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F Guillén Grima

Publications and source records attributed to F Guillén Grima.

At least 19 recordsLinked to original sources
PubMed2005

Validation of the Spanish version of the Phase III ISAAC questionnaire on asthma.

The prevalence of allergic diseases in childhood has increased significantly over the last decades. This increase seems to be closely associated with the way of life of western societies. The high prevalence differences on different regions may be due to linguistic and cultural reasons and not to real variations in prevalence. This is the reason why several authors felt the need to perform an objective validation of their versions. Our working group has published the results of the Phase I validation and now is publishing the Phase III validation in order to guarantee the reliability of this phase results. The study sample is formed by 366 children aged 3 to 17 years. The following steps were followed in this study: I. Assessment of the "Criterion validity" of the Spanish ISAAC-Bronchial Asthma questionnaire, evaluating the sensitivity, specificity, relative value, and positive and negative predictive values. 2. Determine the questionnaire reliability, analysing its "Inner consistency". 3. Statistical comparison between our ISAAC-Bronchial Asthma results and the ones obtained by other groups (external concordance and consistency), in order to prove the previously evaluated reliability. 4. Comparison between the ISAAC-Bronchial asthma questionnaire diagnostic ability and the standard diagnostic criteria universally used in clinical praxis. We could confirm that there is a high and very significant concordance between the questions aimed to detect children with asthma. In this sense, it is especially useful the question about "ever had wheezing" because of its high sensitivity (93.3%) and specificity (89.9%), that make it able to be used as initial screening test in a general population, and that has shown a high concordance percentage with the questions "ever had asthma" (98%), "wheezing with exercise" (75%), and "cough at night"(80%). The questions that give more information about the evolution and control of the asthmatic disease are "wheezing in the last 12 months", "number of attacks in the last 12 months", "wakening at night", "wheezing with exercise" and "dry cough at night in the last 12 months". The questions more related to asthma severity were "number of attacks in the last 12 months", "wakening at night", "stop speaking in order to breath", and "wheezing with exercise". We conclude that ISAAC-Asthma questionnaire Phase III is a useful tool for the assessment of childhood asthma due to its criterion validity, inner consistency and external concordance.

Adolescent↗
PubMed2003

[Models to explain and predict medical case-loads: their use in calculating the maximum family medicine list that allows at least ten minutes per consultation].

OBJECTIVE: To calculate the maximum family medicine list that gives at least ten minutes per consultation.Design. Transversal. SETTING: Three health centres. SUBJECTS: 45 826 inhabitants. MEASUREMENTS: We used the appointments made at three centres to calculate the annual time employed per patient and we adjusted it to allocate a minimum of ten minutes per consultation. We established a cubic regression model to predict the mean case-load per age of patient in general medicine and calculated the maximum list if 70% of the working day were dedicated to care. The results contrasted two centres with greater nursing involvement and one with less. We showed the R2 coefficients. We calculated the maximum lists for the health centres of Navarra and showed them in five clusters worked out on the basis of the percentage of patients >=65. RESULTS: Age explained 86.1% of variability in mean case-load at each age (84% in children and 93.5% in adults). According to the mean percentage of those >=65 years old, the average maximum lists for centres with more or less nursing involvement are as follows: 7.0%>=65 (2025 and 1989); 14.0% (1834 and 1715); 21.2% (1691 and 1558); 27.0% (1648 and 1460), 34.0% (1560 and 1340). CONCLUSION: To a great extent, age explains the variability in case-load and lets us calculate the maximum number of patients on the list that still ensures a minimum time for each consultation.

Adult↗
PubMed2000

[A proposal for capitation payment, based on age, chronicity, and gender, using management databases].

OBJECTIVES: To propose a case-mix methodology for primary care, based on chronicity, type and age. To describe the explanatory value of these variables in the variability of the medical case-load. DESIGN: Observation, descriptive and retrospective study. SETTING: Primary care. Rochapea Health Centre, Pamplona. MATERIAL AND METHODS: Computer records of all the consultations between January 1996 and June 1997. Dependent variable: case-load. INDEPENDENT VARIABLES: age, type, chronic pathologies (diabetes, lipaemia, chronic neurological diseases, COPD-asthma, chronic psychiatric illnesses, cardiopathy, hypertension, alcohol and other drug abuse). The Kruskal-Wallis test was used to compare work-loads by age groups; and multiple linear regression analysis to calculate the predictive power of the independent variables. RESULTS: Significant differences were observed for age groups. In the multivariate model used for general practitioners, all the variables could be included. They explained 24.2% of the variability in work load (R2). For paediatricians, age and asthma, explaining 23.48%, could also be included. CONCLUSIONS: Age, type and chronicity are useful variables for predicting case load from administrative data bases. They can be used in adjustments for case load applicable to capitation payment systems.

Adolescent↗
PubMed1999

[The prevalence of asthma-related symptoms in 13-14-year-old children from 9 Spanish populations. The Spanish Group of the ISAAC Study (International Study of Asthma and Allergies in Childhood)].

BACKGROUND: Asthma is one of the more prevalent diseases in childhood. Geographical differences have been found but it is unknown if they are true or are a consequence of the different methods used in the study of asthma. POPULATION AND METHODS: In 9 Spanish populations: Almería, Barcelona, Bilbao, Bahía de Cádiz, Cartagena, Castellón, Pamplona, Valencia and Valladolid, 27,407 children aged 13-14 years were interviewed using the asthma written and video questionnaires of the ISAAC protocol. Comparisons among geographical areas were performed using a cluster analysis and a Poisson regression model adjusting by gender. RESULTS: The prevalence of resting wheezing using the video questionnaire was higher in males than in females (15.4% versus 12.6%) for wheezing ever. In the last year the prevalence of wheezing was 7.8% in males versus 7.0% in females. The analysis shows a group of centers with low prevalence of asthma symptoms: Valladolid, Almería, Castellón and Pamplona. Nevertheless there are also centers with higher prevalences as Bilbao, Barcelona and Bahía de Cádiz. CONCLUSIONS: Prevalence of asthma and asthmatic symptoms is high in Spanish children aged 13-14 years. There are true geographical differences in Spain, being Valladolid, Almería, Castellón and Pamplona the areas with lowest prevalence.

Adolescent↗
PubMed1998

[Prevalence of mental diseases in women of an urban area].

OBJECTIVES: The main aim was to calculate the prevalence of mental pathology in women between 18 and 70 in a Health District of Pamplona; second, to describe comorbidity and to analyse how mental pathology was recorded in the clinical histories. DESIGN: An observational crossover study with randomised selection. SETTING: A community study in the Txantrea quarter of Pamplona, covering 21,590 inhabitants, with 7605 women between 18 and 70. PATIENTS: Randomised sample, stratified by age, of 237 women between 18 and 70 taken from the 1991 Census. MEASUREMENTS AND RESULTS: In a face-to-face interview at the Health Centre, the DIS Questionnaire, which diagnoses mental illness, was administered to all participants. A check was made to see if mental pathology was recorded in their clinical history. The prevalence of mental illnesses, mainly Phobias and Depression, in the "last year of life" was 33.3% (27.5-39.5), which fell to 24.9% (19.7-30.7) when tobacco abuse was excluded. The most common pathologies were: Depression (17.3%), Tobacco dependency (17.3%), simple Phobia (14.8%), Agoraphobia (13.5%), social Phobia (8.9%) and post-traumatic stress (8.0%). CONCLUSIONS: Understanding the high psychological morbidity in these urban women can contribute to the development of Mental Health Promotion and Prevention Programmes and foment fuller mental health training for Primary Care professionals.

Adolescent↗
PubMed1995

[Cost-effectiveness analysis of different alternatives of universal vaccination against hepatitis B in the region of Murcia].

BACKGROUND: Programs of universal vaccination against hepatitis B have been introduced in Spain with different vaccination calendars. The aim of this study was to determine the most profitable alternative to universal vaccination against hepatitis B. METHODS: A cost-effectiveness study was carried out evaluating the following alternatives: 1) Vaccination of all newborns, 2) vaccination of all preadolescent children (11 years of age), 3) vaccination of all newborns and preadolescents. This study was performed using data from the Autonomic Community of Murcia in 1993 from the perspective of the Regional Council of Health. The costs of the vaccination program are marginal. Cost-effectiveness analysis was carried out in two ways: taking only the direct costs of the program into account and considering the adverse effects and saving in the treatment of the cases avoided. Analysis of sensitivity was performed with the use of different discount rates. RESULTS: The most expensive alternative is vaccination of newborns (118,990 pesetas per case) with vaccination of preadolescent proving to be the most profitable (64,476 pesetas per case avoided) allowing intervention during the period of life with maximum incidence of infection. Nonetheless, the combined alternative of newborns and preadolescents differs little (82,840 pesetas per case avoided) from the latter alternative allowing short term control of the infection and contributing to elimination of the disease. Analysis of sensitivity demonstrated vaccination of preadolescents to be greater than the remaining alternatives. CONCLUSIONS: Using cost-effectiveness criteria the preadolescent vaccination strategy against hepatitis B virus should be implemented and incorporated into the vaccination calendars.

Child↗
PubMed1995

Helmet use by drivers and passengers of motorcycles in Pamplona (Spain), 1992.

In 1992 a new Traffic Rules Code was enacted in Spain. This Code included a helmet law that came into force on 1 September 1992. Since then, helmet use is compulsory for motorcycles in urban areas. Previously, helmet use had been obligatory only for motorcycle in highways. To evaluate driver and passenger compliance with the helmet law, an observational prevalence survey of helmet use in Pamplona (a city of 183,539 inhabitants in the north of Spain) was performed. The utilization of helmet by motorcycle drivers and their passengers was recorded three months before and three after the helmet law took effect. Helmet use increased from 19.7% in the first period to 94.8% in the second period. After the law took effect helmet use was higher among drivers 97.5% than among passengers 77.5%. Passengers used helmet more frequently when the driver was also using helmet. The prevalence ratio of helmet use, in those passengers whose driver used helmet versus those who didn't, was 9.91 (95% CI = 1.52, 64.83). Health education and law enforcement efforts should be targeted to drivers to prevent them from giving a ride to passengers without helmet.

Accidents, Traffic↗
PubMed1992

[Cost-effectiveness study of prevaccination screening tests in vaccination against hepatitis B in hospital health professionals].

BACKGROUND: The aim of this study was to know the cost-effectiveness of a vaccination program of hospital personnel against hepatitis B as compared to vaccination strategy with previous screening tests versus vaccination without screening. METHODS: The costs of the process of vaccination with and without previous screening tests for hospital personnel (first year residents = MIR R1 and staff doctors) was calculated taking, not only the cost of the vaccinations, but also the costs of withdrawal, injection, antibody determination and the displacement costs of the subject into account. RESULTS: In the case of a MIR-R1, the cost of vaccination without previous screening is 12,492 pesetas, with the cost for a staff doctor being 15,092 pesetas. The vaccination strategy with previous antibody screening tests is only profitable with prevalences of 28.77% of positivity in the case of MIR-R1 and 29.55% in staff doctors. CONCLUSIONS: This study defends the elimination of previous antibody screening tests in vaccination against hepatitis B since the legal obligation of previous screening tests is no longer applicable. Moreover, vaccination is practically innocuous and prevaccination screening tests are only profitable with prevalences os seropositivity higher than 28% in the case of MIR-R1 and 29.55% in the case of staff doctors which are ciphers much higher than those of the prevalence of seropositivity normally found among Spanish hospital personnel.

Cost-Benefit Analysis↗
PubMedDate not supplied

[The EMECAM protocol: an analysis of the short-term effect of air pollution on mortality. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica u la Mortalidad].

The aim of this study is to Mortality show the protocol of analysis which was set out as part of the EMECAM Project, illustrating the application thereof to the effect of pollution has on the mortality in the city of Valencia. The response variables considered will be the daily deaths rate resulting from all causes, except external ones. The explicative variables are the daily series of different pollutants (black smoke, SO2, NO2, CO, O3). As possible confusion variables, weather factors, structural factors and weekly cases of flu are taken into account. A Poisson regression model is built up for each one of the four deaths series in two stages. In the first stage, a baseline model is fitted using the possible confusion variables. In the second stage, the pollution variables or the time legs thereof are included, controlling the residual autocorrelation by including mortality time lags. The process of fitting the baseline model is as follows: 1) Include the significant sinusoidal terms up to the sixth order. 2) Include the significant temperature or temperature squared terms with the time lags thereof up to the 7th order. 3) Repeat this process with the relative humidity. 4) Add in the significant terms of calendar years, daily tendency and tendency squared. 5) The days of the week as dummy variables are always included in the model. 6) Include the holidays and the significant time lags of up to two weeks of flu. Following the reassessment of the model, each one of the pollutants and the time lags thereof up to the fifth order are proven out. The impact is analyzed by six-month periods, including interaction terms.

Air Pollution↗
PubMedDate not supplied

[The short-term effects of air pollution on mortality: the results of the EMECAM project in the city of Pamplona, 1991-95. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad].

BACKGROUND: To assess the short-term impact of air pollution on the daily death rate in the city of Pamplona. METHOD: Ecological study with a population of 212,000 inhabitants. A time series data analysis is conducted by means of multiple linear regression and Poisson regression, with the daily death rate data, air pollution levels for Particles and SO2, weather parameters of average relative humidity and temperature daily and number of cases weekly of flu for the 1991-1995 period. RESULTS: The average number of deaths daily for non-external causes is that of 4.15 deaths, with a range from zero to 13 deaths. The city of Pamplona has a mean annual temperature of 12.7 degrees C (-2.3 degrees C to 31.6 degrees C) and a relative humidity of 68.5%. In the model, the temperature (with a one-day time lag and a six-day time lag temperature squared) and the humidity (with a one-day time lag) is related to the death rate for all causes. But the death rate for non-external causes is only related in the model with the temperature (one-day time lag, P: 0.035) and five-day time lag with temperature squared (p: 0.028). The timely estimates of the relative particle-related risk show that the highest risk of dying stems from respiratory causes with a relative risk of 1.13. However, none of these relationships is statistically significant. In the case of Sulfur Dioxide, the estimates closely near the zero figure, and none of them is significant. CONCLUSIONS: The Temperature has an impact of the death rate for all causes, both external and non-external, and the relative humidity solely has an impact on the death rate for non-external causes. It has not been possible to prove any influence of the daily environmental pollution levels on the daily death rate.

Aged↗