Navigated Anterior Full-Endoscopic Transcervical Approach Odontoidectomy for Traumatic Posterior Atlantoaxial Dislocation Without Odontoid Fracture.

BACKGROUND AND IMPORTANCE: Complete posterior atlantoaxial dislocation (PAAD) with an unfractured odontoid process is a rare condition where a dislocated but intact odontoid process is positioned ventrally to the anterior arch of C1. This lesion is related to transverse and alar ligament rupture secondary to hyperextension and rotatory traumatic injury and is often associated with neurological deficit. The treatment strategy remains controversial, and in many cases, odontoidectomy is required. Traditional approaches for odontoidectomy (transnasal and transoral) are technically demanding and are related to several complications. This article describes a 360° reduction and stabilization technique through a navigated anterior full-endoscopic transcervical approach (nAFETA) as a novel technique for odontoidectomy and C1-C2 anterior transarticular fixation supplemented with posterior fusion. CLINICAL PRESENTATION: A 21-year-old man presented to the emergency room by ambulance after a motorcycle accident. On evaluation, incomplete ASIA B spinal cord injury was documented. Imaging revealed a complete PAAD. We performed a two-staged procedure, a nAFETA odontoidectomy plus C1-C2 anterior transarticular fixation followed by posterior C1-C2 wired fusion. At a 2-year follow-up, the patient had a 10-point Oswestry Disability Index score and neurological improvement to ASIA E. CONCLUSION: PAAD can be successfully treated through minimally invasive nAFETA. Noteworthy, the risks of the transoral and endonasal routes were avoided through this approach. In addition, nAFETA allows anterior transarticular fixation during the same procedure providing spinal stability. Further studies are required to expand the use of nAFETA in this field.

Psychosocial and vocational impact of an internship program for people diagnosed with severe mental illnesses.

PURPOSE: Unemployment is an obstacle in recovery for people with severe mental illnesses (SMI), both in reducing psychopathological symptoms and in achieving a high quality of life. The aim of this study was to explore the impact of an internship program for people diagnosed with SMI on psychosocial variables using a pre-test and post-test design. METHOD: Four scales were administered to a sample of 127 study participants, all of whom were diagnosed with SMI. The results of standard and sheltered employment outcomes were obtained by comparing the number and type of contracts gained by participants up to one year after program completion. A repeated measures ANOVA analysis was carried out with intervention being an independent intra-subject variable and type of participant diagnosis being a between-subjects variable. RESULTS: A limited increase in social functioning was found, as well as a significant decrease in psychiatric distress for users diagnosed with personality disorders. Participants in the internship program obtained a greater number of employment contracts than their peers who did not participate in the program, albeit with a low effect size. CONCLUSIONS: Though results were positive, extension of internship length and provision of more intensive counselling for participants may be useful.

An internship program for persons with severe mental illnesses yielded modest improvements in social functioning.A decrease in psychiatric distress in participants with personality disorders was found after the internships.Participants in the internship obtained a greater number of employment contracts.An extended internship programme with workplace support is likely to be beneficial.

Collet-Sicard syndrome: a scoping review.

Collet-Sicard syndrome (CSS) is the unilateral palsy of the cranial nerves (CN) IX, X, XI, and XII. To our knowledge, no review describes the characteristics of patients diagnosed with CSS. Therefore, this review aims to collect and describe all cases in the literature labeled as CSS. We performed a scoping review of the literature and conducted a database search in Embase and PubMed. We included articles and abstracts with case reports or case series of patients with CSS diagnosis. We classified the cases into two groups: "CSS", referring to patients presenting exclusively with IX-XII nerve involvement, and "CSS-plus", which corresponds to cases with CSS and other neurological impairments. We included 135 patients from 126 articles, of which 84 (67.7%) were male. The most common clinical manifestations reported were dysphagia and dysphonia. The most common etiology was tumoral in 53 cases (39.6%) and vascular in 37 cases (27.6%). The majority of patients showed partial or total improvement, with just over half receiving conservative treatment. The most frequent anatomic space was the jugular foramen (44.4%) and the parapharyngeal retrostyloid space (28.9%). Approximately 21% of the patients had other CN impairments, with the seventh and eighth CN most frequently compromised. We conclude that although there is a need for greater rigor in CSS reporting, the syndrome has a clear utility in identifying the localization of jugular foramen and parapharyngeal retrostyloid space pathology.

Predicting rainfall and irrigation requirements of corn in Ecuador.

This work is a case study whose objective is prediction of irrigation needs of corn crops in different regions of Ecuador; being this a fundamental basic food for the country's economy, as in the remaining countries of the Andean area. The proposed methodology seeks to help improving the quality of corn crop. Specifically, we propose the application of regression models, within the framework of Functional Data Analysis (FDA), to predict the amount of rainfall (scalar response variable) in the places with the highest production of corn in Ecuador, as a function of functional covariates such as temperature and wind speed. From the estimation of the amount of rainfall, effective precipitation is calculated. This is the fraction of water used by the crops, from which the value of real evapotranspiration or ETc is obtained and, more importantly, the irrigation requirements at each stage of the corn crop, for its adequate physiological development. Application of regression models based on functional basis, Functional Principal Components (FPC) or Functional Partial Least Squares (FPLS) for scalar response variable, allows us to use the information of variables such as wind speed and temperature (of functional nature) in a better way than using multivariate models, for predicting the amount of rainfall, obtaining, as a result, very explicative models, defined by a high goodness of fit (R2=0.97, with 6 significant parameters and an error of 0.14) and practical utility. The model has been also applied to North Peru regions, obtaining rainfall prediction errors between 9% and 22%. Thus, the geographical limitations of the model could be the Andean regions with similar climate. In addition, this study proposes the application of FDA exploratory analysis and FDA outlier detection techniques as a common and useful practice in the specific domain of rainfall prediction studies, prior to applying the regression models.

Wastewater early warning system for SARS-CoV-2 outbreaks and variants in a Coruña, Spain.

Wastewater-based epidemiology has been widely used as a cost-effective method for tracking the COVID-19 pandemic at the community level. Here we describe COVIDBENS, a wastewater surveillance program running from June 2020 to March 2022 in the wastewater treatment plant of Bens in A Coruña (Spain). The main goal of this work was to provide an effective early warning tool based in wastewater epidemiology to help in decision-making at both the social and public health levels. RT-qPCR procedures and Illumina sequencing were used to weekly monitor the viral load and to detect SARS-CoV-2 mutations in wastewater, respectively. In addition, own statistical models were applied to estimate the real number of infected people and the frequency of each emerging variant circulating in the community, which considerable improved the surveillance strategy. Our analysis detected 6 viral load waves in A Coruña with concentrations between 103 and 106 SARS-CoV-2 RNA copies/L. Our system was able to anticipate community outbreaks during the pandemic with 8-36 days in advance with respect to clinical reports and, to detect the emergence of new SARS-CoV-2 variants in A Coruña such as Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529 and BA.2) in wastewater with 42, 30, and 27 days, respectively, before the health system did. Data generated here helped local authorities and health managers to give a faster and more efficient response to the pandemic situation, and also allowed important industrial companies to adapt their production to each situation. The wastewater-based epidemiology program developed in our metropolitan area of A Coruña (Spain) during the SARS-CoV-2 pandemic served as a powerful early warning system combining statistical models with mutations and viral load monitoring in wastewater over time.

TTS package: Computational tools for the application of the Time Temperature Superposition principle.

The TTS package has been developed in R software to predict the mechanical properties of viscoelastic materials, at short and long observation times/frequencies by applying the Time Temperature Superposition (TTS) principle. TTS is a physical principle used in material science to estimate mechanical properties beyond the experimental range of observed times/frequencies by shifting data curves obtained at other temperatures relative to a reference temperature in the dataset. It is a methodology related to accelerated life-tests and reliability, whereas the TTS library is one of the first open source computational tool to apply the TTS principle. This R package provides free computational tools to obtain master curves that characterize materials from a thermal-mechanical approach. The TTS package also proposes, implements and explains our own method to obtain the shift factors and the master curve in a TTS analysis, based on horizontal shifting of the first derivative function of viscoelastic properties. This procedure provides shift factors estimates and smooth master curve estimates using B-spline fitting, in a fully automatic way, without assuming any parametric expression. Williams-Landel-Ferry (WLF) and Arrhenius TTS parametric models are also implemented in the TTS package. They can be fitted from shifts obtained by the our first derivative based method.

Considerations on the programmed functional life (one generation) of a green artificial reef in terms of the sustainability of the modified ecosystem.

The installation of artificial reefs serves to enhance marine ecosystems, although it also modifies them. These changes do not have to be irreversible, since it is possible to treat the functional life of an artificial reef (AR) as a variable factor to be determined, with the objective of contributing to the sustainability of the ecosystem. The quest for sustainability does not end with the manufacture and installation of the AR units. It is also necessary to analyse the sustainability of the modified ecosystem, through the production of services. This leads to consider the medium-term return of the ecosystem to its initial state, once the functional life of the ARs expires. This paper presents and justifies an AR design/composition for limited functional life. It is the result of acting on the base material, the concrete, with the objective of limiting the useful life to one social generation. Four different dosages were proposed for such a purpose. They were subjected to mechanical tests (compressive strength and absorption after immersion), including an innovative abrasion-resistant one. The results allow estimating the functional life of the four types of concrete from the design variables (density, compactness, and quantity of water and cement as well as its relation). To this end linear regression models and clustering techniques were applied. The described procedure leads to an AR design for limited functional life.

Quality of life and psychiatric distress in people with serious mental illness, the role of personal recovery.

OBJECTIVES: When considering the personal recovery of people with serious mental illness (SMI), it is essential to examine their reported psychiatric distress and quality of life (QoL). However, there is no consolidated model in the literature that clearly relates these variables. In this study we first analysed the relationships between QoL, psychiatric distress and recovery, and several sociodemographic variables. Second, we analysed the linear effects of psychiatric distress and recovery on QoL. Third, and most important, we tested two hypotheses that considered personal recovery as a moderator or mediator of the relationship between psychiatric distress and QoL. DESIGN AND METHODS: 234 volunteers with a diagnosis of SMI completed three self-report questionnaires, The Recovery Assessment Scale-24, The World Health Organization QoL and the Clinical Outcomes in Routine Evaluation-Outcome Measure, which showed very good levels of validity and reliability. The PROCESS macro for SPSS developed by Hayes (Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guilford Press, 2022) was applied using the Bootstrap method to verify our moderation and mediation hypotheses. RESULTS: We found a negative linear effect of psychiatric distress on QoL, as well as a positive effect of recovery on said variable. Our results do not confirm the moderating effect of recovery on the relationship between distress and QoL. However, we do confirm the second hypothesis; recovery functioned as a mediating variable between psychiatric distress and QoL. CONCLUSIONS: These findings allow us to reflect on how personal recovery affect the relationship between psychiatric distress and QoL and discuss its theoretical and practical implications as public policies.

Application of residuals from purification of bivalve molluscs in Galician to facilitate marine ecosystem resiliency through artificial reefs with shells - One generation.

The seas and oceans of the planet provide a wide range of essential resources. However, marine ecosystems are undergoing severe degradation due to the unsustainable exploitation and consumption patterns of the linear economy. On the other hand, many economic activities linked to the sea generate a large amount of waste, leading to negative impacts, such as the cost of treating or disposing of this waste. A case in point is bivalve mollusc production: a purification process is needed to avoid the risk of diseases through faecal contamination. The present work proposes an innovative procedure to convert this waste, calcium carbonate as calcite and aragonite allotropic types, into by-products. These by-products can be used to manufacture green artificial reefs, partially replacing concrete aggregates with a sustainable alternative to the geological sources of CaCO3. By installing these reefs, marine ecosystems could be created in a sustainable way and an innovative approach based on the circular economy could be taken towards protecting them. To this end, different concrete mixtures with bivalve shells are proposed. Although this study had been carried out for Galicia (NW Spain), the methodology followed could also be valid for other regions. A physicochemical characterisation of the waste from purifying the bivalves, including oysters, mussels, clams and scallops, was performed. Statistical and multi-criteria analyses were done in order to select the best dosage. Both have provided justification for using a mixture of shells with a predominance of calcite (oyster, scallop) instead of shells with a predominance of aragonite. The multi-criteria analysis served to identify the two best alternatives with dosages in which the medium aggregates were substituted with shells mainly from oysters, with a predominance of calcite. Finally, the statistical analysis played a role in estimating the compressive strength and water absorption of each mixture from the design parameter values.

"I don't believe I'm going to recover from anything." Understanding recovery amongst people with severe mental illness attending community health services in Spain.

PURPOSE: The concept of recovery has become the backbone of mental health services and professional practices. However, research aimed at analysing the conceptualisation of recovery of people diagnosed with severe mental illness (SMI) has an obvious Anglo-Saxon bias. Our objective was to analyse what a sample of 51 users of mental health services diagnosed with SMI in Spain understand by recovery. METHOD: The participants were interviewed in depth about their concept of recovery, and their responses were thematically analysed by three observers. RESULTS: Four categories of definitions of the concept of recovery were found in the analysis: Socio-Behavioural, Biomedical, Resistance, and Wellbeing-Growth. Inter-rater reliability scores ranged from 0.7 to 0.84 according to Krippendorff's alpha. While the Biomedical category essentially corresponded to the idea of clinical recovery, the Wellbeing-Growth category reproduced the concept of personal recovery (PR) that is dominant in the literature. The most frequent categories were Socio-Behavioural and Biomedical. Assimilation of the PR concept by participants was quite limited. The markedly relational character of the most frequent categories challenges the individualistic core of the classic definition of PR. CONCLUSIONS: We advocate the need to make alternative recovery concepts and narratives visible to the mental health services' users and practitioners.IMPLICATIONS FOR REHABILITATIONThe concept of personal recovery is not common amongst mental health services' users as recovery is mainly understood in social and biomedical terms.Different conceptualizations of recovery can coexist in participants.Mental health services should consider alternative narratives to personal recovery.Mental health services should provide resources for creating community and sense of belonging as first strategies for promoting recovery.

Designing and assessing of an art-based intervention for undocumented migrants.

BACKGROUND: Undocumented immigrants and refugees are more likely to suffer from psychosocial disorders. METHODOLOGY: In this pilot study, an art-based intervention is described and assessed, with a sample of 11undocumented immigrants who recently came to southern Spain on a small boat. The art-based intervention is assessed using a pre-post design and four questionnaires, which consist of The General Health Questionnaire, Beck's Depression Inventory, the Barcelona Immigrant Stress Scale and Carol Ryff's Psychological Well Being Scale. Furthermore, five participants were interviewed before and after the intervention and a thematic analysis of the transcriptions was carried out. RESULTS: A significant reduction of depressive symptoms with a large effect size was found. An increase of reflexive discourse and the feeling of belonging after the intervention was also observed. CONCLUSIONS: The study suggests that the art-based intervention decreased depressive symptoms and stress, redirecting the narratives of the participants towards the future and increasing the sense of community.

Social Positioning Analysis as a Qualitative Methodology to Study Identity Construction in People Diagnosed With Severe Mental Illnesses.

Severe mental illnesses (SMI) in general, and schizophrenia in particular, have been characterized as alterations of the experience of self and identity. When first diagnosed with SMI, the subjective experiences and specific narrative challenges faced by this population are particularly important. Therefore, qualitative approaches which allow to analyze these subjective experiences should be developed. This article presents in detail a specific method, called Social Positioning Analysis, which makes the complexity of narratives and life stories with multiple turning points understandable. To develop this methodological proposal, it has been taken into account the performative aspects of social interaction in which narratives are constructed. The methodology has previously been used in other health contexts and is innovative in the field of mental health. Linguistic criteria, definitions, and multiple examples are included to facilitate its application, as well as some reflections about its potential and possible benefits.

Modeling the number of people infected with SARS-COV-2 from wastewater viral load in Northwest Spain.

The quantification of the SARS-CoV-2 RNA load in wastewater has emerged as a useful tool to monitor COVID-19 outbreaks in the community. This approach was implemented in the metropolitan area of A Coruña (NW Spain), where wastewater from a treatment plant was analyzed to track the epidemic dynamics in a population of 369,098 inhabitants. Viral load detected in the wastewater and the epidemiological data from A Coruña health system served as main sources for statistical models developing. Regression models described here allowed us to estimate the number of infected people (R2 = 0.9), including symptomatic and asymptomatic individuals. These models have helped to understand the real magnitude of the epidemic in a population at any given time and have been used as an effective early warning tool for predicting outbreaks in A Coruña municipality. The methodology of the present work could be used to develop a similar wastewater-based epidemiological model to track the evolution of the COVID-19 epidemic anywhere in the world where centralized water-based sanitation systems exist.

Frecuencia de depresión y calidad de vida en pacientes con diabetes mellitus en establecimientos de salud pública de Lima Metropolitana / Frequency of depression and quality of life in patients with diabetes mellitus in public health facilities in metropolitan Lima

RESUMEN Introducción: La diabetes es una de las principales pandemias en los últimos anos. Su asociación con depresión incrementa el riesgo de mortalidad y morbilidad. La coexistencia de ambas patologías produce un mal manejo de la diabetes, lo que conlleva a una peor calidad de vida. Objetivo: Determinar la frecuencia de depresión en pacientes con diabetes mellitus y el efecto que tienen ambas patologías sobre la calidad de vida en pacientes que acuden de forma ambulatoria a establecimientos de salud públicos de Lima y Callao. Métodos: Análisis secundario de la base de datos del Estudio Epidemiológico de Salud Mental de depresión en adultos diabéticos. El instrumento empleado para determinar el episodio depresivo fue el MINI (Entrevista Neuropsiquiátrica Internacional) mientras que la calidad de vida fue medida empleando el Índice de Calidad de Vida de Mezzich. Se obtuvo información de diagnóstico de diabetes tipo1ó2del registro médico diario (HIS) de atención. Resultados: La frecuencia de depresión en los 471 pacientes con diabetes fue 5,8% en las últimas dos semanas. Mientras que la frecuencia anual fue 8,6% y en algún momento de la vida 31,8%. Ser mujer se asoció con mayor frecuencia de depresión. La calidad de vida fue menor en los pacientes con diabetes y depresión (p<0,005). Conclusiones: La frecuencia de depresión en pacientes con diabetes que son atendidos en forma ambulatoria en centros de salud públicos es mayor a la población general y su calidad de vida se ve reducida significativamente, lo que plantea la necesidad de considerar la depresión como un factor aditivo a la carga de morbilidad de esta condición.

ABSTRACT Introduction: Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life. Objective: To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao. Methodology: Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care. Results: The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p < 0.005). Conclusions: The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition.

Frequency of depression and quality of life in patients with diabetes mellitus in public health facilities in Metropolitan Lima.

INTRODUCTION: Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life. OBJECTIVE: To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao. METHODOLOGY: Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care. RESULTS: The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p < 0.005). CONCLUSIONS: The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition.

Assessing signals of selection and historical demography to develop conservation strategies in the Chilean emblematic Araucaria araucana.

Loss of genetic diversity reduces the ability of species to evolve and respond to environmental change. Araucaria araucana is an emblematic conifer species from southern South America, with important ethnic value for the Mapuche people (Pehuenche); the Chilean Government has catalogued its conservation status as vulnerable. Climatic fluctuations were potentially a major impact in the genetic variation within many tree species. In this context, the restricted geographic distribution of A. araucana in Chile appears to be a consequence of the Last Glacial Maximum (LGM). During the past two centuries, strong human intervention has also affected the geographical distribution and population sizes of A. araucana. Reduction of population size may cause loss of genetic diversity, which could affect frequency of adaptive loci. The aims of this study were to know the existence of potential loci under selection and populations with genetic, demographic disequilibrium in the Chilean distribution of A. araucana. Based on 268 polymorphic AFLP loci, we have investigated potential loci under selection and genetic, demographic disequilibrium within seven Chilean populations of Araucaria araucana. Correlation of 41 outlier loci with the environmental variables of precipitation and temperature reveals signatures of selection, whereas 227 neutral loci provide estimates of demographic equilibrium and genetic population structure. Three populations are recommended as priorities for conservation.

Spanish Validation of the Recovery Assessment Scale (RAS-24).

BACKGROUND: Recovery is an essential construct in healthcare treatment for patients diagnosed with severe mental illnesses (SMI). Of all the psychometric instruments available for measuring recovery, the 41-item Recovery Assessment Scale (RAS) is the most widely used. Several brief versions have been proposed, including the 24-item version. In this study, the RAS-24 was adapted to European Spanish and validated in a clinical sample. METHOD: Participants ( N = 309) diagnosed with SMI were recruited from a community mental health center and a work guidance center. The participants completed the RAS-24 and the Social Functioning Scale (SFS), both self-reported and family-reported versions. RESULTS: The results showed good indices of fit for the original five-factor structure, acceptable internal consistency (α = .93; ω = .95), temporal reliability ( ICC = .89, p <.01), and significant correlation with most of the SFS scales (total SFS self-report r = .50, p <.01; total SFS family reported r =.49, p <.01). CONCLUSIONS: These data support the use of this Spanish version as a measure of recovery in the Spanish clinical population.

Developing a Web-Based Congress: The 2020 International Web-Based Neurosurgery Congress Method.

BACKGROUND: Continuing medical education and continuing professional development have been affected by the ongoing 2019 novel coronavirus disease (COVID-19) pandemic. Therefore, we developed the 2020 International Web-Based Neurosurgery Congress (2020 IWBNC), which became the first successful virtual neurosurgical congress. The aim of this article was to describe the experience designing and organizing a web congress by the 2020 IWBNC method. METHODS: The 2020 IWBNC was organized by the Center for Research and Training in Neurosurgery (Centro de Investigación y Entrenamiento en Neurocirugía [CIEN]) in a record time of 4 weeks. Eight committees were created and assigned a specific task. The event followed a strict protocol based on the double-room method, which consisted of 2 virtual rooms (A and B) hosted from 4 different physical locations to avoid lecture overlapping and connection drops. Quality and impact were measured by a videoconferencing platform and social media parameters as well as an audience perception survey. RESULTS: High quality was achieved in academic standards, worldwide assistance, schedule adherence, and security. The 2020 IWBNC hosted 25 internationally renowned speakers and offered 30 top-of-the-line multidisciplinary conferences. There were 3096 participants from 125 countries, and 22,266 live-stream views were registered. No technical or cybersecurity-related issues occurred. CONCLUSIONS: Web-based academic meetings will continue to be a helpful educational tool for continuing medical education and continuing professional development. The 2020 IWBNC double-room method represents an alternative design that may be replicated by the academic community planning web congresses and similar events.

Assessing the factorial structure of the mental illness public stigma in Spain.

PURPOSE: Despite the importance of the stigma construct for the rehabilitation of people with severe mental illness, there are still no scales that offer a measurement for public stigma in Spanish with good psychometric properties. The aim of this paper is to refine and improve an existing scale to measure public stigma towards people with severe mental illness among the Spanish population. We also intended to decrease the number of items in order to facilitate its applicability. METHOD: 402 college students (73% women) responded to the attributional questionnaire (AQ27) in two subsamples. Exploratory and confirmatory factorial analysis with high cutoffs were conducted. The convergent validity with the resource allocation questionnaire was also tested. RESULTS: We have obtained a parsimonious tool, with 14 items and four factors, and some reliable psychometric indexes and convergent validity. The factors obtained were dangerousness-fear, lack of solidarity, coercion and avoidance. CONCLUSIONS: These results improve the findings from other studies that try to validate the AQ27 in other languages. We discuss the different factors that should be considered in the estimation of public stigma and the necessity to implement programmes to reduce it to enable recovery.IMPLICATIONS FOR REHABILITATIONSince the public stigma of mental illness is an obstacle to recovery and rehabilitation, reliable instruments are needed to assess it.A parsimonious instrument in Spanish with good psychometric characteristics for measuring public stigma is obtained.Using exploratory and confirmatory factor analysis, a questionnaire of 14 items is obtained.Four factors constitute the instrument: "dangerousness-fear", "coercion", "lack of solidarity", and "avoidance".