Dealing with fibromyalgia in the family context: a qualitative description study.

Headings purpose: Fibromyalgia (FM) is a chronic, nondegenerative disease with important limitations in patients. Its average global prevalence is 1.78%, and women are more affected than men (3:1). Due to the lack of objective diagnostic tools, it is a complex medical condition that is frequently unseen by patients' relatives and doctors, which might nonetheless have a noticeable impact on the patient's entourage.Material and Methods: This qualitative descriptive study aimed to elicit family members' views on how FM affects their lives. It was conducted in two community health centers (one rural and one urban) from the Sagunto Health Department (Valencia Community, Spain). We included seven focus groups with 41 family members. We analyzed the data gathered with an inductive thematic semantic analysis approach using NVivo 12 software.Results: We identified four major themes: (1) fibromyalgia as a nosological entity or an invention that is always burdensome; (2) children and spouses as caregivers (or not); (3) adverse effects of fibromyalgia on the couple's sexual life; and (4) harmful consequences of FM on the family economy. The findings showed a negative impact of the disease within the family context. Family members face complex and changing roles and difficulties when living with women with fibromyalgia.Conclusions: Relatives' better understanding of the disease, greater acceptance of new family roles, and improvement of patients' work conditions are all interventions that may help reduce the negative impact of FM in the family context.

Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Impact of fibromyalgia in the family context. FISABIO Foundation Primary Care Research Journey, Generalitat Valenciana (Valencia, Spain). 25th November 2021. Awarded Best Research Project in Primary Care Year 2021.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Qualitative approach in the impact of fibromyalgia in the family context. IV Autonomic Fibromyalgia Journey for professionals and patients. Organized by Sagunto Hospital (Sagunto, Spain). 15th May 2018.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Research project about the Impact of fibromyalgia in the family context. National Spanish Conference about Family Medicine. Organized by the Spanish Family Medicine Society (Madrid, Spain). 6^th May 2017.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Quantitative approach in the impact of fibromyalgia in the family context. III Autonomic Fibromyalgia Journey for Professionals and Patients. Organized by Sagunto Hospital (Sagunto, Spain). 2^nd October 2017.

Relación entre la concentración plasmática de vitamina D, fractura osteoporótica y caídas / Relationship between vitamin D, osteoporotic fracture and falls

Objetivo: Relacionar los niveles de vitamina D con fractura osteoporótica y caídas. Pacientes y método: Estudio transversal observacional, siendo las variables de estudio: edad, niveles de vitamina D, fractura osteoporótica y caídas. La población de estudio han sido los pacientes valorados por el Servicio de Rehabilitación del Hospital de Sagunto desde enero de 2013 hasta diciembre de 2014. Resultados: De los 242 pacientes a los que se les analizó la vitamina D, el 70,6% presentaban niveles inferiores a 30ng/ml. Tuvieron fractura el 48% de los pacientes con niveles de vitamina D por debajo de la normalidad, frente al 32,4% de aquellos con niveles normales, de tal forma que los pacientes con niveles de vitamina D bajos tienen 4,8 veces mayor probabilidad de experimentar una fractura que aquellos con valores normales, controlando por edad. Con respecto a las caídas, existe mayor riesgo de caerse (OR ajustada 2,68) en los pacientes con niveles de vitamina D bajos, controlando por edad. Conclusiones: Los pacientes con niveles de vitamina D bajos tienen mayor probabilidad de experimentar caídas y fracturas (AU)

Objective: Link low levels of vitamin D, osteoporotic fracture and falls. Patients and method: Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. Results: Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. Conclusions: Patients with low vitamin D levels are more likely to suffer falls and fractures (AU)

Relationship between vitamin D, osteoporotic fracture and falls. / Relación entre la concentración plasmática de vitamina D, fractura osteoporótica y caídas.

OBJECTIVE: Link low levels of vitamin D, osteoporotic fracture and falls. PATIENTS AND METHOD: Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. RESULTS: Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. CONCLUSIONS: Patients with low vitamin D levels are more likely to suffer falls and fractures.

Family physicians' professional identity formation: a study protocol to explore impression management processes in institutional academic contexts.

BACKGROUND: Despite significant differences in terms of medical training and health care context, the phenomenon of medical students' declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians' professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management. METHODS/DESIGN: The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the "case" is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed. DISCUSSION: This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians' professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies.

Impacto de la Ley del tabaco en el lugar de trabajo: estudio de seguimiento de una cohorte de trabajadores en España 2005–07 / Impact of the Tobacco Law on the workplace: a follow up study of a cohort of workers in Spain 2005–2007

ObjetivoEs describir los cambios producidos, por la Ley del tabaco en su consurno, en fumadores trabajadores activos.DiseñoEstudio de seguimiento, post-intevención, de una cohorte de usuarios.EmplazamientoCentros de salud de Valencia y Mallorca.ParticipantesUsuarios que acuden a los centros de salud.IntervencionesEl trabajo de campo consistió en la captación y cumplirnentación, para cada paciente, de una hoja de recogida de datos.Mediciones principalesLas variables que se recogieron fueron sexo, edad, lugar de trabajo, nivel educativo, número de trabajadores de la empresa, número de cigarrillos fumados. Se le indicó, que al día siguiente contara los cigarrillos fumados durante todo el día, diferenciando si había sido en horario laboral o fuera de él. Si fue en el trabajo informó si había sido dentro del lugar de trabajo o fuera. Al día siguiente se le llamó por teléfono para que nos indicara el número de cigarrillos fumados. Se repitió esta llamada a los seis y dieciocho meses.ResultadosSe ha reducido la prevalencia en un 9% al mes, y el número de cigarrillos fumados en el lugar de trabajo. Las variables relacionadas con cumplir la ley fueron el nivel educativo, el sexo del trabajador y el tamaño de la empresa.ConclusionesLa entrada en vigor de la Ley del tabaco ha sido efectiva(AU)

Objective: The aim of this study is to describe the changes caused by the Law on Tobacco and its consumption in workers who are active smokers.DesignA post-intervention follow up study of a cohort of users.SettingHealth Centres in Valencia and Majorca.ParticipantsUsers who attended health centres.InterventionThe field work consisted of each patient filling in a case report form with the requested information.Main measurementsThe variables collected were, sex, place of work, education level, number of workers in the company, number of cigarettes smoked. They were told that on the following day they had to count the cigarettes smoked throughout the day, noting whether they had been smoked during or outside working hours. If they smoked during working hours, they reported whether it was inside or outside the workplace. On the following day they were telephoned to let us know the number of cigarettes smoked. This telephone call was repeated at six months and eighteen months.ResultsSmoking prevalence and the number of cigarettes smoked in the workplace has been reduced by 9% per month. The variables associated with compliance with the law were education level, the sex of the worker, and the size of the company.ConclusionsThe coming into force of the Tobacco Law has been effective(AU)

[Impact of the Tobacco Law on the workplace: a follow up study of a cohort of workers in Spain 2005-2007]. / Impacto de la Ley del tabaco en el lugar de trabajo: estudio de seguimiento de una cohorte de trabajadores en España 2005-07.

OBJECTIVE: The aim of this study is to describe the changes caused by the Law on Tobacco and its consumption in workers who are active smokers. DESIGN: A post-intervention follow up study of a cohort of users. SETTING: Health Centres in Valencia and Majorca. PARTICIPANTS: Users who attended health centres. INTERVENTION: The field work consisted of each patient filling in a case report form with the requested information. MAIN MEASUREMENTS: The variables collected were, sex, place of work, education level, number of workers in the company, number of cigarettes smoked. They were told that on the following day they had to count the cigarettes smoked throughout the day, noting whether they had been smoked during or outside working hours. If they smoked during working hours, they reported whether it was inside or outside the workplace. On the following day they were telephoned to let us know the number of cigarettes smoked. This telephone call was repeated at six months and eighteen months. RESULTS: Smoking prevalence and the number of cigarettes smoked in the workplace has been reduced by 9% per month. The variables associated with compliance with the law were education level, the sex of the worker, and the size of the company. CONCLUSIONS: The coming into force of the Tobacco Law has been effective.

Cumplimiento del tratamiento hormonal sustitutivo en mujeres menopáusicas / Compliance of hormone replacement therapy in menopausal women

FUNDAMENTO: El cumplimiento de un tratamiento es necesario para conseguir su efectividad. Se pretende conocer el cumplimiento del tratamiento hormonal sustitutivo (THS) en mujeres menopáusicas. MÉTODO: Estudio descriptivo observacional realizado en tres Áreas de Salud de la Comunidad Valenciana. Período de seguimiento desde 1989 hasta 1999. Se incluyeron mujeres que acudieron a una unidad de menopausia y comenzaron con el THS. La información se obtuvo de la historia clínica y de una encuesta telefónica realizada a las pacientes. Se analizaron la edad de la mujer, la edad de inicio y el tipo de la menopausia, la edad de comienzo del THS, el nivel educativo, el motivo de prescripción, el tiempo de utilización, el grado de información, los efectos secundarios y las causas de abandono. Se utilizó el método de Kaplan-Meier para conocer el cumplimiento y el riesgo proporcional de Cox para conocer las variables que influyen en el cumplimiento. RESULTADOS: Se incluyeron 363 mujeres. Existe un 75 por ciento de probabilidades de que las mujeres alcancen un tiempo de cumplimiento de 5 años, la mediana se corresponde con un cumplimiento de 11 años (intervalo de confianza [IC] del 95 por ciento, 9-13). Las mujeres que han padecido efectos secundarios (odds ratio ajustada [ORa], 2,60; IC del 95 por ciento, 1,84-3,68) presentan mayor tasa de abandono, mientras que éste es menor en las que han tenido beneficios (ORa, 1,77; IC del 95 por ciento, 1,22-2,53), aquellas cuya menopausia ha sido quirúrgica (ORa, 1,60; IC del 95 por ciento, 1,12-2,28) y las que tienen menos de 55 años al comienzo del THS (ORa, 2,61; IC del 95 por ciento, 1,67-4,07). CONCLUSIONES: El cumplimiento del THS en mujeres menopáusicas es alto y está condicionado por el hecho de tener beneficios y/o efectos secundarios, por la edad al inicio del tratamiento y el tipo de menopausia (AU)