Publications by authors named "Maria V Zunzunegui"

Objective: We aimed to estimate regional inequalities in excess deaths and premature mortality in Spain during 2020 and 2021, before high vaccination coverage against COVID-19.

Method: With data from the National Institute of Statistics, within each region, sex, and age group, we estimated the excess deaths, the change in life expectancy at birth (e) and age 65 (e) and years of life lost as the difference between the observed and expected deaths using a time series analysis of 2015-2019 data and life expectancies based on Lee-Carter forecasting using 2010-2019 data.

Results: From January 2020 to June 2021, an estimated 89,200 (men: 48,000; women: 41,200) excess deaths occurred in Spain with a substantial regional variability (highest in Madrid: 22,000, lowest in Canary Islands: -210).

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Background: From March 7 to April 7, 2020, the Community of Madrid (CoM), Spain, issued interventions in response to the COVID-19 epidemic, including hospital referral triage protocols for long-term care facility (LTCF) residents (March 18-25). Those with moderate to severe physical disability and cognitive impairment were excluded from hospital referral. This research assesses changes in the association between daily hospital referrals and the deaths of LTCF residents attributable to the triage protocols.

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In March 2020, a ministerial directive issued by the Government of the Community of Madrid (CoM) in Spain included disability-based exclusion criteria and recommendations against hospital referral of patients with respiratory conditions living in long-term care homes (LTCHs). Our objective was to assess whether the hospitalization mortality ratio (HMR) is greater than unity, as would be expected had the more severe COVID-19 cases been hospitalized. Thirteen research publications were identified in this systematic review of mortality by place of death of COVID-19-diagnosed LTCH residents in Spain.

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We aim to assess how COVID-19 infection and mortality varied according to facility size in 965 long-term care homes (LTCHs) in Catalonia during March and April 2020. We measured LTCH size by the number of authorised beds. Outcomes were COVID-19 infection (at least one COVID-19 case in an LTCH) and COVID-19 mortality.

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Our aim is to assess whether long-term care home (LTCH) ownership and administration type were associated with all-cause mortality in 470 LTCHs in the Community of Madrid (Spain) during March and April 2020, the first two months of the COVID-19 pandemic. There are eight categories of LTCH type, including various combinations of ownership type (for-profit, nonprofit, and public) and administration type (completely private, private with places rented by the public sector, administrative management by procurement, and completely public). Multilevel regression was used to examine the association between mortality and LTCH type, adjusting for LTCH size, the spread of the COVID-19 infection, and the referral hospital.

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It seems necessary to assess the mortality of older people living in long-term care homes to examine its determinants, including the structural and organizational characteristics of these centers and their relationship with the use of health and social services. Attempting to investigate the mortality of the population over 65 years of age living in long-term care homes during COVID-19, we were not able to identify those who died at their long-term care home and, consequently, to know their number of deaths and their causes. In this field note, we describe this anomalous situation and propose a solution: compliance with the law that obliges all citizens to register at their usual address, which should be required in the process of admission to a residence.

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Background: European countries apply a policy of deterrence of migrants in territorial and extraterritorial border areas. The authors apply the model of torturing environments, which has been already applied to other contexts where persons are deprived of liberty, to the situation of the reception center of Moria, on the island of Lesvos (Greece).

Methods: A cross-sectional study was conducted in the months of April and June of 2020.

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Objectives: To examine the relationship between gender roles and self-rated health in older men and women from different contexts.

Methods: 2002 community-dwelling older adults from the International Mobility in Aging Study were recruited from 5 research sites. Gender role was measured with the 12-item Bem Sex Role Inventory, which categorized study participants into four gender roles: Masculine, Feminine, Androgynous, and Undifferentiated.

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Objectives: As reported in other high-income countries, around the 2008 Great Recession the Spanish banking sector engaged abusive practices that satisfy the definition of fraud. Our objective is to examine the association between self-reported bank fraud and physical health, using a gender perspective.

Methods: With data from the 2017 Madrid Health Survey, we examined the association between the economic impact of fraud and poor self-rated health (SRH), comorbidity and pain (N = 4425).

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Background: Immigration status and unemployment may intersect on the health outcomes of men and women. This study aimed to identify intersections between unemployment and immigration in inflammatory, metabolic and nutritional blood markers and assess gender differences.

Methods: We used Canadian Health Measures Survey data on 2493 participants aged 18 to 65.

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Over the past few decades, the financial system has engaged in abusive practices that meet the definition of fraud. Our objective is to compare the prevalence of psychological distress and levels of health-related quality of life according to having been exposed to financial fraud and its economic impact on family finances. The City of Madrid Health Survey 2017 included specific questions on exposure to financial fraud-this section was administered to half of the participants ( = 4425).

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Objectives: We examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories.

Design: Longitudinal analysis of an international cohort study.

Settings And Participants: Older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline.

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Objectives: To examine differences in incidence of functional disability between older women and men.

Methods: 2002 participants (65-74 years) were recruited in 2012 from Canada, Brazil, Colombia, and Albania, and re-assessed in 2016. Three measures of functional disability were used (1) Difficulty in any of five mobility-related Activities of Daily Living (ADL disability); (2) Self-reported difficulty climbing a flight of stairs or walking 400 m (mobility disability); and (3) Poor physical performance.

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This study assessed whether telomere length is related to chronic conditions, cardiovascular risk factors, and inflammation in women aged 65 to 74 from Northeast Brazil. Participants were selected from two sources, a representative sample of the International Mobility in Aging Study ( = 57) and a convenience sample ( = 49) recruited at senior centers. Leukocyte telomere length was measured by quantitative polymerase chain reaction from blood samples in 83 women.

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Objectives: The objectives of this study were to explore the perspectives of older adults about the most important domains of aging well and to identify the social determinants of a person-centered index capturing these domains.

Methods: We conducted a mixed-methods study of 40 semi-structured interviews and epidemiological data from 670 older adults participating in the International Mobility in Aging Study (IMIAS) in Saint-Hyacinthe and Kingston. A composite index capturing the domains of aging well was constructed on the basis of findings from qualitative content analysis.

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The purpose of this study was to develop and validate a new instrument to assess social networks and social support (IMIAS-SNSS) for different types of social ties in an international sample of older adults. The study sample included n = 1995 community dwelling older people aged between 65 and 74 years from the baseline of the longitudinal International Mobility in Aging Study (IMIAS). In order to measure social networks for each type of social tie, participants were asked about the number of contacts, the number of contacts they see at least once a month or have a very good relationship with, or speak with at least once a month.

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Objective: To estimate the prevalence of frailty in older adults in the IMIAS population, to examine associations between lifelong domestic violence and frailty and possible pathways to explain these associations.

Methods: A cross-sectional study with 2002 men and women in the International Mobility in Aging Study, aged between 65 and 74 years old living in five cities of Tirana (Albania), Natal (Brazil), Kingston and Saint-Hyacinthe (Canada), and Manizales (Colombia). Domestic physical and psychological violence by family and intimate partner was assessed by the Hurt, Insult, Threaten and Scream (HITS) scale.

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Objective: The aim of this study was to examine whether neighborhood-level social capital is a risk factor for falls outside of the home in older adults.

Methods: Health questionnaires were completed by community-dwelling Canadians aged +65 years living in Kingston (Ontario) and St-Hyacinthe (Quebec), supplemented by neighborhood-level census data. Multilevel logistic regression models with random intercepts were fit.

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We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a region with substantial socioeconomic inequalities. The low education sample was selected from a representative survey at local neighborhood health centers, while the high education group consisted of a convenience sample recruited by advertising in community centers and centers affiliated with the local university. Relative leukocyte TL was measured by quantitative polymerase chain reaction from blood samples.

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