Cyber sexual harassment against women and impact on health. A cross-sectional study in a representative population sample.

BACKGROUND: This study focuses on the frequency of cyber sexual harassment (CSH) and examines its link with five health impact indicators (self-perceived health, medication, suicidal ideation, suicide attempts and use of health services). METHODS: Analyzing the data provided by the 2019 Macro-survey on violence against women in Spain, two items of which refer to CSH. It was conducted in Spain on a representative sample of 9568 women aged over 16 years old. RESULTS: A total of 9.15% of the women surveyed had experienced CSH at some point in their lives. Being under 25 years old, having higher education, not being in a relationship, having no religious beliefs and having a certified disability are sociodemographic characteristics associated with a higher risk of CSH. Women who have experienced other forms of gender-based violence also show an increased risk. Female victims of CSH reported higher rates of suicidal ideation (20% versus 9.79% in non-victims of CSH) and suicidal attempts (7.20% versus 1.74% in non-victims of CSH). CONCLUSIONS: These findings have significant implications for the design of preventive health polices, which should incorporate strategies to address CSH as part of the continuum of multiple interrelated forms of gender violence that affect women and girls throughout their lives.

Systematic review of healthcare interventions for reducing gender-based violence impact on the mental health of women with disabilities.

PURPOSE: Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for preventing gender-based violence and reducing its impact on the mental health of women with any form of disability. METHOD: Relevant studies were identified through conducting searches in PubMed, Scopus, CINAHL, PsyInfo, Social Services Abstracts, and PILOTS. Two reviewers analyzed and selected studies. A qualitative synthesis was made. RESULTS: 3149 references were obtained, among which eight articles describing nine interventions from the USA and the UK. Most were intended for women with mental/intellectual disability and assessed intimate partner or sexual violence. Only one study showed high methodological quality. They were found to be particularly effective as regards improvement of the skills acquired by participants, but the results as regards improved mental health are not consistent. CONCLUSION: Our review shows very little evidence of effective interventions. Further studies are required with higher internal validity and female sample groups with diverse disabilities. CLINICAL RELEVANCE: Gender-based violence is a highly prevalent problem for women with disabilities, and in addition to being a public health challenge is a violation of human rights. Health care systems and policymakers should take a key role in all three levels of prevention of violence against women with disabilities. Interventions with longer follow-up times are required. It is also important for interventions to be designed in consultation with people with disabilities.

Feasibility of the SINERGIAPS ("Sinergias entre profesionales y pacientes para una Atención Primaria Segura") intervention for improving patient safety in primary care.

AIM: The primary aim was to examine the feasibility of intervention delivery and of trial procedures. Secondary aims were to study the intervention uptake; its acceptability and perceived utility; and its potential to improve safety culture and avoidable hospital admissions. METHODS: We conducted a 3-month, single-arm feasibility study in 10 primary care (PC) centres in Spain. Centres received information regarding patients' experiences of safety (through the Patient Reported Experiences and Outcomes of Safety in Primary Care [PREOS-PC] questionnaire), and were instructed to plan safety improvements based on that feedback. We used a bespoke online tool to recruit PC professionals, collect patient feedback, and deliver it to the centres, and to collect outcome data (patient safety culture [Medical Office Survey on Patient Safety Culture, MOSPSC questionnaire]). We measured recruitment and follow-up rates and intervention uptake (based on the number of safety improvement plans registered). We conducted semistructured interviews with 9 professionals to explore the intervention acceptability and perceived utility. RESULTS: Of 256 professionals invited, 120 (47%) agreed to participate, and 97 completed baseline and postintervention measures. Of 780 patients invited, 585 (75%) completed the PREOS-PC questionnaire. Five of 10 centres (50%) designed an improvement plan, providing 27 plans in total (range per centre, 1-14). The intervention was perceived as a novel strategy for improving safety, although the healthcare professionals identified several factors limiting its acceptability and utility: lack of feedback at the individual professional level; potentially unrepresentative sample of patients providing feedback; and number of educational materials deemed overwhelming. DISCUSSION: It is feasible to deliver the proposed intervention so long as the identified limitations are addressed.

Effect of a mobile-based intervention on mental health in frontline healthcare workers against COVID-19: Protocol for a randomized controlled trial.

AIM: To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness-based approaches on the mental health of healthcare workers at the frontline against COVID-19 in Spain. DESIGN: We will carry out a two-week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention or control App intervention. METHODS: The PsyCovidApp intervention will include five modules: emotional skills, lifestyle behaviour, work stress and burnout, social support, and practical tools. Healthcare workers having attended patients with COVID-19 will be randomized to receive the PsyCovidApp intervention (intervention group) or a control App intervention (control group). A total of 440 healthcare workers will be necessary to assure statistical power. Measures will be collected telephonically by a team of psychologists at baseline and immediately after the 2 weeks intervention period. Measures will include stress, depression and anxiety (DASS-21 questionnaire-primary endpoint), insomnia (ISI), burnout (MBI-HSS), post-traumatic stress disorder (DTS), and self-efficacy (GSE). The study was funded in May 2020, and was ethically approved in June 2020. Trial participants, outcome assessors and data analysts will be blinded to group allocation. DISCUSSION: Despite the increasing use of mobile health interventions to deliver mental health care, this area of research is still on its infancy. This study will help increase the scientific evidence about the effectiveness of this type of intervention on this specific population and context. IMPACT: Despite the lack of solid evidence about their effectiveness, mobile-based health interventions are already being widely implemented because of their low cost and high scalability. The findings from this study will help health services and organizations to make informed decisions in relation to the development and implementation of this type of interventions, allowing them pondering not only their attractive implementability features, but also empirical data about its benefits. CLINICAL TRIAL REGISTRATION: NCT04393818 (ClinicalTrials.gov identifier). APPROVED FUNDING: May 2020.

Intimate partner violence during pregnancy and risk of fetal and neonatal death: a meta-analysis with socioeconomic context indicators.

OBJECTIVE: The objective of the study was to summarize the results from observational studies examining the risk of fetal and neonatal death (perinatal death) as a function of the experience of intimate partner violence during pregnancy and examine the influence of socioeconomic context indicators on this association. DATA SOURCES: Bibliographic searches were conducted in PubMed, EMBASE, CINAHL, and LILACS until March 2019. STUDY ELIGIBILITY CRITERIA: We considered observational studies that provided data on the association between intimate partner violence during pregnancy and perinatal death. STUDY APPRAISAL AND SYNTHESIS METHODS: Information collected included study characteristics, type, and prevalence of intimate partner violence and the reported association between intimate partner violence and perinatal death. Quality of the included studies was assessed using the Newcastle-Ottawa scale. Two reviewers independently conducted all review procedures; disagreements were resolved by a third reviewer. Meta-analyses were conducted based on the specific type of intimate partner violence (physical, psychological, sexual, unspecified) and also based on any type of intimate partner violence, considering 1 effect size per study, regardless of the type of intimate partner violence analyzed. Meta-regression analyses were performed to assess the possible effects of socioeconomic context. The proportion of deaths attributable to the exposure of intimate partner violence based on the crude data from the 3 cohort studies available also was calculated. RESULTS: Seventeen studies were included. The random-effects model showed a statistically significant increase in the odds of perinatal death among women exposed to unspecified intimate partner violence (odds ratio, 3.18; 95% confidence interval, 1.88-5.38), physical intimate partner violence (odds ratio, 2.46; 95% confidence interval, 1.76-3.44), and any type of intimate partner violence during pregnancy (odds ratio, 2.89; 95% confidence interval, 2.03-4.10). Meta-regression analysis showed stronger associations in countries with higher gross domestic product (odds ratio, 1.03; 95% confidence interval, 1.02-1.04) and a higher percentage of health expenditure (odds ratio, 1.27; 95% confidence interval, 1.09-1.46). The proportion of deaths attributable to exposure to intimate partner violence in cohort studies was attributable proportion, 60%; 95% confidence interval, 15-81%. CONCLUSION: Pregnant women who experience intimate partner violence during pregnancy may be about 3 times more likely to suffer perinatal death compared with women who do not experience intimate partner violence. It should be a priority to include intimate partner violence screenings or other detection strategies in pregnancy monitoring or family-planning programs because these could help avoid preventable perinatal deaths.

Effectiveness of interventions to improve cancer treatment and follow-up care in socially disadvantaged groups.

OBJECTIVE: To identify and characterize the interventions that aimed to improve cancer treatment and follow-up care in socially disadvantaged groups. To summarize the state of the art for clinicians and researchers. METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were randomized controlled trials and quasi-experimental studies with a control group (usual care or enhanced usual care) conducted in Organization for Economic Co-operation and Development (OECD) member countries and published until 2016. RESULTS: Thirty-one interventions were identified, the majority of which were conducted in the United States in patients with breast cancer. Most interventions aimed to decrease social inequalities based on ethnicity/race and/or socioeconomic level, with fewer interventions targeting inequalities based on geographical area. The most frequently assessed outcomes were quality of life (n = 20) and psychosocial factors (n = 20), followed by treatment adherence or satisfaction (n = 12,), knowledge (n = 11), pain management (n = 10), and lifestyle habits (n = 3). CONCLUSIONS: The impact of interventions designed to improve cancer treatment and follow-up care in socially disadvantages groups is multifactorial. Multicomponent-intervention approaches and cultural adaptations are common, and their effectiveness should be evaluated in the populations of interest. More interventions are needed from outside the Unite States and in patients with cancers other than breast cancer, targeting gender or geographical inequalities and addressing key outcomes such as treatment adherence or symptom management.

The Effectiveness of HIV Prevention Interventions in Socioeconomically Disadvantaged Ethnic Minority Women: A Systematic Review and Meta-Analysis.

BACKGROUND: Surveys in the United States and Europe have shown a plateau of new HIV cases, with certain regions and populations disproportionately affected by the disease. Ethnic minority women and socioeconomically disadvantaged groups are disproportionately affected by HIV. Previous reviews have focused on prevention interventions targeting ethnic minority men who have sex with men, have not accounted for socioeconomic status, or have included only interventions carried out in clinical settings. OBJECTIVES: To review and assess the effectiveness of HIV prevention interventions targeting socioeconomically disadvantaged ethnic minority women in member states of the Organisation for Economic Co-operation and Development (OECD). SEARCH METHODS: On March 31, 2014, we executed a search using a strategy designed for the MEDLINE (Ovid), CINAHL, Embase, Scopus, and Web of Knowledge databases. Additional searches were conducted through the Cochrane Library, CRD Databases, metaRegister of Controlled Trials, EURONHEED, CEA Registry, and the European Action Program for Health Inequities as well as in gray literature sources. No language or date restrictions were applied. SELECTION CRITERIA: We selected studies assessing the effectiveness of interventions to prevent HIV among ethnic minority women of low socioeconomic status in which at least 80% of participants were reported to belong to an ethnic minority group and to have a low income or be unemployed. We included only studies that were conducted in OECD member states and were randomized controlled trials or quasi-experimental investigations with a comparison group. DATA COLLECTION AND ANALYSIS: A data extraction form was developed for the review and used to collect relevant information from each study. We summarized results both qualitatively and quantitatively. The main outcomes were categorized into 3 groups: improved knowledge regarding transmission of HIV, behavior changes related to HIV transmission, and reductions in the incidence of sexually transmitted infections (STIs). We then performed meta-analyses to assess the effectiveness of the prevention interventions in terms of the 3 outcome categories. MAIN RESULTS: A total of 43 interventions were included, and 31 were judged to be effective, 7 were partially effective, and 5 were ineffective. The most frequently recurring characteristics of these interventions were cultural adaptation, a cognitive-behavioral approach, the use of small groups and trained facilitators, and a program duration of between 1 and 6 weeks. Our meta-analyses showed that the interventions improved knowledge of HIV transmission (odds ratio [OR] = 0.59; 95% confidence interval [CI] = 0.43, 0.75), increased the frequency of condom use (OR = 1.60; 95% CI = 1.16, 2.19), and significantly reduced the risk of STI transmission by 41% (relative risk = 0.59; 95% CI = 0.46, 0.75). CONCLUSIONS: Our study demonstrates the feasibility and effectiveness of HIV prevention interventions targeting socioeconomically deprived ethnic minority women. Public Health Implications. This is one of the first studies to include a meta-analysis assessing reductions in STI incidence among at-risk women who have participated in HIV prevention programs. The fact that our meta-analyses showed a statistically significant reduction in STI transmission provides important evidence supporting the overall effectiveness of directing prevention programming toward this vulnerable population. For policymakers, this review demonstrates the feasibility of working with multiple intervention components while at the same time facilitating more effective interventions that take into account the principal outcome measures of knowledge, behavior change, and STI transmission rates. The review also underscores the need for additional research outside the United States on the effectiveness of prevention interventions in this vulnerable group.

Sexual and reproductive health beliefs and practices of female immigrants in Spain: a qualitative study.

BACKGROUND: Sexuality and reproduction are two areas that have been dealt with differently over time and across cultures. Immigrant women resident in Spain, are largely of childbearing age and have some specific needs. Female immigrants have specific beliefs and behaviors which may influence how they approach to the Spanish sexual and reproductive health services. There is less visibility of the health problems presented by women immigrants. This article aims to shed light on the sexual and reproductive health beliefs and experiences of female immigrants in a region of southern Spain. METHODS: A descriptive study design with qualitative data collection and analysis methods were used. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women's perception and beliefs about their sexual and reproductive health. Thirteen interviews were conducted in 2013 with a multi-ethnic sample of female immigrants, currently all are residing in Andalusia. Interview topics included questions about awareness and beliefs about sexuality and reproduction. Content analysis was used. RESULTS: We have found that female immigrant brings along all of her beliefs, opinions, attitudes and behaviors regarding sexuality, contraceptives, what is "correct" and what is not, etc. The sexual behavior is conditioned by the prevailing social rules of country of origin, and these rules act ambivalently. In general, knowledge of contraceptive methods was big, but there were perceptions that reproductive health was woman's domain, due to gender norms and traditional family planning geared exclusively towards women. CONCLUSION: Results suggest that women's behavior is influenced by the precepts of their origin societies. Therefore, sexual and reproductive health processes should be adapted and incorporated into our society, with special attention being paid to the immigrant population.

Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study.

Introduction: PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. Objectives: (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. Materials and methods: For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. Results: The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. Conclusion: The knowledge derived from this study could inform the design and implementation of future similar digital tools.

Effectiveness of two interventions based on improving patient-practitioner communication on diabetes self-management in patients with low educational level: study protocol of a clustered randomized trial in primary care.

BACKGROUND: In the last decades the presence of social inequalities in diabetes care has been observed in multiple countries, including Spain. These inequalities have been at least partially attributed to differences in diabetes self-management behaviours. Communication problems during medical consultations occur more frequently to patients with a lower educational level. The purpose of this cluster randomized trial is to determine whether an intervention implemented in a General Surgery, based in improving patient-provider communication, results in a better diabetes self-management in patients with lower educational level. A secondary objective is to assess whether telephone reinforcement enhances the effect of such intervention. We report the design and implementation of this on-going study. METHODS/DESIGN: The study is being conducted in a General Practice located in a deprived neighbourhood of Granada, Spain. Diabetic patients 18 years old or older with a low educational level and inadequate glycaemic control (HbA1c > 7%) were recruited. General Practitioners (GPs) were randomised to three groups: intervention A, intervention B and control group. GPs allocated to intervention groups A and B received training in communication skills and are providing graphic feedback about glycosylated haemoglobin levels. Patients whose GPs were allocated to group B are additionally receiving telephone reinforcement whereas patients from the control group are receiving usual care. The described interventions are being conducted during 7 consecutive medical visits which are scheduled every three months. The main outcome measure will be HbA1c; blood pressure, lipidemia, body mass index and waist circumference will be considered as secondary outcome measures. Statistical analysis to evaluate the effectiveness of the interventions will include multilevel regression analysis with three hierarchical levels: medical visit level, patient level and GP level. DISCUSSION: The results of this study will provide new knowledge about possible strategies to promote a better diabetes self-management in a particularly vulnerable group. If effective, this low cost intervention will have the potential to be easily incorporated into routine clinical practice, contributing to decrease health inequalities in diabetic patients. TRIAL REGISTRATION: Clinical Trials U.S. National Institutes of Health, NCT01849731.

Male and female involvement in the birth and child-rearing process.

AIMS AND OBJECTIVES: To know the male involvement during pregnancy and childbirth, with special attention to their participation in public services of perinatal health and the impact that this participation has on their subsequent involvement in child-rearing, to compare the male and female involvement in child-rearing and to identify the factors associated with a greater male involvement. BACKGROUND: Most of the research on male involvement in birth and child-rearing comes from Anglo-Saxon and Scandinavian countries. These studies show a lower involvement of men in relation to women, even in countries with instruments to promote gender shared responsibility. The Spanish Ministry of Health has developed strategies to improve the male involvement in the public services of perinatal health to advance in gender equality. This is a suitable context to contribute to the lack of information about fatherhood and the gender inequalities in the Spanish context. DESIGN: Transversal design. METHODS: A questionnaire was administered to 150 fathers and 157 mothers residing in Granada, with at least one biological child aged 2 months to 3 years. RESULTS: A minority of the men attended the childbirth education whereas most of them attended pregnancy check-ups and were present at birth. Women spent more time with their children and took charge of tasks of child-rearing to a larger extent. The profile of an involved father is a man with a higher level of education, not married, his partner has a full-time employment, born in Spain and attended to the childbirth education classes. CONCLUSION: This study shows gender inequalities in the reproductive field beyond the biological conditions. RELEVANCE TO CLINICAL PRACTICE: The challenge of the health services is to promote social change and identify areas for improvement to include the father figure in public services of perinatal health.

[Barriers and proposals for a health care approach to trafficking for sexual exploitation]. / Barreras y propuestas para el abordaje sanitario de la trata con fines de explotación sexual.

OBJECTIVE: To examine the perception of the trafficking in women for sexual exploitation, identify the difficulties and collect the proposals of professionals in direct contact with the victims of trafficking in women for sexual exploitation in Andalusia (Spain). METHOD: Qualitative study based on interviews with 10 key informants, selected from organizations providing support and care to victims of trafficking in women for sexual exploitation in 2021. Two researchers carried out a thematic categorical content analysis, integrative and relational analysis. Three themes with different sub-themes were analyzed. RESULTS: Difficulties have been identified in relation to women (delay in recognizing themselves as victims, cultural differences, distrust of the system), traffickers (modification of strategies), health professionals (lack of sensitivity and lack of homogeneity in actions) and the health system (lack of cultural intermediation, administrative complexity). The key informants propose more training for professionals, the use of effective action protocols and better coordination between institutions. CONCLUSIONS: The health sector faces a number of challenges in responding comprehensively and effectively to trafficking in women for sexual exploitation. Improvements are needed in raising awareness among health professionals, the development of standardized protocols, greater collaboration between sectors, the provision of specialized mental health services and effective cultural mediation.

Relationship between Sexual Violence and the Health of Spanish Women-A National Population-Based Study.

BACKGROUND: Health consequences are likely to be different when sexual violence is analysed independently from other types of violence. It is also likely that different health consequences will result in the cases of partner or ex-partner sexual violence, non-partner sexual violence and sexual harassment. METHODS: This study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality on a sample of 9568 women aged 16 years or older. Odds ratios were calculated, and multinomial logistic regression analyses were performed. RESULTS: The present study estimates that 4 out of 10 surveyed women had experienced some form of sexual violence in their lifetime. Sexual harassment is the most frequently reported form of this violence, while intimate partner sexual violence is the form with the most unfavourable sociodemographic characteristics and the worst health impact indicators, such as a greater likelihood of suicidal behaviour. CONCLUSIONS: Sexual violence is a widespread, under-studied problem with negative health impacts. Women exposed to intimate partner violence are the most vulnerable and at risk. It is advised that responses and comprehensive care plans be developed that place special emphasis on the protection of victims' mental health.

The prevalence of intimate partner violence against women with disabilities: a systematic review of the literature.

PURPOSE: Although systematic reviews have already been conducted on violence and disability, the evidence is not conclusive in Intimate Partner Violence (IPV). This study examined the prevalence of IPV in women with disabilities, taking account of the different types of violence and disability. METHODS: We performed a search in five databases. We included observational studies that analysed the frequency of IPV in women with disabilities compared to women without. Two independent reviewers selected and assessed studies. We made a qualitative synthesis according to the type of IPV analysed in relation to disability. RESULTS: We identified 26 articles. The frequency and risk of IPV were greater in women with disabilities than in those without. All of the articles that studied financial violence, 81.3% of those that studied physical violence, 78.5% of those that studied psychological violence, 75% of those that studied physical/sexual violence, 73.3% of those that studied sexual violence and 50% of those that studied any type of violence found a significant association whit disability. CONCLUSIONS: Women with disabilities are at higher risk of IPV. Rehabilitation centers and its professionals must have a leading role in the identification of these situations and this should be considered in IPV prevention plans.Implications for rehabilitationPeople with disabilities are at higher risk of multiple types of violence.Violence against women with disabilities therefore involves two public health issues interacting simultaneously.Rehabilitation centers and its professionals should have a leading role in the identification of IPV in women with disabilities.IPV prevention plans should consider rehabilitation centers and its professionals as a main component of interventions in women with disabilities.

Corrigendum: "You knew you had to be there, it had to be done": experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain.

[This corrects the article DOI: 10.3389/fpubh.2023.1089565.].

"You knew you had to be there, it had to be done": Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain.

Introduction: The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. Methods: We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. Results: During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. Conclusion: In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.

Characteristics and effectiveness of interventions to reduce cyberbullying: a systematic review.

Background: This paper presents the results from a systematic review on the effectiveness of interventions to reduce Cyberbullying (CB) as a function of their outcomes and main characteristics; and an analysis of the level of completeness to which the characteristics of these interventions are described. Methods: Systematic searches were conducted in PubMed, Scopus, ERIC and Psycinfo databases on February 14, 2022. In addition, relevant publications were hand searched for relevant studies. We considered interventions that provided data on CB prevalence changes in populations between primary school and college age. Results: In total, 111 studies were retained for further screening from 3,477 results. Following rigorous screening, 43 reports including 46 studies and information from 36 different interventions were included in our systematic review. Results shows that most of the interventions measuring reductions in global CB, cyberperpetration/victimization, cybervictimization and cyberperpetration were effective or partially effective. While the interventions measuring reductions in cyber-bystanding were not effective. Multicomponent interventions showed higher effectiveness than single-component interventions. After completion of the TIDieR check-list, included interventions were considered to offer an insufficient level of detail for a number of the analyzed items in relation to "how well planned," "intervention modifications" and "tailoring." Conclusion: Given the aforementioned, it is critical to increase the number of studies and the quality of interventions targeting CB and the level of detail of its description in order to obtain more robust outcomes about how to reduce its prevalence and facilitate the replication of the effective interventions. Systematic review registration: https://archive.org/details/osf-registrations-wn5u4-v1, Identifer DOI: 10.17605/OSF.IO/WN5U4.

New Patients in Treatment for Opioid Addiction in Spain.

Introduction: Patients seeking first time treatment for opioid consumption reflect the characteristics of the consumer population. This group has not been studied in Spain in decades. The objective of this study was to characterize the opioid user population seeking first time treatment (incidents) and compare them group with those with prior treatment (prevalents). Methods: Cross-sectional study (N = 3325) with patients with opioid addiction seeking care at public addiction centers in the Community of Madrid from 2017 through 2019. Differentiation and comparisons were carried out using bivariate analysis, adjusted by sociodemographic characteristics related and those related to substance use consumption in incident and prevalent patients. Results: About 12.2% were incidents. Compared to prevalents, there were more foreigners (34.1% vs 19.1% P < .001), but with a better social network. Regarding opioid use, incidents were less likely to use injection (10.7% compared to 16.8% P = .008), but had greater daily frequency (75.8% vs 52.2%, P < .001). The age of initial consumption was greater (27 years vs 21.3 years, (P < .001)). About 15.5% of incidents sought care for non-heroin opioids, compared to 4.8% of prevalents (P < .001). Women sought care at twice the rate of men (29.3% vs 12.3%; P > .001). Discussion: New patients presented a profile with many stable characteristics, but which highlighted an increase in the use of other opioids, as occurs in the international context. Surveillance of the new patient characteristics can serve as an early indicator of consumption changes in. Thus, periodic monitoring is important.

Frequency, Types, and Manifestations of Partner Sexual Violence, Non-Partner Sexual Violence and Sexual Harassment: A Population Study in Spain.

BACKGROUND: This study analyzes the frequency and sociodemographic characteristics associated with sexual violence by a partner/ex-partner (PSV), someone other than a partner or ex-partner (NPSV), or sexual harassment (SH). METHODS: The study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality among a sample of 9568 women age 16 or more years. Odds Ratios were calculated and multinomial logistic regression analyses were performed. RESULTS: Forty-four women had suffered some kind of sexual violence over their lifetime, 9.2% had experienced PSV, 6.5% NPSV and 40.4% SH. More than 7% of women had been raped by a partner and 2.2% by another man. In the three groups, violence was associated with lower age and having a certified disability. NPSV and SH were significantly associated with a higher education and internet use. In NPSV, 9.2% of cases were reported to the police and 3.9% were reported to the courts. In SH, 91.7% of women told a family member or a close friend and 4.2% reported it to the police or the courts. CONCLUSIONS: A greater emphasis needs to be placed on reporting sexual violence in its various forms. Rape within intimate partnerships ought to be investigated and studied in greater depth.