Job satisfaction of Spanish and Portuguese optometrists / Satisfacción laboral de los optometristas españoles y portugueses

Purpose: Given the increase in demand for optometry services by society and the importance of the Optometry profession in Portugal and Spain, the objective of this study was to determine job satisfaction and important factors related to this satisfaction in a sample of Portuguese and Spanish optometrists. Methods: A prospective, cross-sectional, and observational study was carried out from June to December 2021. An adaptation of the 15-item job satisfaction in eye-care personnel (JSEP) questionnaire validated by Paudel et al. was administered to Portuguese and Spanish optometrists. The questionnaire was shared through different social media (Facebook, LinkedIn, WhatsApp, etc.) in a Google form during the months of June to December 2021 in Portugal and Spain. Results: A total of 530 surveys were collected in Portugal (42.3%; n = 224) and Spain (57.7%; n = 306). The factors that most influence overall job satisfaction are salary, career development opportunities, recognition/prestige in society, good work-life balance (all p<0.001), workplace equipment and facilities, and encouragement reward positive feedback (both p = 0.002). When comparing the determinants of job satisfaction of optometrists, it was found that Portuguese professionals were generally more satisfied than Spanish ones (p<0.001). However, Spanish optometrists reported feeling more supported by their colleagues (p<0.001). Conclusion: This study has shown that the level of job satisfaction was higher in Portugal than in Spain. The most important factors influencing job satisfaction were salary, job stability, and support from colleagues.(AU)

Cost-effectiveness Analysis of Maternal Immunization with RSVpreF Vaccine for the Prevention of Respiratory Syncytial Virus Among Infants in Spain.

INTRODUCTION: Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRI) in children under one year of age. In high-income countries, RSV infections cause a significant overload of care every winter, imposing a significant burden to the healthcare system, which has made the development of prevention strategies a major global health priority. In this context, a new bivalent RSV prefusion F protein-based vaccine (RSVpreF) has recently been approved. The objective of this study was to evaluate the cost-effectiveness of vaccinating pregnant women with the RSVpreF vaccine to prevent RSV in infants from the Spanish National Healthcare System (NHS) perspective. METHODS: A hypothetical cohort framework and a Markov-type process were used to estimate clinical outcomes, costs, quality-adjusted life years (QALY) and cost-per-QALY gained (willingness-to-pay threshold: €25,000/QALY) for newborn infants born to RSV-vaccinated versus unvaccinated mothers over an RSV season. The base case analysis was performed from the NHS perspective including direct costs (€2023) and applying a discount of 3% to future costs and outcomes. To evaluate the robustness of the model, several scenarios, and deterministic and probabilistic analyses were carried out. All the parameters and assumptions were validated by a panel of experts. RESULTS: The results of the study showed that year-round maternal vaccination program with 70% coverage is a dominant option compared to no intervention, resulting in direct cost savings of €1.8 million each year, with an increase of 551 QALYs. Maternal vaccination could prevent 38% of hospital admissions, 23% of emergency room visits, 19% of primary care visits, and 34% of deaths due to RSV. All scenario analyses showed consistent results, and according to the probabilistic sensitivity analysis (PSA), the probability of maternal vaccination being cost-effective versus no intervention was 99%. CONCLUSIONS: From the Spanish NHS perspective, maternal vaccination with bivalent RSVpreF is a dominant alternative compared with a non-prevention strategy.

[Literacy in sexual and reproductive health as well as associated variables: multicenter study]. / Alfabetización en salud sexual y reproductiva así como variables asociadas: estudio multicéntrico.

OBJECTIVE: Limited Health Literacy implies an insufficient understanding of relevant health information, being associated with various variables. The objective of the study was to measure the prevalence of the level of Limited Sexual and Reproductive Health Literacy (AS-SR), its associated variables and the differences in scores between levels of AS-SR, universities and science of study in Chilean university students. METHODS: A multicenter and cross-sectional study, which applied a validated scale to measure levels of AS-SR, was carried out in a sample of 2,186 Chilean university students, categorizing it as high, medium high, medium low and low. The level of Limited AS-SR was obtained by adding the medium-low and low categories. Tests were carried out: descriptive, psychometric and reliability; association, logistic regression and differences between variables of interest. RESULTS: The prevalence of Limited AS-SR was 52.7%. The variables most associated with the level of Limited AS-SR were: low interest in information about health care (OR=2.819; 95% CI: 2.132-3.726), prevention (OR=2.564; 95% CI: 1.941-3.388), sexuality (OR=2.497; 95% CI: 1.807-3.452) and health promotion (OR=1.515; 95% CI: 1.239-1.853); certain sources of Information (OR=1.915; 95% CI:1.614-2.272); low economic income (OR=1.661; 95% CI: 1.361-2.026), among others. There were statistically significant differences in scores between categories of AS-SR levels, universities and study science. The scale had a reliability of 0.940. CONCLUSIONS: More than half of the students have Limited AS-SR, mainly associated with low interest in health information. The scale presents excellent psychometric indicators, being recommended for diagnoses of health situations.

OBJECTIVE: La Alfabetización en Salud Limitada implica una comprensión insuficiente de la información relevante en salud, asociándose con diversas variables. El objetivo del estudio fue medir la prevalencia del nivel de Alfabetización en Salud Sexual y Reproductiva (AS-SR) Limitada, sus variables asociadas y las diferencias de puntajes entre niveles de AS-SR, universidades y ciencia de estudio en universitarios chilenos. METHODS: Se realizó un estudio multicéntrico y transversal, que aplicó una escala validada para medir niveles de AS-SR, en una muestra de 2.186 estudiantes universitarios chilenos, categorizándola en alta, media-alta, media-baja y baja. El nivel de AS-SR Limitada se obtuvo mediante el sumatorio de categorías media-baja y baja. Se realizaron pruebas: descriptivas, psicométricas y fiabilidad; asociación, regresión logística y de diferencias entre variables de interés. RESULTS: La prevalencia de AS-SR Limitada fue del 52,7%. Las variables mayormente asociadas al nivel de AS-SR Limitada fueron: bajo interés en información sobre atención en salud (OR=2,819; IC 95%:2,132-3,726), prevención (OR=2,564; IC 95%: 1,941-3,388), sexualidad (OR=2,497; IC 95%: 1,807-3,452) y promoción de la salud (OR=1,515; IC 95%: 1,239-1,853); ciertas fuentes de Información (OR=1,915; IC 95%:1,614-2,272); bajo ingreso económico (OR=1,661; IC 95%: 1,361-2,026), entre otras. Existieron diferencias estadísticamente significativas de puntajes entre categorías de niveles de AS-SR, universidades y ciencia de estudio. La escala presentó fiabilidad de 0,940. CONCLUSIONS: Más de la mitad de los estudiantes poseen AS-SR Limitada, asociada principalmente al bajo interés en información en salud. La escala presenta excelentes indicadores psicométricos, siendo recomendable para diagnósticos de situación de salud.

Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis.

BACKGROUND: Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model. METHODS: We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends. RESULTS: A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s. CONCLUSION: While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

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.

[Human resource management in health. Consensual paths forward. SESPAS Report 2024]. / Gestión de recursos humanos en sanidad. Vías de avance consensuables. Informe SESPAS 2024.

Healthcare professionals deserve good management, and Spain, stagnant in its productivity, needs it. Good management is possible, as evidenced during the states of alarm in 2020. None of the lessons learned have been consolidated. Dismissing the term "public management" as an oxymoron is extreme, as there has never been a greater need for a well-functioning state, along with a better market, for reasons beyond the consolidation of the welfare state. The opposite extreme of thinking that salvation lies only within the civil service is also unhelpful. Bureaucratic sclerosis, a sign of deterioration, focused on legality or its appearance, cannot continue to ignore the need for effectiveness. The quality of management, both in general and in the healthcare sector, can be measured, and there is knowledge on how to improve it. More flexible models of labor relations -for selection, recruitment, and retention based on improved criteria of "equality, merit, and capability"- require modifications in institutional architecture, as proposed in this article: competitor benchmarking among autonomous centers and responsible entities that share standardized rules. The healthcare system, the jewel of the country, thanks in large part to the quality of its human resources, not only deserves to have its potential unleashed but can also lead the necessary increase in its resolution capacity, ensuring its impact on social well-being. It can also document its research and innovative capabilities in intellectual property, thereby contributing to the gross domestic product.

Child Sexual Abuse within the Catholic Church in Spain: A Descriptive Analysis of its Characteristics and Long-Term Impact.

Sexual abuse within the Catholic Church is a serious social issue and a significant public health problem that has caused extensive harm worldwide. In 2022, an independent commission was established in Spain to investigate sexual abuse within the Church. The commission gathered data from 334 victims (82.3% men, 17.7% women), who were predominantly aged between 55 and 74 years old (62.5%). A majority of victims (71.0%) endured sexual abuse involving physical contact, while 21% reported instances of oral, anal, or vaginal penetration. Over half of the victims (57.5%) reported emotional and behavioral issues, as well as functional problems, problems in relationships, sexuality, and cognition, and attributed these difficulties to the abuse. The majority of participants (79.0%) had disclosed the abuse before the study, with the Church taking action in 45.8% of cases. Approximately 8.4% of victims reported the perpetrator was relocated, while 16.2% described institutional efforts to conceal the abuse. In conclusion, victims of sexual abuse within the Catholic Church in Spain faced consequences that had a significant impact on their lives, exacerbated by lack of societal recognition and a prevalent dynamic of cover-up and concealment by the Church.

Numerical values and impact of hypertension in Spain.

In Spain, 33% of adults aged 30 to 79 years (10 million) were hypertensive in 2019. Among them, 68% were diagnosed, 57% received drug therapy, and effective therapeutic coverage (control) reached 33%. Both diagnosis and control show geographical and social disparities. Approximately 46 000 cardiovascular deaths per year are attributable to hypertension. In recent decades, the control of hypertension has increased, due to improvements in lifestyle measures and increased use of polytherapy, coinciding with a reduction in stroke mortality. There are several modifiable determinants of the lack of hypertension control: a) white-coat phenomenon affects 22% to 33% of treated individuals, partly due to the limited availability of ambulatory blood pressure monitoring (ABPM) (49%) and self-measured BP (SMBP) (78%); b) inadequate patient adherence to medication and healthy lifestyles (weight loss, the most effective measure, is the least used, ≈40%); and c) insufficient use of polytherapy (≈55%). The remaining challenges include: a) technological aspects, such as measuring BP with more accurate techniques (ABPM, SMBP) and using cardiovascular-risk estimation tools (eg, SCORE); b) clinical challenges, such as reducing therapeutic inertia (≈59%), involving patients in their own management (medication adherence, ≈62%) and effectively implementing clinical guidelines); and c) public health challenges, such as reducing the burden of obesity (≈24%), monitoring progress with updated surveys, and setting national BP control targets.

Short- and mid-term morbidity and primary-care burden due to infant respiratory syncytial virus infection: A Spanish 6-year population-based longitudinal study.

BACKGROUND: The morbidity burden of respiratory syncytial virus (RSV) in infants extends beyond hospitalization. Defining the RSV burden before implementing prophylaxis programs is essential for evaluating any potential impact on short- to mid-term morbidity and the utilization of primary healthcare (PHC) and emergency services (ES). We established this reference data using a population-based cohort approach. METHODS: Infants hospitalized for RSV from January 2016 to March 2023 were matched with non-hospitalized ones based on birthdate and sex. We defined the exposure as severe RSV hospitalization. The main study outcomes were as follows: (1) PHC and ES visits for RSV, categorized using the International Classification of Primary Care codes, (2) prescriptions for respiratory airway obstructive disease, and (3) antibacterial prescriptions. Participants were followed up from 30 days before hospitalization for severe RSV until the outcome occurrence or end of the study. Adjusted incidence rate ratios (IRRs) of the outcomes along with their 95% confidence intervals (CI) were estimated using Poisson regression models. Stratified analyses by type of PHC visit (nurse, pediatrician, or pharmacy) and follow-up period were undertaken. We defined mid-term outcomes as those taking place up to 24 months of follow-up period. RESULTS: The study included 6626 children (3313 RSV-hospitalized; 3313 non-hospitalized) with a median follow-up of 53.7 months (IQR = 27.9, 69.4). After a 3-month follow-up, severe RSV was associated with a considerable increase in PHC visits for wheezing/asthma (IRR = 4.31, 95% CI: 3.84-4.84), lower respiratory infections (IRR = 4.91, 95% CI: 4.34-5.58), and bronchiolitis (IRR = 4.68, 95% CI: 2.93-7.65). Severe RSV was also associated with more PHC visits for the pediatrician (IRR = 2.00, 95% CI: 1.96-2.05), nurse (IRR = 1.89, 95% CI: 1.75-1.92), hospital emergency (IRR = 2.39, 95% CI: 2.17-2.63), primary healthcare emergency (IRR: 1.54, 95% CI: 1.31-1.82), as well as with important increase in prescriptions for obstructive airway diseases (IRR = 5.98, 95% CI: 5.43-6.60) and antibacterials (IRR = 4.02, 95% CI: 3.38-4.81). All findings remained substantial until 2 years of post-infection. CONCLUSIONS: Severe RSV infection in infants significantly increases short- to mid-term respiratory morbidity leading to an escalation in healthcare utilization (PHC/ES attendance) and medication prescriptions for up to 2 years afterward. Our approach could be useful in assessing the impact and cost-effectiveness of RSV prevention programs.

Plant-Based Diets versus the Mediterranean Dietary Pattern and Their Socio-Demographic Determinants in the Spanish Population: Influence on Health and Lifestyle Habits.

BACKGROUND: Plant-based diets are becoming more and more widespread among the Spanish population, progressively replacing the Mediterranean dietary pattern. Different studies have shown the motivations for adherence to these diets, and others have highlighted some health advantages and disadvantages. PURPOSE OF THE STUDY: Further studies are needed to define the socio-demographic determinants that influence the choice of a plant-based diet and to study the relationship that the choice of dietary pattern has on the health and lifestyle habits of the population. METHODS: A descriptive, cross-sectional study was conducted on the Spanish population. The NutSo-HH questionnaire, developed and validated by the research team, was used to gather socio-demographic, nutritional, social, and lifestyle information through non-probabilistic snowball sampling. RESULTS: The questionnaire was completed by 22,181 Spanish citizens, of whom only 19,211 were of interest to the study. The socio-demographic variables gender, age, educational level, income level, and place of residence do not seem to influence the prevalence of a plant-based diet (n = 1638) compared to a Mediterranean diet (n = 17,573). People following a vegetarian or vegan diet have a lower BMI, and they consume less fried food, fast food, and ultra-processed dishes and fewer energy drinks or sugary beverages. They also do more exercise and sleep longer hours, smoke less, and consume alcohol less frequently. However, there seem to be more diagnosed eating disorders among people who follow a plant-based diet than those who follow a Mediterranean diet. CONCLUSIONS: People who adopt a plant-based diet tend to exhibit healthier lifestyle patterns and consume fewer foods that are detrimental to their health. However, it is essential for such dietary choices to be supervised by healthcare professionals to mitigate the risk of maladaptive behaviors evolving into eating disorders.

[Use of social networks as a source of information on health and digital health literacy in the Spanish general population]. / Uso de redes sociales como fuente de información sobre salud y alfabetización digital en salud en población general española.

OBJECTIVE: Social media allows individuals to access a vast amount of health-related information immediately and anonymously, a fact that is turning these platforms into one of the primary sources of reference in this area, especially for younger generations. Given this reality, the objective of determining the impact of social media on digital health literacy in the general Spanish population was proposed. METHODS: A cross-sectional descriptive study was carried out in 2023. Using a non-probabilistic sampling, the population residing in Spain, over eighteen years old, and users of social networks were included, obtaining a sample of 1,307 participants. An adaptation of the validated eHEALS questionnaire on digital health literacy was used. This questionnaire, created in Microsoft Forms, was disseminated through an anonymous link via the research team's social networks and collaborators. A descriptive and inferential statistical analysis was performed using SPSS 22.0, assuming a significance level with a value of p<0.05. RESULTS: All participants affirmed having consumed health information through social networks, but 72.1% stated they had actively used these platforms to search for this health information. Regarding digital health literacy, a median score of 24 out of 40 points was obtained on the questionnaire, being significantly higher among those who claimed to use social networks as a source of health information (p=0.0001). CONCLUSIONS: Actively employing social media as a source of health information is associated with a higher level of digital health literacy.

OBJECTIVE: Las redes sociales permiten a las personas acceder de manera inmediata y anónima a una cantidad ingente de información sobre aspectos de salud, hecho que está provocando que se estén convirtiendo en una de las fuentes de referencia en este ámbito, sobre todo para las generaciones más jóvenes. Atendiendo a esta realidad se planteó el objetivo de determinar el impacto de las redes sociales en la alfabetización digital en salud en la población general española. METHODS: Se realizó un estudio descriptivo transversal en el año 2023. Mediante un muestreo no probabilístico, se incluyó población residente en España, mayor de dieciocho años y usuaria de redes sociales, obteniendo una muestra de 1.307 participantes. Se utilizó una adaptación del cuestionario validado eHEALS sobre alfabetización digital en salud. Dicho cuestionario, elaborado en Microsoft Forms, fue difundido mediante un enlace anónimo a través de las redes sociales del equipo investigador y colaboradores. Se realizó un análisis estadístico descriptivo e inferencial mediante SPSS 22.0, asumiendo un nivel de significación con un valor de p<0,05. RESULTS: La totalidad de los participantes afirmaron haber consumido información sobre salud a través de redes sociales, pero fue el 72,1% el que afirmó haber usado estas plataformas activamente para buscar esta información sobre salud. Con respecto a la alfabetización digital en salud, se obtuvo una puntuación mediana en el cuestionario de 24 sobre 40 puntos, siendo significativamente mayor entre los que afirmaron usar las redes sociales como fuente de información sobre salud (p=0,0001). CONCLUSIONS: Emplear de manera activa las redes sociales como fuente de información sobre salud parece tener relación con un mayor nivel de alfabetización digital en salud.

Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial.

Aim: To assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders. Methods: An open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interventions. The intervention for psychiatrists (PsI) included an educational program based on a patient-centered care model. The intervention for patients and relatives (PtI) included a collaborative care program plus a reminder system that works using an already available medication reminder application. The primary outcome was patient adherence to antidepressant treatment assessed through the Sidorkiewicz Adherence Instrument. Secondary measures were depression severity, comorbid anxiety and health-related quality of life. Mixed regression models with repeated measures were used for data analysis. Results: Ten psychiatrists and 150 patients diagnosed with depressive disorder from eight Community Mental Health Units in the Canary Islands (Spain) were included. Compared with usual care, no differences in long-term adherence were observed in either group PsI or PtI. The PsI group had significantly improved depression symptoms (B = -0.39; 95%CI: -0.65, -0.12; p = 0.004) during the follow-up period. The PtI group presented improved depression symptoms (B = -0.63; 95%CI: -0.96, -0.30; p < 0.001) and mental quality of life (B = 0.08; 95%CI: 0.004, 0.15; p = 0.039) during the follow-up period. Conclusion: The assessed interventions to improve adherence in patients with depressive disorder were effective for depression symptoms and mental quality of life, even over the long term. However, no effect on antidepressant adherence was observed.

Mortality attributable to secondhand smoke exposure in the autonomous communities of Spain.

INTRODUCTION AND OBJECTIVES: Exposure to secondhand smoke (SHS) causes cardiovascular disease, respiratory disease, and cancer. The aim of this study was to estimate the mortality attributed to SHS in people aged ≥ 35 years in Spain and its autonomous communities (AC) by sex from 2016 to 2021. METHODS: Estimates of SHS-attributable mortality were calculated by applying the prevalence-dependent method where SHS exposure was derived from the adjustment of small-area models and based on the calculation of population-attributed fractions. Sex, age group, AC, and cause of death (ischemic heart disease and lung cancer) were included. The estimates of attributed mortality are presented with their 95% confidence interval (95%CI). Crude and age-standardized rates were estimated for each sex and AC. RESULTS: From 2016 to 2021, SHS exposure caused 4,970 (95%CI, 4,787-5,387) deaths, representing 1.6% of total mortality for ischemic heart disease and lung cancer. The burden of attributed mortality differed widely among the AC, with Andalusia having the highest burden of attributed mortality (crude rate: 46.6 deaths per 100 000 population in men and 17.0/100 000 in women). In all the AC, the main cause of death in both sexes was ischemic heart disease. The highest burden of mortality was observed in nonsmokers. CONCLUSIONS: The burden of SHS-attributable mortality was high and varied geographically. The results of this study should be considered to advance tobacco control legislation in Spain.

An Integrated Pest Management Strategy Approach for the Management of the Stable Fly Stomoxys calcitrans (Diptera: Muscidae).

Stable flies, Stomoxys calcitrans, stand as formidable pests with a global impact, inflicting significant economic losses on the livestock sector. Larval development occurs in diverse substrates, including decomposing plant material and manure, while emerged adults pose a threat through blood-feeding on both animals and humans. Conventional chemical control methods, predominantly reliant on insecticides, not only pose environmental risks but also face challenges of resistance among stable fly populations. To address this pressing issue, we propose an integrated pest management (IPM) strategy for stable fly control. This approach involved a combination of sanitary-cultural practices, animal protection, the release of natural enemies targeting immature stages, and a specialized trapping system for adults. The Stomoxycc® trap, designed for mass trapping of adult Stomoxys, was employed alongside the release of the predatory mite Macrocheles robustulus and two wasp parasitoids, Spalangia cameroni and Muscidifurax raptor (under the commercial brands Biomite® and Biowasp®) on animal bedding as a key component of this IPM strategy. The implementation of this initiative has been undertaken at a significant sanctuary for donkeys and mules in western Spain. In this publication, we present the application and results of the IPM strategy utilized and provide insights into its use as a sustainable and environmentally friendly option for controlling stable fly populations.

Toxoplasma gondii Infection in Humans: A Comprehensive Approach Involving the General Population, HIV-Infected Patients and Intermediate-Duration Fever in the Canary Islands, Spain.

A prior investigation in 1993 identified a high seroprevalence of toxoplasmosis (63%) in the Canary Islands. This study aims to assess the current prevalence of the disease in diverse population groups. The study was based on a population-scale screening involving 273 residents utilizing T. gondii IgG ELISA and a 20 year retrospective study (1998-2018). This included AIDS/HIV outpatients (1357, of which 324 were residents), AIDS/HIV hospitalized patients (741) and patients with fever of intermediate duration (158). The seroprevalence in the resident population was 37%, with significant differences between islands. Among resident outpatients with AIDS/HIV, 14.2% had specific anti-T. gondii IgG, and three had anti-T. gondii IgM; however, IgG avidity testing indicated non-active infection. In patients hospitalized for AIDS/HIV, T. gondii causing encephalitis was detected in 2%. Among patients with fever of intermediate duration, 28.5% were positive for T. gondii IgG, and four also showed IgM positivity, although the infection was non-active. The study reveals a decrease in human toxoplasmosis over the past 30 years. However, the current seroprevalence, which stands at 37%, together with the substantial risk that T. gondii represents for immunocompromised individuals, highlights the need to implement preventive and control strategies to control the threat that this infection can pose to public health in the Canary Islands population.

A Set of Multiresistant Isolates of Mycoplasma bovis Subtype ST-1 with a Variable Susceptibility to Quinolones Are Also Circulating in Spain.

Mycoplasma bovis (M. bovis) is one of the worldwide most important infectious agents involved in respiratory complex diseases (RCD). In Spain, the endemic presence of subtypes ST-2 and ST-3 with phenotypic differences linked to their susceptibility to fluoroquinolones opened the way to develop control strategies focused on previous diagnosis of the subtype and the use of directed therapies when M. bovis were involved in RCD. Surprisingly, microbiological studies conducted during 2023 evidenced for the first time the presence of Spanish isolates of a new polC-subtype, previously classified as ST-1, recovered from calves with respiratory symptoms and pneumonia in different areas of the country (n = 16). Curiously, the minimum inhibitory concentration (MIC) to a panel of antimicrobials revealed phenotypic differences between these ST-1 isolates when using fluoroquinolones (FLQ). There is no geographical correlation between MIC profiles even for a set of 8 isolates recovered from different animals in the same flock. Sequencing of 4 genes (gyrA, gyrB, parC and parE) encoding quinolone resistance-determining regions (QRDR) evidenced the presence of accumulate mutations in 2 ST-1 isolates with high FLQ MICs, but not in all them (n = 3), thus suggesting that, as previously recorded for ST-2 isolates, other mechanisms should be involved in the acquisition of resistence to these antimicrobials. Additionally, as previously detected in the Spanish ST-2 and ST-3, subtype ST-1 isolates are also resistant to macrolides or lincosamides.

Cross-cultural adaptation, reliability, validity and responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ-Sp) in Spain.

BACKGROUND: The Michigan Hand Outcomes Questionnaire (MHQ) is a self-report tool widely recognized for measuring the health status of patients with hand and wrist problems from a multidimensional perspective. The aim of this study is to translate and culturally adapt the MHQ and validate its psychometric properties of validity, reliability, and responsiveness for different hand problems in Spain. METHODS: The MHQ was translated and culturally adapted following the recommendations of the American Association of Orthopaedic Surgeons. The validation process adhered to the current Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) group and was conducted on 262 hand patients. Reliability was assessed through internal consistency using Cronbach's alpha. The study evaluated the test-retest reliability of the measurements using the intraclass correlation coefficient (ICC). Additionally, the measurement error was calculated using the standard error of measurement (SEM) and smallest detectable change (SDC). To assess the structural validity, confirmatory factor analysis (CFA) was employed, while construct validity was evaluated using Pearson's correlation coefficient. Finally, responsiveness was assessed using effect size (ES), standardized response mean (SRM), and minimum clinically important difference (MCID). RESULTS: The reliability of the test was confirmed through internal consistency analysis, with a good Crombach's Alpha (0.82-0.85), and test-retest analysis, with good values of ICC (0.74-0.91). The measurement error was also assessed, with low values of SEM (1.70-4.67) and SDC (4.71-12.94)). The CFA confirmed the unidimensionality of each scale with goodness of fit indices, while the MHQ showed a high and negative correlation with DASH (r = - 0.75, P < 0.001) and DASH-work (r = - 0.63, P < 0.001) and was irrelevant with EQ-5D (r = - 0.01, P > 0.005) and grip strength (r = 0.05, P > 0.005). At week 5, all 222 patients across the three diagnosed hand subgroups showed moderate to high values above 0.92 for ES and SRM, with one MCID above 6.85. CONCLUSIONS: The MHQ-Sp was culturally adapted, and the results of this version showed good reliability and validity as well as high responsiveness for a wide range of hand conditions after surgical or conservative treatment in Spain.

Cierre de herida en cirugía protésica de rodilla y cadera (PTR y PTC): Resultados de una encuesta sobre la práctica clínica en España / Wound closure after knee and hip replacement (TKA and THA): Survey results on the clinical practice in Spain

Introducción y objetivos: En cirugía protésica de rodilla y cadera está claro que aún no se ha desarrollado una técnica de cierre estandarizada óptima. A nivel local no existen datos que describan la práctica quirúrgica habitual en cierre de herida. El objetivo de este trabajo es analizar el cierre de herida en cirugía protésica a través de una encuesta sobre una muestra representativa a nivel nacional y así obtener información sobre el contexto del cierre en España. Material y método: Se conforma un grupo ad hoc de especialistas en cirugía protésica. El grupo de expertos, posterior al análisis de la literatura, elabora un cuestionario de 32 preguntas cerradas de opción múltiple, divididas en los siguientes bloques: hemostasia, cierre quirúrgico de la herida y apósitos. Resultados: Un total de 471 cirujanos respondieron la encuesta de forma completa y con información suficiente para efectuar el análisis descriptivo; 79% cree que el ácido tranexámico (ATX) puede influir en la disminución de tasa de infección de sitio quirúrgico; 96% cree que el tipo de cierre profundo a nivel de la artrotomía podría influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 85% cree que el tipo de cierre superficial a nivel subcutáneo puede influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 64% de los cirujanos utiliza la terapia de presión negativa incisional de simple uso para el tratamiento de las complicaciones de la herida quirúrgica (seromas, drenaje prolongado, dehiscencias). Conclusiones: Existe en nuestro entorno una alta variabilidad en el cierre de la herida y una baja inversión en formación sobre este tema. Los autores recomiendan a las diferentes sociedades científicas la inversión de recursos para mejorar la formación en dicho campo y reducir el porcentaje de cirujanos que se consideran inadecuadamente formados, así como adaptar las técnicas de cierre a aquellas consideradas patrón oro según la evidencia.(AU)

Background and objective: In orthopedic surgery, it is clear that an optimal standardized closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyze the clinical practice of surgical wound closure in orthopedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. Method: an ad hoc group of specialists in orthopedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. Results: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). Conclusions: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.(AU)

[Translated article] Wound closure after knee and hip replacement (TKA and THA): Survey results on the clinical practice in Spain / Cierre de herida en cirugía protésica de rodilla y cadera (PTR y PTC): resultados de una encuesta sobre la práctica clínica en España

Introducción y objetivos: En cirugía protésica de rodilla y cadera está claro que aún no se ha desarrollado una técnica de cierre estandarizada óptima. A nivel local no existen datos que describan la práctica quirúrgica habitual en cierre de herida. El objetivo de este trabajo es analizar el cierre de herida en cirugía protésica a través de una encuesta sobre una muestra representativa a nivel nacional y así obtener información sobre el contexto del cierre en España. Material y método: Se conforma un grupo ad hoc de especialistas en cirugía protésica. El grupo de expertos, posterior al análisis de la literatura, elabora un cuestionario de 32 preguntas cerradas de opción múltiple, divididas en los siguientes bloques: hemostasia, cierre quirúrgico de la herida y apósitos. Resultados: Un total de 471 cirujanos respondieron la encuesta de forma completa y con información suficiente para efectuar el análisis descriptivo; 79% cree que el ácido tranexámico (ATX) puede influir en la disminución de tasa de infección de sitio quirúrgico; 96% cree que el tipo de cierre profundo a nivel de la artrotomía podría influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 85% cree que el tipo de cierre superficial a nivel subcutáneo puede influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 64% de los cirujanos utiliza la terapia de presión negativa incisional de simple uso para el tratamiento de las complicaciones de la herida quirúrgica (seromas, drenaje prolongado, dehiscencias). Conclusiones: Existe en nuestro entorno una alta variabilidad en el cierre de la herida y una baja inversión en formación sobre este tema. Los autores recomiendan a las diferentes sociedades científicas la inversión de recursos para mejorar la formación en dicho campo y reducir el porcentaje de cirujanos que se consideran inadecuadamente formados, así como adaptar las técnicas de cierre a aquellas consideradas patrón oro según la evidencia.(AU)

Background and objective: In orthopedic surgery, it is clear that an optimal standardized closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyze the clinical practice of surgical wound closure in orthopedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. Method: an ad hoc group of specialists in orthopedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. Results: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). Conclusions: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.(AU)

Diferencias en la evolución del sobrepeso y la obesidad infantil en España en el periodo 2011-2019 por sexo, edad y nivel socioeconómico: resultados del estudio ALADINO / Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: Results of the ALADINO study

Introducción: El exceso de peso infantil es un problema de salud pública creciente. El objetivo del trabajo es estudiar la evolución de la prevalencia de sobrepeso, de obesidad y de obesidad central en escolares de 6 a 9años en España entre 2011 y 2019 según características demográficas y socioeconómicas.MetodologíaSe incluyeron las rondas 2011, 2015 y 2019 del estudio observacional, descriptivo y transversal ALADINO en escolares de ambos sexos de 6 a 9años. Se realizó un análisis descriptivo de la evolución de la prevalencia de sobrepeso y de obesidad según los criterios de la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF), así como obesidad central, y las variables demográficas y socioeconómicas asociadas.ResultadosEntre 2011 y 2019 se redujo la prevalencia de sobrepeso (criterios OMS) en niños de 6, 7 y 8años (−5,4, −5,7 y −5,3 puntos porcentuales, respectivamente) y niños cuyos progenitores tenían estudios superiores (−5,3 puntos porcentuales). Por renta, el sobrepeso en niños se redujo en todos los niveles de ingresos. Sin embargo, entre 2011 y 2019 se mantuvieron estables tanto la prevalencia de sobrepeso en niñas como la prevalencia de obesidad según las referencias OMS e IOTF y la de obesidad central en ambos sexos.ConclusionesLas prevalencias de sobrepeso y de obesidad en escolares de 6 a 9años en España siguen siendo altas. Entre 2011 y 2019 disminuyó la prevalencia de sobrepeso en niños de 6 a 8años y aquellos cuyos progenitores tienen estudios universitarios, mientras que la obesidad en niños, el sobrepeso y la obesidad en niñas, y la obesidad central en ambos sexos han permanecido estables. (AU)

Introduction: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6 to 9years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics.MethodologyThe analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6 to 9years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization [WHO] and the International Obesity Task Force [IOTF]) and of central obesity, in addition to associated demographic and socioeconomic variables.ResultsBetween 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8years (by −5.4%, −5.7% and −5.3%, respectively) and boys whose parents had a higher educational attainment (by −5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable.ConclusionsThe prevalence of overweight and the prevalence of obesity in schoolchildren aged 6 to 9years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6 to 8years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable. (AU)