[Community participation: COVID-19 learning for new crises. SESPAS Report 2022]. / Participación comunitaria: aprendizajes de la COVID-19 para nuevas crisis. Informe SESPAS 2022.

Community participation has been put as secondary due to the management of the COVID-19 pandemic. This is despite the evidence of its importance in relation to equity and health promotion. Even so, there have been a number of experiences of community participation that can give us clues towards how to confront potential future emergencies focusing on health promotion and social determinants. The main aim of this article is reflecting critically on the role of community participation during the pandemic as well as extracting a number of ideas which could be useful and ensure a better management of a future crisis. They arise from evidence and experiences undertaken in Spain. In order to do so, it is key to build and maintain community networks whilst identifying common goals and the role that different community agents must play, adapting to different contexts and participatory assessments. Community action cannot be improvised: it demands time, resources and specific political willingness to make it sustainable and efficient.

A comparative study of life skills, lifestyle habits and academic performance in health promoting and non-health promoting schools in the Autonomous Community of Aragon, Spain.

Background: There is insufficient evidence about the impact of health promoting schools on the student's health and academic performance. The aim of this study was to compare the life skills, lifestyle habits and academic performance of 7th and 8th grade students registered in health promoting and non-health promoting schools in the Autonomous Community of Aragon. Methods: An observational, descriptive, comparative study of the life skills, lifestyle habits and academic performance of 7th and 8th grade students registered in 43 randomly selected health promoting and non-health promoting schools was carried out. We used an adapted tool, which was validated through the expert panel technique, to evaluate the students' life skills (self-efficacy, social skills and affect balance), lifestyle habits (diet, sleep, physical exercise, use of screen and substance abuse) and academic performance. Results: The socioeconomic level of the mothers and fathers of the students who attended non-health promoting schools was significantly higher than that of the parents of the adolescents who attended health promoting schools (p < 0.001). The students who attended non-health promoting schools had better self-efficacy, led a healthier life generally and achieved better academic results (p = 0.03). Conclusions: As opposed to previous studies, which found a positive association between health promoting schools and life skills, lifestyle habits and academic performance, our findings suggest that the impact of these health programs on the students' health and academic performance is limited. We recommend that the degree of implementation of health promotion programs in health promoting schools is systematically evaluated, and the health promoting school accreditation process and requirements reviewed, in order to ensure that the health of school children and adolescents is safeguarded and promoted in the short, medium and long term.

Psychometric properties and cultural adaptation of "LifeConScale" -Life Conditions Scale for Adolescents.

Promoting the adoption of healthy habits represents a great challenge for health and education professionals. In this sense, childhood and adolescence are propitious times for the acquisition and consolidation of behaviors and skills, being that numerous and different determinants act in the genesis of behavior. The purpose of this study was to test the Psychometric properties and cultural adaptation of "LifeConScale" -Life Conditions Scale for Adolescents-. A cross-sectional and multicenter study was carried out in a representative sample of adolescents enrolled in 1st and 2nd year of Compulsory Secondary Education in 18 educational centers in Aragon, during the 2018-2019 school year. Sociodemographic characteristics, life skills, daily habits, and academic performance were analyzed using an adapted questionnaire from different scales and previous studies. For the adaptation of the questionnaire, the expert panel technique was used and for its validation, exploratory factor analysis was carried out and Cronbach's Alpha was applied, assessing the global internal consistency and of each one of the factors. The instrument showed a Kaiser-Meyer-Olkin sample size adequacy of 0.8122. A 6-dimensional model was chosen that explained 75.25% of the variance. The goodness of fit obtained a value of 0.802 in the Nomed Fix Index. The Comparative Fit Index was 0.891. The result of the analysis of variances and covariances carried out according to the Standardized Root Mean Square Residual yielded a value of 0.093 The analysis showed excellent application conditions in the study population and construct validity. This instrument will be useful for the evaluation of educational programs that work to promote health in educational centers, such as Health Promoting Schools.

Healthy Lifestyle and Academic Performance in Middle School Students from the Region of Aragón (Spain).

A healthy lifestyle is important to the present and future development and health of school age people. This study aims to analyze the relationship between daily lifestyle habits and academic performance in a sample of adolescents from the autonomous community of Aragon (Spain). We performed a cross-sectional study to analyze the lifestyle habits and academic performance of a total of 1745 7th and 8th grade middle school students during the academic year 2018-2019; the participants were selected from a random sample of 43 middle schools from the region of Aragon. The following data were collected through an anonymized, previously validated questionnaire: diet, sleep, physical activity, use of screens, use of toxic substances, and academic performance. We found a statistically significant association between all the lifestyle habits analyzed and academic performance (p < 0.001) in our sample. Based on our findings, we suggest that health promotion and education in healthy lifestyles should be integrated in middle school curricula to improve academic performance and, more importantly, to promote both present and future health outcomes of adolescents.

Dairy farmers' decision-making to implement biosecurity measures: A study of psychosocial factors.

Biosecurity measures are a set of management procedures that prevent the risk of introducing and spreading infectious diseases to a farm, although these measures are rarely implemented in dairy farms. There are some studies that have identified that the decision to implement biosecurity measures can be influenced by several psychosocial factors (attitudes and behaviours). Thus, the objective of this study was to examine the psychosocial factors (and their interactions) influencing the implementation of biosecurity measures in dairy farms in Spain, through the views of dairy farmers and veterinarians from Catalonia (northeast Spain) and Galicia (northwest Spain). Face-to-face in-depth interviews were performed with 16 dairy farmers (nine from Catalonia and seven from Galicia) and 16 veterinarians (eight from Catalonia and eight from Galicia). Grounded theory analysis was performed on the transcripts, following the subtopics of: information sources, individual factors of the farmer, social dynamics, official veterinary services and other factors. The study identified the importance of veterinarians as a source of information, including their communication skills, the individual experiences of farmers, traditions of the farms and availability of time and space in the dairy farmer's decisions making. Further, it suggests the need to deepen the knowledge of the farm workers and the obligatory biosecurity measures. This research represents a starting point to develop future strategies to improve the implementation of biosecurity measures in dairy farms.

[Descriptive analysis of training in community health engagement in Spain]. / Análisis descriptivo de la formación en participación comunitaria en salud en España.

OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals.

[Networking: discussing community health and networks. SESPAS Report 2018]. / En-red-ando: dialogando sobre salud comunitaria y redes. Informe SESPAS 2018.

Four voices from around Spain discuss community health and networks. These voices understand that the networks are systems formed by interconnected people, with a common interest, that provide support. Networks require a common place and time, in order to generate trust and respect for horizontal work. Thus, networks are appropriate structures for health promotion, facilitating the exchange of knowledge, collaboration and innovation through the participation of those who form them. It is important that networks are evaluated by analysing their autonomy, leadership, quality of links, training, network projection, capacity for integrating groups and synergy.

[Networks of experiences on community health as an information system in health promotion: lessons learned in Aragon (Spain)]. / Las redes de experiencias de salud comunitaria como sistema de información en promoción de la salud: la trayectoria en Aragón.

Networks of community health experiences promote interaction and knowledge management in health promotion among their participants. These networks integrate both professionals and social agents who work directly on the ground in small environments, with defined objectives and inclusion criteria and voluntary participation. In this article, networks in Aragon (Spain) are reviewed in order to analyse their role as an information system. The Health Promotion Projects Network of Aragon (Red Aragonesa de Proyectos de Promoción de la Salud, RAPPS) was launched in 1996 and currently includes 73 projects. The average duration of projects is 12.7 years. RAPPS interdisciplinary teams involve 701 people, of which 89.6% are professionals and 10.6% are social agents. The Aragon Health Promoting Schools Network (Red Aragonesa de Escuelas Promotoras de Salud, RAEPS) integrates 134 schools (24.9% of Aragon). The schools teams involve 829 teachers and members of the school community, students (35.2%), families (26.2%) and primary care health professionals (9.8%). Experiences Networks boost citizen participation, have an influence in changing social determinants and contribute to the formulation of plans and regional strategies. Networks can provide indicators for a health promotion information and monitoring system on: capacity building services in the territory, identifying assets and models of good practice, cross-sectoral and equity initiatives. Experiences Networks represent an opportunity to create a health promotion information system, systematising available information and establishing quality criteria for initiatives.

Successful closure of a bronchopleural fistula by intrapleural administration of fibrin sealant: a case report with review of literature.

CONTEXT: There are no established guidelines for the proper treatment of patients with bronchopleural fistulas (BPFs). Apart from attempts to close the fistula, emphasis of treatment and management is placed on preventive measures, early administration of antibiotics, drainage of the empyema and aggressive nutritional and rehabilitative support. CASE REPORT: A 53-year-old male presented with nausea, vomiting, and dry cough with eventual respiratory failure. He was found to have an empyema of the left hemithorax which was managed with thoracostomy drainage and antibiotics. However, he had persistent air leak through the chest tube due to a BPF. Bronchoscopy failed to localize the involved segment. Application of fibrin glue through the chest tube succeeded in completely sealing the leak. CONCLUSION: To our knowledge, this is the first case report in which fibrin glue was successfully used intrapleurally to close a BPF related to an empyema.

An atypical case of right-sided bochdalek hernia in an adult.

Bochdalek hernias are usually congenital in nature and normally present after birth. However, in rare cases, these hernias are present in adulthood. We report an unusual case of a posttraumatic right-sided Bochdalek hernia found incidentally in an adult and treated successfully with conservative management.

Postpneumonectomy-like syndrome presenting in a patient with treated pulmonary tuberculosis: a case report.

INTRODUCTION: Postpneumonectomy syndrome is a rare condition that is characterized by dyspnea resulting from an extreme mediastinal shift and bronchial compression of the residual lung following surgical pneumonectomy. It is even rarer for this syndrome to present in patients without a history of prior lung surgery but induced by autopneumonectomy due to parenchymal disease, an entity termed 'postpneumonectomy-like syndrome'. CASE PRESENTATION: We present a rare case of a 91-year-old Puerto Rican man presenting with progressively worsening dyspnea with a history of pulmonary tuberculosis diagnosed 40 years earlier who developed severe unilateral lung fibrosis. Plain X-ray and computed tomography scans confirmed the presence of postpneumonectomy-like syndrome secondary to his parenchymal lung destruction. The patient developed cor pulmonale due to his extensive lung disease and as a consequence was not a suitable candidate for surgical intervention. The patient was otherwise stable until he developed acute respiratory distress from an acute upper gastrointestinal bleed and died four days into his hospital course. CONCLUSION: We present a rare case of postpneumonectomy-like syndrome as sequelae of severe pulmonary parenchymal tuberculosis infection along with a review of literature, in the hopes of aiding clinicians to include the differential of postpneumonectomy-like syndrome in patients presenting with worsening dyspnea without a history of surgical lung resection.

Foreign body aspiration presenting with asthma-like symptoms.

Aspiration of a foreign body into the tracheobronchial tree is rare in adults. In the majority of these cases there is an underlying condition such as mental retardation, depressed mental status, impairment in the swallowing reflex, neurological impairment, alcohol or sedative abuse, or complications from dental manipulations that contributed to the aspiration. These patients are commonly misdiagnosed with asthma and typically do not respond to mainstay anti-inflammatory and/or bronchodilator therapy. We describe the case of a patient with a foreign body aspiration in the upper trachea not recognized by radiographic studies that presented with asthma-type symptoms.