Effectiveness of Modified Vaccinia Ankara-Bavaria Nordic Vaccination in a Population at High Risk of Mpox: A Spanish Cohort Study.

BACKGROUND: With more than 7500 cases reported since April 2022, Spain has experienced the highest incidence of mpox in Europe. From 12 July onward, the modified vaccinia Ankara-Bavaria Nordic (MVA-BN) smallpox vaccine was offered as pre-exposure prophylaxis for those receiving pre-exposure prophylaxis for human immunodeficiency virus (HIV-PrEP). Our aim was to assess the effectiveness of 1 dose of MVA-BN vaccine as pre-exposure prophylaxis against mpox virus (MPXV) infection in persons on HIV-PrEP. METHODS: National retrospective cohort study between 12 July and 12 December 2022. Individuals aged ≥18 years receiving HIV-PrEP as of 12 July with no previous MPXV infection or vaccination were eligible. Each day, we matched individuals receiving a first dose of vaccine and unvaccinated controls of the same age and region. We used a Kaplan-Meier estimator, calculated risk ratios (RR) and vaccine effectiveness (VE = [1 - RR]x100). RESULTS: We included 5660 matched pairs, with a median follow-up of 62 days (interquartile range, 24-97). Mpox cumulative incidence was 5.6 per 1000 (25 cases) in unvaccinated and 3.5 per 1000 (18 cases) in vaccinated. No effect was found during days 0-6 post-vaccination (VE, -38.3; 95% confidence interval [CI], -332.7 to 46.4), but VE was 65% at ≥7 days (95% CI, 22.9 to 88.0) and 79% at ≥14 days (95% CI, 33.3 to 100.0) post-vaccination. CONCLUSIONS: One dose of MVA-BN vaccine offered protection against mpox in most-at-risk population shortly after the vaccination. Further studies need to assess the VE of a second dose and the duration of protection over time.

Integrated pollution-based real-time control of sanitation systems.

An integrated pollution-based real-time control (RTC) approach is proposed for a sewer network (SN) integrated with wastewater treatment plants (WWTPs) in a sanitation system (SS) to mitigate the impacts of pollution from combined sewer overflows (CSOs) on ecosystems. To obtain the optimal solution for the SS while considering both quantity and quality dynamics for multiple objectives, model predictive control (MPC) is selected as the optimal control method. To integrate SN and WWTP management, a feedback coordination algorithm is developed. A closed-loop virtual-reality simulator is used to assess the results of the optimal management approach achieved by applying MPC. The Badalona SS (Spain) provides a pilot case study to assess the efficacy and applicability of the proposed approach. A comparison with local rule-based and volume-based control strategies currently in use indicates that the proposed integrated pollution-based RTC approach can reduce the pollutant loads released to the receiving environment.

Electrochemically Gated Long-Distance Charge Transport in Photosystem†I.

The transport of electrons along photosynthetic and respiratory chains involves a series of enzymatic reactions that are coupled through redox mediators, including proteins and small molecules. The use of native and synthetic redox probes is key to understanding charge transport mechanisms and to the design of bioelectronic sensors and solar energy conversion devices. However, redox probes have limited tunability to exchange charge at the desired electrochemical potentials (energy levels) and at different protein sites. Herein, we take advantage of electrochemical scanning tunneling microscopy (ECSTM) to control the Fermi level and nanometric position of the ECSTM probe in order to study electron transport in individual photosystem I (PSI) complexes. Current-distance measurements at different potentiostatic conditions indicate that PSI supports long-distance transport that is electrochemically gated near the redox potential of P700, with current extending farther under hole injection conditions.

The Notijoves Project: Protocol for a Randomized Controlled Trial About New Communication Technologies and Gamification to Promote Partner Notification of Sexually Transmitted Infections Among Young People.

BACKGROUND: An increase in sexually transmitted infections (STIs) as well as an increase in the use of new information and communication technologies among young people in Catalonia is the inspiration behind the idea of designing a smartphone app to promote partner notification of STIs. OBJECTIVE: The main objective of this study is to design a Web-based tool adapted to smartphones for partner notification of STIs among youth who are 16 to 24 years old. Additionally, the objective is to evaluate the Web-based tool's role in increasing the patient referral partner notification. METHODS: This is a multicenter randomized controlled trial with a proportional stratification of the sample by center and random allocation of participants to the 3 arms of the study (simple Web-based intervention, game Web-based intervention, and control). This study is being conducted by midwives, gynecologists, and physicians in the sexual and reproductive areas of the primary health care centers. RESULTS: The primary outcome measure is the number and proportion of partner notifications. Additional outcome measures are the yield of early diagnosis and treatment of those exposed and infected, acceptability, barriers, and preferences for partner notification. Expected results include an increase in the yield of partner notification, early diagnosis and treatment among youth using Web-based interventions compared with those receiving the traditional advice to notify, and a description of sexual networks among those participating in the study. CONCLUSIONS: The Notijoves is expected to have a sustainable positive impact in the partner notification practice among youth and contribute to increasing the awareness of STI prevention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12896.

Rationale and methods of the MOVI-da10! Study -a cluster-randomized controlled trial of the impact of classroom-based physical activity programs on children's adiposity, cognition and motor competence.

BACKGROUND: Although physical activity (PA) integrated in schools' classrooms have shown a positive effect on children's behaviors, its effectiveness on cognitive functions, PA levels and other health variables remains unclear. This article outlines the rationale and methods of two classroom-based PA interventions (MOVI-da10!) on improving adiposity, executive function and motor competence in preschool children. METHODS: A three-arm cluster-randomized controlled trial (RCT) was carried out including eight schools (rural and urban areas) from Cuenca province, Spain. The schools were allocated to one of three groups: MOVI-da10-Enriched! intervention (n = 3), MOVI-da10-Standard! intervention, (n = 2), and the control group (n = 3). Around 900 children aged 4 to 6 years old were assesed at baseline (September 2017) and at the end (June 2018) of the intervention. The primary outcomes were changes in body fat by bioimpedance, executive function and motor competence. During a school year (from October 2017 to May 2018), children belonging to the MOVI-da10-Enriched! group performed enriched PA integrated into the academic curriculum including two active breaks lasting 10 min, 5 days/week. The children belonging to the MOVI-da10-Standard! group performed PA breaks (with low cognitive demand, where curricular contents were not reinforced) including two active breaks lasting 10 min, 5 days/week. In the control group, regular PA continued. DISCUSSION: To our knowledge, MOVI-da10! is the first RCT to examine the effectiveness of two programs (enriched PA integrated into the academic curriculum and PA breaks only) versus a control group on improving adiposity, executive function and motor competence in preschool children. TRIAL REGISTRATION: NCT03236363 (clinicaltrials.gov), 31st July 2017.

¿Puede tener un papel la mascarilla laríngea en la práctica de la terapia electroconvulsiva? Un estudio piloto / Can the laryngeal mask play a role in electroconvulsive treatment? A pilot study

Introducción. Optimizar el control de la ventilación en el proceso anestésico de la terapia electroconvulsiva (TEC) puede ser una forma de mejorar la efectividad y la seguridad del tratamiento. Existen varios métodos para inducir una convulsión terapéutica adecuada en pacientes con enfermedad médica comórbida o en aquellos con elevado umbral convulsivo, aunque todos presentan alguna limitación. Un nuevo abordaje es la hiperventilación con mascarilla laríngea, que produce una mayor oxigenación e hipocapnia, disminuyendo el umbral convulsivo. Este hecho puede, hipotéticamente, servir para disminuir la energía necesaria para obtener una convulsión terapéutica adecuada. Material y métodos. Se ha realizado un estudio piloto aleatorizado y cruzado con 14 pacientes en TEC de mantenimiento, utilizando mascarilla laríngea versus mascarilla facial. Las sesiones de TEC con mascarilla facial se realizaron con la energía estándar, mientras que en las sesiones de TEC con mascarilla laríngea se disminuyó la energía en un 45%. Resultados. A pesar de la reducción del 45% en la energía aplicada con el uso de mascarilla laríngea, no se han encontrado diferencias significativas en la duración de la convulsión en ambos grupos. Conclusiones. Con estos resultados se podría proponer la ventilación con mascarilla laríngea como una alternativa para disminuir la energía aplicada sin repercutir en la duración de la crisis. Este es un estudio preliminar con una muestra pequeña, aunque abre nuevas líneas de investigación. Sería necesario aumentar la muestra y valorar otras medidas de calidad de las convulsiones en futuros estudios con el fin de estudiar sus efectos no solo en la dosis de energía necesaria, sino también en una posible mejora de la ventilación y una posible minimización de los potenciales efectos secundarios de la TEC, algo que sería relevante sobre todo en pacientes con comorbilidad médica (AU)

Introduction. Optimising ventilation control in the anaesthetic process of electroconvulsive therapy (ECT) can be a method for improving the effectiveness and safety of some treatments. There are several approaches for inducing adequate therapeutic seizures in patients with medical co-morbidity or in those with high seizure thresholds, although all of them present limitations. A new approach is hyperventilation with laryngeal mask, a method that improves oxygenation, achieves hypocapnia, and lowers seizure threshold. Thus, hyperventilation with laryngeal mask could, hypothetically, be useful to decrease the energy needed to obtain adequate therapeutic seizures. Material and methods. A randomized crossover study was conducted on 14 patients on maintenance ECT, using a laryngeal mask versus a facemask. When laryngeal masks were applied, the energy was reduced by 45% compared with the energy required when ventilated with facemasks (performed with standard dose). Results. The results of the study revealed that, despite a 45% energy reduction with laryngeal mask, there were no significant differences in seizure length in either group. Conclusions. These results prompt us to propose ventilation with laryngeal mask as an alternative to decrease energy applied without lowering seizure times. This is a preliminary study with a small sample, which opens new lines of research. Larger samples and other measurements of seizure adequacy are needed in future studies, in order to study possible improvements in ventilation and minimising adverse effects of ECT, especially in patients with medical co-morbidities (AU)

Coordinated management of combined sewer overflows by means of environmental decision support systems.

During heavy rainfall, the capacity of sewer systems and wastewater treatment plants may be surcharged producing uncontrolled wastewater discharges and a depletion of the environmental quality. Therefore there is a need of advanced management tools to tackle with these complex problems. In this paper an environmental decision support system (EDSS), based on the integration of mathematical modeling and knowledge-based systems, has been developed for the coordinated management of urban wastewater systems (UWS) to control and minimize uncontrolled wastewater spills. Effectiveness of the EDSS has been tested in a specially designed virtual UWS, including two sewers systems, two WWTP and one river subjected to typical Mediterranean rain conditions. Results show that sewer systems, retention tanks and wastewater treatment plants improve their performance under wet weather conditions and that EDSS can be very effective tools to improve the management and prevent the system from possible uncontrolled wastewater discharges.

Can the laryngeal mask play a role in electroconvulsive treatment? A pilot study. / ¿Puede tener un papel la mascarilla laríngea en la práctica de la terapia electroconvulsiva? Un estudio piloto.

INTRODUCTION: Optimising ventilation control in the anaesthetic process of electroconvulsive therapy (ECT) can be a method for improving the effectiveness and safety of some treatments. There are several approaches for inducing adequate therapeutic seizures in patients with medical co-morbidity or in those with high seizure thresholds, although all of them present limitations. A new approach is hyperventilation with laryngeal mask, a method that improves oxygenation, achieves hypocapnia, and lowers seizure threshold. Thus, hyperventilation with laryngeal mask could, hypothetically, be useful to decrease the energy needed to obtain adequate therapeutic seizures. MATERIAL AND METHODS: A randomized crossover study was conducted on 14 patients on maintenance ECT, using a laryngeal mask versus a facemask. When laryngeal masks were applied, the energy was reduced by 45% compared with the energy required when ventilated with facemasks (performed with standard dose). RESULTS: The results of the study revealed that, despite a 45% energy reduction with laryngeal mask, there were no significant differences in seizure length in either group. CONCLUSIONS: These results prompt us to propose ventilation with laryngeal mask as an alternative to decrease energy applied without lowering seizure times. This is a preliminary study with a small sample, which opens new lines of research. Larger samples and other measurements of seizure adequacy are needed in future studies, in order to study possible improvements in ventilation and minimising adverse effects of ECT, especially in patients with medical co-morbidities.

Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria / Impact of an informative intervention on the colorectal cancer screening program in primary care professionals

OBJETIVO: Evaluar el impacto de una intervención informativa a profesionales de atención primaria sobre sus conocimientos de cribado de cáncer colorrectal, recomendaciones de vigilancia posterior y estrategias de derivación. Método DISEÑO: Ensayo clínico controlado y aleatorizado por conglomerados. Emplazamiento: centros de atención primaria de L'Hospitalet de Llobregat (Barcelona). PARTICIPANTES: médicos y enfermeras de atención primaria. Intervención: sesión informativa y envío de píldoras informativas en 6 de 12 centros (seleccionados aleatoriamente) sobre el programa de cribado cáncer colorrectal. MEDICIONES PRINCIPALES: cuestionario ad hoc que recoge las características de los profesionales, los centros y 2 variables contextuales; implicación de los profesionales en el programa de cribado; conocimientos sobre el cáncer colorrectal, los factores de riesgo, los procedimientos de cribado, las recomendaciones de seguimiento posterior a la exploración diagnóstica y las estrategias de derivación. RESULTADOS: La media de la puntuación total en el primer cuestionario fue 8,07(1,38) sobre 11 y la del segundo 8,31(1,39). No se encontraron diferencias estadísticamente significativas entre el grupo intervención y control, sin embargo, en 9 preguntas se aumentó el porcentaje de respuestas correctas en el grupo intervención, mayoritariamente relacionadas con el seguimiento posterior a la exploración diagnóstica. CONCLUSIONES: La intervención mejora el porcentaje de respuestas correctas, sobre todo en aquellas en las que se obtuvo peor puntuación en el primer cuestionario. Este estudio muestra que los profesionales están familiarizados con el cribado de cáncer colorrectal, pero es importante tener una comunicación frecuente con ellos para mantener actualizada la información relacionada con el cribado y fomentar su implicación con el mismo

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. Methods DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). Intervention: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening

[Impact of an informative intervention on the colorectal cancer screening program in primary care professionals]. / Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria.

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. METHODS DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). INTERVENTION: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening.

Evaluación de dos estrategias de cribado de cáncer colorrectal: test inmunológico versus test bioquímico. Cataluña, 2008-2010 / Evaluating colorectal cancer screening strategies (Immunological Test vs Biochemical Test) in Catalonia, Spain 2008-2010

Fundamento: El objetivo del estudio fue evaluar el cambio de estrategia de cribado (test inmunológico cuantitativo) en un programa poblacional de detección precoz de cáncer colorrectal (CCR) en Cataluña. Métodos: La cuarta ronda del programa de cribado de CCR en Hospitalet de Llobregat se implementó en 2008-2010. Se ofreció un test bioquímico a 50.227 individuos y uno inmunológico cuantitativo a 12.707 individuos. Se analizaron diferencias en las dos estrategias de cribado respecto a variables de aceptabilidad (entre participación, abandonos y adherencia a la colonoscopia), de precisión diagnóstica (valor predictivo positivo y tasas de detección), de resultados (tamaño y localización de lesiones, estadio de los cánceres detectados) y de recursos (número necesario de colonoscopias e intervalo de tiempo entre el resultado positivo del test y la colonoscopia). Resultados: La participación en el cribado fue superior entre los individuos que utilizaron el test inmunológico (OR: 1,35; IC95%:1,27- 1,42). Las tasas de detección fueron superiores para el test inmunológico destacando la de adenomas de alto riesgo (26,7‰vs 3,0‰). El valor predictivo positivo para adenomas de alto riesgo fue del 45,0% y del 46,9% en el inmunológico y el guayaco, respectivamente. El número de colonoscopias necesarias para detectar un cáncer fue de casi el doble que en el guayaco (13,6 vs 7,4). Conclusiones: El test inmunológico es una buena estrategia de cribado especialmente sensible para la detección de adenomas de alto riesgo. Sin embargo, requiere realizar un gran número de colonoscopias y por ello se debe disponer de los recursos y medios necesarios (AU)

Background: The aim of this study was to evaluate the screening strategy (quantitative immunological test vs biochemical test) in a population- based screening program for colorectal cancer (CRC) in Catalonia. Methods: The fourth round of a screening program for CRC with a fecal occult blood test was implemented in Hospitalet de Llobregat during 2008-2010.Abiochemical test was offered to 50,227 individuals and a quantitative immunological test was offered to 12,707 individuals. We analysed differences according to the screening strategy in the following variables: acceptability of the target population (participation, dropouts, and adherence to colonoscopy), diagnostic accuracy (positive predictive value and detection rates), results (size and location of lesions, staging of CRC) and resources (number of colonoscopies needed and time interval between the positive test and colonoscopy). Results: Participation was higher among individuals who used the immunological test (OR: 1.35; CI95%:1.27-1.42). Detection rates for adenomas and cancer were also higher for the immunological test, hightlighting the detection rate for high-risk adenomas (26.7‰ vs. 3.0‰). The positive predictive value for high-risk adenomas was 45.0% and 46.9% in the immunological test and guaiac test, respectively. The number of colonoscopies needed to detect cancer with the immunological test was almost two-fold than those needed with the guaiac test (13.6 vs 7.4). Conclusions: The immunological test is a good screening strategy particularly sensitive for detecting high-risk adenomas. However, it is paramount to have enough resources to assure the quality of the CRC screening due to the large number of colonoscopies that would be required (AU)

[Evaluating colorectal cancer screening strategies (immunological test vs biochemical test) in Catalonia, Spain 2008-2010]. / Evaluación de dos estrategias de cribado de cáncer colorrectal: test inmunológico versus test bioquímico. Cataluña, 2008-2010.

BACKGROUND: The aim of this study was to evaluate the screening strategy (quantitative immunological test vs biochemical test) in a population-based screening program for colorectal cancer (CRC) in Catalonia. METHODS: The fourth round of a screening program for CRC with a fecal occult blood test was implemented in Hospitalet de Llobregat during 2008-2010. A biochemical test was offered to 50,227 individuals and a quantitative immunological test was offered to 12,707 individuals. We analysed differences according to the screening strategy in the following variables: acceptability of the target population (participation, dropouts, and adherence to colonoscopy), diagnostic accuracy (positive predictive value and detection rates), results (size and location of lesions, staging of CRC) and resources (number of colonoscopies needed and time interval between the positive test and colonoscopy). RESULTS: Participation was higher among individuals who used the immunological test (OR: 1.35; CI95%:1.27-1.42). Detection rates for adenomas and cancer were also higher for the immunological test, hightlighting the detection rate for high-risk adenomas (26.7‰ vs. 3.0‰). The positive predictive value for high-risk adenomas was 45.0% and 46.9% in the immunological test and guaiac test, respectively. The number of colonoscopies needed to detect cancer with the immunological test was almost two-fold than those needed with the guaiac test (13.6 vs 7.4). CONCLUSIONS: The immunological test is a good screening strategy particularly sensitive for detecting high-risk adenomas. However, it is paramount to have enough resources to assure the quality of the CRC screening due to the large number of colonoscopies that would be required.

Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea.

RATIONALE: Continuous positive airway pressure (CPAP) is the current treatment for patients with symptomatic obstructive sleep apnea (OSA). Its use for all subjects with sleep-disordered breathing, regardless of daytime symptoms, is unclear. OBJECTIVES: This multicenter controlled trial assesses the effects of 1 year of CPAP treatment on blood pressure (BP) in nonsymptomatic, hypertensive patients with OSA. METHODS: We evaluated 359 patients with OSA. Inclusion criteria consisted of an apnea-hypopnea index (AHI) greater than 19 hour(-1), an Epworth Sleepiness Scale score less than 11, and one of the following: under antihypertensive treatment or systolic blood pressure greater than 140 or diastolic blood pressure greater than 90 mm Hg. Patients were randomized to CPAP (n = 178) or to conservative treatment (n = 181). BP was evaluated at baseline and at 3, 6, and 12 months of follow-up. MEASUREMENTS AND MAIN RESULTS: Mean (SD) values were as follows: age, 56 +/- 10 years; body mass index (BMI), 32 +/- 5 kg x m(-2); AHI, 45 +/- 20 hour(-1); and Epworth Sleepiness Scale score, 7 +/- 3. After adjusting for follow-up time, baseline blood pressure values, AHI, time with arterial oxygen saturation less than 90%, and BMI, together with the change in BMI at follow-up, CPAP treatment decreased systolic blood pressure by 1.89 mm Hg (95% confidence interval: -3.90, 0.11 mm Hg; P = 0.0654), and diastolic blood pressure by 2.19 mm Hg (95% confidence interval: -3.46, -0.93 mm Hg; P = 0.0008). The most significant reduction in BP was in patients who used CPAP for more than 5.6 hours per night. CPAP compliance was related to AHI and the decrease in Epworth Sleepiness Scale score. CONCLUSIONS: In nonsleepy hypertensive patients with OSA, CPAP treatment for 1 year is associated with a small decrease in BP. This effect is evident only in patients who use CPAP for more than 5.6 hours per night. Clinical trial registered with www.clinicaltrials.gov (NCT00127348).

Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire.

BACKGROUND: The EQ-5D questionnaire is an instrument for describing and valuing health states. OBJECTIVES: To compare general population health status measured by the EQ-5D in 6 European countries. METHODS: In the European Study of the Epidemiology of Mental Disorders representative population samples in Belgium (n = 2411), France (n = 2892), Germany (n = 3552), Italy (n = 4709), the Netherlands (n = 2367), and Spain (n = 5473) completed the EQ-5D as part of personal computer-based home interviews in 2001 to 2003. RESULTS: Of all respondents, 35.1% reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (28.5%), followed by mobility (13.6%), usual activities (10.5%), anxiety/depression (8.0%), and self-care (3.6%). Proportions of respondents reporting any problems differed significantly between countries, ranging from 26.6% in Spain to 44.5% in France. Mean EQ VAS score was 77.1, ranging from 75.0 in Spain to 82.0 in the Netherlands. After adjusting for sociodemographic variables, the proportion of respondents reporting problems in any of the EQ-5D dimensions was significantly higher in France and lower in Spain and Italy than the grand mean. Even after controlling for reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and lower in Spain than the grand mean. Age, female gender, low educational level, lack of paid employment, and low income were associated with more problems in most of the EQ-5D dimensions and lower EQ VAS scores. CONCLUSIONS: Self-reported EQ-5D health status differed considerably between countries, calling for caution when making international comparisons of disease burden and health care effectiveness.

[Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study]. / Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España.

BACKGROUND AND OBJECTIVE: The ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. SUBJECTS AND METHOD: Cross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5.473 individuals. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. RESULTS: 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime-prevalence) and 8.4% in the last 12 months (12 month-prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime-prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and dysthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. CONCLUSIONS: The ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain.

Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España / Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study

Fundamento y objetivo: El proyecto ESEMeD-España es un estudio epidemiológico sobre los trastornos mentales en nuestro país. Se presentan la prevalencia-año y prevalencia-vida de los principales trastornos del estado de ánimo, de ansiedad y de abuso de alcohol, así como la influencia de los factores de riesgo sociodemográficos en su presencia y la edad de inicio de los trastornos. Sujetos y método: Encuesta personal domiciliaria realizada a una muestra representativa de la población española mayor de 18 años de 5.473 individuos. El instrumento utilizado fue la versión del Composite International Diagnostic Interview (WMH-CIDI) desarrollada para la iniciativa Encuestas de Salud Mental de la Organización Mundial de la Salud (WHO World Mental Health Surveys). La tasa de respuesta fue del 78,6%. Los resultados se presentan ponderados a la población española. Resultados: Un 19,5% de las personas presentaron un trastorno mental en algún momento de su vida (prevalencia-vida) y un 8,4% en los últimos 12 meses (prevalencia-año). El trastorno mental más frecuente es el episodio depresivo mayor, que tiene un 3,9% de prevalencia-año y un 10,5% de prevalencia-vida. Después del episodio depresivo mayor, los trastornos con mayor prevalencia-vida son la fobia específica, el trastorno por abuso de alcohol y la distimia. Los factores asociados a padecer un trastorno mental son el sexo femenino, estar separado, divorciado o viudo, y estar desempleado, de baja laboral o con una incapacidad. La fobia social, la agorafobia y la fobia específica aparecen a edades más tempranas. Los trastornos del estado de ánimo (episodio de depresión mayor y distimia), junto con el trastorno de angustia, muestran una aparición más tardía. Conclusiones: El estudio ESEMeD-España puede proporcionar resultados necesarios para conocer el impacto de los trastornos mentales en España

Background and objective: The ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. Subjects and method: Cross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5.473 individuals. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results: 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime-prevalence) and 8.4% in the last 12 months (12 month-prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime-prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and disthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. Conclusions: The ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain