Papers by Magdalena Murphy
Pleural mesothelioma in relation to meteorological conditions and residential distance from an in... more Pleural mesothelioma in relation to meteorological conditions and residential distance from an industrial source of asbestos
Journal of Diabetes & Metabolism, 2014
Aim: To analyse glycaemic control and antihyperglycaemic treatment in patients with varying durat... more Aim: To analyse glycaemic control and antihyperglycaemic treatment in patients with varying duration of type 2 diabetes in a population-based database. Methods: A cross-sectional survey of 286,791 patients with type 2 diabetes registered in the primary care centres of the Catalan Health Institute (Catalonia, Spain) in 2009. We analysed the effects of types of treatment, diabetes duration and renal function on glycaemic control, adjusting for other clinical variables. Results: Twenty-four percent of patients were treated with lifestyle changes only, 35.5% with oral glucoselowering monotherapy, 21% with oral combinations and 17.7% with insulin (alone or in combination). Insulin was more frequently used in patients with longer duration of diabetes or severe renal impairment. Fifty-six percent of patients achieved the optimal target of HbA1c ≤ 7% (≤ 53 mmol/mol), a result more frequently observed in patients older than 65, early in the course of the disease and at the lower steps of treatment (p<0.001). Impaired renal function was present in 18.4% of patients. A significant number of patients with severe renal impairment were taking metformin (16.2%) or sulfonylureas (12.1%), which are contraindicated at this stage. Multivariable analyses confirmed that lower steps of treatment, advanced age and lesser years of diabetes duration were the variables positively related to good glycaemic control. Conclusions: Glycaemic control deteriorates with the progression of the disease despite the treatment intensification. Impaired renal function was frequent and a remarkable proportion of these patients were taking contraindicated drugs. J ou rna l o f D ia be tes & M e ta bolism
Diabetes Care, 2012
OBJECTIVE The objective of this study was to analyze the clinical characteristics and levels of g... more OBJECTIVE The objective of this study was to analyze the clinical characteristics and levels of glycemic and cardiovascular risk factor control in patients with type 2 diabetes that are in primary health care centers in Catalonia (Spain). RESEARCH DESIGN AND METHODS This was a cross-sectional study of a total population of 3,755,038 individuals aged 31–90 years at the end of 2009. Clinical data were obtained retrospectively from electronic clinical records. RESULTS A total of 286,791 patients with type 2 diabetes were identified (7.6%). Fifty-four percent were men, mean (SD) age was 68.2 (11.4) years, and mean duration of disease was 6.5 (5.1) years. The mean (SD) A1C value was 7.15 (1.5)%, and 56% of the patients had A1C values ≤7%. The mean (SD) blood pressure (BP) values were 137.2 (13.8)/76.4 (8.3) mmHg, mean total cholesterol concentration was 192 (38.6) mg/dL, mean HDL cholesterol concentration was 49.3 (13.2) mg/dL, mean LDL cholesterol (LDL-C) concentration was 112.5 (32.4) ...
Atención Primaria, 2004
Objetivo. Describir la evolución del hábito tabáquico durante el embarazo y en un largo período p... more Objetivo. Describir la evolución del hábito tabáquico durante el embarazo y en un largo período posparto, y analizar los factores asociados con el abandono del tabaco. Diseño. Estudio descriptivo retrospectivo. Emplazamiento. Centro de atención primaria de Badia del Vallès (Barcelona). Participantes. Mujeres con gestaciones a término en un período de 3 años (n = 309; 68% de la población diana). Mediciones principales. Tabaquismo antes del embarazo. Cesación en el embarazo y factores relacionados (sociodemográficos, hábito tabáquico, creencias sobre la salud). Recaídas en el posparto. Resultados. El 50% fumaba antes del embarazo. De ellas, el 46% dejó de fumar durante la gestación y el 44% disminuyó el consumo. En las gestantes primíparas se apreció un mayor riesgo de continuar fumando cuanto mayor fuera el consumo de tabaco previo (odds ratio [OR] = 5,3 si ≥ 20 cigarrillos/día y OR = 4,7 para 10-19 cigarrillos/día) y al no creer en el efecto del tabaco sobre la salud del niño (OR = 3,9). En las gestantes multíparas se asoció con la ausencia de abandono del tabaco en anteriores embarazos (OR = 43,8) y con el tabaquismo de la pareja (OR = 7,2). En los 2 años posteriores el parto recayó el 80% de las que dejaron de fumar. Conclusiones. En nuestro medio coexiste una elevada prevalencia de fumadoras antes del embarazo con una alta tasa de abandonos durante la gestación. Finalmente, una de cada 4 mujeres fuma durante el embarazo. El abandono del tabaco se relaciona con factores como la dependencia, la motivación, el entorno y la experiencia previa.
Background: Scotland has a policy aimed at increasing physical activity levels in the population,... more Background: Scotland has a policy aimed at increasing physical activity levels in the population, but evidence on how to achieve this is still developing. Studies that focus on encouraging real world participants to start physical activity in their settings are needed. The Walking for Well-being in the West study was designed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation. The study was multi-disciplinary and based in the community. Walking for Well-being in the West investigated whether Scottish men and women, who were not achieving the current physical activity recommendation, increased and maintained walking behaviour over a 12 month period. This paper outlines the rationale and design of this innovative and pragmatic study. Participants were randomised into two groups: Group 1: Intervention (pedometerbased walking programme combined with a series of physical activity consultations); Group 2: Waiting list control for 12 weeks (followed by minimal pedometer-based intervention). Physical activity (primary outcome) was measured using pedometer step counts (7 day) and the International Physical Activity Questionnaire (long version). Psychological processes were measured using questionnaires relating to the Transtheoretical Model of Behaviour Change, mood
American Journal of Industrial Medicine, 2020
Please confirm that the funding sponsor list below was correctly extracted from your article: tha... more Please confirm that the funding sponsor list below was correctly extracted from your article: that it includes all funders and that the text has been matched to the correct FundRef Registry organization names. If a name was not found in the FundRef registry, it may not be the canonical name form, it may be a program name rather than an organization name, or it may be an organization not yet included in FundRef Registry. If you know of another name form or a parent organization name for a "not found" item on this list below, please share that information. FundRef name FundRef Organization Name (Country)
![Research paper thumbnail of [Evaluation of a supervised physical exercise program in primary care]](https://a.academia-assets.com/images/blank-paper.jpg)
Atención Primaria
To compare self-perception of health with physical parameters in a population group with chronic ... more To compare self-perception of health with physical parameters in a population group with chronic illnesses when conducting a group intervention of supervised physical exercise. Intervention study with test-retest evaluation. Serraparera Primary Care Centre (PCC) in the town of Cerdanyola del Vallès (24,735 inhabitants). Patients between 30 and 65 with a chronic illness and attended at the PCC (n = 87). A seven-month programme, based on regular supervised physical exercise, three times a week for an hour, supplemented by organised monthly walks on varying routes. Blood pressure, BMI, flexibility, sub-maximum and at-rest heart rates were measured, and the Nottingham Health Profile (NHP) self-perception test conducted. 87 patients began the programme and 51 reached the end. The following was observed in the 51: self-perception of overall improvement in health on the NHP of 9.51 points (CI 95%, 5.73-13.23); lowering of blood pressure, systolic 4.8 mmHg (CI 2.47-7.13) and diastolic 4.78 ...
BMJ Open, 2012
Objective: The purpose of this study was to assess the effectiveness of a quality improvement (QI... more Objective: The purpose of this study was to assess the effectiveness of a quality improvement (QI) plan aimed at primary healthcare teams (PHCTs) to optimise hypertension control and to compare it with standard clinical care.
Objetivo: Conocer si una intervención puede mejorar el soporte social, es efectiva para disminuir... more Objetivo: Conocer si una intervención puede mejorar el soporte social, es efectiva para disminuir la sobrecarga de los cuidadores principales de los pacientes del programa de atención domiciliaría (ATDOM) y mejorar la calidad de vida. Material y métodos Diseño: Ensayo de intervención comunitaria, controlado, multicéntrico, aleatorizado con asistencia por conglomerados. Población: Cuidadores principales informales de pacientes ATDOM, mayores de 18
Enfermería Clínica, 2006
Objetivo. Conocer la distribución de frecuencia de uso de los distintos tipos de absorbentes, en ... more Objetivo. Conocer la distribución de frecuencia de uso de los distintos tipos de absorbentes, en función de las características físicas del residente y su nivel de autonomía, tras la implementación de la guía sobre el uso de absorbentes en la incontinencia urinaria del Institut Català de la Salut (ICS). Método. Estudio observacional, descriptivo, transversal, de 12 meses de duración en 2 residencias geriátricas de Cerdanyola del Vallès (Barcelona). Se incluyeron a los residentes con diagnóstico de incontinencia y en tratamiento paliativo con absorbentes. Variables principales: proporción de tipos de absorbente utilizados; proporción de residentes con una selección de talla de absorbente incorrecta; número de cambios diarios y estado del absorbente; número de cambios según valor del índice de Barthel. Resultados. Del total de residentes (n = 74), el 74,3% (55) presentaba incontinencia urinaria y fecal; el 89,2% (66) utilizaba 2 tipos de absorbente (mayoritariamente combinación tipo día con tipo noche elástico); en el 21,6% (16) de los residentes la talla utilizada no era la recomendada por la guía del ICS. La media global del número de cambios diarios de absorbente por residente fue de 4,1 (desviación estándar [DE] = 1,76) y la media de fugas 0,11 (DE = 0,37). En los residentes con un índice de Barthel < 33 puntos, la media de cambios diarios fue de 4,48 (DE = 1,58). Conclusiones. Los residentes incontinentes con menor autonomía necesitaban un mayor número de cambios de absorbente, hecho que debería considerarse cuando se analiza el consumo de los absorbentes en las residencias. En general hubo un correcto seguimiento de las recomendaciones de la guía del ICS.
BMC Public Health, 2008
Background: Preventive activities carried out in primary care have important variability that mak... more Background: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients.
BMC Family Practice, 2014
Background: Despite the existence of formal professional support services, informal support (main... more Background: Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life.
BMC Public Health, 2015
Background: Despite evidence of the benefits of prevention activities, studies have reported only... more Background: Despite evidence of the benefits of prevention activities, studies have reported only partial integration and great variability of screening in daily clinical practice. The study objectives were: 1) To describe Primary Health Care (PHC) screening for arterial hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption in 2008 in 2 regions of Spain, based on electronic health records, and 2) To assess and quantify variability in screening, and identify factors (of patient, general practitioners and PHC team) associated with being screened, that are common throughout the PHC population. Methods: Multicentre, cross-sectional study of individuals aged ≥16 years (N = 468,940) who visited the 426 general practitioners (GPs) in 44 PHC teams in Catalonia and Navarre in 2008. Outcomes: screening for hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption. Other variables were considered at the individual (sociodemographics, visits, health problems), GP and PHC team (region among others). Individual and contextual factors associated with the odds of being screened and the variance attributable to each level were identified using the SAS PROC GLIMMIX macro. Results: The most prevalent screenings were for dyslipidaemia (64.4%) and hypertension (50.8%); the least prevalent was tobacco use (36.6%). Overall, the odds of being screened were higher for women, older patients, those with more comorbidities, more cardiovascular risk factors, and more frequent office visits, and those assigned to a female GP, a GP with a lower patient load, or a PHC team with a lower percentage of patients older than 65 years. On average, individuals in Navarre were less likely to be screened than those in Catalonia. Hypertension and dyslipidaemia screenings had the least unexplained variability between PHC teams and GPs, respectively, after adjusting for individual and contextual factors.
Objectiu Conèixer si una intervenció per millorar el suport social, és efectiva per disminuir la ... more Objectiu Conèixer si una intervenció per millorar el suport social, és efectiva per disminuir la sobrecàrrega dels cuidadors principals dels pacients del programa d’atenció domiciliària (ATDOM) i millorar-ne la qualitat de vida. Material i mètodes Disseny: Assaig d'intervenció comunitària, controlat, multicèntric, aleatoritzat amb assignació per conglomerats. Població: Cuidadors principals informals de pacients ATDOM, majors de 18 anys, amb història als
Occupational and Environmental Medicine, 2013
Few studies have focused on pleural mesothelioma and environmental exposure in individuals residi... more Few studies have focused on pleural mesothelioma and environmental exposure in individuals residing around an industrial source of asbestos. The aim of this study is to determine whether residential distance and wind conditions are related to the risk of developing pleural mesothelioma. In this retrospective cohort study carried out in an area of Barcelona province (Catalonia, Spain), 24 environmental pleural mesothelioma cases were diagnosed between 2000 and 2009. We calculated the age-standardised incidence rate ratios of developing this disease in the population studied, taking into account the residential distance from the plant. For cases living within a 500-m radius of the plant, the geographical location in relation to the factory was also assessed. The incidence rate of environmental pleural mesothelioma was higher in the population living within 500 m of the plant than in those living in a radius of 500-2000 m and much higher than those living at 2000-10 000 m. The highest incidence rate ratio for pleural mesothelioma (161.9) was found in the southeast quadrant of the 500-m area, coinciding with the predominant wind direction. Residential distance from an industrial source of asbestos and local wind conditions have a considerable impact on the risk of developing environmental pleural mesothelioma.
European Journal of Cancer Prevention, 1998
Uploads
Papers by Magdalena Murphy