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Biomedical subjects

D Orozco

Publications and source records attributed to D Orozco.

33 records · Page 2Linked to original sources
PubMed1995

[Diabetes mellitus mortality in Spain: a comparative analysis between Spanish provinces in the period of 1981-1986].

OBJECTIVE: To find and compare mortality because of diabetes mellitus (DM) among the different provinces of Spain in the 1981 to 1986 period. SETTING: The natural movement of population figures of the National Institute of Statistics (INE) and the census of 1981 and register of 1986 were used. DESIGN: A descriptive observation study of a crossover type. Standardisation of rates by the indirect method. Calculation of the ratio of standardised mortality for each province. RESULTS: At the national level, the Communities with an excess of mortality in 1981 were Andalusia, Melilla, the Community of Valencia, Murcia, the Balearics, the Canaries and Extremadura, as well as the provinces of Tarragona, Gerona, Ciudad Real and Albacete. In 1986 the following still had excess of mortality: Andalusia, the Community of Valencia, Murcia, the Balearics, the Canaries, Asturias and Cantabria, along with the provinces of Badajoz and Pontevedra. CONCLUSIONS: The provinces with an excess mortality because of diabetes mellitus are geographically grouped (with some exceptions) in the south and south-east of Spain and the island communities.

Adult↗
PubMed1995

[Opinion of university professors on the suitability of specific primary care training in medical students].

OBJECTIVE: To find the opinion of teachers at the University of Alicante about the appropriateness of a Primary Care Theory-Practice programme within the Medicine curriculum. DESIGN: A descriptive observation study of a crossover nature. SETTING: Teachers of the Departments of Medicine and Public Health who had had contact with the Primary Care Theory-Practice programme. PARTICIPANTS: 44 out of 71 teachers (62%) replied. INTERVENTION: An 11-question survey was answered anonymously between October 1993 and June 1994. MEASUREMENTS AND MAIN RESULTS: 77.3% (95% Confidence Interval 64.9-89.7%) considered appropriate the theoretical content at undergraduate level, where there was an average 18.5 hours teaching (C.I. 15.8-21.2); and 95.5% (C.I.89.4-100%), the practicals at a Health Centre, where there was an average 65.2 hours (C.I. 43.1-87.3) work. 43.9% thought it was appropriate to form a separate subject and 39% favored integrating these themes into other subjects. Theoretical contents would be basically teaching general information about Primary Care; and practical work would be clinical activities. The greatest advantages regarding carrying out practical work in Health Centres were: the student finds pathology more prevalent and learns to provide practical answers. The greatest disadvantages were: the low methodological knowledge and teaching preparation of the Teams. CONCLUSIONS: Those interviewed considered that the teaching at undergraduate level of a Primary Care subject with theoretical-practical content would be useful. The advantages, its contents and some difficulties were noted.

Aged↗
PubMed1994

[An opinion/satisfaction survey on 2 models of clinical histories used in primary care].

OBJECTIVE: We aimed to discover the opinion of primary care doctors regarding the structure, usefulness and problems when using two models of clinical records employed consecutively in the same health centres. DESIGN: A double crossover study. An opinion poll (with 22 closed questions and one open), filled out in 1988 (evaluating the type A clinical record) and then in 1992 (for type B), was used. Chi squared statistical analysis with Yates corrections and Fisher test. SETTING AND PARTICIPANTS: Staff doctors and third-year family and community medicine interns at their teaching centres in Alicante province. In 1988, 49 doctors took part, and in 1992, 68: 70 and 75% respectively of the target group. RESULTS: The new record was an improvement over the earlier one. It was broader and corresponded more closely to the actual case. But problems of completion and legibility persisted, as did the difficulties in filling out socio-economic data and work/school history. Model B favoured use by all the team members. It was better for new patients and when doing later checks, although it did not avoid the accumulation of inactive documentation. The need for specific documents for preventive activities was detected. Computerisation would improve manageability. For both models lack of time was the main reason for under-recording. CONCLUSIONS: The new model is better than the earlier one but is lacking in the areas of manageability and difficulty in retrieving information. The methodology employed shows its use for evaluating health-care innovations and detecting insufficiencies, as well as allowing user-satisfaction to be more easily identified.

Attitude of Health Personnel↗
PubMed1994

[An analysis of domiciliary medical care in 7 health centers of Alicante Province].

OBJECTIVE: To know the characteristics of medical care at home done by the doctor and to what extent it is justified. DESIGN: An observational, descriptive-prospective study. Form filled out by the doctor after completing the visit. SETTING: Outpatients, 7 hospitals in area 17 of the Valencian Community. PATIENTS: 188 different patients attended in February 1993 by 15 family doctors. The statistical tests used were ji-squared test, Student's t-test and Anova. MEASUREMENTS AND MAIN RESULTS: An average of 0.4 visits/doctor/day were made. Less than 2 hours/week/doctor were needed. 80.5% of the cases were resolved using usual means available in the doctors emergency briefcase. 64.5% of the patients attended were over the age of 65.66% of the visits were considered to be justified. CONCLUSIONS: 66% of medical care at home was considered justified and did not require excessive time. Elderly patients are the ones who most require medical care at home.

Adult↗
PubMed1993

[An evaluation study of a scale of diabetological education in primary care].

OBJECTIVE: To devise and evaluate a scale of measurement which would permit evaluation at primary care level, of the knowledge that diabetic patients have of diabetes. Secondly, to ascertain the level of knowledge of the sample of diabetic patients attending the Xixona Health Centre. DESIGN: Non-longitudinal, observational, descriptive study. SETTING: Primary health care (health centre). MEASUREMENTS AND MAIN RESULTS: The degree of internal consistency of the diabetes scale of knowledge (DISK) attained a Cronbach Alpha value of 0.87. The coefficients of correlation of each of the factors--defined a priori (general knowledge, diet, exercise, hygiene and self-regulation)--oscillated between 0.77 and 0.83. The Garret index of corrected difficulty was at 0.64. The homogeneity of each item with the questionnaire showed values above 0.31. The reliability measured by means of the KR20 index was 0.86. The odd-even coefficient of reliability was at 0.89. The mean level of correct answers was 70%. A relation was found between the level of knowledge and the variables age and years the patient had been subject to the condition. No relation was found with the treatment, sex, glycaemia or HbA1C level, nor educational level. CONCLUSIONS: The indices obtained by the scale can be considered to be judiciously acceptable, both in terms of their internal consistency and their ability to characterise. The DISK (ECODI) is, then, a valuable tool in the field of primary health care.

Diabetes Mellitus↗
PubMed1993

[Undergraduate training in primary health care: 6 years' experience at the University of Alicante].

OBJECTIVE: To assess the opinion of medical students on the teaching offered in the Primary Care context (TOPC). DESIGN: Observational and crossover study. The assessment used an opinion questionnaire. PARTICIPANTS: 296 sixth-year medical students between 1987 and 1992. INTERVENTIONS: The TOPC consisted of four weeks stay in a Health Centre with an eminently practical programme. However this also included hour-long theoretical seminars on the most important Primary Care questions and the student's completion of a research project related to Primary Care. RESULTS: The students expressed satisfaction with the TOPC (average score of 4 out of 5). Moreover this satisfaction increased over the five years (from 3.7 to 4.6, p = 0.0001). They believed the TOPC to be useful (3.6 to 4.7, p = 0.0001) and relevant to their future professional activity (3.1 to 4.6, p = 0.0001). They thought that the tutors were very competent (4 out of 5, with no significant variation) and the Health Centres' teaching facilities suitable (3.8 to 4, with no significant variation). Finally, they considered that TOPC should become a compulsory undergraduate subject (3.9 out of 5). CONCLUSIONS: Medical students give a positive rating to the Primary Care teaching offered and believe it should be integrated into the Medicine syllabus as a compulsory subject.

Adult↗
PubMed1992

Slowing of mortality rates at older ages in large medfly cohorts.

It is generally assumed for most species that mortality rates increase monotonically at advanced ages. Mortality rates were found to level off and decrease at older ages in a population of 1.2 million medflies maintained in cages of 7,200 and in a group of approximately 48,000 adults maintained in solitary confinement. Thus, life expectancy in older individuals increased rather than decreased with age. These results cast doubt on several central concepts in gerontology and the biology of aging: (i) that senescence can be characterized by an increase in age-specific mortality, (ii) that the basic pattern of mortality in nearly all species follows the same unitary pattern at older ages, and (iii) that species have absolute life-span limits.

Aging↗
PubMed1991

[The satisfaction of the primary care consumer: a comparison between distinct models of care].

The results of a questionnaire about satisfaction in the users of an urban health area of the city of Alicante, where the traditional model of primary care (the clinic, C), the new model (the health center, HC) and private practice (P) coexist are reported. The questionnaires were administered by staff unrelated with the health center. In general, satisfaction was significantly greater (p = 0.001) in users of HC and P than in C users. no significant difference was found between HC and P. The specific satisfaction was also greater (p less than 0.05) for all services in HC than in C: General practice (GP), nursing care (N), pediatrics (PED), and administration-information (ADMON). The general satisfaction did not correlate with sociodemographic variables; it was weakly correlated with the service use variables, and was clearly correlated (p less than 0.001) with the specific satisfaction with the use of services such as GP (r = 0.57), PED (r = 0.49), ADMON (r = 0.56), and N (r = 0.58).

Community Health Centers↗
PubMed1990

[The validation and usefulness of a questionnaire for evaluating the infrastructure of health centers].

A questionnaire was distributed in all the health centers of the Comunidad Valenciana to establish its validity and usefulness for the evaluation of the physical structure of the health centers. Subsequently, the results were validated by direct verification in 30% of centers. The results of the first part of the questionnaire, related to the type of premises that should be available, and of the second, about the characteristics of such premises, were significantly related with the satisfaction degree (r = -0.724, p less than 0.01), as well as with the criterion of previous planning (p less than 0.001) and the inclusion in structures of a traditional model (p less than 0.001). The 75th percentile of the results of the first and second part of the questionnaire are proposed to select those centers with an unacceptable structure, and, as a quick method, it is recommended to test the parameters of satisfaction degree, previous planning, and inclusion within traditional model structures.

Community Health Centers↗
PubMedDate not supplied

[Identification of variables influencing waiting times for specialized care].

OBJECTIVE: To identify the variables influencing waiting time for specialized care (waiting lists) through multiple regression analysis and to analyze the health districts with long waiting times according to these variables. DESIGN: Descriptive, cross sectional and retrospective study of waiting times for access to specialized care between 1997 and 1998. SETTING: Area 20 of the Health Department of the Autonomous Community of Valencia (Spain) consisting of 12 health districts with 204,424 inhabitants. INTERVENTIONS: The following variables were gathered: variables influencing demand: type of municipality, aging and indexes of dependent population, and percentage of pensioners; variables influencing supply: age, sex, training and professional stability of the doctor, and size of the patient list; variables influencing resource consumption: percentage of referrals to specialized care per thousand inhabitants, mean WT for access to specialized care (in natural days) by district and year, number of consultations, and workload. A multiple regression model was constructed through (backward) elimination, taking the mean WT as the dependent variable and the remaining variables as independent variables. The resulting equation enabled calculation of the expected WT per health district and the deviation of the real WT from the expected WT. A district was considered to have a high WT when its deviation was above the mean plus one standard deviation of the distribution. RESULTS: The mean WT for access to specialized care was 37 days in 1997 and 34 days in 1998. A significant correlation (p < 0.005) was found between WT and the percentage of the population aged less than 14 years (r = 0.693), the percentage of the population aged between 14-65 years (r = 0.517), the number of consultations (r = 0.689), and coastal population (r = 0.470). Our final model included: percentage of the population aged less than 14 years, number of consultations, and coastal population (F = 41.803; p < 0.000; r = 0.945; r2 = 0.893). Three districts (37.5%) with high WTs were identified. CONCLUSIONS: The number of consultations, the percentage of the pediatric population, and proximity to the coast were closely correlated with WT for specialized care, with a consequent influence on waiting lists.

Adult↗
PubMedDate not supplied

[Medicine at the primary care level (optional undergraduate subject at the University of Alicante): 2 years of experience].

OBJECTIVE: We want to put on record two years' experience of undergraduate teaching of an optional subject, "Medicine at the Primary Care level". This was given to sixth-year students by Family and Community Medicine specialist doctors within the Department of Medicine. DESIGN AND SETTING: A crossover study carried out at the University of Alicante. PARTICIPANTS: In the first year, 73 out of the 102 students making up the complete course took part (71.6%); and in the second year, 33 out of 93 (35.5%). MEASUREMENTS AND MAIN RESULTS: The methodology employed, the teaching staff and the documents handed out were given high marks by the students in both cases; as were the course contents in the second year. Deficiencies were noted in the presentation of practical hypotheses. In the first course the students criticised the lack of certain points, basically the tackling of the more common chronic pathologies, something which was corrected in the second year. The survey identified students' wishes to spend longer on the subject. CONCLUSIONS: The students valued positively the existence of a theoretical content specific to Primary Care Medicine. In particular, they requested to be taught performance patterns for prevalent pathologies and for seminars to be organised around practical hypotheses.

Education, Medical↗