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1.
Arch Sex Behav ; 52(2): 629-638, 2023 02.
Article in English | MEDLINE | ID: mdl-36066681

ABSTRACT

The objective of the study was to describe the impact of the COVID-19 pandemic on sex workers in accessing health and social services. A qualitative study was conducted using semi-structured interviews with 29 participants in Barcelona, Spain. Data were analyzed using thematic analysis. Four themes were identified: (1) impact of COVID-19 on physical/mental health, (2) barriers and facilitators to health/social service access, (3) health decision-making, and (4) suggestions for future pandemic situations. Barriers to accessing health services were structural. Non-governmental organization support was the main facilitating factor. A person-centered, intersectional approach is suggested for future practice, considering co-occurring syndemic factors.


Subject(s)
COVID-19 , HIV Infections , Sex Workers , Male , Humans , Female , Sex Workers/psychology , HIV Infections/epidemiology , Pandemics , Spain , Qualitative Research
2.
Int J Behav Med ; 30(6): 824-835, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36333554

ABSTRACT

BACKGROUND: Transgender women and cisgender men sex workers are vulnerable to HIV and sexually transmitted infections (STIs). This study aimed to explore in depth the prevalence of syndemic conditions and their association with the sexual risk behaviors for HIV/STI acquisition in cis men and trans women sex workers in Barcelona (Catalonia, Spain). METHOD: We conducted a study between 2014 and 2018 to determine whether syndemic conditions (frequent alcohol consumption and polydrug use (> 2) during sex with clients; experience of violence; and lack of healthcare access) are associated with HIV/STI sexual risk behaviors. A "syndemic index" was calculated based on the cumulative number of syndemic conditions (0 to 4). RESULTS: In the last year (2018), 78.8% of cisgender men and 68.1% of transgender women reported at least one syndemic condition. The most prevalent syndemic factor in both cisgender men and transgender women was violence (38.8% and 43.6% respectively). In multivariable analysis, an association was found between condomless anal sex and violence (aOR = 1.81), and frequent alcohol consumption and violence with reporting > 10 clients/week (aOR = 2.73 and 1.88, respectively). The higher the number of syndemic factors, the greater probability of having > 10 clients/week and reporting condomless anal sex with clients. CONCLUSION: Psychosocial conditions have a syndemic effect on risky sexual behaviors highlighting the need for a more holistic approach to HIV/STI prevention targeting these populations.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Sex Workers , Sexually Transmitted Diseases , Transgender Persons , Male , Humans , Female , HIV Infections/epidemiology , HIV Infections/psychology , Sexually Transmitted Diseases/epidemiology , Spain/epidemiology , Transgender Persons/psychology , Syndemic , Sexual Behavior/psychology , Risk-Taking , Homosexuality, Male
3.
AIDS Behav ; 21(10): 3013-3025, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28643241

ABSTRACT

Within the MSM population, men who have sex with both men and women (MSMW) are identified as a high-risk group both worldwide and in Europe. In a multi-centred bio-behavioural cross-sectional study, we aimed to assess the relationship(s) between socio-demographic factors, stigma, sexual behavioural patterns, test seeking behaviour and sero-status amongst MSMW. A multi-level analysis was conducted to identify factors associated with being MSMW versus Men who have Sex with Men Only (MSMO). A total of 4901 MSM were enrolled across the 13 study sites. Participants were categorised as MSMW in the 12.64% of the cases. Factors such as educational status, perceived homonegativity, testing facilities knowledge and HIV testing lifetime seem to be relevant factors when characterising the MSMW group. The results highlight the vulnerability of MSMW and the wide spectrum of risky behavioural and psycho-social patterns, particularly in terms of HIV testing, 'outness', and perceived stigma.


Subject(s)
AIDS Serodiagnosis/statistics & numerical data , Bisexuality/psychology , HIV Infections/diagnosis , HIV Infections/prevention & control , Homosexuality, Male/psychology , Patient Acceptance of Health Care , Sexual Behavior , Sexual Partners , Adult , Bisexuality/statistics & numerical data , Cities , Cross-Sectional Studies , Ethnicity , Europe/epidemiology , Female , HIV Infections/epidemiology , Homosexuality, Male/statistics & numerical data , Humans , Male , Mass Screening , Social Stigma , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
4.
Sex Transm Infect ; 92(1): 70-5, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26136507

ABSTRACT

OBJECTIVES: To identify the HIV incidence and its associated factors (AFs) of the ITACA, a community-based cohort of HIV-negative men who have sex with men (MSM) established in Barcelona, Spain from 2008 to 2011. METHODS: Participants were men aged 18 years or older, having a negative HIV test result at baseline and agreeing to participate. Bio-behavioural data were collected by peers in each visit. HIV incidence rates using person-time measures and 95% CIs were calculated. Cox logistic regression models were used to identify AFs to seroconversion. RESULTS: Over the period, 3544 participants with at least one follow-up visit or those who had a first visit no longer than a year prior to the date of data censoring were included in the analysis contributing 3567.09 person-year (p-y) and 85 MSM seroconverted for an overall HIV incidence of 2.4 per 100 p-y (95% CI 1.9 to 2.9) ranging from 1.21/100 (2009) to 3.1/100 p-y (2011). Independent AF included: foreign origin, having more than five HIV tests at baseline, reporting in the preceding 6 months the following: condomless anal sex with the last steady partner of unknown serostatus, more than 10 casual partners, condomless anal sex with casual partner, self-reported gonorrhoea and entered in the cohort in 2010 or 2011. CONCLUSIONS: The ITACA cohort revealed a high and increasing HIV incidence among MSM, especially important among foreign-born men. The findings underscore the need to implement multilevel interventions for MSM taking into account different types of partners, cultural origins and the exposure to other sexually transmitted infections.


Subject(s)
Condoms/statistics & numerical data , HIV Infections/prevention & control , Health Education , Homosexuality, Male , Sexual Partners/psychology , Adult , Directive Counseling , HIV Infections/epidemiology , HIV Infections/psychology , Health Knowledge, Attitudes, Practice , Humans , Incidence , Logistic Models , Male , Middle Aged , Risk Factors , Risk-Taking , Spain/epidemiology
5.
BMC Public Health ; 16: 212, 2016 Mar 02.
Article in English | MEDLINE | ID: mdl-26935752

ABSTRACT

BACKGROUND: Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach. METHODS/DESIGN: Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for 'hard-to-reach' populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection. DISCUSSION: Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.


Subject(s)
Epidemics , HIV Infections/epidemiology , Homosexuality, Male/psychology , Population Surveillance/methods , Sexually Transmitted Diseases/epidemiology , Adult , Cross-Sectional Studies , Europe/epidemiology , Homosexuality, Male/statistics & numerical data , Humans , Male , Surveys and Questionnaires , Young Adult
6.
Eur J Public Health ; 25(3): 494-500, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25161202

ABSTRACT

OBJECTIVES: The purpose of this article is to assess the distribution of undiagnosed HIV infection in men who have sex with men (MSM) in Southern and Eastern European countries, to describe the differences in epidemiology and behaviour between undiagnosed, diagnosed HIV-positive and HIV-negative MSM and to identify factors associated with undiagnosed HIV infection in the study population. METHODS: A multi-centre biological and behavioural cross-sectional study was conducted in 2008. Time-location sampling was used to recruit men attending different venues. A self-administered questionnaire was completed and oral fluid samples were collected to estimate HIV prevalence. RESULTS: HIV prevalence was 17% in Barcelona, 12% in Verona, 6% in Bratislava, 5% in Ljubljana, 5% in Bucharest and 3% in Prague while undiagnosed HIV infection was 47, 62, 67, 83, 85 and 57%, respectively. Diagnosed HIV-positive men reported more casual partners than HIV-negative MSM (mean: 19 and 9, respectively) (P < 0.001), and they were more likely to self-reported condyloma in the last year than undiagnosed HIV-positive and HIV-negative men (15, 1 and 3%, respectively) (P < 0.001). Factors associated with undiagnosed HIV infection included attending sex-focused venues (OR = 2.49), reporting syphilis in the previous 12 months (OR = 2.56), using poppers at last sexual intercourse (OR = 3.36) and having had an HIV test in the previous year (OR = 2.00). CONCLUSIONS: Many HIV infections remain undiagnosed, and there is evidence of the persistence of frequent risk behaviours and sexually transmitted infections (STI) despite knowledge of HIV-positive status, emphasising the need for a multidimensional approach to HIV/STI prevention. Access to HIV testing should be considered a priority in prevention programs targeted at MSM, especially in Eastern Europe.


Subject(s)
HIV Infections/epidemiology , Homosexuality, Male/statistics & numerical data , Urban Population/statistics & numerical data , Adult , Cross-Sectional Studies , Europe/epidemiology , Humans , Male , Prevalence , Risk Factors , Risk-Taking , Sexual Partners
7.
Enferm Infecc Microbiol Clin ; 33(5): 303-10, 2015 May.
Article in English | MEDLINE | ID: mdl-25444047

ABSTRACT

OBJECTIVES: To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to identify factors associated with a diagnosis of HCV. METHODS: The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data. RESULTS: Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% (n=250), and of those currently infected with the virus was 0.6% (n=78). The percentage of those first diagnosed in the last 12 months was 0.4% (n=46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months. CONCLUSIONS: HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV.


Subject(s)
Hepatitis C/epidemiology , Homosexuality, Male , Risk-Taking , Sexual Behavior , Adult , Europe , Health Surveys , Humans , Internet , Male , Spain
8.
Compr Psychiatry ; 55(6): 1342-9, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24889338

ABSTRACT

BACKGROUND: Although Adjustment Disorder (AD) is a prevalent diagnosis in adolescent mental health services and linked to suicidal tendency in adolescence, little research exists examining prevalence and gender differences of suicidal symptoms among AD patients using standardized instruments. AIMS: The present study aims to assess the presence of suicidal tendency in a clinical sample of Spanish adolescents with AD analyzing gender differences. METHOD: Ninety-seven adolescents with AD were recruited at a public mental health center and included in the AD sample; they were administered the Inventario de Riesgo Suicida para Adolescentes (Suicide Risk Inventory for Adolescents-IRIS) and the Millon Adolescent Clinical Inventory (MACI). Ninety-nine community adolescents were recruited and administered the IRIS inventory. The community sample works as a contrast group. RESULTS: Girls with AD show higher levels of suicidal symptoms than boys on both the IRIS Suicidal Ideation and Intention scale (t=8.15, p<.001) and the MACI Suicidal Tendency scale (t=6.6, p<.001). Girls with AD scored significantly higher than girls from the community contrast group sample in the IRIS Suicidal Ideation and Intention scale, but boys with AD presented no differences with regard to boys form the community contrast group sample. Compared with normative clinical samples of the MACI, no differences in the Suicidal Tendency scale scores were found between AD and normative girls, but AD boys showed significantly lower mean scores than normative boys. Suicidal symptoms were presented by 27% of girls and 18% of boys, although only 6% of the girls and none of the boys presented clear suicidal tendencies. CONCLUSIONS: Considering suicidal tendencies in adolescents with Adjustment Disorder is important-especially in girls, who present high suicidal tendencies in relation both to boys and to community peers and the normative clinical population.


Subject(s)
Adjustment Disorders/psychology , Outpatients , Suicidal Ideation , Adolescent , Child , Female , Humans , Male , Outpatients/psychology , Outpatients/statistics & numerical data , Parent-Child Relations , Peer Group , Risk Assessment , Risk Factors , Schools , Sex Distribution , Sex Factors , Surveys and Questionnaires
9.
Enferm Infecc Microbiol Clin ; 32(6): 341-9, 2014.
Article in Spanish | MEDLINE | ID: mdl-24246777

ABSTRACT

OBJECTIVE: To identify factors associated with high risk sexual practices among men who have sex with men (MSM) in Spain. METHODS: An online survey was conducted in 2010, which included, among others, questions on HIV/STI sexual behaviours and prevention needs. Unprotected anal intercourse (UAI) with a partner of unknown or discordant HIV status in the past year was defined as a high risk sexual behaviour. RESULTS: Of the 13,111 participants, 49.4% had had sex with steady partners (SP) and 73.4% with non-steady partners (NSP) in the last 12months; and the prevalence of high risk UAI was 25.4% and 29.4%, respectively. Factors associated with high risk UAI with SP were: living in a city of less than 500,000 inhabitants (OR=1.42 <100,000 inhabitants), being out to no-one or only a few people (OR=1.42), and being HIV-positive with undetectable viral load among those with a high level of HIV/STI knowledge (OR=3.18). Factors associated with high risk UAI with NSP were mainly: having a higher number of sexual partners (OR=4.31 >50 partners), having used drugs for sex (OR=1.33), and at parties (OR=1.19), having a medium (OR=1.82) or low (OR=1.33) level of HIV/STI knowledge, and being HIV-positive (OR=1.56). CONCLUSIONS: Among MSM, the prevalence of high risk sexual practices is high with both SP and NSP. Factors associated with high risk UAI vary by type of sexual partner (e.g., having HIV with an undetectable viral load). These must be taken into account when planning strategies for primary and secondary prevention.


Subject(s)
Homosexuality, Male/psychology , Risk-Taking , Sexual Behavior/statistics & numerical data , Sexual Partners , Adult , Cross-Sectional Studies , Humans , Male , Sexual Partners/classification , Surveys and Questionnaires
10.
J Child Fam Stud ; 31(8): 2229-2238, 2022.
Article in English | MEDLINE | ID: mdl-35789963

ABSTRACT

Due to COVID-19, many countries, like Spain, imposed lockdown on the entire population to prevent the virus from spreading. The purpose of this exploratory study is to investigate the severity of psychological symptoms, dyadic adjustment, and parental stress of parents during the first three weeks of the outbreak. It also aims to identify several risk factors that contribute to this distress. A total of 727 parents completed a form on an online platform with sociodemographic data, BSI- 18, EAD-13, and the Spanish version of the PPS. Linear regression analyses were used to explore the significant associations between the sample characteristics (sociodemographic variables and their lockdown circumstances) and parents' psychological symptoms, dyadic adjustment, and parenting stress level during the COVID-19 epidemic. Most parents maintained good emotional, personal, conjugal, and family stability; however, female gender, not living with the partner, having a child with a mental disorder and were unable to balance the work and family lives were significantly associated with greater psychological distress. Being receiving psychiatric or psychological treatment has also been associated with poorer psychological and partner adjustment during the outbreak. It is essential to continue researching the impact of lockdowns on families so that, both the government and public health authorities, can offer resources to the most vulnerable families.

11.
Gac Sanit ; 36(4): 368-375, 2022.
Article in Spanish | MEDLINE | ID: mdl-33896656

ABSTRACT

OBJECTIVE: The objective of the study is to assess the health status of immigrant men and women from non-EU countries living in the Metropolitan Area of Barcelona (Catalonia, Spain) and to identify the social determinants of health from a gender perspective. METHOD: Cross-sectional analysis from a cohort of immigrant families recruited in Badalona and Santa Coloma de Gramenet, in Spain (PELFI cohort). In 2015-2016, 167 immigrants answered the baseline epidemiological questionnaire and the 5-level EuroQol instrument (EQ-5D) which measures health status. To identify health determinants, Tobit models were constructed to the EQ-5D index. RESULTS: Women rated poorer self-perceived health (p=0.005). To be diagnosed with and illness was only associated with poor self-perceived health among men (p<0.05). Length of residence, domestic work, and especially double workload deteriorated women's health. After adjusting models by demographics and social determinants, permanent administrative status (-0.136; p=0.015) and social support (0.182; p=0.02) were associated with health status in both sexes. To have a job was associated with better health only in men. CONCLUSIONS: Non-EU immigrants living in the Metropolitan Area of Barcelona are a socially vulnerable group of population and present inequalities in health by sex. Social support and occupation are key factors of their health status. Interventions to reduce immigrant vulnerabilities and inequalities in health should promote their social inclusion and cohesion from a gender perspective.


Subject(s)
Emigrants and Immigrants , Cross-Sectional Studies , Female , Health Status , Humans , Male , Occupations , Socioeconomic Factors , Spain
12.
Int J STD AIDS ; 33(12): 1045-1053, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36113447

ABSTRACT

BACKGROUND: The aim of this study was to describe the socio-demographics, and the sexual and health-seeking behaviours of cisgender men and transgender women sex workers (M & TWSW) attending community-based organisations (CBOs) in Barcelona, Spain, as well as to estimate the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Chlamydia Trachomatis (CT) and Neisseria gonorrhoeae (NG) among them at different anatomical sites. METHODS: The Sweetie Project was a community-based cross-sectional study of 147 M & TWSW recruited in two CBOs in Barcelona between 2017 and 2018. A nurse collected biological samples from rectum, pharynx and urethra from the subjects at each CBO and the participants self-completed an epidemiological questionnaire. RESULTS: The highest prevalence observed was for HIV infection (25.3%) followed by bacterial STIs (NG 19.2% and CT 10.3%). The most prevalent anatomical site was pharyngeal (17.7%) followed by rectal (13.8%). More than half of participants who had a pharyngeal infection presented an isolated pharyngeal infection (57.7%) and half of those who had a rectal or urethral infection presented an isolated infection respectively. The seroprevalence of HCV and HBV was 2.4% and 34.2% respectively. There was a poor but statistically significant correlation between HIV and rectal CT infection (r = 0.31), previous exposure to HCV (r = 0.27) or self-reported STI (r = 0.23), as well as between previous exposure to HCV and rectal CT (r = 0.21) or self-reported STI (r = 0.20). DISCUSSION: The Sweetie Project confirms the high burden of HIV and bacterial STIs among a sample of M&TWSW recruited in CBOs and reinforces the need to routinely screen them at all exposed anatomical sites.


Subject(s)
Chlamydia Infections , Gonorrhea , HIV Infections , Hepatitis C , Sex Workers , Sexually Transmitted Diseases , Transgender Persons , Male , Female , Humans , Sexually Transmitted Diseases/epidemiology , Gonorrhea/epidemiology , Gonorrhea/microbiology , HIV Infections/epidemiology , Prevalence , Cross-Sectional Studies , Homosexuality, Male , Seroepidemiologic Studies , Spain/epidemiology , Chlamydia Infections/epidemiology , Neisseria gonorrhoeae , Chlamydia trachomatis
13.
Vaccines (Basel) ; 10(11)2022 Nov 15.
Article in English | MEDLINE | ID: mdl-36423025

ABSTRACT

COVID-19 is associated with poor maternal and pregnancy outcomes. COVID-19 vaccination is recommended in Spain, yet vaccination rates in pregnancy are suboptimal. This study investigates the perceptions of pregnant women and healthcare workers (HCW) regarding COVID-19 vaccination. A web-based cross-sectional quantitative study was conducted in 2021-2022 among 302 pregnant women and 309 HCWs in the Catalan public health system. Most pregnant women (83%) and HCWs (86%) were aware of COVID-19 maternal vaccines. The recommendation of the COVID-19 vaccination by an HCW was identified as the greatest facilitator for maternal vaccine uptake, while the fear of harming the foetus was the most significant barrier reported for rejecting vaccination. HCWs recognised they received limited information and training about COVID-19 vaccination in pregnancy, which hindered them from providing informed recommendations. This study highlights that information and education on COVID-19 vaccines to pregnant women and health professionals are pivotal to ensuring informed decision-making and increasing vaccine uptake.

14.
Actas Esp Psiquiatr ; 39(4): 226-35, 2011.
Article in English, Spanish | MEDLINE | ID: mdl-21769746

ABSTRACT

Deliberate self-harm, suicide intents and suicidal ideation are suicide risk symptoms in adolescence. The knowledge of their prevalence and associated characteristics is needed to prevent and treat them properly. The aims of the present study are: a) to analyse the presence of deliberate self-harm and suicidal ideation among a general adolescent population according to sex, b) to investigate the link between these two symptoms, calculating the risk ratio (RR) of self-harming behavior among adolescents with suicidal ideation, and c) to analyze the coping strategies used by adolescents with presence/absence of these behaviors. Participants are 1,171 Catalonian high school students (518 boys and 653 girls) aged 12 to 16 years. Self-harm behavior was assessed by means of YSR and coping strategies by means of CRI-Youth. Results indicate that the prevalence of self-harm behavior is 11.4% and the one for the suicidal ideation is 12.5%, percentages that are in accordance with the literature. No gender differences are found, but there is an increase with age in both types of risk behaviors. There is a significant link between deliberate self-harm and suicidal ideation. The RR indicates that the self-harming behavior is 10 times more likely to occur in the adolescents with suicidal ideation than in the adolescents without such ideation. The use of specific coping strategies differentiates between adolescents with presence/absence of these risk behaviors, especially in the case of girls. These findings may have important preventive value and contribute to the implementation of more effective treatments. Key words: Self-harm behavior, suicidal ideation, coping strategies, adolescence, sex differences.


Subject(s)
Adaptation, Psychological , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/psychology , Suicidal Ideation , Adolescent , Child , Female , Humans , Male , Sex Factors
15.
Biomed Opt Express ; 12(8): 4852-4872, 2021 Aug 01.
Article in English | MEDLINE | ID: mdl-34513229

ABSTRACT

We highlight the potential of a predictive optical model method for tissue recognition, based on the statistical analysis of different polarimetric indicators that retrieve complete polarimetric information (selective absorption, retardance and depolarization) of samples. The study is conducted on the experimental Mueller matrices of four biological tissues (bone, tendon, muscle and myotendinous junction) measured from a collection of 157 ex-vivo chicken samples. Moreover, we perform several non-parametric data distribution analyses to build a logistic regression-based algorithm capable to recognize, in a single and dynamic measurement, whether a sample corresponds (or not) to one of the four different tissue categories.

16.
Article in English, Spanish | MEDLINE | ID: mdl-30558955

ABSTRACT

OBJECTIVE: Little is known about the role of coping in relation to suicidal risk in adolescents with Adjustment Disorder (AD). The present study aimed to assess the relation between suicidal ideation and intention and coping strategies in a clinical sample of adolescents with AD, paying special attention to gender differences. MATERIAL AND METHOD: Self-reported questionnaires about suicidal ideation and intention and coping strategies were administered to 108 adolescents with an AD diagnosis. RESULTS: Compared with the normative population, adolescents with an AD diagnosis made more use of Acceptance-Resignation (an avoidance-type coping strategy) and less use of Positive Reappraisal (an approach-type coping strategy). Nevertheless, gender introduced some peculiarities. A relationship was observed between the use of certain coping strategies and suicidal ideation and intention, but with notable differences depending on gender: significant and high correlations were found between these two variables in AD boys, both in the total approach score (r=.53, p<.01) and in the total avoidant score (r=.60, p<.01), with coping strategies explaining 41% of suicidal ideation and intention; in girls, in contrast, the only significant relationship was with an avoidant strategy, Emotional Discharge (r=.25, p<.05), although it had low explanatory power. CONCLUSIONS: Coping strategies must be taken into consideration when assessing and treating adolescents with AD at risk of suicide, especially in the case of boys. The absence of association between coping strategies and suicidal risk in girls is discussed, and some therapeutic proposals are presented.

17.
Gac. sanit. (Barc., Ed. impr.) ; 36(4): 368-375, jul.-ago. 2022. tab, graf
Article in Spanish | IBECS (Spain) | ID: ibc-212555

ABSTRACT

Objetivo: Evaluar el estado de salud de hombres y mujeres inmigrantes extracomunitarios residentes en el Área Metropolitana de Barcelona (Cataluña, España) e identificar determinantes sociales de la salud desde una perspectiva de género. Método: Análisis transversal de una cohorte de familias inmigrantes reclutadas en Badalona y Santa Coloma de Gramenet (cohorte PELFI). En 2015-2016, 167 inmigrantes respondieron al cuestionario epidemiológico basal y al instrumento EuroQol de cinco dimensiones (EQ-5D) que mide el estado de salud. Para identificar determinantes de la salud se construyeron modelos Tobit con el índice EQ-5D. Resultados: Las mujeres declararon una peor salud percibida (p=0,005). Tener una enfermedad diagnosticada se asoció con una peor percepción de la salud en los hombres (p<0,05). El tiempo de estancia y las cargas familiares, en especial la doble jornada de trabajo, empeoraron la salud percibida de las mujeres. En el modelo ajustado por variables demográficas y determinantes sociales, la situación administrativa estable (−0.136; p=0,015) y el apoyo social (0,182; p=0,02) se asociaron con el índice EQ-5D en ambos sexos. Estar ocupado se asoció a mejor salud en los hombres. Conclusiones: Las personas inmigrantes extracomunitarias residentes en el Área Metropolitana de Barcelona son una población vulnerable y presentan desigualdades en salud por sexo. El apoyo social y la ocupación son factores clave de su estado de salud. Las intervenciones para reducir las vulnerabilidades y desigualdades en salud de las personas inmigrantes deberían promover su inclusión y cohesión social, e incorporar la perspectiva de género. (AU)


Objective: The objective of the study is to assess the health status of immigrant men and women from non-EU countries living in the Metropolitan Area of Barcelona (Catalonia, Spain) and to identify the social determinants of health from a gender perspective. Method: Cross-sectional analysis from a cohort of immigrant families recruited in Badalona and Santa Coloma de Gramenet, in Spain (PELFI cohort). In 2015-2016, 167 immigrants answered the baseline epidemiological questionnaire and the 5-level EuroQol instrument (EQ-5D) which measures health status. To identify health determinants, Tobit models were constructed to the EQ-5D index. Results: Women rated poorer self-perceived health (p=0.005). To be diagnosed with and illness was only associated with poor self-perceived health among men (p<0.05). Length of residence, domestic work, and especially double workload deteriorated women's health. After adjusting models by demographics and social determinants, permanent administrative status (−0.136; p=0.015) and social support (0.182; p=0.02) were associated with health status in both sexes. To have a job was associated with better health only in men. Conclusions: Non-EU immigrants living in the Metropolitan Area of Barcelona are a socially vulnerable group of population and present inequalities in health by sex. Social support and occupation are key factors of their health status. Interventions to reduce immigrant vulnerabilities and inequalities in health should promote their social inclusion and cohesion from a gender perspective. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Health Status , Emigrants and Immigrants , Gender Perspective , Demography , Socioeconomic Factors , Surveys and Questionnaires
18.
Vaccine ; 34(33): 3719-22, 2016 07 19.
Article in English | MEDLINE | ID: mdl-27265448

ABSTRACT

Maternal pertussis vaccination is associated with higher levels of pertussis antibodies at birth. We assessed the persistence of pertussis antibodies until primary vaccination in infants whose mothers received Tdap (tetanus, diphtheria, acellular pertussis) vaccine during pregnancy. Infants were born at the Hospital Clinic of Barcelona (Spain) in November 2014. Anti-PT IgG was determined by ELISA at delivery, between the first and second month of life, and estimated at 2months of age. The study included 37 infants whose mothers received Tdap between 21 and 38weeks of gestation. Infants presented a decline in GMC of anti-PT IgG between peripartum and follow-up levels, 52.7 (95% CI 34.7-80.2) versus 7.5 (95% CI 4.2-13.3) at 2months of age (p<0.001). The median half-life of maternal antibodies was 47days. More than half (51.4%) the infants presented detectable anti-PT IgG before the start of primary infant vaccination.


Subject(s)
Antibodies, Bacterial/blood , Diphtheria-Tetanus-acellular Pertussis Vaccines/therapeutic use , Immunity, Maternally-Acquired , Whooping Cough/prevention & control , Adult , Female , Half-Life , Humans , Immunoglobulin G/blood , Infant , Male , Pregnancy , Prospective Studies , Young Adult
19.
Pediatr. catalan ; 81(3): 138-142, Juliol - Setembre 2021. tab, ilus
Article in Catalan | IBECS (Spain) | ID: ibc-218070

ABSTRACT

Introducció. L’encefalomielitis aguda disseminada (EMAD) és una malaltia inflamatòria immunomediada desmielinitzant del sistema nerviós central. Associa simptomatologia neurològica multifocal i encefalopatia. Afecta fonamentalment la població infantil, amb una incidència anual estimada en menors de catorze anys del 0,64/100.000. El diagnòstic de l’EMAD és d’exclusió. Cas clínic. Lactant de quatre mesos, sana i amb neurodesenvolupament adequat, és portada a urgències per desviació lateral dreta de cap i coll. Associa quadre catarral sense febre. A les 48 hores de l’ingrés desenvolupa oftalmoplegia, sialorrea i nivell d’alerta alternant. Atesa l’aparició de simptomatologia neurològica, es deriva a centre de referència on s’amplia l’estudi etiològic. La ressonància magnètica (RM) cerebroespinal mostra alteració d’intensitat de senyal de tàlems, nuclis lenticulars i tronc de l’encèfal esquerre. Davant la sospita d’EMAD, rep tractament amb glucocorticoides i gammaglobulina. També rep biotina i tiamina a l’espera de l’estudi metabòlic. La RM cerebroespinal al cap de deu dies mostra reducció de les lesions. La recuperació dels dèficits neurològics dos mesos després és completa. Comentaris. La clínica, l’evolució i els estudis complementaris són suggestius d’EMAD. Les lesions típiques d’aquesta entitat a la RM afecten la substància blanca subcortical profunda de forma bilateral i asimètrica. També hi pot haver afectació de ganglis de base, tàlem i tronc de l’encèfal. El diagnòstic diferencial inclou encefalitis infecciosa, esclerosi múltiple i metabolopaties. La primera línia de tractament són els bols de glucocorticoides. La majoria de casos presenta recuperació completa. L’interès del cas exposat rau en l’edat de presentació. (AU)


Introducción. La encefalomielitis aguda diseminada (EMAD) es una enfermedad inflamatoria inmunomediada desmielinizante del sistema nervioso central. Asocia sintomatología neurológica multifocal y encefalopatía. Afecta fundamentalmente la población infantil con una incidencia anual estimada en menores de 14 años del 0,64/100.000. El diagnóstico de EMAD es de exclusión. Caso clínico. Lactante de 4 meses, sana y con adecuado neurodesarrollo, es traída a urgencias por desviación lateral derecha de cabeza y cuello; asocia cuadro catarral sin fiebre. A las 48 horas del ingreso desarrolla oftalmoplejía, sialorrea y nivel de alerta alternante. Dada la aparición de sintomatología neurológica, se deriva a centro de referencia donde se amplía el estudio etiológico. La resonancia magnética (RM) cerebroespinal muestra alteración de intensidad de señal de tálamos, núcleos lenticulares y tronco del encéfalo izquierdo. Ante la sospecha de EMAD, recibe tratamiento con glucocorticoides y gammaglobulina. También recibe biotina y tiamina a la espera del estudio metabólico. La RM cerebroespinal a los 10 días muestra reducción de las lesiones. La recuperación de los déficits neurológicos dos meses después es completa. Comentarios. La clínica, evolución y estudios complementarios son sugestivos de EMAD. Las lesiones típicas de esta entidad en la RM afectan la sustancia blanca subcortical profunda de forma bilateral y asimétrica. También puede haber afectación de ganglios de base, tálamo y tronco del encéfalo. El diagnóstico diferencial incluye encefalitis infecciosa, esclerosis múltiple y metabolopatías. La primera línea de tratamiento son bolus de glucocorticoides. La mayoría de casos presenta recuperación completa. El interés del caso expuesto radica en la edad de presentación. (AU)


Introduction. Acute disseminated encephalomyelitis (ADEM) is a demyelinating immune mediated inflammatory disease affecting the central nervous system. It associates multifocal neurological symptoms and encephalopathy. It predominantly affects children, and its annual cumulative incidence in children under 14 years is 0.64/100,000. The diagnosis of ADEM is one of exclusion. Case report. A previously healthy 4-month-old infant with adequate neurodevelopment was seen in the emergency department due to acute onset of right lateral deviation of head and neck, associated with cold symptoms without fever. 48 hours after admission, the infant developed ophthalmoplegia, sialorrhea and alternating alert level. Given the development of neurological symptoms, she was referred to a tertiary hospital for evaluation. Cerebrospinal magnetic resonance imaging (MRI) showed altered signal intensity of the thalamus, lenticular nuclei, and left brainstem. ADEM was suspected and glucocorticoids and gamma globulin were administered. She also received biotin and thiamine while awaiting results of a metabolic panel. Cerebrospinal MRI at 10 days showed improvement of the lesions, and a full recovery was reached after two months. Comments. The clinical presentation, diagnostic studies, and clinical evolution are suggestive of ADEM. Typical MRI lesions involve deep subcortical white matter bilaterally and asymmetrically. There may also be involvement of the basal ganglia, thalamus, and brainstem. Differential diagnosis includes infectious encephalitis, multiple sclerosis, and metabolic diseases. First line treatment are glucocorticoids. Most cases have complete recovery. The interest of the case lies in the age of presentation. (AU)


Subject(s)
Humans , Female , Infant , Torticollis/diagnosis , Torticollis/therapy , Encephalomyelitis, Acute Disseminated/diagnosis , Encephalomyelitis, Acute Disseminated/therapy , Virus Diseases/diagnosis , Virus Diseases/therapy
20.
Reumatol Clin ; 12(2): 85-90, 2016.
Article in English, Spanish | MEDLINE | ID: mdl-26078022

ABSTRACT

Behçet's disease is a systemic vasculitis characterized by the presence of oral and genital ulcers. Neurological involvement or neuro-Behçet is an uncommon manifestation. It manifestation has predominance in the male gender appearing 2 to 4 years after the first clinical manifestation. However, neuro-Behçet disease sometimes occurs with pseudotumoral brain lesions. Herein, we present the cases of two patients diagnosed with neuro-Behçet after detection of pseudotumoral brain lesions. A review of the literature is performed.


Subject(s)
Behcet Syndrome/diagnosis , Brain Diseases/diagnosis , Adult , Female , Humans , Male , Middle Aged
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