·53, 95% CI 1·01-2·31) between occupational class and hospitalization for A(H1N1)pmd09 was observed. Influenza vaccination was a protective factor for A(H1N1)pmd09 infection (aOR 0·41, 95% CI 0·23-0·73) but not for hospitalization. We conclude that manual workers have the highest risk of hospitalization when infected by influenza than other occupations but they do not have a different probability of being infected by influenza.
Subject(s)
Hospitalization , Influenza A Virus, H1N1 Subtype/physiology , Influenza, Human/epidemiology , Occupations , Social Class , Adolescent , Adult , Aged , Aged, 80 and over , Female , Hospitalization/statistics & numerical data , Humans , Influenza, Human/virology , Male , Middle Aged , Prevalence , Risk Factors , Seasons , Spain/epidemiology , Young AdultABSTRACT
The objective of this paper was to develop a prognostic index for severe complications among hospitalized patients with influenza A (H1N1) 2009 virus infection. We conducted a prospective observational cohort study of 618 inpatients with 2009 H1N1 virus infection admitted to 36 Spanish hospitals between July 2009 and February 2010. Risk factors evaluated included host-related factors and clinical data at admission. We developed a composite index of severe in-hospital complications (SIHC), which included: mortality, mechanical ventilation, septic shock, acute respiratory distress syndrome, and requirement for resuscitation maneuvers. Six factors were independently associated with SIHC: age >45 years, male sex, number of comorbidities, pneumonia, dyspnea, and confusion. From the ß parameter obtained in the multivariate model, a weight was assigned to each factor to compute the individual influenza risk score. The score shows an area under the receiver operating characteristic (ROC) curve of 0.77. The SIHC rate was 1.9 % in the low-risk group, 10.3 % in the intermediate-risk group, and 29.6 % in the high-risk group. The odds ratio for complications was 21.8 for the high-risk group compared with the low-risk group. This easy-to-score influenza A (H1N1) 2009 virus infection risk index accurately stratifies patients hospitalized for H1N1 virus infection into low-, intermediate-, and high-risk groups for SIHC.
Subject(s)
Hospitalization , Influenza A Virus, H1N1 Subtype/pathogenicity , Influenza, Human/diagnosis , Severity of Illness Index , Adult , Aged , Body Mass Index , Case-Control Studies , Comorbidity , Computational Biology/methods , Female , Humans , Influenza, Human/virology , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Pregnancy , Prognosis , Prospective Studies , ROC Curve , Respiration, Artificial/methods , Respiratory Distress Syndrome/virology , Risk Factors , Shock, Septic/virologyABSTRACT
Hemos estudiado el cumplimiento de los indicadores de calidad del Proceso Asistencial Hipertrofia Benigna de Próstata (HBP) Cáncerde Próstata (CP) en la Zona Básica de Salud de Vejer de la Frontera por parte de médicos y enfermero, y el papel de estos últimos enla implantación, desarrollo y control de calidad de dicho proceso.Los resultados obtenidos a los 7 meses de la evaluación indican un alto grado de implicación por parte del servicio de Enfermería deAtención Primaria tanto en la implicación como en el desarrollo de dicho proceso así como un alto índice de satisfacción por parte delos usuarios de la atención enfermera recibida (AU)
We have studied the fulfillment of the indicators of quality of the Process Assisted Hypertrophy Benign of Prostate (HBP) - Cancer ofProstate (CP) in the Basic Area of Health of Vejer de la Frontera which was carried out by doctors and nurses, and role of nurses inthe introduction, development and quality assurance of this process.The results obtained at the 7 months of the evaluation indicate a high degree of implication on the part of the service of nursing ofPrimary Care in the implication as well as in the development of this process as well as a high index of satisfaction of users of thenurse attention receive (AU)
Subject(s)
Humans , Male , Nursing Process/standards , Prostatic Hyperplasia/nursing , Prostatic Neoplasms/nursing , Primary Health Care/methods , Prostatectomy , Quality of Health Care/trendsABSTRACT
El objetivo general de esta investigación es estudiar los patrones de conducta violenta en la escuela, así como su relación con las estrategias cognitivas de aprendizaje y motivación, y el rendimiento académico en los adolescentes. Para ello se administraron dos cuestionarios (CEVEO y CEAM) en una muestra de 1.512 estudiantes de ESO, pertenecientes a centros educativos de la Comunidad de Madrid, situados en localidades de más de 50.000 habitantes. Los principales resultados del estudio fueron los siguientes: a) las principales diferencias con respecto a las estrategias cognitivas de aprendizaje se encontraron en búsqueda de lo esencial y enfoque superficial; b) en general, se encontraron diferencias en relación con las estrategias cognitivas de motivación; y c) existen diferencias significativas con respecto al rendimiento académico (AU)
This paper presents a study of violent behavior patterns of adolescents at school, along with its relation to learning and motivational cognitive strategies and to academic performance. Two questionnaires (CEVEO and CEAM) were completed by 1,512 secondary education students in Madrid region schools located in towns over 50,000 inhabitants. The main outcomes were the following: a) the main differences in learning cognitive strategies focused on finding the essential and superficial approach; b) significant differences in motivational cognitive strategies were observed; and c) significant differences were also found in academic performance (AU)
