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)

Mortality risk factors in the dependent population of Castilla-La Mancha (Spain) before and during the first COVID-19 wave.

The coronavirus disease pandemic has had an important impact worldwide. The population aged over 65 years and aged dependent persons are the population groups which have suffered in a highest level the consequences of the pandemic in terms of cases and death. In Spain, the situation is similar to other countries, but regional studies are needed because competencies on long-term care depend on regional public administration. Thus, the aim of this work is to analyse social and individual factors associated with the risk of mortality of legally recognised dependent people during the pandemic compared to a non-pandemic period. The data were extracted from the administrative database on individuals included in Castilla-La Mancha's long-term care system and it was merged with the information from the Spanish National Death Index administered by the Ministry of Health, Consumption and Social Welfare. The results show that the risk of mortality between March and June 2020 was positively associated with being male; being older than 65, with an especially high impact in the group aged over 90; having a higher level of dependency; living in a nursing home; and living in a place with more population density. Intraregional differences related to health areas also exists in both pandemic and non-pandemic periods. These findings are critical with a view to enhancing protocols for the care of the most vulnerable population groups.

Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021).

Background: Estimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical characteristics of hospitalizations with a diagnosis of influenza over five flu seasons (2016-2017 to 2020-2021), (b) assess the associated morbidity (hospitalization rates and ICU admissions rate), mortality and cost of influenza hospitalizations in different age groups and (c) analyze the risk factors for mortality. Methods: This retrospective study included all hospital admissions with a diagnosis of influenza in Spain for five influenza seasons. Data were extracted from the Spanish National Surveillance System for Hospital Data from 1 July 2016 to 30 June 2021. We identified cases coded as having influenza as a primary or secondary diagnosis (International Classification of Diseases, 10th revision, J09-J11). The hospitalization rate was calculated relative to the general population. Independent predictors of mortality were identified using multivariable logistic regression. Results: Over the five seasons, there were 127,160 hospitalizations with a diagnosis of influenza. The mean influenza hospitalization rate varied from 5/100,000 in 2020-2021 (COVID-19 pandemic) to 92.9/100,000 in 2017-2018. The proportion of influenza hospitalizations with ICU admission was 7.4% and was highest in people aged 40-59 years (13.9%). The case fatality rate was 5.8% overall and 9.4% in those aged 80 years or older. Median length of stay was 5 days (and 6 days in the oldest age group). In the multivariable analysis, independent risk factors for mortality were male sex (odds ratio [OR] 1.14, 95% confidence interval [95% CI] 1.08-1.20), age (<5 years: OR 1; 5-19 years: OR 2.02, 95%CI 1.17-3.49; 20-39 years: OR 4.11, 95% CI 2.67-6.32; 40-59 years: OR 8.15, 95% CI 5.60-11.87; 60-79 years: OR 15.10, 95% CI 10.44-21.84; ≥80 years: OR 33.41, 95% CI 23.10-48.34), neurological disorder (OR 1.97, 95% CI 1.83-2.11), heart failure (OR 1.85, 95% CI 1.74-1.96), chronic kidney disease (OR 1.33, 95% CI 1.25-1.41), chronic liver disease (OR 2.95, 95% CI 2.68-3.27), cancer (OR 1.85, 95% CI 1.48-2.24), coinfection with SARS-CoV2 (OR 3.17, 95% CI 2.34-4.28), influenza pneumonia (OR 1.76, 95% CI 1.66-1.86) and admission to intensive care (OR 7.81, 95% CI 7.31-8.36). Conclusion: Influenza entails a major public health burden. People aged over 60-and especially those over 80-show the longest hospital stays. Age is also the most significant risk factor for mortality, along with certain associated comorbidities.

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.

The influence of age, period, and cohort factors on the incidence of kidney cancer in Spain 1990-2019: Evidence from the global burden of disease study.

OBJECTIVE: This study aimed to assess the influence of age, period, and cohort (A-P-C) factors on kidney cancer (KC) incidence trends in Spain from 1990 to 2019. METHODS: Employing data from the Global Burden of Disease Study 2019, we employed joinpoint analysis to determine long-term patterns and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects. RESULTS: Over the period 1990-2019, an estimated 142,811 cases of KC were diagnosed in Spain. A consistent upward trend in KC incidence was observed for both men and women, with the male-to-female ratio remaining stable at 2.6. Joinpoint analysis identified three distinct periods for men: An initial period (1990-1995) characterised by a significant increase in rates, a subsequent period (1995-2016) characterised by a slowdown in the rate of increase, and a final period (2016-2019) in which rates have plateaued. In women, 2 time periods were observed: an initial period (1990-2007) in which rates increased significantly, followed by a period of stabilization (2007-2019). Men born in the early-mid 20th century had a rising KC risk, peaking in the 1960s. Women's risk rose steadily, peaking in the late 1990s. CONCLUSION: A-P-C analysis reveals steady KC incidence increase in both genders over three decades. This highlights the need for targeted public health policies and effective prevention strategies.

Enhancing water quality prediction for fluctuating missing data scenarios: A dynamic Bayesian network-based processing system to monitor cyanobacteria proliferation.

Tackling the impact of missing data in water management is crucial to ensure the reliability of scientific research that informs decision-making processes in public health. The goal of this study is to ascertain the root causes associated with cyanobacteria proliferation under major missing data scenarios. For this purpose, a dynamic missing data management methodology is proposed using Bayesian Machine Learning for accurate surface water quality prediction of a river from Limia basin (Spain). The methodology used entails a sequence of analytical steps, starting with data pre-processing, followed by the selection of a reliable dynamic Bayesian missing value prediction system, leading finally to a supervised analysis of the behavioral patterns exhibited by cyanobacteria. For that, a total of 2,118,844 data points were used, with 205,316 (9.69 %) missing values identified. The machine learning testing showed the iterative structural expectation maximization (SEM) as the best performing algorithm, above the dynamic imputation (DI) and entropy-based dynamic imputation methods (EBDI), enhancing in some cases the accuracy of imputations by approximately 50 % in R2, RMSE, NRMSE, and logarithmic loss values. These findings can impact how data on water quality is being processed and studied, thus, opening the door for more reliable water management strategies that better inform public health decisions.

Enhancing employee wellbeing and happiness management in the wine industry: unveiling the role of green human resource management.

BACKGROUND: In today's business environment, where sustainability has emerged as a strategic axis of business practices, the study of the link between human resources management and environmental management becomes increasingly necessary. In this sense, the present research focuses on analyzing the impact of Green Human Resource Management (GHRM) on the Sustainable Performance (SP) of Spanish wineries, as well as the mediating effect of Employee Wellbeing (EW) and Work Engagement (WE) on this linkage. In addition, age, size and membership in a Protected Designation of Origin (PDO) are introduced as control variables to increase the precision of the cause-effect relationships examined. METHODS: The study proposes a conceptual model based on previous studies, which is tested using structural equations (PLS-SEM) with data collected from 196 Spanish wineries between September 2022 and January 2023. RESULTS: The findings of the research reveal the existence of a positive and significant relationship between the GHRM development and the SP of Spanish wineries, as well as the partial mediation of EW and WE in this association. CONCLUSIONS: The uniqueness and significance of this study can be attributed to several crucial factors. First, it enhances the understanding and knowledge regarding the advantages associated with GHRM development. Second, no prior research has conducted a comprehensive study on GHRM as a catalyst for SP within the context of Spanish wineries. Third, to the best of the authors' knowledge, no previous study has analyzed the mediating role of EW and WE as mediators in the relationship between GHRM and SP of wineries.

Models Used by Nurse Case Managers in Different Autonomous Communities in Spain: A Scoping Review.

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences.

Suicide Interventions in Spain and Japan: A Comparative Systematic Review.

(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components.

Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire.

Purpose: The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire. Methods: The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains. Results: Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains. Conclusion: The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.

Impact of dementia on 30-, 180-, and 365-day mortality during the first pandemic wave in older adults seen in spanish emergency departments diagnosed with or without COVID-19.

OBJECTIVES: To assess whether dementia is an independent predictor of death after a hospital emergency department (ED) visit by older adults with or without a COVID-19 diagnosis during the first pandemic wave. METHOD: We used data from the EDEN-Covid (Emergency Department and Elderly Needs during Covid) cohort formed by all patients ≥65 years seen in 52 Spanish EDs from March 30 to April 5, 2020. The association of prior history of dementia with mortality at 30, 180 and 365 d was evaluated in the overall sample and according to a COVID-19 or non COVID diagnosis. RESULTS: We included 9,770 patients aged 78.7 ± 8.3 years, 51.1% men, 1513 (15.5%) subjects with prior history of dementia and 3055 (31.3%) with COVID-19 diagnosis. 1399 patients (14.3%) died at 30 d, 2008 (20.6%) at 180 days and 2456 (25.1%) at 365 d. The adjusted Hazard Ratio (aHR) for age, sex, comorbidity, disability and diagnosis for death associated with dementia were 1.16 (95% CI 1.01-1.34) at 30 d; 1.15 at 180 d (95% CI 1.03-1.30) and 1.19 at 365 d (95% CI 1.07-1.32), p < .001. In patients with COVID-19, the aHR were 1.26 (95% CI: 1.04-1.52) at 30 days; 1.29 at 180 d (95% CI: 1.09-1.53) and 1.35 at 365 d (95% CI: 1.15-1.58). CONCLUSION: Dementia in older adults attending Spanish EDs during the first pandemic wave was independently associated with 30-, 180- and 365-day mortality. This impact was lower when adjusted for age, sex, comorbidity and disability, and was greater in patients diagnosed with COVID-19.

[Evaluation of the management and follow-up of diabetic patients in the prevention of diabetic retinopathy]. / Evaluación del manejo y seguimiento de los pacientes diabéticos en la prevención de la retinopatía diabética.

OBJECTIVE: Diabetes mellitus is a chronic disease with high morbidity and mortality, affecting 537 million adults worldwide. Spain is the second European country in prevalence, with 14.8% in the population aged twenty/seventy-nine years; with 11.6 cases per 1,000 people/year. Diabetic retinopathy (DR) is the fifth cause of vision loss worldwide and the seventh cause of blindness/visual impairment among members of the National Organization of the Blind in Spain (ONCE). Early detection of DR prevents blindness in diabetics and is conditioned by glycosylated hemoglobin. The aim of this paper was to analyze the management of diabetic patients in Aljarafe region (Seville) and identify opportunities for improvement in the coordination of their follow-up between the Primary Care physician and the ophthalmologist. METHODS: A retrospective observational study (2016-2019) was carried out, with patients registered in the diabetic census of the twenty-eight municipalities of Aljarafe. The primary care and hospital health history, and telemedicine program were consulted. About statistical analysis, for qualitative variables, totals and percentages were calculated; for quantitative variables, mean and standard deviation (if normally distributed) and median and quartiles (if non-normally distributed). RESULTS: There were 17,175 diabetics registered in Aljarafe (5.7% of the population); 14,440 patients (84.1%) had some determination of hemoglobin during the period, 9,228 (63.9%) had all of them in the appropriate range. Fundoscopic control was performed on 12,040 diabetics (70.1%), and of those who did not, 346 (10.6%) had all of them out of range. There were 1,878 (10.9%) patients without fundoscopic or metabolic control, 1,019 (54.3%) were women, 1,219 (64.9%) were under sixty-five years of age, 1,019 (54.3%) had severe comorbidity. CONCLUSIONS: Most patients have adequate screening, and more than half have determinations within range. However, a significant percentage with no glycated hemoglobin within range lack fundoscopic control, and another smaller group lack fundoscopic or metabolic control, with inter-municipal variability. We propose to improve communication channels between levels.

OBJECTIVE: La diabetes mellitus es una enfermedad crónica con alta morbimortalidad que afecta a 537 millones de adultos en el mundo. España es el segundo país europeo en prevalencia, con un 14,8% en población de veinte-setenta y nueve años, con 11,6 casos por cada 1.000 personas/año. La retinopatía diabética (RD) es la quinta causa de pérdida de visión a nivel mundial y la séptima causa de ceguera/discapacidad visual entre afiliados a la Organización Nacional de Ciegos de España (ONCE). La detección precoz de RD previene la ceguera en diabéticos y está condicionada por la hemoglobina glicosilada. El objetivo de este trabajo fue analizar el manejo de los pacientes diabéticos en la comarca del Aljarafe (Sevilla) e identificar oportunidades de mejora en la coordinación de su seguimiento entre el médico de Atención Primaria y el médico oftalmólogo. METHODS: Se realizó un estudio observacional retrospectivo (2016-2019) con los pacientes registrados en el censo de diabéticos de los veintiocho municipios del Aljarafe. Se consultó la historia de salud de Atención Primaria y Hospital, así como el programa de Telemedicina. En cuanto al análisis estadístico, para variables cualitativas se calcularon totales y porcentajes; para variables cuantitativas, media y distribución estándar (si distribución normal), y la mediana y cuartiles (distribución no normal). RESULTS: Se registraron 17.175 diabéticos en el Aljarafe (5,7% de población); 14.440 pacientes (84,1%) tenían alguna determinación de hemoglobina durante el periodo, 9.228 (63,9%) las tenían todas en rango adecuado. Tenían control fundoscópico 12.040 diabéticos (70,1%), y de los que no, 346 (10,6%) tenían todas fuera de rango. Hubo 1.878 (10,9%) pacientes sin control fundoscópico ni metabólico, 1.019 (54,3%) eran mujeres, 1.219 (64,9%) menores de sesenta y cinco años, 1.019 (54,3%) con comorbilidad grave. CONCLUSIONS: La mayoría de los pacientes presentan un cribado adecuado y, más de la mitad, determinaciones en rango. Sin embargo, un porcentaje relevante con ninguna hemoglobina glicosilada en rango carecen de control fundoscópico, y otro grupo menor está sin control fundoscópico ni metabólico, con variabilidad intermunicipios. Planteamos mejorar los circuitos de comunicación entre niveles.

Migraine treatment: quo vadis? Real-world data study (2015-2022) in Spain.

BACKGROUND: Migraine is a leading cause of disability, estimated to affect one-in-ten people in Spain. This study aimed to describe the management of migraine in Spain and identify improvement areas. METHODS: Non-interventional, retrospective, cross-sectional cohort study conducted using an electronic medical records database covering visits to public healthcare providers for 3% of the Spanish population. Patients with a migraine diagnosis (ICD-9 346) between 01/2015 and 04/2022 were included, as well as their demographic and clinical characteristics, prescribed migraine treatments and the specialty of the prescribing physicians. RESULTS: The database included 61,204 patients diagnosed with migraine. A migraine treatment had been prescribed to 50.6% of patients over the last 24 months (only acute to 69.5%, both acute and preventive to 24.2%, and only preventive to 6.3%). The most frequently prescribed treatments were NSAIDs (56.3%), triptans (44.1%) and analgesics (28.9%). Antidepressants were the most common preventive treatment (prescribed to 17.9% of all treated patients and 58.7% of those treated with a preventive medication), and anti-CGRP monoclonal antibodies the least prescribed (1.7%; 5.7%). In 13.4% of cases, preventive medications were the first treatment: alone in 5.8% of cases and together with an acute medication in 7.6%. A fifth of patients who were initially prescribed with only acute treatment were later prescribed a preventive medication (20.7%). On average, it took 29.4 months for this change to occur. Two-thirds of patients started their preventive treatment in primary care (64.2%). The percentage of patients treated by a neurologist increased with the number of received preventive medications. However, 28.8% of patients who had already been prescribed five or more distinct preventive treatments were not treated by a neurologist. Migraine patients had between 1.2- and 2.2-times higher prevalence of comorbidities than the general population, age-gender adjusted. CONCLUSIONS: Our study emphasizes the need for improved management of migraine in Spain to reduce the risk of chronification and improve patient outcomes. More training and coordination across healthcare professionals is necessary to recognize and address risk factors for migraine progression, including multiple associated comorbidities and several lines of treatment, and to provide personalized treatment plans that address the complex nature of the condition.

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)

Validación de una escala enfermera para evaluar las actitudes del profesorado en la atención diabética / Validation of a nursing scale for assessing teachers' attitudes to diabetes care

Objetivo: Validar el Inventario de Actitudes Negativas del Profesorado hacia la Atención del Alumnado con Diabetes Mellitus tipo 1 (INAPAD) y estudiar su fiabilidad mediante los coeficientes Alfa de Cronbach y Omega de McDonald. Material y método: Este estudio describe el proceso de diseño y validación de la escala enfermera INAPAD en una muestra de 382 docentes en las etapas de Educación Infantil, Educación Primaria, Educación Secundaria Obligatoria, Bachillerato y Formación Profesional en una provincia española. El INAPAD pretende valorar diversas dimensiones actitudinales sobre la atención educativa al alumnado con Diabetes Mellitus tipo 1, incidiendo tanto en el perfil docente y profesional del profesorado, como en las características y necesidades específicas de este alumnado. Por su parte, la validez de constructo se ha evaluado mediante análisis factoriales exploratorios por componentes principales y rotación varimax. Resultados y Conclusión: Los resultados obtenidos informan de la viabilidad del INAPAD para ser utilizado como un instrumento útil para el diagnóstico del prejuicio o predisposición del profesorado hacia la atención del alumnado con DM tipo 1 y, por ende, para predecir el éxito de las medidas psicopedagógicas y los cuidados del niño y adolescente con diabetes. (AU)

Objective: To validate the Inventory of Teachers' Negative Attitudes towards the Care of Students with Diabetes Mellitus type 1 (INAPAD) and to study its reliability using Cronbach's Alpha and McDonald's Omega coefficients. Enfermería GlobalNº 74 Abril 2024Página 195Methods: This study describes the design and validation process of the INAPAD nursing scale in a sample of 382 teachers in the stages of Early Childhood Education, Primary Education, Compulsory Secondary Education, Baccalaureate and Vocational Training in a Spanish province. In order to validate the INAPAD, its reliability has been studied using Cronbach's Alpha and McDonald's Omega Coefficients. Hence, the construct validity has been evaluated through exploratory factor analysis by principal components and varimax rotation. Results and conclusion: The findings obtained inform the viability of the INAPAD to be used as an effective instrument for the diagnosis of prejudice or predisposition of educators towards the care of learners with type 1 DM and for the prediction of the success of psycho-pedagogical measures and of the care for children and adolescents with diabetes. (AU)

La alimentación de los enfermos en los hospitales de la edad moderna, el caso de Vitoria (Álava, España) / A alimentação dos doentes nos hospitais na era moderna, o caso de Vitoria (Álava, Espanha) / Feeding the sick in hospitals in the modern age, the case of Vitoria (Álava, Spain)

El conocimiento sobre alimentación en los hospitales de laedad moderna en España está sustentado en documentaciónde muy pocos centros, mayoritariamente de grandes urbes,siendo necesarias nuevas aportaciones para ampliar la evidenciaexistente. A tal objeto se ha analizado la documentación delhospital Santiago de Vitoria, un hospital y una ciudad másrepresentativos de la mediana peninsular.Se ha hallado un inequívoco enfoque económico de ladocumentación sobre alimentos y la consignación de suadquisición solo recoge gastos extraordinarios, mayoritariamentealimentos destinados a la botica (80% de los asientos). Ladieta basal solo nos es conocida por su descripción teórica,anotándose su gasto por número de raciones o su fracción.Se evidencia una supervisión triple en su preparación yadministración, así como una cuidada prescripción médicade los alimentos en las dietas individualizadas.En conclusión, los gastos no evidencian el consumo efectivo nitampoco representan la dieta real, pues la inmensa mayoría delos alimentos consignados estuvieron destinados a la botica yno a la alimentación de los enfermos. Debe preguntarse si losestudios precedentes, que utilizan también datos de gastos,no han hecho una mala interpretación de estos extrapolandoerróneamente una dieta magnífica cuando, en el caso vitoriano,tuvo una composición de clases populares.

Knowledge of hospital food in modern-age hospitals in Spainis based on documentation from very few centers, mostlyin large cities, and new contributions are needed to expandthe existing evidence. To this end, the documentation of theSantiago de Vitoria hospital has been analysed, a hospital nd a city more representative of the peninsular median.An unequivocal economic focus has been found in thedocumentation on foodstuffs, and the record of their acquisitiononly includes extraordinary expenses, mainly foodstuffsdestined for the apothecary's shop (80% of the entries). Thebasal diet is only known to us by its theoretical description,and its expenditure is recorded by number of portions ortheir fraction. There is evidence of triple supervision in itspreparation and administration, as well as careful medicalprescription of the food in the individualised diets.In conclusion, the expenditures do not show the actualconsumption, nor do they represent the real diet, since thevast majority of the food items recorded were destined for thepharmacy and not for the feeding of the sick. It must be askedwhether previous studies, which also use expenditure data,have not misinterpreted these data by wrongly extrapolatinga magnificent diet when, in the case of Vitoria, it was madeup of the working classes.(AU)

O conhecimento da alimentação hospitalar nos hospitais daIdade Moderna em Espanha baseia-se na documentação deum número muito reduzido de centros, principalmente nasgrandes cidades, e são necessárias novas contribuições paraampliar a evidência existente. Para o efeito, analisámos adocumentação do hospital de Santiago de Vitoria, um hospitale uma cidade mais representativos da mediana peninsular.Na documentação relativa aos géneros alimentícios, encontramosum enfoque económico inequívoco, sendo que o registoda sua aquisição apenas inclui despesas extraordinárias,sobretudo géneros destinados à botica (80% das entradas).A dieta basal só nos é conhecida pela sua descrição teórica,e a sua despesa é registada pelo número de porções oupela sua fração. Há indícios de uma tripla vigilância na suapreparação e administração, bem como de uma cuidadosaprescrição médica dos alimentos nas dietas individualizadas.Em conclusão, as despesas não mostram o consumo real nemrepresentam a dieta real, uma vez que a grande maioria dosalimentos registados se destinava à farmácia e não à alimentaçãodos doentes. É de perguntar se estudos anteriores, que tambémutilizam dados de despesas, não terão interpretado mal estesdados, extrapolando erradamente uma dieta magnífica quando,no caso de Vitória, era constituída pelas classes populares.(AU)

Validez e invariancia de medida de la Escala de Homonegatividad Moderna en alumnado del ámbito de la educación / Validity and measurement invariance of the Modern Homonegativi-ty Scale for students in the field of education

Aquellas investigaciones orientadas a analizar las actitudes hacia la homosexualidad sugieren el uso de instrumentos que detecten los aspectos sutiles en la discriminación hacia hombres gais y mujeres lesbianas. Asimismo, se señala que la invariancia de medida de los constructos es imprescindible para que las comparaciones entre grupos sean válidas. Este trabajo pretende validar la Escala de Homonegatividad Moderna (MHS) en estudiantes universitarios del ámbito de la educación (N = 1.283) con un rango de edad entre los 17 y los 49 años (M = 2.88; DT = 3,02). Del mismo modo, se interesa por examinar la invariancia de medida de la MHS en relación con ciertas variables sociodemográficas y personales (p. ej. identidad de género), así como ideológicas (p. ej. inclinación política). Los resultados aportaron evidencias sobre la unidimensionalidad de la escala y un alto grado de consistencia interna (wMHS-G = .879; wMHS-L = .906), además de unos índices de ajuste (CFIMHS-G = .95, CFIMHS-L = .97; RMSEAMHS-G = .064, 90% IC: .057-.071, RMSEAMHS-L = .059, 90% IC: .052-.066) y unos valores de validez externa (MHS-G y AN-T: r = .753, I.C. 95% = .722-.785; MHS-L y AN-T: r = .76. I.C. 95% = .730-.790) satisfactorios. Asimismo, sugirieron que tanto la subescala hacia hombres gais (MHS-G) como mujeres lesbianas (MHS-L) son constructos invariantes conforme a las variables estudiadas. Las conclusiones apuntan a la validez y la invariancia de medida del modelo propuesto para comparar los niveles de homonegatividad moderna entre los grupos estudiados.(AU)

The research aimed at analysing attitudes towards homosexuality recommends the use of instruments that can detect subtle aspects of dis-crimination against gay men and lesbian women. It also asserts that the measurement invariance of constructs is essential for valid comparisons between groups. The present study aims to validate the Modern Ho-monegativity Scale (MHS) in university students in the fieldof education (N= 1.283) with an age range of 17 to 49 years old (M = 2.88; SD = 3.02). In addition, we seekto examine the measurement invariance of the MHS in relation to certain sociodemographic and personal variables (e.g. gender identity), as well as ideological variables (e.g. political inclination). The re-sults provided evidence of the scale'sunidimensionality and a high degree of internal consistency (MHS-G= .879; MHS-L= .906), as well as satisfac-tory fit indices (CFIMHS-G= .95, CFIMHS-L= .97; RMSEAMHS-G= .064, 90% CI: .057-.071, RMSEAMHS-L= .059, 90% CI: .052-.066) and external validity values (MHS-G and AN-T: r= .753, CI 95% = .722-.785; MHS-L and AN-T: r= .76. CI 95% = .730-.790). They also indicated that both the subscales –towards gay men (MHS-G) and lesbian women (MHS-L) –are invariant constructs according to the variables studied. The findings point to the validity and measurement invariance of the proposed model for comparing levels of modern homonegativity between the groups studied.(AU)

[Maternal and Child Health and Perinatal Mental Health: an area of improvement in Spanish Healthcare]. / Salud materno-infantil y salud mental perinatal: un ámbito de mejora en la sanidad española.

Although the right to enjoy the highest level of mental and physical health that can be achieved is a universal human right, it has not been until very recent stages that mental health has begun to gain the relevance it deserves . Attention to maternal and child health exemplifies the limitations of the Spanish Health Service to offer comprehensive care that includes the dimension of mental health. For years, the main objective has been to combat preventable maternal mortality, practically eradicated in our country thanks to its health benefits . However, the enjoyment of health cannot be limited to achieving the survival of mothers and their babies, and good maternal health necessarily implies good perinatal mental health.

Aunque el derecho al goce del más alto nivel de salud mental y física que se pueda lograr es un derecho humano universal, no ha sido hasta etapas muy recientes que la salud mental ha empezado a cobrar la relevancia que merece . La atención a la salud materno-infantil ejemplifica las limitaciones de la Sanidad española para ofrecer una atención integral que incluya la dimensión de la salud mental. Durante años, el objetivo principal ha sido combatir la mortalidad materna prevenible, prácticamente erradicada en nuestro país gracias a sus prestaciones sanitarias . Sin embargo, el disfrute de la salud no puede limitarse a lograr la supervivencia de las madres y de sus bebés, y una buena salud materna implica, necesariamente, una buena salud mental perinatal.