A trial-based cost-effectiveness analysis of antibiotic prescription strategies for non-complicated respiratory tract infections in children.

Background: Antibiotic prescription for respiratory tract infections (RTIs) in children attending primary care centres is almost double that predicted according to bacterial prevalence. Delayed antibiotic prescription (DAP) is designed to deploy a more rational use of antibiotics. While studies have evaluated DAP efficacy and safety for children with RTIs, little research has been conducted on the economic implications.

Delayed Antibiotic Prescription for Children With Respiratory Infections: A Randomized Trial.

Objectives: To assess the effectiveness and safety of delayed antibiotic prescription (DAP) compared to immediate antibiotic prescription (IAP) and no antibiotic prescription (NAP) in children with uncomplicated respiratory infections.

Methods: Randomized clinical trial comparing 3 antibiotic prescription strategies. The participants were children with acute uncomplicated respiratory infections attended to in 39 primary care centers.

Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review.

The effectiveness and safety of shoulder arthroplasties in the general context of a Spanish patient population remains unclear. The aim of this study was to ascertain both the effectiveness and safety of primary shoulder arthroplasties and the prosthesis types used in Spain. A systematic review of all the available literature evaluating the effectiveness and safety of primary shoulder arthroplasties in Spain was performed.

Controlled trial of balance training using a video game console in community-dwelling older adults.

Background: gamification is a potentially attractive option for improving balance and reducing falls.

Objectives: to assess the effect of balance training using the NintendoTM Wii game console on balance (primary outcome), falls and fear of falling.

Design: quasi-randomised, open-label, controlled clinical trial in parallel groups, carried out on community-dwelling patients over 70 years, able to walk independently.

The Barcelona-Asymptomatic Intracranial Atherosclerosis study: Subclinical intracranial atherosclerosis as predictor of long-term vascular events.

Background And Aims: Symptomatic intracranial atherosclerosis (ICAS) is associated with a high risk of stroke recurrence and occurrence of other vascular events. However, ICAS has been poorly studied from its asymptomatic stage. The objective of our study was to determine if subclinical intracranial atherosclerosis is associated with long-term incident vascular events in Caucasians.

[Process indicators: tools for monitoring the management of severe trauma cases in Catalonia].

Objectives: Process indicators have been widely used to monitor the way trauma care is provided. We aimed to analyze whether data from a hospital's severe trauma register could facilitate the evaluation of aspects of the initial management of severe injuries.

Material And Methods: Observational, retrospective population-based study.

Can a workplace 'sit less, move more' programme help Spanish office employees achieve physical activity targets?

We evaluated the impact of a workplace 'sit less, move more' programme (Walk@WorkSpain, W@WS, 19-week) on self-reported activity-related energy expenditure (AREE) in Spanish office employees (n = 264; 42 ± 10 years; 171 female) randomly assigned to Intervention (IG; used W@WS; n = 129) or comparison groups (CGs; n = 135). A linear mixed model assessed changes in METs-min/wk of total, vigorous, moderate and light physical activity (IPAQ short form) between baseline and 2 months follow-up. Over the CG, IG significantly increased light intensity AREE (P = 0.

Impact of a workplace 'sit less, move more' program on efficiency-related outcomes of office employees.

Background: Few studies have examined the impact of 'sit less, move more' interventions on workplace performance. This study assessed the short and mid-term impacts of and patterns of change within, a 19-week workplace web-based intervention (Walk@WorkSpain; W@WS; 2010-11) on employees´ presenteeism, mental well-being and lost work performance.

Methods: A site randomised control trial recruited employees at six Spanish university campuses (n = 264; 42 ± 10 years; 171 female), assigned by worksite and campus to an Intervention (IG; used W@WS; n = 129; 87 female) or an active Comparison group (A-CG; pedometer, paper diary and self-reported sitting time; n = 135; 84 female).

[Adequacy of treatment for osteoporosis in primary prevention. Quantitative and qualitative study].

Objective: Quantitative study: To assess the prevalence of inadequacy of treatment for osteoporosis in primary prevention (OPP) in women aged 60-74years. Qualitative study: To evaluate the diagnostic and treatment criteria of the OPP and it's variability in primary care physicians (PC) and specialists.

Material And Methods: Quantitative study: observational, cross-sectional and retrospective study.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care.

Background: Participation rates in colorectal cancer screening are below recommended European targets.

Aim: To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals' participation in an organised, population-based colorectal cancer screening programme when compared with usual care.

Design And Setting: Cluster randomised controlled trial in primary care centres of Barcelona, Spain.

Prescription Strategies in Acute Uncomplicated Respiratory Infections: A Randomized Clinical Trial.

Importance: Delayed antibiotic prescription helps to reduce antibiotic use with reasonable symptom control. There are different strategies of delayed prescription, but it is not yet clear which one is the most effective.

Objective: To determine the efficacy and safety of 2 delayed strategies in acute, uncomplicated respiratory infections.

Self-reported sitting time and physical activity: interactive associations with mental well-being and productivity in office employees.

Background: Little is known about how sitting time, alone or in combination with markers of physical activity (PA), influences mental well-being and work productivity. Given the need to develop workplace PA interventions that target employees' health related efficiency outcomes; this study examined the associations between self-reported sitting time, PA, mental well-being and work productivity in office employees.

Methods: Descriptive cross-sectional study.

Patterns of impact resulting from a 'sit less, move more' web-based program in sedentary office employees.

Purpose: Encouraging office workers to 'sit less and move more' encompasses two public health priorities. However, there is little evidence on the effectiveness of workplace interventions for reducing sitting, even less about the longer term effects of such interventions and still less on dual-focused interventions. This study assessed the short and mid-term impacts of a workplace web-based intervention (Walk@WorkSpain, W@WS; 2010-11) on self-reported sitting time, step counts and physical risk factors (waist circumference, BMI, blood pressure) for chronic disease.

Prevalence of Work-Related Asthma and its Impact in Primary Health Care.

Background And Objective: To determine the prevalence of occupational asthma (OA) and work-exacerbated asthma (WEA) among asthmatic patients diagnosed in Primary Health Care (PHC). To analyze the impact at PHC level caused by under-diagnosis and inappropriate referral of OA.

Patients And Methods: A descriptive, cross-sectional multicenter study in patients aged between 16 and 64years diagnosed with asthma, according to their medical record; all were working or had worked, and were assigned to one of 16 PHC centers in a healthcare district.

Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial.

Background: Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation.

Exposure of health workers in primary health care to glutaraldehyde.

Background: In order to avoid proliferation of microorganisms, cleaning, disinfection and sterilisation in health centres is of utmost importance hence reducing exposure of workers to biological agents and of clients that attend these health centres to potential infections. One of the most commonly-used chemical is glutaraldehyde. The effects of its exposure are well known in the hospital setting; however there is very little information available with regards to the primary health care domain.

Level of distress, somatisation and beliefs on health-disease in newly arrived immigrant patients attended in primary care centres in Catalonia and definition of professional competences for their most effective management: PROMISE Project.

Background: Newly arrived immigrant patients who frequently use primary health care resources have difficulties in verbal communication. Also, they have a system of beliefs related to health and disease that makes difficult for health care professionals to comprehend their reasons for consultation, especially when consulting for somatic manifestations. Consequently, this is an important barrier to achieve optimum care to these groups.

Measurement of the ankle brachial index with a non-mercury sphygmomanometer in diabetic patients: a concordance study.

Background: The removal of mercury sphygmomanometers from health centers requires the validation of other instruments to measure blood pressure in the limbs to calculate the ankle-brachial index (ABI).

Methods: Descriptive cross-sectional study of agreement between two measurement methods in type 2 diabetes patients from three urban primary healthcare centres in the Barcelonès Nord i Maresme area (Catalonia, Spain).

Results: 211 patients were included, from these, 421 limbs were available for study.

Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study.

Background: Undiagnosed airflow limitation is common in the general population and is associated with impaired health and functional status. Smoking is the most important risk factor for this condition. Although primary care practitioners see most adult smokers, few currently have spirometers or regularly order spirometry tests in these patients.

Female genital mutilation: perceptions of healthcare professionals and the perspective of the migrant families.

Background: Female Genital Mutilation (FGM) is a traditional practice which is harmful to health and is profoundly rooted in many Sub-Saharan African countries. It is estimated that between 100 and 140 million women around the world have been victims of some form of FGM and that each year 3 million girls are at risk of being submitted to these practices. As a consequence of the migratory phenomena, the problems associated with FGM have extended to the Western countries receiving the immigrants.

Perception of primary health professionals about female genital mutilation: from healthcare to intercultural competence.

Background: The practice of Female Genital Mutilation (FGM), a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature.

Methods: The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM.

In utero exposure to background concentrations of DDT and cognitive functioning among preschoolers.

p,p'-DDT (bis[p-chlorophenyl]-1,1,1-trichloroethane) is a persistent organochlorine compound that has been used worldwide as an insecticide. The authors evaluated the association of cord serum levels of DDT and its metabolite, 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene (DDE), with neurodevelopment at age 4 years. Two birth cohorts in Ribera d'Ebre and Menorca (Spain) were recruited between 1997 and 1999 (n = 475).

Prenatal dichlorodiphenyldichloroethylene (DDE) and asthma in children.

Prevalence of asthma increases with increasing dichlorodiphenyldichloroethylene (DDE) levels. However, the effect of early-life exposure, the fundamental window of exposure, is unknown. We assessed the association between prenatal DDE and other organochlorine compounds, and atopy and asthma during infancy.

A prospective study of Fel d1 and Der p1 exposure in infancy and childhood wheezing.

The impact of domestic exposure to cat allergen (Fel d1) and house dust mite (Der p1) on wheezing from birth to the age of 4 years was investigated in a multicenter prospective birth cohort; 1,611 mothers were recruited before delivery in Ashford, England, and Barcelona and Menorca, Spain. Exposures were gathered via dust sample collection at children's home in their first year of life. Families provided complete outcome data (wheezing status in all 4 years) for 1,289 children.