Quality and safety actions in primary care practices in COVID-19 pandemic: the PRICOV-19 study in Spain.

BACKGROUND: Primary Health Care (PHC) has been key element in detection, monitoring and treatment of COVID-19 cases in Spain. We describe how PHC practices (PCPs) organized healthcare to guarantee quality and safety and, if there were differences among the 17 Spanish regions according to the COVID-19 prevalence. METHODS: Cross-sectional study through the PRICOV-19 European Online Survey in PCPs in Spain. The questionnaire included structure and process items per PCP. Data collection was due from January to May 2021. A descriptive and comparative analysis and a logistic regression model were performed to identify differences among regions by COVID-19 prevalence (low < 5% or high ≥5%). RESULTS: Two hundred sixty-six PCPs answered. 83.8% of PCPs were in high prevalence regions. Over 70% PCPs were multi-professional teams. PCPs attended mainly elderly (60.9%) and chronic patients (53.0%). Regarding structure indicators, no differences by prevalence detected. In 77.1% of PCPs administrative staff were more involved in providing recommendations. Only 53% of PCPs had a phone protocol although 73% of administrative staff participated in phone triage. High prevalence regions offered remote assessment (20.4% vs 2.3%, p 0.004) and online platforms to download administrative documents more frequently than low prevalence (30% vs 4.7%, p < 0.001). More backup staff members were hired by health authorities in high prevalence regions, especially nurses (63.9% vs 37.8%, p < 0.001. OR:4.20 (1.01-8.71)). 63.5% of PCPs provided proactive care for chronic patients. 41.0% of PCPs recognized that patients with serious conditions did not know to get an appointment. Urgent conditions suffered delayed care in 79.1% of PCPs in low prevalence compared to 65.9% in high prevalence regions (p 0.240). A 68% of PCPs agreed on having inadequate support from the government to provide proper functioning. 61% of high prevalence PCPs and 69.5% of low ones (p: 0.036) perceived as positive the role of governmental guidelines for management of COVID-19. CONCLUSIONS: Spanish PCPs shared a basic standardized PCPs' structure and common clinical procedures due to the centralization of public health authority in the pandemic. Therefore, no relevant differences in safety and quality of care between regions with high and low prevalence were detected. Nurses and administrative staff were hired efficiently in response to the pandemic. Delay in care happened in patients with serious conditions and little follow-up for mental health and intimate partner violence affected patients was identified. Nevertheless, proactive care was offered for chronic patients in most of the PCPs.

PRECISE-DAPT, ARC-HBR, or Simplified Clinical Evaluation for the Prediction of Major Bleeding After Percutaneous Coronary Intervention in older Patients.

Older patients have been remarkably underrepresented in bleeding risk cohorts. Thus, the PRECISE-DAPT (Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy) and Academic Research Consortium for High Bleeding Risk (ARC-HBR) scores are not validated in older adults. Therefore, we sought to evaluate the PRECISE-DAPT and ARC-HBR scores in an exclusively older population and assess the prognostic value of a truly simplified clinical evaluation (SCE), consisting of only 3 binary clinical variables (hemoglobin <11 g/100 ml, previous bleeding, and anticipated use of anticoagulants). This is a retrospective analysis of the prospective single-center older-HCD registry. Consecutive patients aged ≥75 years who underwent percutaneous coronary intervention from 2012 to 2019 were included. The primary end point was postdischarge bleeding at 12 months of follow-up, defined according to the Bleeding Academic Research Consortium 3 or 5 criteria. A total of 693 patients with a mean age of 81 (±4.4) years were included in the study and 60 patients (6.8%) met the primary end point. The PRECISE-DAPT and ARC-HBR scores did not significantly predict postdischarge bleeding in the Cox regression models (hazard ratio 1.65 [0.78 to 3.42] and 1.46 [0.72 to 4.24], respectively), whereas the SCE outperformed both scores (hazard ratio 2.47, 1.34 to 4.49). All 3 scores exhibited a moderate discriminatory potential, as determined by a receiver-operating characteristic curve analysis (areas under the curve 0.601, 0.621, and 0.616, respectively), with no significant differences between them. The SCE showed an Integrated Discrimination Improvement of 0.25, p = 0.02 (SCE vs ARC-HBR) and 0.24, p = 0.01 (SCE vs PRECISE-DAPT), with an Net Reclassification Improvement of 6.54%, p = 0.37 and 7.12%, p = 0.43, respectively. In conclusion, the PRECISE-DAPT score and ARC-HBR criteria showed insufficient predictive value in older adults. A truly SCE consisting of 3 easily accessible variables not only provides equal discriminatory potential but also demonstrates superior predictive value, as determined by Cox regression models. This makes it a highly appealing tool for risk stratification, pending its evaluation in larger prospective studies.

Physical Activity Policies at National and Subnational Levels: A Study in Colombia, Costa Rica, Ecuador, and Mexico.

BACKGROUND: National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national-subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries. METHODS: The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were assessed using descriptive statistics. RESULTS: Twenty-three (response rate = 85.2%) informants provided data, mainly from the health sector (52.2%), followed by the sport (26.1%), transport (13.0%), and education (8.7%) sectors. Most informants reported that their countries had a current PA policy embedded within noncommunicable diseases prevention plans (46.2%), other plans (46.2%), or obesity prevention/management/control plans (7.7%). Respondents at the subnational level rated PA promotion as central (64.3%), while the national-level role was important but not central (75.0%). National and subnational policymakers indicated low-to-little involvement in the other level's PA policy processes across the 5 policy stages. CONCLUSIONS: This study demonstrated that collecting national and subnational PA policy data across countries with the active collaboration of the GoPA! network was feasible. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels.

Albumin Redox Modifications Promote Cell Calcification Reflecting the Impact of Oxidative Status on Aortic Valve Disease and Atherosclerosis.

Calcific aortic valve disease (CAVD) and coronary artery disease (CAD) are related cardiovascular diseases in which common mechanisms lead to tissue calcification. Oxidative stress plays a key role in these diseases and there is also evidence that the redox state of serum albumin exerts a significant influence on these conditions. To further explore this issue, we used multimarker scores (OxyScore and AntioxyScore) to assess the global oxidative status in patients with CAVD, with and without CAD, also evaluating their plasma thiol levels. In addition, valvular interstitial cells were treated with reduced, oxidized, and native albumin to study how this protein and its modifications affect cell calcification. The differences we found suggest that oxidative status is distinct in CAVD and CAD, with differences in redox markers and thiol levels. Importantly, the in vitro interstitial cell model revealed that modified albumin affects cell calcification, accelerating this process. Hence, we show here the importance of the redox system in the development of CAVD, emphasizing the relevance of multimarker scores, while also offering evidence of how the redox state of albumin influences vascular calcification. These data highlight the relevance of understanding the overall redox processes involved in these diseases, opening the door to new studies on antioxidants as potential therapies for these patients.

Unlocking the key role of bentonite fungal isolates in tellurium and selenium bioremediation and biorecovery: Implications in the safety of radioactive waste disposal.

Research on eco-friendly bioremediation strategies for mitigating the environmental impact of toxic metals has gained attention in the last years. Among all promising solutions, bentonite clays, to be used as artificial barriers to isolate radioactive wastes within the deep geological repository (DGR) concept, have emerged as effective reservoir of microorganisms with remarkable bioremediation potential. The present study aims to investigate the impact of bentonite fungi in the speciation and mobility of selenium (Se) and tellurium (Te), as natural analogues 79Se and 132Te present in radioactive waste, to screen for those strains with bioremediation potential within the context of DGR. For this purpose, a multidisciplinary approach combining microbiology, biochemistry, and microscopy was performed. Notably, Aspergillus sp. 3A demonstrated a high tolerance to Te(IV) and Se(IV), as evidenced by minimal inhibitory concentrations of >16 and >32 mM, respectively, along with high tolerance indexes. The high metalloid tolerance of Aspergillus sp. 3A is mediated by its capability to reduce these mobile and toxic elements to their elemental less soluble forms [Te(0) and Se(0)], forming nanostructures of various morphologies. Advanced electron microscopy techniques revealed intracellular Te(0) manifesting as amorphous needle-like nanoparticles and extracellular Te(0) forming substantial microspheres and irregular accumulations, characterized by a trigonal crystalline phase. Similarly, Se(0) exhibited a diverse array of morphologies, including hexagonal, irregular, and needle-shaped structures, accompanied by a monoclinic crystalline phase. The formation of less mobile Te(0) and Se(0) nanostructures through novel and environmentally friendly processes by Aspergillus sp. 3A suggests it would be an excellent candidate for bioremediation in contaminated environments, such as the vicinity of deep geological repositories. It moreover holds immense potential for the recovery and synthesis of Te and Se nanostructures for use in numerous biotechnological and biomedical applications.

Association of the Complement System with Subclinical Atherosclerosis in Psoriasis: Findings from an Observational Cohort Study.

Psoriasis is a chronic and inflammatory disease that affects the skin and joints and is associated with multiple comorbidities and cardiovascular risk factors. Consequently, patients with psoriasis have an increased risk of cardiovascular diseases such as atherosclerosis, a chronic pathology that shares common inflammatory and immune-response mechanisms with psoriasis, including vascular inflammation and complement activation. To better understand the relationship between atherosclerosis and psoriasis, a proteomics study followed by a bioinformatics analysis was carried out, with a subsequent validation step using ELISA and western blotting. When the plasma from patients with psoriasis alone was compared with that from patients with psoriasis and atherosclerosis, 31 proteins of interest related to the complement system and oxygen transport were identified. After the validation phase, 11 proteins appeared to define the presence of subclinical atherosclerosis in patients with psoriasis, indicating the importance of complement cascades in the development of atherosclerotic plaques in individuals with psoriasis. These results are a step forward in understanding the pathological pathways implicated in the cardiovascular risk associated with this population, which may represent an interesting starting point for developing predictive tools that improve the follow-up of these patients and design more effective therapies.

Use of psychological interventions among healthcare workers over the 2-year period following the COVID-19 pandemic: A longitudinal study.

INTRODUCTION: Although healthcare workers (HCWs) have reported mental health problems since the beginning of the COVID-19 pandemic, they rarely use psychological support. Here, we described the use of psychological support among HCWs in Spain over the 2-year period following the initial pandemic outbreak and explore its association with workplace- and COVID-19-related factors measured at baseline, in 2020. MATERIALS AND METHODS: We conducted a longitudinal study on HCWs working in Spain. We used an online survey to collect information on sociodemographic characteristics, depressive symptoms, workplace- and COVID-19-related variables, and the use of psychological support at three time points (2020, 2021, and 2022). Data was available for 296, 294, and 251 respondents, respectively at time points 1, 2, and 3. RESULTS: Participants had a median age of 43 years and were mostly females (n = 242, 82%). The percentage of HCWs using psychological support increased from 15% in 2020 to 23% in 2022. Roughly one in four HCWs who did not use psychological support reported symptoms compatible with major depressive disorder at follow up. Baseline predictors of psychological support were having to make decisions about patients' prioritisation (OR 5.59, 95% CI 2.47, 12.63) and probable depression (wave 2: OR 1.12, 95% CI 1.06, 1.19; wave 3: OR 1.10, 95% CI 1.04, 1.16). CONCLUSIONS: Our results suggest that there is call for implementing mental health promotion and prevention strategies at the workplace, along with actions to reduce barriers for accessing psychological support.

Severe Rickettsia typhi Infections, Costa Rica.

Murine typhus is a febrile, fleaborne disease caused by infection with Rickettsia typhi bacteria. Cases can range from mild and nonspecific to fatal. We report 2 cases of murine typhus in Costa Rica, confirming the presence and circulation of R. typhi causing severe disease in the country.

Cognitive Alterations in Old Mice Are Associated with Intestinal Barrier Dysfunction and Induced Toll-like Receptor 2 and 4 Signaling in Different Brain Regions.

Emerging evidence implicate the 'microbiota-gut-brain axis' in cognitive aging and neuroinflammation; however, underlying mechanisms still remain to be elucidated. Here, we assessed if potential alterations in intestinal barrier function and microbiota composition as well as levels of two key pattern-recognition receptors namely Toll-like receptor (TLR) 2 and TLR4, in blood and different brain regions, and depending signaling cascades are paralleling aging associated alterations of cognition in healthy aging mice. Cognitive function was assessed in the Y-maze and intestinal and brain tissue and blood were collected in young (4 months old) and old (24 months old) male C57BL/6 mice to determine intestinal microbiota composition by Illumina amplicon sequencing, the concentration of TLR2 and TLR4 ligands in plasma and brain tissue as well as to determine markers of intestinal barrier function, senescence and TLR2 and TLR4 signaling. Cognitive function was significantly impaired in old mice. Also, in old mice, intestinal microbiota composition was significantly altered, while the relative abundance of Gram-negative or Gram-positive bacteria in the small and large intestines at different ages was not altered. Moreover, intestinal barrier function was impaired in small intestine of old mice, and the levels of TLR2 and TLR4 ligands were also significantly higher in both portal and peripheral blood. Furthermore, levels of TLR2 and TLR4 ligands, and downstream markers of TLR signaling were higher in the hippocampal and prefrontal cortex of old mice compared to young animals. Taken together, our results suggest that even in 'healthy' aging, cognitive function is impaired in mice going along with an increased intestinal translocation of TLR ligands and alterations of TLR signaling in several brain regions.

Global Oxidative Status Is Linked to Calcific Aortic Stenosis: The Differences Due to Diabetes Mellitus and the Effects of Metformin.

Calcific aortic stenosis (CAS) and type 2 diabetes mellitus (T2DM) are related and often concomitant pathologies, accompanied by common comorbidities such as hypertension or dyslipidemia. Oxidative stress is one of the mechanisms that trigger CAS, and it can drive the vascular complications in T2DM. Metformin can inhibit oxidative stress, yet its effects have not been studied in the context of CAS. Here, we assessed the global oxidative status in plasma from patients with CAS, both alone and with T2DM (and under treatment with metformin), using multimarker scores of systemic oxidative damage (OxyScore) and antioxidant defense (AntioxyScore). The OxyScore was determined by measuring carbonyls, oxidized LDL (oxLDL), 8-hydroxy-20-deoxyguanosine (8-OHdG), and xanthine oxidase (XOD) activity. In contrast, the AntioxyScore was determined through the catalase (CAT) and superoxide dismutase (SOD) activity, as well as the total antioxidant capacity (TAC). Patients with CAS displayed enhanced oxidative stress compared to control subjects, probably exceeding their antioxidant capacity. Interestingly, patients with CAS and T2DM displayed less oxidative stress, possibly due to the benefits of their pharmacological therapy (metformin). Thus, reducing oxidative stress or enhancing antioxidant capacity through specific therapies could be a good strategy to manage CAS, focusing on personalized medicine.

Perturbation of maternal gut microbiota in mice during a critical perinatal window influences early neurobehavioral outcomes in offspring.

The gut microbiota is increasingly recognized as a key environmental factor that shapes host development and physiology, including neural circuits formation and function. Concurrently, there has been growing concern that early-life antibiotic exposure may alter brain developmental trajectories, increasing the risk for neurodevelopmental disorders such as autism spectrum disorder (ASD). Here, we assessed whether perturbation of the maternal gut microbiota in mice during a narrow critical perinatal window (last week of pregnancy and first three postnatal days), induced by exposure to a commonly used broad-spectrum oral antibiotic (ampicillin), influences offspring neurobehavioral outcomes relevant to ASD. Our results demonstrate that neonatal offspring from antibiotic-treated dams display an altered pattern of ultrasonic communication, which was more pronounced in males. Moreover, juvenile male, but not female, offspring from antibiotic-treated dams showed reduced social motivation and social interaction, as well as context-dependent anxiety-like behavior. However, no changes were observed in locomotor or exploratory activity. This behavioral phenotype of exposed juvenile males was associated with reduced gene expression of the oxytocin receptor (OXTR) and several tight-junction proteins in the prefrontal cortex, a key region involved in the regulation of social and emotional behaviors, as well as a mild inflammatory response in the colon. Further, juvenile offspring from exposed dams also showed distinct alterations in several gut bacterial species, including, Lactobacillus murinus, and Parabacteroides goldsteinii. Overall, this study highlights the importance of the maternal microbiome in early-life, and how its perturbation by a widely used antibiotic could contribute to atypical social and emotional development of offspring in a sex-dependent manner.

Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak.

BACKGROUND: During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain. MATERIALS AND METHODS: Healthcare workers from inpatient and outpatient facilities (N=2,053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted. RESULTS: Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression (B=2.4, 95 percent CI: 1.8, 2.9) and psychological distress (B=1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR=2.0, 95 percent CI: 1.4, 3.1). CONCLUSIONS: Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.

The impact of resilience as a protective factor on Health-Related Quality of Life's psychological dimensions among adolescents who experience peer victimization.

Peer victimization have a negative impact on Health-Related Quality of Life (HRQoL) during adolescence, however some personal skills such a person's resilience could play a significant role in this relationship. In this context, this study aims to analyse if resilience is a moderator of the relation between peer victimization and HRQoL's psychological dimensions. Sociodemographic data, peer victimization, psychological domains of HRQoL and resilience were measures in a sample of 1428 secondary school students using the following scales: "Adolescent Peer Relations Instrument-Bullying", "KIDSCREEN-52" and "Brief Resilient Coping Scale. Different multivariate analyses were carried out using linear regression. PROCESS tool was used to examine the moderating role of resilience, with John-Neyman post-hoc approach to quantify moderation. Results suggest that resilience could moderate the association between physical (ß = - 0.0021; p = 0.025) and verbal victimization (ß = - 0.0018; p = 0.024) and the "Mood and Emotions" dimension of adolescents' HRQoL. Nevertheless, this regulating influence appears to be faint (∆R2 0.004). Resilience showed no moderating effect between social victimization and psychological dimensions of HRQoL. We concluded that resilience could function as a protective factor that weakly regulates the negative association between physical and verbal victimization and the psychological sphere of adolescents' HRQoL.

[Health impact of COVID pandemic. SESPAS Report 2022]. / El impacto de la pandemia de COVID-19 sobre la salud. Informe SESPAS 2022.

OBJECTIVE: The World Health Organization declared the global SARS-CoV-2 infection a pandemic on March 11, 2020. The objective of this paper is to present its impact in terms of physical and mental health 22 months later. METHOD: We have reviewed results from published meta-analysis and systematic reviews, and some individual articles on specific aspects of special interest. National information on infection comes for the Red Nacional de Vigilancia Epidemiológica (RENAVE). RESULTS: Up to the end of October, more than 250 million infections and 5 million deaths had been reported globally. In Spain, 4.7 million infections have been documented although the real figure might be above 7 million. The pandemic has reduced life expectancy, and its effects have been especially dramatic in people with comorbidities and the elderly. There is a worsening of mental health in the general population. It is foreseeable that some groups, such as health professionals, mostly women, and front-line workers, may have a greater risk of developing mental health pathologies. The pandemic and the control measures have had other undesirable consequences such as a decrease in healthcare utilization, an increase in sedentary lifestyle or an increase in gender violence. In addition to its immediate effect on morbidity and mortality, the control measures have damaged the overall health status of the global population. CONCLUSIONS: Longitudinal studies are necessary to determine the mid and long consequences of the pandemic and the control measures, and to identify and evaluate effective health interventions.

Sustained Negative Mental Health Outcomes Among Healthcare Workers Over the First Year of the COVID-19 Pandemic: A Prospective Cohort Study.

Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible participants were healthcare workers working in Spain. Baseline data were collected during the initial pandemic outbreak. Survey-based self-reported measures included COVID-19-related exposures, sociodemographic characteristics, and three mental health outcomes (psychological distress, depression symptoms, and posttraumatic stress disorder symptoms). We examined three longitudinal trajectories in mental health outcomes between baseline and follow-up assessments (namely asymptomatic/stable, recovering, and persistently symptomatic/worsening). Results: We recruited 1,807 participants. Between baseline and follow-up assessments, the proportion of respondents screening positive for psychological distress and probable depression decreased, respectively, from 74% to 56% and from 28% to 21%. Two-thirds remained asymptomatic/stable in terms of depression symptoms and 56% remained symptomatic or worsened over time in terms of psychological distress. Conclusion: Poor mental health outcomes among healthcare workers persisted over time. Occupational programs and mental health strategies should be put in place.

Medidas de seguridad, una reflexión desde la práctica clínica / Compulsory treatment orders, a reflection from a clinical perspective

Las medidas de seguridad son medidas de tratamiento obligatorio en régimen ambulatorio o de internamiento que se imponen vía judicial a personas diagnosticadas de alguna patología mental que cometen un delito sin ser plenamente libres y responsables en el momento de la acción delictiva. Exponemos la experiencia práctica de profesionales de distintos dispositivos sanitarios a donde remiten a los pacientes que son penados y tienen que cumplir una medida de seguridad. Reflexionaremos sobre sus posibles efectos en la evolución clínica, las posibles estrategias que se podrían utilizar para que no se tuvieran que llegar a emplear y la necesidad de coordinación con el sistema judicial. (AU)

Compulsory treatment orders are compulsory outpatient or inpatient treatment orders that are judicially imposed on persons diagnosed with a mental disorder who commit a crime without being fully free and responsible at the time of the criminal action. We present the practical experience of professionals from different health facilities that work with patients who are convicted and must follow a compulsory treatment order. We argue their possible effects on their clinical evolution, the possible strategies that could be used to reduce them and the need for coordination with the judicial system. (AU)

Role of access to personal protective equipment, treatment prioritization decisions, and changes in job functions on health workers' mental health outcomes during the initial outbreak of the COVID-19 pandemic.

BACKGROUND: During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access to protective equipment, change in job functions, and patient prioritization decision-making) and mental health outcomes (depression symptoms, psychological distress, suicidal thoughts, and fear of infection) in a large sample of Spanish HCWs during the initial COVID-19 outbreak. METHODS: We conducted a cross-sectional study including HCWs from three regions of Spain between April 24th and June 22nd, 2020. An online survey measured sociodemographic characteristics, work-related stressors, fear of infection, and mental health outcomes (depression [PHQ-9], psychological distress [GHQ-12], death wishes [C-SSRS]). We conducted mixed-effects regression models to adjust all associations for relevant individual- and region-level sources of confounding. RESULTS: We recruited 2,370 HCWs. Twenty-seven percent screened positive for depression and 74% for psychological distress. Seven percent reported death wishes. Respondents were more afraid of infecting their loved ones than of getting infected themselves. All work-related stressors were associated with depression symptoms and psychological distress in adjusted models. LIMITATIONS: Non-probabilistic sampling, potential reverse causation. CONCLUSIONS: Modifiable work-related stressors are associated with worse mental health among HCWs. Our results suggest that workplace prevention strategies for HCWs should provide sufficient protective equipment, minimize changes in job functions, favor the implementation of criteria for patient triage and on-call bioethics committees, and facilitate access to stepped-care, evidence-based mental health treatment.

Health-Related Quality of Life in Adult Spanish Women with Endometriomas or Deep Infiltrating Endometriosis: A Case-Control Study.

Endometriosis is a disabling disease that may significantly compromise a woman's social relationships, sexuality, and mental health. Considering the impact of endometriomas and deep infiltrating endometriosis (DIE) on quality of life and the limited number of papers on this topic, the objective of this study was to assess health-related quality of life (HRQoL) in adult Spanish women with the condition. A case-control study was conducted on a group of 99 patients with ovarian endometriomas or DIE and 157 controls. Women underwent physical and gynecological examinations, and they completed health questionnaires including the Short Form-12v2 (SF-12v2), a survey for HRQoL. Eight scales and two component summary scores (Physical (PCS) and Mental (MCS), respectively) were calculated. Women with endometriomas or DIE had significantly worse PCS: 47.7 ± 9.7 vs. 56.1 ± 5.9, respectively (p < 0.001) compared to controls, as well as lower scores on seven out of the eight scales (p < 0.01). No significant differences were found for the MCS. Conclusions: HRQoL was significantly lower in patients with endometriomas or DIE compared to controls. If confirmed, these results may have important implications for prevention, clinical practice, and intervention.

Assessment of Optimism in Women with Polycystic Ovary Syndrome: A Case Control-Study.

Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy characterized by hyperandrogenism and anovulation that may pervade psychological dimensions such as dispositional optimism. Considering how PCOS influences mental health and the lack of studies on this matter, this research was aimed at assessing optimism and associated factors in PCOS. A case-control study of 156 patients with PCOS and 117 controls was conducted. All woman filled out the Life Orientation Test-Revised (LOT-R), a self-report questionnaire for measuring dispositional optimism. Medication, pain severity, gynecological, and sociodemographic information was also collected. Lower optimism was found in patients with PCOS compared to controls, even after covariate adjustment (LOT-R global scores: 14.1 vs. 15.9, p = 0.020). Our study provides evidence that a personality characteristic with important implications in illness prognosis may be affected in PCOS. We propose to assess dispositional optimism with the LOT-R scale in the gynecological appointment and tailor medical attention accordingly as a way to improve the comprehensive care of these patients within a multidisciplinary team.

Is dispositional optimism associated with endometriomas and deep infiltrating endometriosis?

INTRODUCTION: Endometriosis is a chronic painful condition characterized by high prognostic uncertainty, as well as the threat of infertility and emotional symptoms that may affect many aspects of women, including psychological characteristics like dispositional optimism. Considering the impact of endometriosis on psychological health and the paucity of papers on this topic, the aim of this study is to explore optimism and associated factors in endometriosis. METHODS: A case-control study was performed on a group of 95 women with endometriosis and 156 controls. All participants completed the Life Orientation Test-Revised (LOT-R), a self-administered tool for assessing dispositional optimism. Pain severity, medication, gynecological and socio-demographic information was also collected. RESULTS: Low optimism was observed for women with endometriosis compared to controls even after covariate adjustment (LOT-R global scores: 14.5 vs. 15.9 points, p = .045). CONCLUSIONS: This study provides the first evidence that a personality dimension with many prognostic implications may be altered in women with endometriosis. Our findings highlight the importance of a broader understanding of this condition, treating this disorder from a biopsychosocial perspective and suggests the need for non-medical attention within a multidisciplinary team.