The Roma population's fear of donating their own organs for transplantation

BACKGROUND

The refusal rate for donating organs among the Roma people is much higher than that of any other social group.

OBJECTIVE

To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain.

METHOD

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TYPE OF STUDY

Spanish national observational sociological study stratified by gender and age.

STUDY POPULATION

Roma population aged ≥15 years living in Spain.

SAMPLE SIZE

1,253 respondents. Assessment instrument: Validated questionnaire on attitude towards organ donation for transplantation "PCID - DTO Ríos". Field work: Random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required.

STATISTICS

Student's t test, χ², Fisher's exact test and a logistic regression analysis.

RESULTS

The degree of completion was 18.2% (n = 228). Of those who completed the questionnaire, 42.1% (n = 96) were in favor of donation, 30.3% (n = 69) were undecided and the remaining 27.6% (n = 63) were against it. Of the 1,025 (81.8%) who declined to complete the questionnaire, 1,004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n = 96) in favor of donating their organs compared to 92.2% (n = 1166) not in favor (against or undecided).

CONCLUSIONS

A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group.

Trends in premature mortality due to ischemic heart disease in Spain from 1998 to 2018

INTRODUCTION AND OBJECTIVES

Ischemic heart disease (IHD) is the leading cause of death and one of the leading causes of disability. The aim of this study was to analyze trends in premature mortality due to IHD in patients younger than 75 years in Spain from 1998 to 2018 by region.

METHODS

Observational study of temporal trends in premature mortality due to IHD in Spain by region and sex from 1998 to 2018. The study population included resident citizens aged between 0 and 74 years. The data sources were the continuous population register and the mortality registry of the National Institute of Statistics. We calculated age-adjusted mortality rates and their average annual percent change estimated by Poisson models.

RESULTS

During the study period, mortality rates due to IHD decreased, both in the country as a whole and by provinces (53% in men and 61% in women), with an average annual percent change of -3.92% and -5.07%, respectively. In the first year (1998), mortality was unequally distributed among provinces, with higher mortality in the south of Spain.

CONCLUSIONS

Premature mortality due to IHD significantly decreased in Spain during the study period in both sexes to roughly half of initial cases. This decrease was statistically significant in almost all regions. Interprovincial differences in mortality and their variation also decreased in recent years.

[Provincial savings of costs in road accidents in Spain (2000-2014)]

OBJECTIVE

To quantify cost savings obtained before and after the implementation of the penalty-points driving licence on the interurban roads in Spain.

METHOD

Descriptive study through the construction of three indicators that expressed the cost savings by the number of victims avoided. We defined two periods according to the objective and collected data on fatalities, serious injuries and slight injuries on interurban roads in 1999-2014 for each Spanish province. Thus, data for its population, GDP or number of vehicles-kilometres travelled on its roads (MVKT) were used for each province. The quantification of savings was obtained using official figures of costs for each type of victim in 2014 prices.

RESULTS

The cost savings per inhabitant on fatalities in the period of validity of the penalty-points driving licence was between ⿬ 3.89 and ⿬ 19.65 per year. Savings on serious injuries by MVKT were reduced by 15%-66% between 2006 and 2014, being from ⿬ 449.15 to 1707.88 ⿬ annually.

CONCLUSIONS

During the period of validity of the penalty-points driving licence, the Spanish provinces have achieved significant cost savings.

Trends in Mortality From Diabetes Mellitus in Spain: 1998-2013

INTRODUCTION AND OBJECTIVES

Diabetes mellitus (DM) is a leading causes of death, mainly due to cardiovascular complications. The aim of this study was to describe DM mortality in Spain from 1998 to 2013 and to compare it between distinct provinces.

METHODS

Ecological time-trend study. Data sources consisted of the population register and the death rate figures, by cause of death, from Spain's National Statistics Institute. Rates were age-standardized by the direct method. Standardized mortality rates were calculated for each province every 5 years (1998-2013). Time trends in mortality were established by joint point regression models.

RESULTS

The standardized mortality rate for DM fell markedly, by 25.3% in men and by 41.4% in women from 1998 to 2013. At the beginning of the study period, mortality rates were higher in southern than in northern regions, but this difference gradually disappeared in later years. The highest mortality rates were consistently found in the Canary Islands.

CONCLUSIONS

Mortality from DM fell substantially from 1998 to 2013. The marked geographical clustering showing higher mortality in the south and southeastern areas of the country was significantly reduced during the study period, except in the Canary Islands, where mortality remains strikingly high.

Comparative analysis of the incidence of bladder cancer in the communities of Andalusia, Catalonia and Madrid in 2011

OBJECTIVES

To determine the incidence of bladder cancer (BC) in the autonomous communities that include the largest number of cases in the national hospital BC registry (Andalusia, Catalonia and Madrid) and report the clinical, pathological and diagnostic differences and similarities of BC in these regions.

MATERIAL AND METHODS

An observational epidemiological study was performed in 2011 in 12 public hospitals with reference population areas according to the National Health System (Spain). Demographic and clinical variables were collected from new cases and relapses, with histopathologic confirmation of BC. The raw incidence rate was calculated using the number of diagnosed cases in all the participating centers compared with the aggregate total population assigned to each center. The raw rates by age and sex were obtained from the National Institute of Statistics (2011) by weighting the assigned population with the distribution by age and sex.

RESULTS

The 3 autonomous communities recorded 51% of the 4285 cases included in the national registration, with relapses corresponding to 42.8% of these cases. The raw annual incidence rate for new episodes was 22.6 (95% CI: 20.7; 24.6) in Andalusia, 23.5 (95% CI: 20.9; 26.0) in Catalonia and 22.0 (95% CI: 19.9; 24.1) in Madrid.

CONCLUSIONS

Except for the larger proportion of smokers and lower tumor grade of lesions in Andalusia, the 3 autonomous communities studied are similar in terms of clinical characteristics, comorbidities, patient symptoms and diagnostic processes for BC.

[Perception of cardiovascular risk in an outpatient population of the Madrid Community]

INTRODUCTION

Cardiovascular diseases are responsible for the largest burden of global mortality. The study of the degree of knowledge of their population risk factors and cardiovascular risk is a priority preventive strategy.

MATERIAL AND METHODS

A cross-sectional study with 369 people was performed. The sociodemographic variables were cardiovascular risk and perception as well as physical and anthropometric factors. The risk was stratified with the SCORE table.

RESULTS

A total of 49.6% were men and 50.4% were women. The proportion of diagnosis was 23.8% in HTA, 39% in hypercholesterolemia, 31.4% in smoking, 26.3% in obesity and 4.6% in diabetes. Concordance between perceived and real cardiovascular risk was very weak.

DISCUSSION

The population has good knowledge about diabetes and acceptable knowledge about hypertension, and hypercholesterolemia but knowledge in prediabetic states and perception of the associated cardiovascular risk is low.

[Self-rated health in adults: influence of poverty and income inequality in the area of residence]

OBJECTIVE

To evaluate the influence of income inequality and poverty in the towns of Bogotá, Colombia, on poor self-rated health among their residents.

METHODS

The study was based on a multipurpose survey applied in Bogotá-Colombia. A hierarchical data structure (individuals=level1, locations=level 2) was used to define a logit-type multilevel logistic model. The dependent variable was self-perceived poor health, and local variables were income inequality and poverty. All analyses were controlled for socio-demographic variables and stratified by sex.

RESULTS

The prevalence of self-reported fair or poor health in the study population was 23.2%. Women showed a greater risk of ill health, as well as men and women with a low educational level, older persons, those without work in the last week and persons affiliated to the subsidized health system. The highest levels of poverty in the city increased the risk of poor health. Cross-level interactions showed that young women and men with a low education level were the most affected by income inequality in the locality.

CONCLUSIONS

In Bogotá, there are geographical differences in the perception of health. Higher rates of poverty and income inequality were associated with an increased risk of self-perceived poor health. Notable findings were the large health inequalities at the individual and local levels.

Survival in Mediterranean ambulatory patients with chronic heart failure. A population-based study

INTRODUCTION AND OBJECTIVES

Scarce research has been performed in ambulatory patients with chronic heart failure in the Mediterranean area. Our aim was to describe survival trends in our target population and the impact of prognostic factors.

METHODS

We carried out a population-based retrospective cohort study in Catalonia (north-east Spain) of 5659 ambulatory patients (60% women; mean age 77 [10] years) with incident chronic heart failure. Eligible patients were selected from the electronic patient records of primary care practices from 2005 and were followed-up until 2007.

RESULTS

During the follow-up period deaths occurred in 950 patients (16.8%). Survival after the onset of chronic heart failure at 1, 2, and 3 years was 90%, 80%, 69%, respectively. No significant differences in survival were found between men and women (P=.13). Cox proportional hazard modelling confirmed an increased risk of death with older age (hazard ratio=1.06; 95% confidence interval, 1.06-1.07), diabetes mellitus (hazard ratio=1.53; 95% confidence interval, 1.33-1.76), chronic kidney disease (hazard ratio=1.73; 95% confidence interval, 1.45-2.05), and ischemic heart disease (hazard ratio=1.18; 95% confidence interval, 1.02-1.36). Hypertension (hazard ratio=0.73; 95% confidence interval, 0.64-0.84) had a protective effect.

CONCLUSIONS

Service planning and prevention programs should take into consideration the relatively high survival rates found in our area and the effect of prognostic factors that can help to identify high risk patients.