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Toledo D.,CIBER ISCIII | Toledo D.,University of Barcelona | Aerny N.,Subdireccion de Promocion de la Salud y Prevencion | Soldevila N.,CIBER ISCIII | And 17 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

Online surveys are increasingly used due to their speed and efficiency. The aim of this study was to analyze factors that may have contributed to the quality and speed of response of an online survey on influenza vaccination in primary healthcare workers. A multicenter study including family physicians, nurses and pediatricians from primary healthcare teams from seven Spanish Autonomous Communities was designed. The centers were selected by simple random sampling. The survey remained active and accessible for 56 days and four reminders were sent. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the association of sociodemographic variables and responding to the survey before the second reminder. Complete, validated information was obtained from 1965 primary healthcare workers. The total response rate was 36.2%. More nurses (46.3%) responded before the second reminder and more family physicians (52.8%) after the second reminder. The adjusted OR shows that family physicians responded later (AOR 1.46, 95% CI 1.2–1.8) than nurses. The responses obtained in the first 24 h after the initial sending and the reminders accounted for 41.7% of the completed surveys, indicating the importance of reminders. © 2015 by the authors; licensee MDPI, Basel, Switzerland. Source

Baricot M.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Toledo D.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Castilla J.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Castilla J.,Institute Salud Publica Of Navarra | And 13 more authors.
Vacunas | Year: 2013

Influenza is a highly contagious disease that has a significant effect on the community. During the season 2010-2011, the overall rate of hospitalization for severe confirmed influenza in Spain was estimated at 5.76 cases per 100,000 inhabitants, although this number is probably underestimating the problem. Health workers can act as vectors for nosocomial transmission of influenza virus to patients, thus their immunization is an essential aspect in programs for prevention and control of infections associated with health care. In order to investigate the influenza vaccination coverage in season 2011-2012 and in the 3 previous seasons, and also to determine the knowledge and attitudes of medical and primary care professionals in Spain as regards the seasonal and pandemic influenza vaccine, a multicentre study was conducted in 7 regions (Andalusia, Castile and Leon, Catalonia, Valencia, Madrid, Navarra and Basque Country) using an anonymous online questionnaire. The objectives and methodology of the study are presented, as well as the main lessons to be learned from the use of new information technologies and communication, together with the information available for research in Public Health are discussed. © 2013 Elsevier España, S.L. Todos los derechos reservados. Source

Dominguez A.,University of Barcelona | Dominguez A.,CIBER ISCIII | Soldevila N.,CIBER ISCIII | Toledo D.,University of Barcelona | And 12 more authors.
PLoS ONE | Year: 2016

Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged ≥65 years hospitalized due to causes unrelated to influenza in Spain.We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models.We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19-2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45-19.48); and 23-valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38-2.80) were associated with receiving the influenza vaccine. Vaccination coverage of hospitalized elderly people is low in Spain and some predisposing characteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccination to all patients aged ≥65 years. © 2016 Domínguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

Martin V.,University of Leon | Martin V.,CIBER ISCIII | Davila-Batista V.,University of Leon | Castilla J.,CIBER ISCIII | And 15 more authors.
BMC Public Health | Year: 2016

Background: Obesity is a world-wide epidemic whose prevalence is underestimated by BMI measurements, but CUN-BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) estimates the percentage of body fat (BF) while incorporating information on sex and age, thus giving a better match. Our aim is to compare the BMI and CUN-BAE in determining the population attributable fraction (AFp) for obesity as a cause of chronic diseases. Methods: We calculated the Pearson correlation coefficient between BMI and CUN-BAE, the Kappa index and the internal validity of the BMI. The risks of arterial hypertension (AHT) and diabetes mellitus (DM) and the AFp for obesity were assessed using both the BMI and CUN-BAE. Results: 3888 white subjects were investigated. The overall correlation between BMI and CUN-BAE was R2 = 0.48, which improved when sex and age were taken into account (R2 > 0.90). The Kappa coefficient for diagnosis of obesity was low (28.7 %). The AFp was 50 % higher for DM and double for AHT when CUN-BAE was used. Conclusions: The overall correlation between BMI and CUN-BAE was not good. The AFp of obesity for AHT and DM may be underestimated if assessed using the BMI, as may the prevalence of obesity when estimated from the percentage of BF. © 2016 Martín et al. Source

Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Godoy P.,CIBER ISCIII | Dominguez A.,CIBER ISCIII | And 22 more authors.
Clinical Infectious Diseases | Year: 2013

Background. In most seasons, the influenza vaccine is effective in preventing influenza, but it is not clear whether it is equally effective in preventing mild and severe cases. We designed a case-control study to compare the effectiveness of the influenza vaccine in preventing outpatient, inpatient, and severe or fatal cases of laboratory-confirmed influenza.Methods. Hospitalized patients (n = 691) with laboratory-confirmed influenza in the 2010-2011 season recruited in 29 Spanish hospitals were individually matched by age, admission/visit date, and province with an outpatient with laboratory-confirmed influenza and an outpatient control. Severe cases were considered those patients admitted to intensive care units or who died in the hospital (n = 177). We compared the influenza vaccine status of controls and outpatient cases, inpatient cases, and severe cases using conditional logistic regression adjusted for potential confounding factors. Severe and nonsevere inpatient influenza cases were compared using unconditional logistic regression. Vaccine effectiveness was (1-odds ratio) × 100.Results. Vaccine effectiveness was 75% (adjusted odds ratio [AOR], 0.25; 95% confidence interval [CI],. 16-.39) in preventing influenza outpatient cases, 60% (AOR, 0.40; 95% CI,. 25-.63) in preventing influenza-associated hospitalizations, and 89% (AOR, 0.11; 95% CI,. 04-.37) in preventing severe cases. In inpatients, influenza vaccination was associated with a lower risk of severe influenza (AOR, 0.42; 95% CI,. 22-.80).Conclusions. Influenza vaccination prevented influenza cases and hospitalizations and was associated with a better prognosis in inpatients with influenza. The combined effect of these 2 mechanisms would explain the high effectiveness of the vaccine in preventing severe cases due to influenza. © 2013 The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. Source

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