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Ponce J, Rodriguez-Lescure A, Delgado S, Peiró G, Pastor-Valero M, Reche M, Lozano I, Massuti Sureda B. 255P Predictive factors of distant recurrence disease in breast cancer patients achieving pathological complete response to neoadjuvant chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lumbreras B, Vilar J, González-Álvarez I, Guilabert M, Parker LA, Pastor-Valero M, Domingo ML, Fernández-Lorente MF, Hernández-Aguado I. Evaluation of clinicians' knowledge and practices regarding medical radiological exposure: findings from a mixed-methods investigation (survey and qualitative study). BMJ Open 2016; 6:e012361. [PMID: 27799242 PMCID: PMC5093629 DOI: 10.1136/bmjopen-2016-012361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/26/2016] [Accepted: 09/13/2016] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To assess the impact of initiatives aiming to increase clinician awareness of radiation exposure; to explore the challenges they face when communicating with patients; to study what they think is the most appropriate way of communicating the long-term potential risks of medical radiological exposure to patients. DESIGN A quantitative and qualitative evaluation through a survey and focal groups. SETTING San Juan Hospital and Dr Peset Hospital (Southeast Spain) and clinicians from Spanish scientific societies. PARTICIPANTS The surveys were answered (a) in person (216: all the radiologists (30), urologists (14) and surgeons (44) working at both participant hospitals; a sample of general practitioners from the catchment area of one hospital (45), and a consecutive sample of radiologists attending a scientific meeting (60)) or (b) electronically through Spanish scientific societies (299: radiologists (45), pneumologists (123), haematologists (75) and surgeons (40)). Clinicians were not randomly selected and thus the results are limited by the diligence of the individuals filling out the survey. PRIMARY AND SECONDARY OUTCOME MEASURES Clinicians' knowledge and practices regarding medical radiological exposure, and what they considered most appropriate for communicating information to patients. RESULTS Nearly 80% of the clinicians surveyed had never heard of the European recommendations. Fewer than 20% of the clinicians surveyed identified correctly the radiation equivalence dose of intravenous urography or barium enema. It was reported by 31.7% that they inform patients about the long-term potential risks of ionising radiation. All participants agreed that the most appropriate way to present information is a table with a list of imaging tests and their corresponding radiation equivalence dose in terms of chest X-rays and background radiation exposure. CONCLUSIONS Medical radiological exposure is frequently underestimated and rarely explained to patients. With a clear understanding of medical radiological exposure and proper communication tools, clinicians will be able to accurately inform patients.
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Affiliation(s)
- B Lumbreras
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University, and CIBER en Epidemiología y Salud Pública, Alicante, Spain
| | - J Vilar
- Radiodiagnostic Department, Peset Hospital, Valenciana, Spain
| | | | - M Guilabert
- Psychology Department, Miguel Hernández University, Alicante, Spain
| | - L A Parker
- Public Health Department, Miguel Hernández University, Alicante, Spain
- CIBER en Epidemiología y Salud Pública, Spain
| | - M Pastor-Valero
- Public Health Department, Miguel Hernández University, Alicante, Spain
- CIBER en Epidemiología y Salud Pública, Spain
| | - M L Domingo
- Radiodiagnostic Department, Peset Hospital, Valenciana, Spain
| | | | - I Hernández-Aguado
- Public Health Department, Miguel Hernández University, Alicante, Spain
- CIBER en Epidemiología y Salud Pública, Spain
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Abstract
BACKGROUND The financial sector has seen an increase in the number of cases of violence and stress, which can result in adverse health outcomes, including depressive symptoms, but studies related to stress at work and depression for these workers are scarce. AIMS To investigate the association between exposure to psychosocial work stressors and depressive symptoms in bank employees. METHODS A self-administered questionnaire was completed by a sample of bank employees in Pará and Amapá, Brazil. The survey assessed sociodemographic characteristics, mental health (Patient Health Questionnaire-9), Demand-Control-Support and Effort-Reward Imbalance (ERI). Outcomes included two levels of depressive symptoms: major depressive symptoms (MDS) and other forms of depressive symptoms (ODS). Logistic regression models were used to estimate associations between depressive symptoms, the two job stress models and relevant covariates. RESULTS Of 2806 eligible subjects, there were 1445 respondents (52% response rate) and the final analyses included 1046 participants. The overall prevalence of depressive symptoms was 32% (MDS = 18%; ODS = 14%), with no statistically significant difference between men and women. High demands, low levels of control and low social support were associated with MDS and/or ODS, adjusted for gender, age and other work-related conditions. High effort/low reward, over-commitment and ERI were also associated with MDS and ODS. CONCLUSIONS Psychosocial conditions in banking activity involving high strain, low social support at work, high effort with low reward and over-commitment may represent possible risk factors for depressive symptoms in bank employees.
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Affiliation(s)
- M S S Valente
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil,
| | - P R Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil, Center of Research in Mental Health Population, University of São Paulo, São Paulo 01246-903, Brazil
| | - M Pastor-Valero
- Department of Public Health, History of Science and Gynecology, Faculty of Medicine, Miguel Hernández University, Campus de San Juan, Spain, CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C S Lopes
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro 20550-013, Brazil
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Rey-López JP, de Rezende LF, Pastor-Valero M, Tess BH. The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used. Obes Rev 2014; 15:781-90. [PMID: 25040597 DOI: 10.1111/obr.12198] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 04/25/2014] [Accepted: 05/12/2014] [Indexed: 12/12/2022]
Abstract
We performed a systematic review of the prevalence of metabolically healthy obesity (MHO). Medline, Web of Science and EMBASE were searched for original articles from inception to November 2013. Only prospective and cross-sectional studies were included. After screening 478 titles, we selected 55 publications, of which 27 were population-based studies and were used in the narrative synthesis. From the 27 studies, we identified 30 definitions of metabolic health, mainly based on four criteria: blood pressure, high-density lipoprotein cholesterol, triglycerides and plasma glucose. Body mass index ≥30 kg m(-2) was the main indicator used to define obesity (74% of the studies). Overall, MHO prevalence ranged between 6% and 75%. In the studies that stratified the analysis by sex, prevalence was higher in women (seven out of nine studies) and in younger ages (all four studies). One-third of the studies (n = 9) reported the response rate. Of these, four reported a response rate of ≥70% and they showed MHO prevalence estimates between 10% and 51%. The heterogeneity of MHO prevalence estimates described in this paper strengthens calls for the urgent need for a commonly established metabolic health definition.
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Affiliation(s)
- J P Rey-López
- Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
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Gómez-Sáez N, González-Álvarez I, Vilar J, Hernández-Aguado I, Domingo ML, Lorente MF, Pastor-Valero M, Parker LA, Picazo N, Calbo J, Lumbreras B. Prevalence and variables associated with solitary pulmonary nodules in a routine clinic-based population: a cross-sectional study. Eur Radiol 2014; 24:2174-82. [PMID: 24962823 PMCID: PMC4126995 DOI: 10.1007/s00330-014-3249-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 05/06/2014] [Accepted: 05/15/2014] [Indexed: 12/19/2022]
Abstract
Objective To determine the prevalence of solitary pulmonary nodules (SPNs) in chest radiology studies and patient’s features associated with malignancy in a non-high-risk clinical population. Methods Patients ≥35 years were referred for thoracic imaging in two hospitals (2010-2011). Eight radiologists determined the presence and characteristics of SPN. Selected variables were collected from radiological register and medical records. Observer agreement in the diagnosis of SPN was assessed. Results 25,529 patients were included: 23,102 (90.5 %) underwent chest radiograph and 2,497 (9.5 %) a CT. The prevalence of SPN was 2.1 % (95 % CI 1.9 – 2.3) in radiographs and 17.0 % (95 % CI 15.5 – 18.5) in CT. In patients undergoing chest radiograph, detection of SPN with an irregular border was more frequent among smokers. In patients who had a CT, larger SPNs appeared to be associated with 60 years of age or over, diagnosis of a respiratory illness, or male gender. In addition, an irregular border was also more common among men. Conclusions The prevalence of SPNs detected by both radiograph and CT was lower than that shown in screening studies. Patient characteristics such as age, sex, respiratory disease, or smoking habit were associated with nodule characteristics that are known to be related with malignancy. Key Points • There is a lower SPN prevalence in the clinical population than in screening studies. • SPN prevalence is associated with some patient characteristics: sex, age, imaging test. • Nodule characteristics related to malignancy were associated with some patient characteristics.
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Affiliation(s)
- N. Gómez-Sáez
- Public Health Department, Miguel Hernández University, Alicante, Spain
| | | | - J. Vilar
- Radiodiagnostic Department, Peset Hospital, Valencia, Spain
| | - I. Hernández-Aguado
- Public Health Department, Miguel Hernández University, Alicante, Spain
- Ciber en Epidemiología y Salud Pública, Barcelona, Spain
| | - M. L. Domingo
- Radiodiagnostic Department, Peset Hospital, Valencia, Spain
| | - M. F. Lorente
- Radiodiagnostic Department, San Juan Hospital, Alicante, Spain
| | - M. Pastor-Valero
- Public Health Department, Miguel Hernández University, Alicante, Spain
- Ciber en Epidemiología y Salud Pública, Barcelona, Spain
| | - L. A. Parker
- Public Health Department, Miguel Hernández University, Alicante, Spain
- Ciber en Epidemiología y Salud Pública, Barcelona, Spain
| | - N. Picazo
- Radiodiagnostic Department, San Juan Hospital, Alicante, Spain
| | - J. Calbo
- Radiodiagnostic Department, San Juan Hospital, Alicante, Spain
| | - B. Lumbreras
- Public Health Department, Miguel Hernández University, Alicante, Spain
- Ciber en Epidemiología y Salud Pública, Barcelona, Spain
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Vioque J, Navarrete-Munoz EM, Gimenez D, Rebagliato M, Ballester F, Iniguez C, Granado F, de la Hera MG, Pastor-Valero M. P1-480 Validation of a food frequency questionnaire to assess diet in children aged 4-5 years. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.142976g.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pastor-Valero M, Vioque J, Navarrete-Munoz EM, Monzo DG. P2-238 A high fruit and vegetable intake is associated with a reduced risk of cataract in the Spanish EUREYE study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pastor-Valero M, Furlan-Viebig R, Menezes PR, Scazufca M. P2-236 Better cognitive function associated with who recommended fruit and vegetable intake in a low-income elderly population in Brazil. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pastor-Valero M, Furlan-Viebig R, Menezes PR, Scazufca M. P2-237 -carotene is associated with reduced risk of cognitive function in low- income elderly from Sao Paulo, Brazil. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barceló A, Gregg EW, Pastor-Valero M, Robles SC. Waist circumference, BMI and the prevalence of self-reported diabetes among the elderly of the United States and six cities of Latin America and the Caribbean. Diabetes Res Clin Pract 2007; 78:418-27. [PMID: 17669541 DOI: 10.1016/j.diabres.2007.06.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 06/20/2007] [Indexed: 11/20/2022]
Abstract
Using data from the Salud Bienestar y Envejecimiento (SABE) project and the U.S. National Health and Nutrition Examination Survey (NHANES 1999-2004), we examined the prevalence of obesity and diagnosed diabetes among older adults in the Americas; we also examined the association of age, sex, level of education, weight status, waist circumference, smoking, and race/ethnicity with diabetes among older adults. The prevalence of diagnosed diabetes was highest in the US Blacks and Mexican Americans, followed by Bridgetown and Mexico City (22% for each) and lowest in Santiago, Montevideo, Havana, and US Whites (13-15%). Diagnosed diabetes was significantly associated with BMI among participants from Bridgetown, Sao Paulo, and the three US ethnic groups, while it was associated with waist circumference in all sites except Mexico City. Our findings suggest major geographical and ethnic variation in the prevalence of diagnosed diabetes among older adults. Waist circumference was more consistently associated with the prevalence of diagnosed diabetes than BMI. Higher prevalences of diabetes are found among the elderly of African or Mexican descent in the United States and in other countries of the Americas when compared to the prevalence among whites in the United States and in other Latin American countries with populations of predominant Western European descent.
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Affiliation(s)
- A Barceló
- Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA.
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