Guillén Grima, Francisco
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Guillén Grima
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Francisco
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Ciencias de la Salud
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Publication Open Access Accelerated bacterial identification with MALDI-TOF MS leads to fewer diagnostic tests and cost savings(MDPI, 2024-12-02) Uzuriaga, Miriam; Guillén Grima, Francisco; Rua, Marta; Leiva, José; Yuste, José R.; Ciencias de la Salud; Osasun ZientziakIntroduction: Rapid microbiology reporting can enhance both clinical and economic outcomes. Material and Methods: This three-year, quasi-experimental study, single-group pretest¿posttest study, conducted at a university medical center, aimed to evaluate the clinical and economic impact of rapid microbiological identification reporting using MALDI-TOF MS. A total of 363 consecutive hospitalized patients with bacterial infections were evaluated, comparing a historical control group (CG, n = 183) with an intervention group (IG, n = 180). In the CG, microbiological information (bacterial identification and antibiotic susceptibility) was provided between 18:00 and 22:00 h, while in the IG, bacterial identification was reported between 12:00 and 14:00 h, and antibiotic susceptibility was reported between 18:00 and 22:00 h. Results: The IG demonstrated a significant reduction in the number of patients undergoing Microbiology (p = 0.01), Biochemistry (p = 0.05), C-Reactive Protein (p = 0.02), Radiological Tests (p = 0.05), Computed Tomography Tests (p = 0.04), and Pathology (p = 0.01). However, no statistically significant reduction was observed in economic costs related to microbiological testing (p = 0.76) or antibiotic consumption (p = 0.59). The timely reporting of microbiological identification to clinicians resulted in fewer patients undergoing additional diagnostic tests, ultimately contributing to reduced healthcare resource utilization without adversely affecting clinical outcomes.Publication Open Access Valoración de la repercusión del dolor sobre la productividad laboral: validación del cuestionario WPAI:Pain(Gobierno de Navarra. Departamento de Salud, 2016) Varela, N.; Guillén Grima, Francisco; Pérez-Cajaraville, J. J.; Pérez Hernández, C.; Monedero, P.; Ciencias de la Salud; Osasun ZientziakFundamento. Los instrumentos de medida de salud son esenciales en la actividad clínica diaria. Sin embargo, es necesario un proceso de validación para poder certificar la validez y fiabilidad de los mismos. En la actualidad no existe ninguno que permita evaluar la repercusión del dolor en la productividad laboral de los pacientes. El objetivo de nuestro estudio es validar un cuestionario para evaluar las consecuencias del dolor en dicha productividad. Método. En base al Work Productivity and Activity Impairment Questionnaire – General Health hemos creado una versión modificada denominada WPAI: Pain con el fin obtener un cuestionario que pudiera medir las consecuencias del dolor en la productividad laboral. El estudio se realizó siguiendo las pautas habituales de validación de pruebas, omitiéndose las fases de redacción y validez de contenido ya que se modificaba un cuestionario existente. Resultados. Se obtuvieron 577 cuestionarios en dos hospitales universitarios españoles. Se comprobó la capacidad discriminante del cuestionario mediante prueba de U de Mann-Whitney. Se realizaron los test de fiabilidad obteniéndose un alfa de Cronbach de 0,896 con un test de dos mitades de Guttman de 0,921. Se comprobó la estabilidad con un test-retest estadísticamente significativo. La validez de constructo se estableció mediante correlación de Pearson comparando los resultados del cuestionario con el dolor en escala visual analógica, que resultó estadísticamente significativa para todos los valores. Conclusiones. El cuestionario WPAI: Pain es un instrumento de medida válido para determinar las consecuencias del dolor en la productividad laboral de los pacientes, siendo el único validado en español. Sin embargo, se requieren estudios de mayor envergadura para poder confirmar una validez universal.Publication Open Access Estudio transversal de los factores que influyen en la adhesión a la dieta mediterránea en el embarazo(Arán Ediciones, 2015) Álvarez Álvarez, Ismael; Aguinaga Ontoso, Inés; Marín Fernández, Blanca; Guillén Grima, Francisco; Niu, Hao; Ciencias de la Salud; Osasun ZientziakIntroducción: La dieta mediterránea es un estilo de vida con efectos beneficiosos contrastados en el embarazo, tanto para la madre como para su descendencia. Sin embargo, se desconocen los factores que influyen en la adhesión a esta dieta. Objetivo: Investigar los factores (nivel educativo, ocupación, lugar de nacimiento, número de hijos previo y edad) que influyen en la adhesión a la dieta mediterránea en mujeres embarazadas de la comarca de Pamplona. Material y métodos: Utilizando los datos del Estudio Internacional de Sibilancias en Lactantes (EISL) en la comarca de Pamplona, se analizaron las asociaciones entre los alimentos y los factores. Se estableció una puntuación de dieta mediterránea y se estudiaron las puntuaciones de acuerdo a los factores. Resultados: Se encontraron diferencias significativas en la puntuación de dieta mediterránea según el nivel de estudios (p=<0,001), la ocupación (p=0,015) y la edad (p=<0,001). Conclusión: Mujeres con mejor nivel educativo, mejor ocupación y mayor edad muestran una mayor afinidad a la dieta mediterránea durante el embarazo.Publication Open Access Production of vegetables and artichokes is associated with lower cardiovascular mortality: an ecological study(MDPI, 2020) Arnedo Pena, Alberto; Puig Barberà, Joan; Bellido Blasco, Juan; Romeu García, María Ángeles; Guillén Grima, Francisco; Ciencias de la Salud; Osasun ZientziakMortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischaemic heart disease (IHD), was considerably different in eight municipalities of the province of Castellón, Community of Valencia (Spain) during the period of 1991–2011. In addition, these villages showed differences in agricultural practices and production. Since high vegetable consumption has been linked to decreased all-cause, CVD, and CED mortalities, we hypothesized that the diversity in vegetable and artichoke production, used as proxies for their consumption, could be associated with the diversity of mortality rates. In order to test our hypothesis, we estimated the smoothed standardized mortality ratios (SMRs) of CVD, CED, and IHD mortalities and a directed, age-adjusted mortality rate (AMR). We used a multilevel linear regression analysis to account for the ecological nature of our study. After adjustment, the CVD and CED SMRs were inversely associated with vegetable and artichoke production, with a reduction in SMRs for CVD: −0.19 (95% Confidence Interval [CI] −0.31 to −0.07) and −0.42 (95% CI −0.70 to −0.15) per hectare/103 inhabitants, respectively. The SMRs for CED also decreased: −0.68 (95% CI −1.61 to −0.19) and −1.47 (95% CI −2.57 to −0.36) per hectare/103 inhabitants, respectively. The SMRs for IHD were not associated with vegetal and artichoke production. When the directed AMR was used, CED mortality was consistent with the previous results, whereas the CVD mortality association was lost. Our results indicate that vegetable and artichoke production may act as protective factors of CED and CVD mortalities.Publication Open Access The influence of gender and atopy in the relationship between obesity and asthma in childhood(Elsevier, 2017-01-24) Álvarez Zallo, Noelia; Aguinaga Ontoso, Inés; Álvarez Álvarez, Ismael; Guillén Grima, Francisco; Azcona San Julián, María Cristina; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako GobernuaBackground: the objective of the study was to examine the relationship between asthma and overweight¿obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. Methods: the study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight-obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. Results: the prevalence of overweight and obesity in 6-7-year-old children was 18.6% and 5.2% respectively and in 13-14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6-7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15-2.47], asthma ever: OR 2.29 [1.43-3.68], current asthma 2.56 [1.54-4.28], severe asthma 3.18 [1.50-6.73], exercise-induced asthma 2.71 [1.45-5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05-2.91], asthma ever: OR 3.12 [1.67-5.82], current asthma 3.20 [1.65-6.19], severe asthma 4.83[1.94-12.04], exercise-induced asthma 3.68 [1.67-8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. Conclusions: obesity and asthma symptoms were associated in 6-7 year-old children but not in 13-14 year-old teenagers. The association was stronger in non-atopic children and obese girls.Publication Open Access Influence of the Mediterranean diet during pregnancy in the development of wheezing and eczema in infants in Pamplona, Spain(Codon Publications, 2017-06-17) Álvarez Zallo, Noelia; Aguinaga Ontoso, Inés; Álvarez Álvarez, Ismael; Marín Fernández, Blanca; Guillén Grima, Francisco; Azcona San Julián, María Cristina; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako GobernuaBackground: this study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. Methods: the study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). Results: no association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. Conclusions: the present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema.Publication Open Access Validation study of a Spanish version of the modified Telephone Interview for Cognitive Status (STICS-m)(Elsevier, 2018) Muñoz-García, Mariana; Cervantes, Sebastián; Razquin, Cristina; Guillén Grima, Francisco; Toledo, Juan B.; Martínez González, Miguel Ángel; Toledo, Estefanía; Ciencias de la Salud; Osasun ZientziakObjetivo: Estudiar la correlación de la Telephone Interview for Cognitive Status modificada en español(STICS-m) con el Mini-Mental State Examination (MMSE) y predecir la capacidad de la primera para detectar el desarrollo de demencia. Método: Ciento seis sujetos de un estudio de intervención dietética fueron evaluados personalmente con el MMSE y por teléfono con la STICS-m. La correlación entre ambos se midió con el coeficiente de correlación intraclase (CCI) de consistencia. Además, 932 participantes mayores de 55 años de la cohorte 'Seguimiento Universidad de Navarra' fueron evaluados con la STICS-m. Durante una mediana de seguimiento de 6,5 años, se recogió información sobre el desarrollo de demencia. Mediante regresión logística se estudió la asociación entre la puntuación de la STICS-m o el cambio a 2 años en la puntuación y el riesgo de desarrollar demencia, ajustando por apolipoproteína E, edad y años de educación universitaria. Resultados: El CCI entre el MMSE y la STICS-m fue de 0,31 (intervalo de confianza del 95% [IC95%]:0,13-0,48). La odds ratio (OR) ajustada para el desarrollo de demencia para cada punto adicional en la puntuación basal de la STICS-m fue de 0,85 (IC95%: 0,72-1,02; p = 0,084). Al considerar el cambio en la puntuación a los 2 años como variable independiente, la OR fue de 0,79 (IC95%: 0,67-0,93; p = 0,006).Publication Open Access Perfil de la demanda urgente e influencia del fútbol televisado en un servicio extrahospitalario en la Zona Básica de Salud de Tafalla, Navarra(Ministerio de Sanidad y Consumo, 2003) Pérez Ciordia, Ignacio; Catalán Fabo, Francisca; Zalacain Nicolay, Fernando; Barriendo Antoñanzas, Maite; Solaegui Díaz de Guereñu, Ramón; Guillén Grima, Francisco; Ciencias de la Salud; Osasun ZientziakFundamento: la demanda a los servicios de urgencias, tanto hospitalarios como extrahospitalarios, mantiene un ritmo creciente. El objetivo del presente trabajo es doble: cuantificación y estudio de las características personales de los usuarios demandantes de atención urgente y valorar si el fútbol televisado influye en la utilización del servicio de urgencias. Métodos: Estudio descriptivo longitudinal (9.723 usuarios demandantes) y estudio de casos y controles (1.284 usuarios demandantes) según presencia o no de fútbol televisado mediante modelo de regresión logística. Las asociaciones se han cuantificado mediante la odds ratio (OR). Se excluyen del estudio las consultas telefónicas y las de enfermería. Resultados: El 10,6% de la demanda ha correspondido a consultas en domicilio y se han remitido al hospital el 4,8% del total. El 13,3% de la demanda corresponde a personas desplazadas de otras zonas de salud y son 65 los usuarios hiperfrecuentadores con 8 o más consultas. El mes de agosto (32,3%), el domingo (44,56%) y el grupo horario de 12 a 14 horas (8,38%) son los momento de mayor demanda de atención, siendo las diferencias estadísticamente significativas. El fútbol televisado se asoció a un aumento de la demanda del 19,8% (p<0,001) respecto al periodo control. Conclusiones: Se observa una alta frecuentación a los servicios de urgencia extrahospitalaria, con una importante concentración de la demanda en momentos muy concretos. Es muy importante la atención prestada a personas desplazadas. La retransmisión de fútbol televisado se asocia con una mayor utilización del servicio de urgencias.Publication Open Access Coverage and development of specialist palliative care services across the World Health Organization European Region (2005-2012): results from a European Association for Palliative Care Task Force survey of 53 countries(SAGE, 2016) Centeno, Carlos; Lynch, Thomas; Garralda, Eduardo; Carrasco, José Miguel; Guillén Grima, Francisco; Ciencias de la Salud; Osasun ZientziakBackground: The evolution of the provision of palliative care specialised services is important for planning and evaluation. Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region – home care teams, hospital support teams and inpatient palliative care services. Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented. Results: Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005–2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively. Conclusion: Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.Publication Open Access Individual- and community-level determinants of maternal health service utilization in southern Ethiopia: a multilevel analysis(SAGE, 2023) Yoseph, Amanuel; Teklesilasie, Wondwosen; Guillén Grima, Francisco; Astatkie, Ayalew; Ciencias de la Salud; Osasun ZientziakBackground: Maternal health service utilization decreases maternal morbidity and mortality. However, the existing evidence is inadequate to design effective intervention strategies in Ethiopia. Objectives: This study aimed to examine the utilization of maternal health service and identify its determinants among women of reproductive age in southern Ethiopia. Design: A community-based cross-sectional study was conducted from October 21 to November 11, 2022 on a sample of 1140 women selected randomly from the Northern Zone of the Sidama region. Methods: Data were collected using the Open Data Kit mobile application and exported to Stata version 15 for analysis. We used a multilevel mixed-effects modified Poisson regression with robust standard error to identify determinants of maternal health service utilization. Results: Utilization of antenatal care, health facility delivery, and postnatal care was 52.0% (95% confidence interval: 49.0%, 55.0%), 48.5% (95% confidence interval: 45.6%, 51.4%), and 26.0% (95% confidence interval: 23.0%, 29.0%), respectively. Antenatal care use was associated with receiving model family training (adjusted prevalence ratio: 1.19; 95% confidence interval: 1.06, 1.35), knowledge of antenatal care (adjusted prevalence ratio: 1.54; 95% confidence interval: 1.31, 1.81), perceived quality of antenatal care (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), and having birth preparedness plan (adjusted prevalence ratio: 1.13; 95% confidence interval: 1.02, 1.25). The identified determinants of health facility delivery use were middle wealth rank (adjusted prevalence ratio: 1.35; 95% confidence interval: 1.03, 1.77), perceived quality of health facility delivery (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), antenatal care (adjusted prevalence ratio: 1.76; 95% confidence interval: 1.36, 2.26), and high community-level women literacy (adjusted prevalence ratio: 1.55; 95% confidence interval: 1.10, 2.19). Postnatal care use was associated with facing health problems during postpartum period (adjusted prevalence ratio: 1.79; 95% confidence interval: 1.18, 2.72), urban residence (adjusted prevalence ratio: 3.52; 95% confidence interval: 2.15, 5.78), knowledge of postnatal care (adjusted prevalence ratio: 1.11; 95% confidence interval: 1.04, 1.19), and low community-level poverty (adjusted prevalence ratio: 0.43; 95% confidence interval: 0.25, 0.73). Conclusion: Maternal health service use was low in the study area and was influenced by individual- and community-level determinants. Any intervention strategies must consider multi-sectorial collaboration to address determinants at different levels. The programs should focus on the provision of model family training, the needs of women who have a poor perception, and knowledge of maternal health service at the individual level.