Fernando Fernández Palacín

Objective: To assess the mental health of patients admitted to hospital with suspected ischae- mic heart disease, by means of two instruments, the General Health Questionnaire (GHQ-28) and the MH (1-5) dimension of the SF-36 Health Survey Questionnaire, and to compare the psychometric properties of both questionnaires in this population. Methods: A study was conducted of 185 patients consecutively admitted to hospital with suspected is- chaemic heart disease, classified into four groups: Acute Myocardial Infarctus (AMI), unstable angina, non-ischaemic cardiologies, and non-cardiological conditions. Their mental health was assessed by means of the GHQ-28 and the MH 1-5 sub-scales of the SF-36; the validity of the results were analysed by the association of each instrument with socio-demo- graphic (age, sex, social class, and educational level) and clinical (co-morbidity, risk factors, diagnostic groups and background to the illness) variables. The correlation of each instrument with ...

BACKGROUND The aim is to know the factors related to the evolution of Health Related Quality of Life (HRQL) in Coronary Patients (CP) from a longitudinal perspective using an appropriate method that handles missing data adequately when the mechanism of missingness is uncertain. METHODS Prospective study with repeated measures at baseline, 3 and 6months. 250 patients with acute myocardial infarction or unstable angina were studied. Sociodemographic and clinical data were collected at baseline. Mental health (GHQ-28) and HRQL (SF-36v1) were assessed during the follow-up. The missingness mechanism was tested. Friedman test and partial eta-squared were used to analyse changes in SF-36 scores and WGEE were used to identify the predictors of the evolution of HRQL. RESULTS 95 dropped out after 3months and 72 after 6months. The missingness was likely to be at random. All the dimensions of the SF-36 improved over time, except PF. The factors related to the evolution of HRQL were: being woman (B=-23.9 in RE; B=-6.9 in MCS), older age (B=-0.5 in BP; B=-0.3 in VT), being single/separated (B=-14.5 in GH; B=-14.1 in SF; B=-23.3 in MH) and widow(er) (B=-23.2 PF; B=-29.8 in SF), hypertensive (B=-19.8 in RP; B=-8.9 in VT), worse mental health (B=-3 in PF; B=-2.8 in RP; B=-3.1 in BP; B=-1.2 in PCS; B=-3.8 in VT; B=-2.6 in SF), previous history of CHD (B=-12.5 in PF; B=-5.2 in PCS), and performing heart-healthy physical activities (B=13.9 in PF). CONCLUSIONS HRQL improves over time. A global approach, including age, marital status, performing physical activities or hypertension, is required to improve HRQL in CP.

The Chronic Kidney Disease Epidemiology Collaboration (CDK-EPI) equation has been proposed as a replacement for the Modification of Diet in Renal Disease (MDRD) equation to estimate the glomerular filtration rate, but this equation has not yet been evaluated in the general population. Cross-sectional analysis of a random sample of 858 participants from the general population aged 50-75 years without known kidney disease. The prevalence of low eGFR (< 60 mL/min/1.73 m(2)) was assessed with the MDRD and the CKD-EPI equations in the overall sample and in normoalbuminuric individuals. With the MDRD equation the median eGFRs (interquartile range) in men/women were 63.3(12.2)/56.7(9.4)mL/min/1.73 m(2), and with the CKD-EPI equation 66.6(14.2)/61.3(11.6) mL/min/1.73 m(2). The prevalence of low eGFR in men/women was 35.2%/68.5% and 25.1%/45.7% with the MDRD and the CKD-EPI equations, respectively. Normoalbuminuric women without risk factors for CKD experienced the most pronounced reduction in the number of cases with low eGFR with the CKD-EPI equation. The prevalence of renal impairment in this subgroup still remained even greater than that in men with diabetes, hypertension, or cardiovascular disease. Compared with the MDRD, the CKD-EPI equation generates a substantial reduction in the prevalence of renal impairment in subjects with diabetes, hypertension, cardiovascular disease, and in subjects without risk factors. The prevalence of renal impairment in normoalbuminuric females may be still overestimated with the CKD-EPI equation.

To establish clusters of Health-Related Quality of Life (HRQL) in a population of patients hospitalised for suspected Coronary Heart Disease (CHD), and to examine the relationship between mental health and other sociodemographic and clinical variables associated with worse HRQL. We conducted a cross-sectional study of 185 patients admitted to the Cardiology Service. We used the General Health Questionnaire (GHQ-28) to assess the mental status, and the SF-36 to assess Health Related Quality Life (HRQL). Using the patients' scores obtained from the SF-36, we performed a cluster analysis and used a logistic model for the analysis of the variables associated with HRQL clusters. We identified two HRQL clusters: good quality of life, for which the patients scored highest in all the dimensions of SF-36, and worse quality of life, for which patients had lower scores in all dimensions. The variables associated with the worse quality of life group were: female gender, previous history of Coronary Heart Disease (CHD), and poor mental health. Being female, having poor mental health and a previous history of CHD were identified as representing a vulnerable group with worse HRQL.

Disclosure/Conflict of interest: The authors declare that they have no conflicts of interest. Funding: This work was supported by the “Cátedra Externa del Dolor, ” a collaboration between the “Universidad de Cadiz ” and “Fundación Grünenthal.” Fundación Grünenthal is a private, nonprofit-making organization that promotes the dissemination of scientific knowledge and supports research. Objective. This study aims to assess the preva-lence of chronic pain, its characteristics, and its impact on the general Spanish population. Also, to establish chronic pain patient subgroups accord-ing to the characteristics of pain and to identify variables specifically associated with each sub-

En este trabajo se presenta el paquete ORLOCA (Operations Research LOCation Analysis), desarrollado con el lenguaje R, que incluye una serie funciones para la resolucion de algunos problemas de localizacion continua en el plano. En la version 3 que se presenta, ORLOCA resuelve el problema de Weber ponderado (mediana) y p-mediana. El paquete se puede usar para resolver los citados problemas y para hacer representaciones gra cas, tanto de los datos como de las soluciones. Se proporciona una interfaz gra ca de usuario en forma de plugin para R-Commander que facilita su uso mediante menus. Ademas se incluyen ayudas, ejemplos de uso y demostraciones, tanto en ingles como en espa~nol. Tanto la licencia del software, GNU GPL, como su dise~no permiten su uso tanto a los investigadores que quieran extender o adaptar las funcionalidades del paquete, como a los usuarios nales o programadores.

En los ultimos anos se ha producido un cambio en la forma de abordar el problema de la depuracion de los datos y la falta de respuesta, del tratamiento tradicional consistente en analizar las causas que originan la informacion incorrecta y los datos missing, incluyendo los sucesivos reintentos para mejorar la tasa de respuesta, se ha pasado a la generacion de los datos faltantes mediante tecnicas de imputacion, tanto simple como multiple. En este trabajo pretendemos analizar el estado actual de esta cuestion, tanto en lo que respecta a las cuestiones conceptuales, como en su posterior implementacion a traves del software especifico

A pesar de los cambios sociales y politicos que se han llevado a cabo en las ultimas decadas en el ambito laboral, continua siendo patente la escasa participacion de las mujeres en los puestos de trabajo directivos. Con la finalidad de contribuir al principio de igualdad de oportunidades en el acceso de las mujeres al poder, en el presente trabajo se realiza un analisis del Techo de Cristal en las pequenas y medianas empresas a partir de una muestra de 816 PYMEs de la Comunidad Autonoma de Andalucia, pertenecientes a diferentes sectores de actividad, en el que se pone de manifiesto que la cultura predominante en el ambito laboral continua provocando una clara segregacion de genero vertical. ABSTRACT In spite of social and political changes throughout in the last decades, it’s still evident the low presence of women in managerial positions. In the pursuit of contribute with the equal opportunities principle, this paper analyzes the glass ceiling in 816 SMEs of different activity area...

La importancia de la incidencia del entomo en el que act ŭan las empresas sobre su estrategia global. nos ha Ilevado a realizar en el presente trabajo un estudio con un doble objeŭvo: por un lado, analizar distintas clasificaciones de las dimensiones que constituyen el entomo y, por otro, caracterizar un cierto tipo de sociedad economica en la que la dimension geografica incide de manera determinante sobre el resto. Para ello vamos a plantear un modelo que nos perrnitira realizar el estudio en una region cuyas caracteristicas geograficas, orograficas o medioambientales limitan la circulacion de flujos econornicos y en la que, en consecuencia, se preve que el sector geografico va a jugar un papel determinante. La metodologia MTMM (Multirasgo-Multimetodo) nos permitira descomponer los factores del entomo asi como validar distintas hipotesis que se establecen para valorar dicha influencia. La inforrnacion obtenida se tratara utilizando la tecnica de Analisis de Estructuras Latentes.

On 10 October 2011, a submarine eruption occurred in El Hierro island. Thus, the eruptive process in the Canary islands was reactivated after 40 years of inactivity. The main objective of this work is to evaluate, using Functional Data Analysis, how the surface deformation phenomenon explains the seismic–volcanic activity in the island. The GNSS-GPS data are from the FRON (GRAFCAN) station, located in Frontera. These data measure, each 4 h, the distance between the FRON station and the reference station LPAL (La Palma island) from August, 2010 to December, 2013. In this study a functional correlation measure is employed to establish the relation between the deformation curve and the curve of cumulative energy released. The period of time analysed has been divided into four phases to avoid the mix of phenomena. For each phase, the correlation measure and the time lag between deformation curve and the curve of cumulative energy released have been estimated. These values show a strong ...

En nuestro trabajo, tratamos el problema de localizacion de un centro peligroso en un poligono convexo, S -aunque en la Segunda parte del Capitulo II consideramos un caso en el que solo exigimos a S que sea multiplemente conexo- dentro de una region donde existen otras localizaciones que pueden verse afectadas. Para cada una de dichas localizaciones existentes establecemos un area de seguridad poligonal convexa donde queda excluida la localizacion del centro peligrosos, que llamamos Area de respeto de la poblacion o enclave. El criterio utilizado es el de maximizar la minima distancia a las Areas de respeto. El esquema de la presente memoria es el siguiente:En el primer capitulo abordamos el problema de la inscripcion de un circulo en un poligono, tomando como base un trabajo de Karkazis y Karagiorgis, al cual hemos anadido numerosas aportaciones y realizado algunas modificaciones. En concreto, se han eliminado algunos conceptos que realmente aportaban poco a la compresion del probl...

To analyse the use of healthcare resources by chronic pain (CP) patients in Spain and their satisfaction thereof. A nationwide, cross sectional study was carried out on a representative sample of 1,957 Spanish adults. A telephone survey was conducted with the aim of analysing the prevalence of CP, the characteristics and consequences of pain, the use of healthcare resources and the patient's satisfaction with them. A descriptive, bivariate and multivariate analyses were performed. Of the 1,957 subjects interviewed, 325 suffered CP. The mean duration of CP was 10 years (SD: 11.3) and 48.9% of the CP sufferers reported severe/unbearable pain. Moreover, about 30% felt sad/very sad or anxious/very anxious, 24.4% had been on sick leave, 12% had left/lost their jobs and 47.2% considered their pain affected their families. Likewise, 92.9% had consulted a healthcare professional due to their CP, on average 3.49 times (SD: 3.9), and 69.2% took medication. In addition, 67.3% and 63.8% wer...

To identify the predictive factors of mental disorders in patients with suspected Ischaemic Cardiopathy (IC). The patients admitted to the Cardiology Service of an University Hospital (SW Spain) for acute thoracic pain with suspected IC were studied. Patients were classified into four diagnostic groups (acute myocardial infarction, unstable angina, non-ischaemic cardiological process, non-cardiological) based on clinical, electrocardiographical and biochemical data. The sociodemographic and clinical variables were obtained by a 'ad hoc' questionnaire and the clinical records of the patient. The GHQ-28 questionnaire was used to assess the status of mental health, and a score of > or = 6 was taken as the cut-off point for being a 'probable psychiatric case'. Crude odds ratios (OR +/- 95% CI), and adjusted OR according to a logistic model, were calculated in order to study the variables associated with the mental disorders. The tabulation and analysis of data was carried out with the SPSS v.8 (for Windows) program. From June 1996 to November 1997, 185 patients were studied; 72% were males and the mean age was 60.2 years (SD = 10.4). 49.2% of the patients were scored at > or = 6 on the GHQ-28, and the sub-scale accounting for the highest scores was that of somatic symptoms of psychological origin. The adjusted ORs showed that female sex (OR: 2.5; 95% CI: 1.2-5.0), previous personal history of IC (OR: 2.3; 95% CI: 1.1-4.4), and the presence of arterial hypertension (OR: 2.0; 95% CI: 1.1-3.9), were the predictive variables for being a 'probable psychiatric case', whereas neither age nor comorbidity were predictive. The percentage of subjects considered to be a 'probable psychiatric case' among patients with suspected ischaemic cardiopathy was high. Screening for mental disorders and intervention to control the risk factors associated are measures recommended in these patients.

To identify the predictive factors of mental disorders in patients with suspected Ischaemic Cardiopathy (IC). The patients admitted to the Cardiology Service of an University Hospital (SW Spain) for acute thoracic pain with suspected IC were studied. Patients were classified into four diagnostic groups (acute myocardial infarction, unstable angina, non-ischaemic cardiological process, non-cardiological) based on clinical, electrocardiographical and biochemical data. The sociodemographic and clinical variables were obtained by a 'ad hoc' questionnaire and the clinical records of the patient. The GHQ-28 questionnaire was used to assess the status of mental health, and a score of > or = 6 was taken as the cut-off point for being a 'probable psychiatric case'. Crude odds ratios (OR +/- 95% CI), and adjusted OR according to a logistic model, were calculated in order to study the variables associated with the mental disorders. The tabulation and analysis of data was carried out with the SPSS v.8 (for Windows) program. From June 1996 to November 1997, 185 patients were studied; 72% were males and the mean age was 60.2 years (SD = 10.4). 49.2% of the patients were scored at > or = 6 on the GHQ-28, and the sub-scale accounting for the highest scores was that of somatic symptoms of psychological origin. The adjusted ORs showed that female sex (OR: 2.5; 95% CI: 1.2-5.0), previous personal history of IC (OR: 2.3; 95% CI: 1.1-4.4), and the presence of arterial hypertension (OR: 2.0; 95% CI: 1.1-3.9), were the predictive variables for being a 'probable psychiatric case', whereas neither age nor comorbidity were predictive. The percentage of subjects considered to be a 'probable psychiatric case' among patients with suspected ischaemic cardiopathy was high. Screening for mental disorders and intervention to control the risk factors associated are measures recommended in these patients.

This study aims to assess the prevalence of chronic pain, its characteristics, and its impact on the general Spanish population. Also, to establish chronic pain patient subgroups according to the characteristics of pain and to identify variables specifically associated with each subgroup. Telephone-based, cross-sectional nationwide study. A sample of 1,957 individuals representative of the Spanish population. Data were collected through telephone interviews. A subject was considered to have chronic pain if they had suffered pain (at least 4 days a week) during the last 3 months. The subjects were divided into two subgroups through a cluster analysis, and a regression model was established to determine the variables most specifically associated with these subgroups. The prevalence of chronic pain was 16.6% (95% confidence interval: 14.9-18.3) and among these subjects, more than 50% referred to limitations in their daily activities, 30% felt sad and/or anxious, and 47.2% indicated that their pain was affecting their family life. Two subgroups of subjects with pain were identified: 1) characterized by generalized pain in more than one location and of a long evolution (150 months); and 2) characterized by pain localized to only one site with a shorter duration (100 months). Individuals who felt anxious because of their pain and those who considered that their pain was affecting their family were more likely to belong to group 1. Pain affects an important proportion of the Spanish adult population and that it has a strong personal impact. Two pain groups were clearly distinguished by their clinical characteristics.