J. Martinmoreno
Universitat de València, Medicina Preventiva, Faculty Member
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Research Interests: Health Sciences, Health Promotion, Global Health, Public Health Policy, Environmental Health, and 10 morePublic Health, Health Policy, Global Health Policy, Medicine, Health Systems, International Public Health, Epidemiology and Public Health, Public health systems and services research, Public Policy, and COVID-19 PANDEMIC
Research Interests: Epistemology, Global Governance, Political Science, Global Health, Policy, and 15 morePublic Health Policy, Public Health, Health Policy, Global Health Policy, Medicine, Equity, Infection and immunity, Global Health Governance, Vaccination, Public health systems and services research, Global health security, Pandemic, Vaccine Policy, CoVid, and coronavirus outbreak
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The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample... more
The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample included 1112 children, aged 6–7 years, from Cadiz, Madrid, Orense and Murcia, Spain. Children were selected through random cluster-sampling in schools. We analysed the percentage contributed by each food item to total energy and nutrient intake. The most important food sources were: white bread in the case of carbohydrate (13·4 %); olive oil in the case of total lipids (18·3 %) and monounsaturated fatty acids (29·2 %); whole milk in the case of protein (10·2 %) and saturated fatty acids (14·9 %); chips (French fried potatoes) in the case of polyunsaturated fatty acids (30·4 %). The greatest proportion of Na, consumed in excess, came from salt added to meals. Ham ranked second as a source of saturated fats. Fruits and green leafy vegetables proved to have...
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ObjectiveTo compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.DesignThis was a cross-sectional study. Food data were collected using a... more
ObjectiveTo compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.DesignThis was a cross-sectional study. Food data were collected using a food-frequency questionnaire.Subjects and methodsThe sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI).ResultsEnergy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P < 001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL childr...
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Research Interests: Food Science, Anthropometry, Biomarkers, Environmental Health, Diet, and 15 moreLipids, Humans, Child, Female, Male, Cluster Analysis, Juvenile nutrition and metabolism, Body Mass Index, Feeding Behavior, Food habits, Body Weight, Biological markers, Body Height, Cross Sectional Studies, and Energy Intake
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Research Interests: Environmental Health, Diet, Humans, Child, Female, and 15 moreFood Frequency Questionnaire, Food intake, European, Dietary pattern, Dietary fiber, Dietary Carbohydrates, Food Sciences, Cross sectional Study, Cross Sectional Studies, Cluster Sampling, Diet Quality, Energy Intake, Calories, Dietary fats, and Healthy Eating Index
Objective: The objective of the present study was to evaluate the prospective association of eGFR, calculated by using CKD-EPI, with all-cause mortality and in-hospital admissions for newly diagnosed cardiovascular endpoints in high-risk... more
Objective: The objective of the present study was to evaluate the prospective association of eGFR, calculated by using CKD-EPI, with all-cause mortality and in-hospital admissions for newly diagnosed cardiovascular endpoints in high-risk subjects from a health registry from Valencia (Spain) from 2008 to 2012. Figure. No caption available. Design and method: 54,620 men and women aged 30 years or older with at least one of hypertension, diabetes mellitus and/or dyslipidemia, who attended for routine health maintenance have been selected. Patients with a history of a previous CVD event were excluded. At the time of inclusion information about CV risk factors and their active treatments as well as smoking habit and biochemistry lab values were collected from the EHR. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Participants were followed-up for the first episode of hospitalization for myocardial infarction or stroke and all cause of death were collected....
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Over the past few decades, public health systems have been slowly but steadily eroding, culminating in national governments’ inability to swiftly respond to the COVID-19 pandemic. This structural erosion has not only led to a lack of... more
Over the past few decades, public health systems have been slowly but steadily eroding, culminating in national governments’ inability to swiftly respond to the COVID-19 pandemic. This structural erosion has not only led to a lack of preparedness, but also a decreased the ability of governments to generate sufficient human, physical, financial and knowledge resources. However, key lessons can be learned from governments’ responses to the pandemic and in identifying factors contributing to failure or success. In light of historical trends and national case studies, the Association of Schools of Public Health in the European Region (ASPHER) highlights essentials for the strengthening and “building back better” of our public health systems moving forward as well as calls upon key stakeholders to take action.
Research Interests: Health Sciences, Health Promotion, Global Health, Public Health Policy, Public Health, and 9 moreHealth Policy, Global Health Policy, Public Health Systems & Services Research, Health Systems, International Public Health, Epidemiology and Public Health, Public health systems and services research, Public Policy, and COVID-19 PANDEMIC
Dairy products might influence breast cancer (BC) risk. However, evidence is inconsistent. We sought to examine the association between dairy product consumption—and their subtypes—and incident BC in a Mediterranean cohort. The SUN... more
Dairy products might influence breast cancer (BC) risk. However, evidence is inconsistent. We sought to examine the association between dairy product consumption—and their subtypes—and incident BC in a Mediterranean cohort. The SUN (“Seguimiento Universidad de Navarra”) Project is a Spanish dynamic ongoing cohort of university graduates. Dairy product consumption was estimated through a previously validated 136-item food frequency questionnaire (FFQ). Incident BC was reported in biennial follow-up questionnaires and confirmed with revision of medical records and consultation of the National Death Index. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated with Cox regression models. Among 123,297 women-years of follow-up (10,930 women, median follow-up 12.1 years), we confirmed 119 incident BC cases. We found a nonlinear association between total dairy product consumption and BC incidence (pnonlinear = 0.048) and a significant inverse association for women with modera...
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Inter-country alliances, articulated through regional approaches, have increasingly been used to drive economic development and social progress in the past several decades. The South Eastern Europe Health Network (SEEHN) stands out among... more
Inter-country alliances, articulated through regional approaches, have increasingly been used to drive economic development and social progress in the past several decades. The South Eastern Europe Health Network (SEEHN) stands out among these types of initiatives for the tangible improvements it has achieved in regional governance for health, with several important lessons for public health leaders worldwide. This review paper, written by several key participants in SEEHN operation, follows the main milestones in network development, including its foundation under the Stability Pact’s Initiative for Social Cohesion and the three ministerial forums that have shaped its evolution, in order to show how it can constitute a model for regional collaboration in public health. Herewith we summarise the main accomplishments of the network and highlight the keys to its success, drawing lessons that both international bodies and other regions may use in their own design of collaborative initi...
The objective of the present study was to evaluate the potential impact of hypertension in the increased CVD risk associated with CKD in a population with at least one main CV risk factor (CVRF), hypertension, dyslipidemia or... more
The objective of the present study was to evaluate the potential impact of hypertension in the increased CVD risk associated with CKD in a population with at least one main CV risk factor (CVRF), hypertension, dyslipidemia or diabetes.(Figure is included in full-text article.) : 54,620 men and women aged 30 years or older with at least one of main CVRF (hypertension, diabetes mellitus and/or dyslipidemia), who attended for routine health maintenance have been selected. Patients with a history of a previous CVD event were excluded. At the time of inclusion information about CVRF and their active treatments as well as smoking habit and biochemistry lab values were collected from the EHR. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Participants were followed-up for the first episode of hospitalization for myocardial infarction or stroke and all cause of death were collected. Interaction terms for dichotomous eGFR (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;=60, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;60 ml/min/1.73 m2) with the corresponding indicator variables for subgroups defined by sex, hypertension, diabetes, dyslipidemia, and obesity in separate models were calculated using the Wald test. 54,620 patients were included. Hypertension was present in 76%, dislipidemia 86%, diabetes in 35.5% and obesity in 41,8%. A total of 7884 (14.4%) patients had eGFR below 60 ml/min/1.73 m2 and among them 1807 (3.3%) 45 ml/min/1.73 m2 or lower. During a time follow-up of 3.2 years, patients years exposure, 960 death were recorded. A significant increment in the risk for total mortality was observed in subjects with eGFR 45 ml/min/1.73 m2 or below adjusted for multiple potential confounders (HR 1.83, 1.28-2.62; CI 95th). In normotensive subjects the risk did not increase below 60 ml/min/1.73 m2 in contrast with the increment in hypertensives. (Figure 1 on the previous page). eGFR is a prevalent condition in patients with the main CV risk factors. eGFR below &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;45 ml/min/1.73 m2 increases mortality risk. Hypertension by itself had an important role in the risk of mortality in patients with low eGFR on top of other CV risk factors.
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This document reviews the current policy and legislation instruments and tools in place for delivering public health operations in the WHO European Region. It aims to underpin and complement the European Action Plan for Strengthening... more
This document reviews the current policy and legislation instruments and tools in place for delivering public health operations in the WHO European Region. It aims to underpin and complement the European Action Plan for Strengthening Public Health Capacities and Services (EAP). It provides initial findings on the wide spectrum of legal and policy frameworks at regional and global levels discovered by mapping the available public health instruments and tools across 10 essential public health operations (EPHOs). The main findings are that at the global level legally binding instruments and tools are mainly concentrated in EPHO 3 (health protection) with 306 tools, EPHO 4 (health promotion) with 31 and EPHO 6 (governance) with 41. This corresponds to more than 90% of the total number of public health tools. However, there were only 2 tools for EPHO 5 (disease prevention), 3 for EPHO 7 (workforce) and 1 for EPHO 8 (organizational structures and financing). No legally binding tools were ...
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No study that analyzes how the investigators who work in the Spanish hospitals perceived and evaluate the current research system has been performed. This work, carried out by the Scientific Forum of the Lilly Foundation, aims to improve... more
No study that analyzes how the investigators who work in the Spanish hospitals perceived and evaluate the current research system has been performed. This work, carried out by the Scientific Forum of the Lilly Foundation, aims to improve the level of information on the research activity performed in the hospitals. By means of a «self-administered» interview made up of 34 items and aimed at physicians and other research professionals who work in the Spanish hospitals (272 surveyed), 3 questions were analyzed: a) general situation of biomedical research in Spain; b) administration of available resources: need for better resources, and c) evaluation and giving priority to biomedical research. The use of the data has shown strengths in the system such as the initiatives to promote research through contracts with FIS and post-residency (7.6/10 points); the beneficial effects of research and care quality (7.3/10); or support of the pharmaceutical industry through the sponsoring of clinical trials (6.9/10). However, it has also shown that there are some weaknesses in the organization of the centers, as for example, those referring to the differentiated allocation of the care cost of the research activity (5.1/10); to the coordination between them and the health care centers (2.8/10); to the integration and organization among care, teaching and research (3.6/10); and to decide the priorities (5.2/10) and evaluation (5.2/10) of the research activities. Furthermore, the value of the research as a fundamental activity of the hospitals is emphasized (4.7/10). The investigators surveyed consider that biomedical research in recent decades in the hospital setting has significantly improved and has had a positive effect in the number of publications. The subjects surveyed consider that research should have greater institutional support and recognition, and a more translational orientation, which would be translated into better quality of life of the citizens and registry of patents.
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Summary: The authors of a European Parliament report on palliative care summarise the process of the five-month investigation, as well as the real and potential results of the study. Engaging a large number of national and international... more
Summary: The authors of a European Parliament report on palliative care summarise the process of the five-month investigation, as well as the real and potential results of the study. Engaging a large number of national and international stakeholders, including ministries of health, national palliative care associations and the European Association for Palliative Care (EAPC), we were able to draw on a well of previous research and diverse experiences before formulating operative policy options for the EU and its Member States. While the report itself fomented some self-examination in the countries studied, its full exploitation by palliative care advocates is still pending.
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Research Interests: New Media, Health Communication, Health Promotion, Medical Informatics, International organizations, and 15 moreObesity, Health Literacy, Diet, Health, Public Health, Communication Technology, Library and Information Studies, Nongovernmental organizations, Humans, Chronic Disease, Alcohol Drinking, Communication and media Studies, International Organizations, Alcohol Use, and Coomunication and Development
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Research Interests: Cancer, European Union, Health Policy, Mortality, Humans, and 15 moreEurope, Service Delivery, Population Growth, Burden of Disease, Registries, European, Neoplasms, Cancer Incidence, World Health Organization, Integrated Care, SECONDARY PREVENTION, Primary Prevention, Member States, Incidence Rate, and mass Screening
Research Interests: Breast Cancer, European Union, Cardiovascular disease, Continuing Medical Education, European Commission, and 15 moreHumans, Europe, Legislation, Female, Alcohol Drinking, Cervical Cancer, Fruit and vegetables, European, Food habits, Cost Benefit Analysis, Cancer Incidence, Breast Self Examination, European Community, Cancer Risk, and Delivery of Health Care
Research Interests: Public Health, Multidisciplinary, Cardiovascular Risk, Family history, Heavy metals, and 15 moreHumans, Europe, Heavy Metal, Male, Acute Myocardial Infarction, Neutron Activation Analysis, Risk factors, Middle Aged, Myocardial Infarction, Cerium, Cardiovascular Risk Factor, Risk Factors, Case Control Study, Nails, and Case Control Studies
Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic... more
Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study. Methods/Design A cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS) that is the usual way to register clinical practice in the Valencian Health System (primary and secondary care). The system covers about 95% of population (near 5 million people). The system is linked with database of mortality register, hospital withdrawals, prescriptions and assurance databases in which each individual have a unique identification number. Diagnoses in clinical practic...