Lung Function and Symptoms of Exposure to the Volcanic Eruption in the Canary Islands: First Follow-Up of the ASHES Study.

INTRODUCTION: Exposure to gases and particulate matter released during volcanic eruptions can prove harmful to population health. This paper reports the preliminary results of the ASHES study, aimed at ascertaining the respiratory health effects of the 2021 volcanic eruption in La Palma Island (Spain) on the adult population without previous respiratory disease. METHODS: Ambispective cohort study on the healthy adult population. Three exposure groups were considered: Group 1, high exposure; Group 2, moderate exposure; and Group 3, minor or no exposure. We carried out a descriptive analysis of symptoms during and after the eruption, as well as measure lung function after the eruption (through forced spirometry and diffusing capacity of carbon monoxide). RESULTS: The analysis included 474 subjects: 54 in Group 1, 335 in Group 2, and 85 in Group 3. A significant increase in most symptoms was observed for subjects in the groups exposed during the eruption. After the eruption, this increase remained for some symptoms. There seems to be a dose-response relationship, such that the higher the exposure, the higher the odds ratio. A prebronchodilator FEV1/FVC ratio<70% was observed in 13.0% of subjects in Group 1, 8.6% of subjects in Group 2, and 7.1% of subjects in Group 3. CONCLUSIONS: This study is the first to report a dose-response relationship between exposure to volcanic eruptions and the presence of symptoms in adults. Furthermore, there is a tendency toward obstructive impairment in individuals with higher exposure.

Personal assistance, independent living, and people with disabilities: An international systematic review (2013-2023).

BACKGROUND: The article discusses the contribution of personal assistance for the independent living of people with disabilities. This right is evolving at different speeds internationally, presents controversial aspects, and is under continuous debate. OBJECTIVE: To synthesize the evidence relating to the promotion of self-determination and independent living through personal assistance. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published was conducted during March 2023 across nine databases. The findings of the included studies were coded and analyzed via inductive content analysis. RESULTS: 26 articles were included, mostly qualitative, from four different continents. The analysis revealed six different key themes. The social framework highlighted the influence of international agreements and disability activism on cultural shifts in understanding disability. Secondly, healthy relationships and life or service expectations were emphasized. Key agents included users, personal assistants, family members, service providers, and other professionals. Personal assistants' work context explored ethical dilemmas, training, and working rights. Decision-making about personal assistance involved factors like lack of information, access requirements, and funding. Lastly, the implications underscored the positive impact of personal assistance on independent living, while identifying threats, and best practices for improvement. CONCLUSION: This systematic review was the first to explore the promotion of independent living of people with disabilities through personal assistance schemes and highlights the need for governments to prioritize and coordinate efforts to ensure access for all, emphasizing the ethical imperative to progress toward social justice.

A longitudinal and multidesign epidemiological study to analyze the effect of the volcanic eruption of Tajogaite volcano (La Palma, Canary Islands). The ASHES study protocol.

INTRODUCTION: Volcanic eruptions emit gases and particulate matter into the atmosphere which, if inhaled, can have an impact on health. The eruption of the volcano situated in the Cumbre Vieja Nature Reserve (La Palma, Canary Islands, Spain) affords a unique opportunity to study the effect of such a phenomenon on health. The aim of the proposed study is to assess the short-, medium- and long-term respiratory health effects of exposure to volcanic emissions from the eruption in three different population groups. METHODS: We propose to undertake a multidesign study: an ambispective cohort study to analyze the effect of the eruption on the general population, the highly exposed population, and the childhood population; and a pre-post quasi-experimental study on subjects with previously diagnosed respiratory diseases. The information will be collected using a personal interview, biologic specimens, air pollution data, data from medical records, respiratory tests and imaging tests. The study has an envisaged follow-up of five years, to run from the date of initial recruitment, with annual data-collection. This study has been approved by the Santa Cruz de Tenerife Provincial Research Ethics Committee (Canary Island Health Service) on March 10, 2022. CONCLUSIONS: This study will make it possible to advance our knowledge of the effect a volcano eruption has on population health, both short- and long-term, and to assess the potential respiratory injury attributable to volcanic eruptions. It may serve as a model for future studies of new volcanic eruptions in the coming years.

[Approximation to the cost of occupational diseases treated in seven hospitals in Spain]. / Aproximación al coste de enfermedades profesionales atendidas en siete hospitales en España.

OBJECTIVE: To estimate the hospital cost of a sample of cases treated in seven hospitals of the National Health System in several Spanish cities. METHOD: Study based on 78 cases of occupational disease recognized by the social security, and previously treated in hospitals in Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid and Vigo between 2017 and 2019. RESULTS: The healthcare activity generated by these hospitals to attend these processes involved a total cost of 282,927€. CONCLUSIONS: It is urgent to improve the coordination between the two public health systems, the social security health care system and the National Health System.

Risk Factors of Mortality in Hospitalized Patients With COVID-19 Applying a Machine Learning Algorithm.

Introduction: Risk stratification of patients with COVID-19 can be fundamental to support clinical decision-making and optimize resources. The objective of our study is to identify among the routinely tested clinical and analytical parameters those that would allow us to determine patients with the highest risk of dying from COVID-19. Material and methods: We carried out a retrospective cohort multicentric study by consecutively, including hospitalized patients with COVID-19 admitted in any of the 11 hospitals in the healthcare network of HM Hospitals-Spain. We collected the clinical, demographic, analytical, and radiological data from the patient's medical records.To assess each of the biomarkers' predictive impact and measure the statistical significance of the variables involved in the analysis, we applied a random forest with a permutation method. We used the similarity measure induced by a previously classification model and adjusted the k-groups clustering algorithm based on the energy distance to stratify patients into a high and low-risk group. Finally, we adjusted two optimal classification trees to have a schematic representation of the cut-off points. Results: We included 1246 patients (average age of 65.36 years, 62% males). During the study one hundred sixty-eight patients (13%) died. High values of age, D-Dimer, White Blood Cell, Na, CRP, and creatinine represent the factors that identify high-risk patients who would die. Conclusions: Age seems to be the primary predictor of mortality in patients with SARS-CoV-2 infection, while the impact of acute phase reactants and blood cellularity is also highly relevant.

Introducción: La estratificación del riesgo de los pacientes con COVID-19 puede ser fundamental para apoyar la toma de decisiones clínicas y optimizar los recursos. El objetivo de nuestro estudio es identificar, entre los parámetros clínicos y analíticos probados de forma rutinaria, aquellos que nos permitirían determinar a los pacientes con mayor riesgo de morir por COVID-19. Material y métodos: Se realizó un estudio multicéntrico de cohorte retrospectiva de forma consecutiva, incluyendo pacientes hospitalizados con COVID-19 ingresados en cualquiera de los 11 hospitales de la red sanitaria de HM Hospitales-España.Los datos clínicos, demográficos, analíticos y radiológicos se recopilaron de las historias clínicas de los pacientes.Para evaluar el impacto predictivo de cada uno de los biomarcadores y medir la significación estadística de las variables involucradas en el análisis, se aplicó un bosque aleatorio con un método de permutación. Utilizamos la medida de similitud inducida por un modelo de clasificación previo, y ajustamos el algoritmo de agrupación de grupos k en función de la distancia de energía para estratificar a los pacientes en un grupo de alto y bajo riesgo. Finalmente, ajustamos 2 árboles de clasificación óptimos para tener una representación esquemática de los puntos de corte. Resultados: Se incluyeron 1.246 pacientes (edad promedio de 65,36 años, 62% varones). Durante el estudio murieron 168 pacientes (13%). Los factores que identifican a los pacientes de alto riesgo de mortalidad son los valores elevados de edad, dímero D, glóbulos blancos, Na, PCR y creatinina. Conclusiones: La edad parece ser el principal predictor de mortalidad en pacientes con infección por SARS-CoV-2, mientras que el impacto de los reactantes de fase aguda y la celularidad sanguínea también es muy relevante.

Psychometric properties of the Maslach Burnout Inventory - Human Services in Social Work professionals in Spain.

The burnout syndrome has traditionally been identified in the service sector professions, among which is Social Work. In order to determine this syndrome, different measuring instruments have emerged, including the Maslach Burnout Inventory. The main objective of this study was to evaluate the psychometric properties of this instrument and to find evidence of its validity (corroborating the original factorial structure and its convergent validity) and reliability (internal consistency). The Spanish adapted version of the Maslach Burnout Inventory was used. Four hundred social workers participated, randomly divided into two samples of 200 individuals (Sample 1: M = 43.06, SD = 9.04 and Sample 2: M = 40.89, SD = 8.78). We carried out principal components exploratory factor analysis with Varimax rotation. The results identified a factorial structure with four factors (Emotional Exhaustion, Depersonalization, Personal Realization, and Interpersonal Psychological Stress) (χ2 /df = 1.73, CFI = 0.929, NNFI = 0.859, SRMR = 0.069, RMSEA = 0.061), different from that of the original questionnaire, which indicated three dimensions. The data also show a high internal consistency (α = 0.882). The four factors were directly and moderately associated with each other (r between 0.328 and 0.534). In conclusion, this study provides new data of a valid and reliable tool for evaluating professional burnout or exhaustion.

[Asbestos pulmonary content in workers of Ferrol shipyards, Spain]. / Contenido pulmonar de amianto en trabajadores de los astilleros de Ferrol.

BACKGROUND AND OBJECTIVE: In the last years, a study is being conducted about exposure to asbestos among shipyards workers in order to know the diagnosis of the diseases associated with the exposure. Our goal was to know the asbestos pulmonary contents in this population. MATERIAL AND METHODS: We obtained autopsy pulmonary samples from individuals who had worked in Ferrol shipyards. We analyzed samples from both lungs in most cases. After removing the lung organic matter with sodium hypochlorite, the inorganic residue was analyzed with optic microscopy. Results were expressed as asbestos bodies (AB) per gram of dry tissue. We considered as disease causative levels those above 1,000 AB/g. RESULTS: We studied 30 males, with a mean age of 67 years (r: 56-89 years). Twenty-six were smokers or former smokers, and 4 had never smoked. All had a lung, pleural or peritoneal disease related to asbestos exposure (16 lung cancer, 6 mesothelioma, 25 benign pleural disease). Only in 6 out of the 16 lung cancer cases there was coexisting asbestosis. The median (interval) of AB was 6,171 (249-4,660,059) AB/g. Ninety-seven per cent of individuals had levels above 1,000 AB/g. There was a correlation between AB and age (r=.5676; P=.0011). CONCLUSIONS: Workers from Ferrol shipyards who were analyzed had increased pulmonary levels of asbestos. It is essential to raise clinical suspicion of asbestos as a factor that can potentially cause lung disease in this group.