Corrosion Assessment in Reinforced Concrete Structures by Means of Embedded Sensors and Multivariate Analysis-Part 1: Laboratory Validation.

Reinforced Concrete Structures (RCS) are a fundamental part of a country's civil infrastructure. However, RCSs are often affected by rebar corrosion, which poses a major problem because it reduces their service life. The traditionally used inspection and management methods applied to RCSs are poorly operative. Structural Health Monitoring and Management (SHMM) by means of embedded sensors to analyse corrosion in RCSs is an emerging alternative, but one that still involves different challenges. Examples of SHMM include INESSCOM (Integrated Sensor Network for Smart Corrosion Monitoring), a tool that has already been implemented in different real-life cases. Nevertheless, work continues to upgrade it. To do so, the authors of this work consider implementing a new measurement procedure to identify the triggering agent of the corrosion process by analysing the double-layer capacitance of the sensors' responses. This study was carried out on reinforced concrete specimens exposed for 18 months to different atmospheres. The results demonstrate the proposed measurement protocol and the multivariate analysis can differentiate the factor that triggers corrosion (chlorides or carbonation), even when the corrosion kinetics are similar. Data were validated by principal component analysis (PCA) and by the visual inspection of samples and rebars at the end of the study.

Effectiveness of a Road Traffic Injury Prevention Intervention in Reducing Pedestrian Injuries, Barcelona, Spain, 2002-2019.

This study aimed to evaluate the effectiveness of the Safe Routes to School (SRTS) intervention in Barcelona, Spain, at reducing the number of road traffic collisions and injuries in the school environment. It was a pre-post, quasi-experimental evaluation with a matched comparison group. Road traffic injuries were significantly reduced in the intervention schools-especially among school-age pedestrians-but not in the comparison schools. The SRTS program significantly improved road safety among children. (Am J Public Health. 2023;113(5):495-499. https://doi.org/10.2105/AJPH.2022.307216).

Estimation of Humidity Variation and Electric Resistivity in Hardened Concrete by Means of a Stainless Steel Voltammetric Sensor.

Reinforced concrete structures' (RCSs) ageing and early deterioration are some of the main challenges faced by the building sector today, and steel bar corrosion is one of the main problems. In this phenomenon, water and concrete's electric resistivity play a fundamental role. Therefore, developing sensor systems capable of estimating any variations in these parameters in real time and remotely would represent considerable progress in sustainably maintaining RCSs. Many types of sensors capable of estimating humidity variation and electrical resistivity in concrete currently exist, but the variability of these sensors' sensitivity can be extreme depending on several factors; for example, temperature or presence of ions and their incorporation into smart monitoring systems, which is difficult. As an alternative to today's sensors, this study centered on developing two estimation models by means of the response of a novel voltammetric stainless steel (SS) sensor. The estimation models were one of humidity variation and another of concrete's electric resistivity. These models were calibrated, fitted and validated. In the validation, both these models explained a percentage of variance over 80%.

Porous Structure of Ultra-High-Performance Fibre-Reinforced Concretes.

The aim of this experimental work was to study the porous structure of Ultra-High-Performance Fibre-Reinforced Concretes (UH) made with different fibre volume contents (0%, 1%, 2%) under several curing conditions (laboratory environment, 20 °C, 60 °C, 90 °C), comparing the results with those recorded for ordinary, high strength and very high strength concretes. Scanning electron microscopy, mercury intrusion porosimetry, thermogravimetry, water absorption and oxygen permeability tests were carried out. The results showed a low portlandite content in UH (in the order of 75% lower than in concrete C50) and a low degree of hydration, but they rise with curing temperature. These concretes have a very fine porous structure, with a high concentration of pores on the nanoscale level, below 0.05 µm. Their porosity accessible to water is consequently around 7-fold lower than in conventional (C30), 6-fold lower than in high-strength (C50) and 4-fold lower than in very high-strength (C90) concretes. Their oxygen permeability is at least one order of magnitude lower than in C90, two orders of magnitude lower than in C50 and three orders of magnitude lower than in C30. The percentage of added steel fibre does not affect the UH porous structure.

Stainless Steel Voltammetric Sensor to Monitor Variations in Oxygen and Humidity Availability in Reinforcement Concrete Structures.

The present work presents the results obtained with a stainless steel (SS) voltammetric sensor to detect variations in humidity (H2O) and oxygen (O2) availability in concretes. First, studies in solution were run by preparing several solutions to represent the different conditions that can be found in concrete pores. Second, the sensor's response was studied by varying O2 availability by argon or synthetic air bubbling. Then concrete conditions with different degrees of carbonation were simulated using solutions with a pH between 13 and 8.45. After characterization in solution, a study by means of concrete samples with several water/cement ratios (0.6, 0.5 and 0.4) was performed, in which sensors were embedded and studied under different O2 and H2O saturation conditions. The obtained results revealed that with the voltagram, it is possible to evaluate O2 availability variation from the slopes of the lines identified logarithmically in the voltagram for the obtained cathodic sweeping. All the results obtained with the sensor were correlated/validated by standard assays to characterize porosity in hardened concretes.

Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recession.

BACKGROUND: The effect of inequalities aggravated by economic recessions in the mortality rates of certain diseases has been previously described. In this study, we analyzed the relationship between socio-economic deprivation and cancer mortality. We focused on lung, colon, prostate, and breast cancers in nine European urban areas over three periods: two before (2000-2003 and 2004-2008) and one after (2009-2014) the onset of the 2008 financial crisis. METHODS: This is an ecological study of trends. The units of analysis were small areas within nine European urban areas. We used a composite deprivation index as a socio-economic indicator. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyze the evolution of socio-economic inequalities, we fitted an ecological regression model that included the socio-economic indicator, the period of time, and the interaction between these terms. RESULTS: In men, socio-economic inequalities in all-cancer and lung cancer mortality were observed in most of the cities studied, but did not increase after the onset of the economic crisis. In women, only two cities (Stockholm and London) showed socio-economic inequalities in all-cancer and lung cancer mortality; there was also no increase in inequalities. CONCLUSIONS: Our results did not validate our hypothesis that inequalities increase in times of crisis. However, they emphasize the importance of socio-economic measurements for understanding mortality inequalities, and can be used to inform prevention strategies and help plan local health programs aimed at reducing health inequalities.

Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities.

BACKGROUND: The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001-2004, 2005-2008) and during (2009-2012) the economic crisis in seven Spanish cities. METHODS: This ecological study of trends, with census tracts as the areas of analysis, was based on three periods. Several causes of death were studied. A socioeconomic deprivation index was calculated for each census tract. For each small area, we estimated standardized mortality ratios, and controlled for their variability using Bayesian models (sSMR). We also estimated the relative risk of mortality according to deprivation in the different cities, periods, and sexes. RESULTS: In general, a similar geographical pattern was found for the socioeconomic deprivation index and sSMR. For men, there was an association in all cities between the deprivation index and all-cause mortality that remained stable over the three periods. For women, there was an association in Barcelona, Granada, and Sevilla between the deprivation index and all-cause mortality in the third period. Patterns by causes of death were more heterogeneous. CONCLUSIONS: After the start of the financial crisis, socioeconomic inequalities in total mortality in small areas of Spanish cities remained stable in most cities, although several causes of death showed a different pattern.

Trends in cancer mortality in Spain: the influence of the financial crisis / Evolución de la mortalidad por cáncer en España: influencia de la crisis económica

Objective: To determine if the onset of the economic crisis in Spain affected cancer mortality and mortality trends. Method: We conducted a longitudinal ecological study based on all cancer-related deaths and on specific types of cancer (lung, colon, breast and prostate) in Spain between 2000 and 2013. We computed age-standardised mortality rates in men and women, and fit mixed Poisson models to analyse the effect of the crisis on cancer mortality and trends therein. Results: After the onset of the economic crisis, cancer mortality continued to decline, but with a significant slowing of the yearly rate of decline (men: RR = 0.987, 95%CI = 0.985-0.990, before the crisis, and RR = 0.993, 95%CI = 0.991-0.996, afterwards; women: RR = 0.990, 95%CI = 0.988-0.993, before, and RR = 1.002, 95%CI = 0.998-1.006, afterwards). In men, lung cancer mortality was reduced, continuing the trend observed in the pre-crisis period; the trend in colon cancer mortality did not change significantly and continued to increase; and the yearly decline in prostate cancer mortality slowed significantly. In women, lung cancer mortality continued to increase each year, as before the crisis; colon cancer continued to decease; and the previous yearly downward trend in breast cancer mortality slowed down following the onset of the crisis. Conclusions: Since the onset of the economic crisis in Spain the rate of decline in cancer mortality has slowed significantly, and this situation could be exacerbated by the current austerity measures in healthcare

Objetivo: Determinar si el inicio de la crisis económica en España afectó a la mortalidad por cáncer y sus tendencias. Método: Estudio ecológico longitudinal que analiza todas las muertes por cáncer y por tipos específicos de cáncer (pulmón, colon, mama y próstata) en España entre 2000 y 2013. Se estimaron las tasas de mortalidad estandarizadas por edad en hombres y mujeres, y se ajustaron modelos mixtos de Poisson para analizar el efecto de la crisis sobre la mortalidad por cáncer y sus tendencias. Resultados: Después del inicio de la crisis económica, la mortalidad por cáncer continuó su tendencia a la baja, pero con una disminución significativa del decrecimiento anual (hombres: riesgo relativo [RR] = 0,987, intervalo de confianza del 95% [IC95%] = 0,985-0,990, antes de la crisis, y RR = 0,993, IC95% = 0,991-0,996 después; mujeres: RR = 0,990, IC95% = 0,988-0,993, antes, y RR = 1,002, IC95% = 0,998-1,006 después). En los hombres, la mortalidad por cáncer de pulmón se redujo, continuando la tendencia observada en el periodo anterior a la crisis; la tendencia en la mortalidad por cáncer de colon no cambió significativamente y siguió aumentando; y la disminución anual de la mortalidad por cáncer de próstata se desaceleró significativamente. En las mujeres, la mortalidad por cáncer de pulmón continuó aumentando cada año, como antes de la crisis; el cáncer de colon continuó disminuyendo; y la tendencia a la disminución de la mortalidad por cáncer de mama se desaceleró después del inicio de la crisis. Conclusiones: Desde el inicio de la crisis económica en España, la disminución de la tasa de mortalidad por cáncer se ha desacelerado significativamente y esta situación podría verse exacerbada por las actuales medidas de austeridad en el sistema sanitario

Trends in cancer mortality in Spain: the influence of the financial crisis.

OBJECTIVE: To determine if the onset of the economic crisis in Spain affected cancer mortality and mortality trends. METHOD: We conducted a longitudinal ecological study based on all cancer-related deaths and on specific types of cancer (lung, colon, breast and prostate) in Spain between 2000 and 2013. We computed age-standardised mortality rates in men and women, and fit mixed Poisson models to analyse the effect of the crisis on cancer mortality and trends therein. RESULTS: After the onset of the economic crisis, cancer mortality continued to decline, but with a significant slowing of the yearly rate of decline (men: RR = 0.987, 95%CI = 0.985-0.990, before the crisis, and RR = 0.993, 95%CI = 0.991-0.996, afterwards; women: RR = 0.990, 95%CI = 0.988-0.993, before, and RR = 1.002, 95%CI = 0.998-1.006, afterwards). In men, lung cancer mortality was reduced, continuing the trend observed in the pre-crisis period; the trend in colon cancer mortality did not change significantly and continued to increase; and the yearly decline in prostate cancer mortality slowed significantly. In women, lung cancer mortality continued to increase each year, as before the crisis; colon cancer continued to decease; and the previous yearly downward trend in breast cancer mortality slowed down following the onset of the crisis. CONCLUSIONS: Since the onset of the economic crisis in Spain the rate of decline in cancer mortality has slowed significantly, and this situation could be exacerbated by the current austerity measures in healthcare.

[Proposals for social class classification based on the Spanish National Classification of Occupations 2011 using neo-Weberian and neo-Marxist approaches]. / Propuestas de clase social neoweberiana y neomarxista a partir de la Clasificación Nacional de Ocupaciones 2011.

In Spain, the new National Classification of Occupations (Clasificación Nacional de Ocupaciones [CNO-2011]) is substantially different to the 1994 edition, and requires adaptation of occupational social classes for use in studies of health inequalities. This article presents two proposals to measure social class: the new classification of occupational social class (CSO-SEE12), based on the CNO-2011 and a neo-Weberian perspective, and a social class classification based on a neo-Marxist approach. The CSO-SEE12 is the result of a detailed review of the CNO-2011 codes. In contrast, the neo-Marxist classification is derived from variables related to capital and organizational and skill assets. The proposed CSO-SEE12 consists of seven classes that can be grouped into a smaller number of categories according to study needs. The neo-Marxist classification consists of 12 categories in which home owners are divided into three categories based on capital goods and employed persons are grouped into nine categories composed of organizational and skill assets. These proposals are complemented by a proposed classification of educational level that integrates the various curricula in Spain and provides correspondences with the International Standard Classification of Education.

Spinal cord injury and traumatic brain injury: a cost-of-illness study.

BACKGROUND: Among traumatic injuries, spinal cord injuries (SCI) and traumatic brain injuries (TBI) are of major importance because of their epidemiological and economic impact on society. The overall objective of this study was to estimate the economic cost associated with people with SCI and TBI in Spain in 2007. METHODS: A cost-of-illness analysis was performed, considering the perspective of society, using a 1-year time horizon. Medical costs, adaptation costs, material costs, administrative costs, and costs of police, firefighters and roadside assistance, productivity losses due to institutionalization and sick leave, as well as an estimate of productivity losses of carers, and productivity losses due to death were included. RESULTS: The economic cost associated with people with SCI is between EUR 92,087,080.97 and 212,496,196.41 (USD 131 million and 302 million) according to the injury mechanism, and between EUR 1,079,223,688.66 and 3,833,752,692.78 (USD 1,536 million and 5,458 million) for people with TBI. CONCLUSIONS: There is an urgent need to develop effective interventions known to prevent SCI and TBI, and to evaluate their effectiveness and efficiency.

Incidence trends of traumatic spinal cord injury and traumatic brain injury in Spain, 2000-2009.

AIMS: The aim of the present study was to estimate the incidence of hospital discharges for traumatic spinal cord injury (TSCI) and traumatic brain injury (TBI) in Spain by injury circumstances (traffic crashes and others), injury severity, gender and age group and to describe its trends over the period 2000-2009. METHODS: It is a study of trends that includes hospital discharges with a primary diagnosis of TSCI or TBI. Crude and age-standardised rates were calculated per million inhabitants. Changes in rates between 2000 and 2009 were assessed through calculation of the relative risk adjusted for age, using Poisson regression. RESULTS: Between 2000 and 2009 in Spain, 10,274 patients were admitted for traumatic TSCI, and 206,503 for TBI. The annual incidence rate for TSCI was 23.5 per million, that for TBI was 472.6 per million. The overall incidence rate for TSCI fell significantly between 2000 and 2009 by 24.2% (traffic-related 40.9%, other 12.9%), as did that for TBI (23.8% overall, 60.2% traffic-related, with no change for other circumstances). Among people aged 65 years and over, no change was observed for TSCI, incidence of TBI fell significantly when due to traffic crashes, but there was a dramatic increase of 87% in men and 89.3% in women when due to other circumstances. CONCLUSIONS: Over the last decade the incidence of these types of injury has fallen significantly when the injury resulted from traffic crashes, and to a lesser extent when from other circumstances. However TBI incidence among people aged 65 and over injured in non-traffic-related circumstances has risen dramatically.

Road safety in the political agenda: the impact on road traffic injuries.

BACKGROUND: This paper aims at assessing the effectiveness of the package of road safety measures implemented after road safety was included in the political agenda in the year 2004 on the number of road traffic-injured people in Spain. METHODS: An evaluation study was performed using an interrupted time-series design. The study population was people injured in road traffic crashes in Spain between 1 January 2000 and 31 December 2006. The road traffic crashes database of the General Directorate for Traffic was used. The dependent variable was the monthly number of people injured, stratified by sex, age, severity and type of road user. The explanatory variable (intervention) compared the post-intervention period (2004-6) with the pre-intervention period (2000-3). Quasi-Poisson regression models were adjusted, controlling for time trend and for seasonality. RESULTS: Results show a reduction in the risk of being injured for both men (RR 0.91; 95% CI 0.87 to 0.95) and women (RR 0.89; 95% CI 0.85 to 0.94). Risk reductions were observed across all age groups and all road users, except for pedestrians. CONCLUSIONS: The present study suggests that prioritising road safety reduces the number of people injured in road traffic collisions.

Impact of the penalty points system on road traffic injuries in Spain: a time-series study.

OBJECTIVES: We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries. METHODS: We performed an evaluation study with an interrupted time-series design. We stratified dependent variables-numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)--by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality. RESULTS: Among men, we observed a significant risk reduction in the postintervention period for seriously injured drivers (relative risk [RR] = 0.89) and seriously injured people (RR = 0.89). The RRs among women were 0.91 (P = .095) and 0.88 (P < .05), respectively. Risk reduction was greater among male drivers, moped riders, and on urban roads. CONCLUSIONS: The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain.

Psicosis y diferencias sociales: comparando la prevalencia de las psicosis en dos medios urbanos diferenciados / Psychosis and social differences: comparing psychosis prevalence between two socially differentiated urban settings

Objetivos: Contribuir a la reflexión sobre la etiología y/o los factores de riesgo para las psicosis comparando la prevalencia en población general y población de riesgo de la esquizofrenia y otras psicosis en dos barrios de Barcelona (España). Método: Nuestras aportaciones en este trabajo se apoyan sobre todo en un estudio descriptivo transversal de todos los pacientes con psicopatología detectados en la USM de Sant Martí-La Mina: un territorio geodemográfica y asistencialmente delimitado formado por 5 Áreas Básicas de Salud (103.615 habitantes. Resultados: Sobre un total de 21.536 pacientes con registro de casos abierto desde el año 1982 hasta el año 2000, se halló que 838 cumplían los criterios restrictivos para ser diagnosticados como «esquizofrénicos» (N=476) o «afectados por otras psicosis» (N=362). Sin embargo, las prevalencias de esquizofrenia y otras psicosis en el barrio sujeto a más factores de riesgo psicosociales eran alrededor de 2 veces mayores que las encontradas en el barrio colindante por el mismo equipo y en el mismo período temporal. Conclusión: Es necesario tener en cuenta el gran peso de los factores de sociales y psicosociales para poderse explicar las diferencias de prevalencia de la esquizofrenia y otras psicosis entre diferentes poblaciones (AU)

Objectives: To contribute to the discussion about aetiology and risk factors of psychosis comparing the prevalence in general population and in «age of risk population» for schizophrenias and other psychoses on two neighbourhoods of Barcelona (Spain). Method: We base our reflections in a transversal study about the results of an informatized case register of all the patients' with detected psychopathology in this geodemographic and assistencially differentiated area: 5 Basic Areas of Health (103.615 inhabitants). Results: The total «psychopathological patients» detected were 21.536. From them, 838 completed the restrictive criteria to be diagnosed as «schizophrenics» (476) or «affected by other psychoses» (362). Among the neighborhood charged with psychosocial risk factors and the other 4 adjacent basic areas of health, assisted for the same team, so much clinical as investigator, the incidence and the prevalence of the schizophrenia and other psychoses is twice as much, almost in each group diagnosis. Conclusion: It seems necessary to keep in mind the great weight of the social and psychosocial factors to explain those differences of incidence and prevalence of the schizophrenia and the psychoses in different populations (AU)

Disability among older people in a southern European city in 2006: trends in gender and socioeconomic inequalities.

BACKGROUND AND AIMS: We wished to describe disability prevalence in people aged >or=65 years in Barcelona in 2006, its trends since 1992, and disability inequalities by gender and socioeconomic position (SEP). METHODS: This was a cross-sectional design, including data from the 1992, 2000, and 2006 Barcelona Health Interview Surveys (noninstitutionalized population >or=65 years old). Disability was defined as having difficulty carrying out at least one of seven activities of daily living (ADL). The number of ADLs carried out with difficulty was considered a measure of disability severity. Independent variables were age and educational level as a measure of SEP. Prevalence and prevalence ratio (PR) of disability stratified by sex were obtained through log-binomial regression models or using zero-inflated Poisson regression models. RESULTS: The prevalence of disability increased between 1992 and 2006 among women but not men because of the higher increase in older age among women. Disability prevalence was 30% in men and 53% in women in 2006. Disability inequalities by SEP were present in all the ADL analyzed and in all 3 years, remaining stable throughout the period. Overall, the PR of disability in lower SEP compared with higher SEP was 1.61 (95% CI 1.32-1.98) in men and 1.53 (95% CI 1.33-1.76) in women. CONCLUSIONS: Disability prevalence is increasing among older women at the turn of the century in this southern European city, and socioeconomic inequalities in disability persist. Although women have longer life expectancy, their disability prevalence in older age is much higher than that of men.

Neighborhood differences in psychoses: prevalence of psychotic disorders in two socially-differentiated metropolitan areas of Barcelona.

INTRODUCTION: The prevalence of schizophrenia and other psychoses can vary between close geographic locations and can be biased by the use of epidemiological designs. With data derived from a public mental health centre with close relations to primary care teams we have compared the distribution of psychotic disorders in two neighborhoods in Barcelona with marked psycho-social differences. METHODS: Using a computerized database from Barcelona's National Health Service covering 5 basic health-care areas with a total population of 103,615 inhabitants, we have accessed case records showing any psycho-pathology between the years of 1982 and 2000. RESULTS: From the case records of 21,536 registered patients showing any psycho-pathology, and using strict diagnostic, clinical and assistance criteria, we found that there were 476 patients diagnosed as "schizophrenic" and 362 that were "affected by other psychoses." Despite being evaluated by the same mental health personal, the same research team using identical criteria and over the same period of time (thus precluding operator and selection bias) the prevalence of these disorders was twice as high in La Mina (a district with a marked accumulation of psycho-social risk-factors) as compared to the neighboring district of La Verneda. CONCLUSIONS: When assessing prevalence of psychoses, it is necessary to consider the impact of social and psycho-social factors, even in neighboring communities.

Factores de riesgo para padecer trastornos psicóticos: ¿es posible realizar una detección preventiva? / Psychosis risk factors: is there a chance for preventive identification?

Introducción: Revisión de los factores de riesgo para las psicosis desde la perspectiva de la literatura internacional y desde la perspectiva de la experiencia clínica e investigadora del equipo. Objetivo principal: Se presenta el diseño y las primeras pruebas de un instrumento de exploración y cribaje de señales de alarma y factores de riesgo de trastornos mentales severos, y en especial trastornos psicóticos, aplicable en los primeros años de vida por parte de los servicios de atención primaria de salud y los equipamientos de salud mental vinculados con ellos. Se trata del LISMEN(Listado de ítems de Salud Mental en edades preescolares y escolares). Metodología: 5 muestras diferentes, tanto de edad infantil como de adultos. El trabajo se centra en la muestra A del Proyecto LISMEN: Se trata de un estudio descriptivo retrospectivo de los dossieres de los pacientes que han desarrollado una psicosis (N=838) y se habían visitado previamente, ya durante la infancia, en la misma Unidad de Salud Mental (N=120). Resultados: Se utilizan los resultados de las muestras anteriormente estudiadas para encuadrar el tema y presentar los primeros resultados de la muestra A: Estos señalan una constelación de factores de riesgo que aparecen ya en las historias o dossiers clínicos de la infancia de los pacientes que van a desarrollar una psicosis postpuberal. Conclusiones: Aunque hoy poseemos un amplio acervo de conocimientos sobre factores de riesgo de la esquizofrenia y otras psicosis, eso no implicaque podamos predecir el trastorno en base a los mismos. El LISMEN es un intento en ese sentido (AU)

This paper reviews risk factors associated with psychosis from both a literatureperspective and the clinical and research practice. The development of atool for the diagnosis and screening of alarm signs and risk factors of severemental disorders is described along with preliminary tests. The tool is aimedto be administered by primary health care systems and associated mentalhealth teams during a person’s early years. The tool is called LISMEN–standing for “list of mental health items at pre-school and school ages”.The list was administered to 5 different samples including children andadults. This paper focuses on Project LISMEN sample A. It is an investigationof medical records of patients who had developed a psychosis (N = 838). Anumber of them (N = 120) had already been assisted by the same MentalHealth Unit during their childhood. Samples already assisted were used as abenchmark for sample A preliminary results. A constellation of risk factors hadalready been identified in medical records during the childhood of people whowould develop a psychosis after their adolescence.Even though there is a broad pool of knowledge on risk factors associatedwith schizophrenia and other psychoses, this does not mean that prediction ofthe disorder can be made on this base. Nevertheless, LISMEN is a contributionin this direction (AU)

[Schizophrenic disorders in primary care mental health]. / Trastornos esquizofrénicos en la atención primaria a la salud mental.

OBJECTIVES: To determine the prevalence and incidence of schizophrenia and other psychoses in a mental health unit (MHU) closely connected to primary health care. DESIGN: Retrospective longitudinal study of the register of all patients with psychiatric illnesses detected in a specific geo-demographic and health care area. SETTING: Five basic health care areas of Barcelona (103 615 inhabitants). PARTICIPANTS: MHU patients who had attended clinics due to mental health disorders during the period from 1982-2000 (N=21 236). Strict health and diagnostic criteria based on the DSM-4 classification were applied. All cases were validated using clinical history review and concensus. MEASUREMENTS: Incidence (in the last 3 years) and prevalence of schizophrenia and other psychoses in the whole period of study, both in the general population and in the risk population age group (15-54 years). RESULTS: In total, 838 patients complied with the diagnosis of suffering from schizophrenia (N=476) or other psychoses (N=362). The incidence of schizophrenia was 3.47/10,000 (95% confidence interval [CI], 2.3-4.6) in the general population and 5.09/10,000, 95% CI, 3.2-6.9) in the population at risk, and the prevalence of schizophrenia was 54.9/10,000 (95% CI, 41.8-50.1) in the general population and 80.7/10,000 (95% CI, 73.5-88) in the population at risk. CONCLUSIONS: The MHU-primary health care interface can be a good place to detect and study schizophrenic syndromes and other psychoses, as long as they comply with the agreed health and research criteria.

Trastornos esquizofrénicos en la atención primaria a la salud mental / Schizophrenic disorders in primary care mental health

Objetivos. Determinar la prevalencia y la incidencia de la esquizofrenia y otras psicosis en una unidad de salud mental (USM) estrechamente vinculada con la atención primaria de salud. Diseño. Estudio longitudinal, retrospectivo, del registro de todos los pacientes con psicopatología detectados en un área geodemográfica y asistencialmente delimitada. Emplazamiento. Cinco áreas básicas de salud de Barcelona (103.615 habitantes). Participantes. Pacientes de la USM que habían consultado por trastornos de salud mental durante el período 1982-2000 (n = 21.236). Se aplicaron criterios asistenciales y diagnósticos estrictos basados en la clasificación DSM-4. Todos los casos fueron validados mediante consulta de la historia clínica y el censo. Mediciones. Incidencia (en los últimos 3 años) y prevalencia de esquizofrenia y otras psicosis, en todo el período del estudio, tanto en población general como en la población en edad de riesgo (15-54 años). Resultados. En total, 838 pacientes cumplían los criterios para ser diagnosticados como esquizofrénicos (n = 476) o afectados por otras psicosis (n = 362). La incidencia de esquizofrenia es de 3,47/10.000 (intervalo de confianza [IC] del 95%, 2,3-4,6) en la población general y de 5,09/10.000/IC del 95%, 3,2-6,9) en la población en riesgo, y la prevalencia de esquizofrenia es de 54,9/10.000 (IC del 95%, 41,8-50,1) en la población general y de 80,7/10.000 (IC del 95%, 73,5-88) en la población en riesgo. Conclusiones. La interfase USM comunitaria-atención primaria de salud puede ser un buen lugar para la detección y el estudio de los síndromes esquizofrénicos y otras psicosis, siempre que se cumplan determinados criterios asistenciales y de investigación

Objectives. To determine the prevalence and incidence of schizophrenia and other psychoses in a mental health unit (MHU) closely connected to primary health care. Design. Retrospective longitudinal study of the register of all patients with psychiatric illnesses detected in a specific geo-demographic and health care area. Setting. Five basic health care areas of Barcelona (103 615 inhabitants). Participants. MHU patients who had attended clinics due to mental health disorders during the period from 1982-2000 (N=21 236). Strict health and diagnostic criteria based on the DSM-4 classification were applied. All cases were validated using clinical history review and concensus. Measurements. Incidence (in the last 3 years) and prevalence of schizophrenia and other psychoses in the whole period of study, both in the general population and in the risk population age group (15-54 years). Results. In total, 838 patients complied with the diagnosis of suffering from schizophrenia (N=476) or other psychoses (N=362). The incidence of schizophrenia was 3.47/10 000 (95% confidence interval [CI], 2.3-4.6) in the general population and 5.09/10 000, 95% CI, 3.2-6.9) in the population at risk, and the prevalence of schizophrenia was 54.9/10 000 (95% CI, 41.8-50.1) in the general population and 80.7/10 000 (95% CI, 73.5-88) in the population at risk. Conclusions. The MHU-primary health care interface can be a good place to detect and study schizophrenic syndromes and other psychoses, as long as they comply with the agreed health and research criteria