The rise of online sports betting, its fallout, and the onset of a new profile in gambling disorder: young people.

HYPOTHESIS: Since 2015 the gambling trend may have changed among young people between 18 and 30 years old. METHODOLOGY: Range of document review techniques obtained by therapeutic data regarding the personal development of each person in rehabilitation to analyze 13 different variables. FINDINGS: Due to the new regulations legalizing online gambling in Spain, and the constant increase in its advertising, a shift could have taken place in the gamblers' profile: a preference for online sports betting and placing other bets using devices connected to the Internet, such as smartphones, laptops, tablets, and similar technologies. Gamblers who use online media to place their bets also incur debts over the Internet. We find a possible proliferation of online betting services, that could imply an increase of social, psychological, and family relationship problems affecting young gamblers, which may constitute a new profile of gambling disorder.

Maternal and Perinatal Outcomes Associated With Extremely High Values for the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio.

Background There is little knowledge about the significance of extremely high values (>655) for the ratio of sFlt-1 (soluble fms-like tyrosine kinase 1) to PlGF (placental growth factor). We aim to describe the time-to-delivery interval and maternal and perinatal outcomes when such values are demonstrated while assessing suspected or confirmed placental dysfunction based on clinical or sonographic criteria. Methods and Results A multicenter retrospective cohort study was performed on 237 singleton gestations between 20+0 and 37+0 weeks included at the time of first demonstrating a sFlt-1/PlGF ratio >655. Clinicians were aware of this result, but standard protocols were followed for delivery indication. Main outcomes were compared for women with and without preeclampsia at inclusion. In those with preeclampsia (n=185, of whom 77.3% had fetal growth restriction), severe preeclampsia features and fetal growth restriction in stages III or IV were present in 49.2% and 13.5% cases, respectively, at inclusion and in 77.3% and 28.6% cases, respectively, at delivery. In the group without preeclampsia (n=52, 82.7% had fetal growth restriction), these figures were 0% and 30.8%, respectively, at inclusion and 21.2% and 50%, respectively, at delivery. Interestingly, 28% of women without initial preeclampsia developed it later. The median time to delivery was 4 days (interquartile range: 1-6 days) and 7 days (interquartile range: 3-12 days), respectively (P<0.01). Overall, perinatal mortality was 62.1% before 24 weeks; severe morbidity surpassed 50% before 29 weeks but became absent from 34 weeks. Maternal serious morbidity was high at any gestational age. Conclusions An sFlt-1/PlGF ratio >655 is almost invariably associated with preeclampsia or fetal growth restriction that progresses rapidly. In our tertiary care settings, we observed that maternal adverse outcomes were high throughout gestation, whereas perinatal adverse outcomes diminished as pregnancy advanced.

Experiencia en la implementación del programa de educación para la salud Si es urgente para ti, ¿es urgente para mí? / Experience in the implementation of the health education programme If it is urgent for you, is it urgent for me?

Objetivo: analizar la experiencia que supone la implementación de un programa de educación para la salud pediátrico en Atención Primaria. Material y métodos: estudio observacional y retrospectivo. Emplazamiento: cinco centros de salud urbanos y semiurbanos. Participantes: gestantes en el último trimestre de su gestación y sus parejas. Se desarrollaron seis talleres de 90 minutos: uno sobre el uso racional de los Servicios de Urgencias Pediátricas, y otros cinco sobre el manejo de los problemas de salud más frecuentes del niño: fiebre, infecciones respiratorias agudas (IRA), gastroenteritis aguda (GEA), lesiones de la piel y traumatismos, heridas, quemaduras y esguinces. Se han analizado datos epidemiológicos, nivel de conocimientos previos, control de asistencia y grado de satisfacción. Resultados: acudieron a los talleres el 44,21% de la población universo de gestantes. Las mujeres fueron más participativas que sus parejas varones. La mayoría eran primerizas, con estudios universitarios, trabajando de forma activa y españolas. La edad media fue de 34,53 años. Se detectaron más carencias formativas en padres primerizos, menores de 30 años, con estudios no universitarios y en algunos centros de salud. Los talleres sobre la fiebre e infecciones respiratorias fueron los de mayor asistencia. El desarrollo fue ameno y participativo. Generó un nivel de satisfacción muy alto y comentarios positivos. Conclusiones: se propone el empleo de este tipo de programas para mejorar la preparación de los futuros padres respecto a los cuidados de los problemas de salud de sus hijos y al uso adecuado de los servicios sanitarios

Objective: to analyse our experience in the implementation of a health education programme in the Primary Care Paediatrics setting. Materials and methods: observational and retrospective study. Setting: five primary care centres in urban and semi-urban areas. Participants: pregnant women in the third trimester of gestation and their partners. We held six 90-minute workshops: one on the appropriate use of paediatric emergency services and another five on the management of the most common health problems in children: fever, acute respiratory tract infections (ARTIs), acute gastroenteritis (AGE), skin lesions and traumatic injuries, burns and sprains. We analysed epidemiological data, the baseline level of knowledge, attendance and degree of satisfaction with the intervention. Results: of the total universe of pregnant women, 44.21% attended the workshops. Women attended more frequently than their male partners. Most women were primiparous, had attended university, were currently employed and of Spanish nationality. Their mean age was 34.53 years. We found greater gaps in knowledge in attendees that were going to be parents for the first time, aged less than 30 years, without a college education and receiving care in specific primary care centres. The workshops with the highest attendance were those on fever and respiratory tract infections. The workshops were designed to be entertaining and interactive. Participants reported a high level of satisfaction and gave positive feedback. Conclusions: we propose the use of this type of programmes to better prepare parents-to-be to manage potential health problems in their children and make appropriate use of health care services