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1.
An. psicol ; 37(2): 189-201, mayo-sept. 2021. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-202543

RESUMO

El objetivo principal de este trabajo fue revisar el estado de la investigación psicopatológica del duelo complicado en población adulta de España. Una búsqueda sistemática en PsycINFO, PsycArticles, PTSDpubs y PSICODOC identificó 13 estudios en los que, en conjunto, se había evaluado a 1,655 adultos. Los resultados de esta revisión ponen de manifiesto que no existe consenso en el diagnóstico de duelo complicado, en el uso de instrumentos de detección ni en los factores de riesgo y protección del duelo complicado. La prevalencia media ponderada basada en 6 de los estudios revisados fue de 21,53%. Tomando en consideración el tipo de instrumento de medida del duelo utilizado, se obtuvo una prevalencia de 7,67-10,68% en aquellos estudios que utilizaban instrumentos diagnósticos y de 28,77% en los instrumentos sintomáticos. Los resultados indican que el duelo complicado se relaciona con: un menor nivel socioeconómico y situación laboral desfavorable, la pérdida de un hijo o cónyuge, menor edad del fallecido, vulnerabilidad psicológica previa, consumo de psicofármacos y comorbilidad con otros trastornos. El apoyo social, los cuidados paliativos, las estrategias de afrontamiento centradas en el problema, el empleo de actividades agradables y la trascendencia o espiritualidad se presentan como factores protectores


The main objective of this research was to review the status of the psychopathological research of complicated grief in adult population of Spain, specifically the prevalence and risk factors. A systematic review of PsycINFO, PsycArticles, PTSDpubs, and PSICODOC databases identified 12 studies in which, overall, 1.627 adults had been evaluated. The results of this review show that there is no consensus about the diagnosis of complicated grief, the use of detection instruments, or the risk and protective factors for complicated grief. The weighted mean prevalence based on 6 of the reviewed studies was 21.53%. Taking into account the type of grief measurement used, a prevalence of 7.67 - 10.68% was obtained in those studies that used diagnostic instruments, and 28.77% in those using symptomatic instruments. The results indicate that complicated grief is related to: a lower socioeconomic level and unfavorable work situation, the loss of a child or spouse, younger age of the deceased, previous psychological vulnerability, the use of psychotropic medication, and comorbidity with other disorders. Social support, palliative care, problem-centered coping strategies, the use of pleasant activities, and transcendence or spirituality are shown as protective factors


Assuntos
Humanos , Adulto , Pesar , Fatores de Proteção , Transtornos de Adaptação/epidemiologia , Transtornos de Adaptação/diagnóstico , Fatores de Risco , Prevalência , Transtornos de Adaptação/psicologia , Fatores de Tempo , Espanha/epidemiologia
2.
Rev Esp Salud Publica ; 952021 Jul 02.
Artigo em Espanhol | MEDLINE | ID: mdl-34212940

RESUMO

OBJECTIVE: The preventive measures to be taken in the face of a new epidemic require knowledge of the number of infected and which groups are most vulnerable. To know the cumulative incidence of COVID-19 in the city of Madrid and its 21 districts in the first 4 months of the epidemic and its relationship with some socioeconomic and demographic variables. METHODS: Cross-sectional ecological study (39,270 cases). The 39,270 cases diagnosed from the beginning of the pandemic until June 26, 2020, published by the Comunidad de Madrid in were studied. In the districts, the distribution of gross and fair incidence is related to the ones of the independent variables (Municipal Statistics and Estudio de Salud 2018, Madrid Salud). The Incidence and the r and r2 coefficients, obtained with the factors and the Multiple Linear Regression (MLR) model, are studied. RESULTS: The city of Madrid presents a cumulative incidence of COVID-19, which is double the national one (100), with a Standardized Cumulative Incidence Ratio (RIAE) of 204.59 per 100. The districts with the most RIAE were those in the southeast, all>240 per 100. In the districts, the per capita household rate, the per capita income, and the mortality rate from infectious diseases in men reached high and inverse correlations with RIAE (all r>-0.3). The RLM model with these 3 indicators predicts 30% of the RIAES. CONCLUSIONS: The relationship between material wealth and the risk of COVID-19 infection is inverse. The knowledge in the districts of per capita income, household rate and mortality rate due to infectious diseases in men reduces the uncertainty about the accumulated incidence by 30%.


Assuntos
COVID-19/epidemiologia , Disparidades nos Níveis de Saúde , Pandemias , Idoso , Idoso de 80 Anos ou mais , Cidades/epidemiologia , Estudos Transversais , Demografia , Feminino , Humanos , Incidência , Masculino , Fatores Socioeconômicos , Espanha/epidemiologia
3.
Rev Esp Salud Publica ; 952021 Jul 05.
Artigo em Espanhol | MEDLINE | ID: mdl-34219127

RESUMO

OBJECTIVE: Deescalation began in May 2020 increases social interaction, which has an influence on COVID-19 epidemiological surveillance. The aim of this study was the characterization of COVID-19 cases detected during this period. METHODS: We analyzed certain variables of interest coming from the epidemiological surveys carried out in an area of Madrid during May 2020, and stratified the results depending on its temporal relation with the deescalation. Prevalence for each category of response and average duration in minutes of the telephonic call were calculated. Confidence intervals were estimated at 95%. RESULTS: We included 167 cases, being 30.5% of them incident and 49.1% prevalent. The main source of infection was home (38.0%; CI 95% 31.4-46.2). Regarding healthcare and social care workers, the main source of infection was workplace (93.0%; 85.4-100). Average number of close contacts per case was 2.0 (1.8-2.2), being 1.5 (1.0-2.0) among pre-deescalation incident cases and 2.4 (1.8-3.0) among those post-deescalation. Average duration of each survey was 35.9 minutes (32.2-38.9), being 32.1 (24.4-39.8) among pre-deescalation incident cases and 37.0 (29.6-44.4) among those post-deescalation. Most of the contacts were household, both before and after beginning of deescalation. CONCLUSIONS: Home is the most prevalent place for the acquisition of the infection among general population, while workplace is the most prevalent among healthcare and social care workers. The initial phase of deescalation do not represents a change regarding sources of infection, but it may increase the number of close contacts.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante , Adolescente , Adulto , Idoso , COVID-19/transmissão , Criança , Pré-Escolar , Cidades/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Adulto Jovem
4.
Sci Rep ; 11(1): 13678, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34211001

RESUMO

During the unfolding of a crisis, it is crucial to forecast its severity at an early stage , yet access to reliable data is often challenging early on. The wisdom of crowds has been effective at forecasting in similar scenarios. We investigated whether the initial regional social media reaction to the emerging COVID-19 pandemic in three critically affected countries has significant relations with their observed mortality a month later. We obtained COVID-19 related regionally geolocated tweets from Italian, Spanish, and United States regions. We quantified the predictive power of the wisdom of the crowds using correlations and regressions of geolocated Tweet Intensity (TI) during the initial social media attention peak versus the cumulative number of deaths a month ahead. We found that the intensity of initial COVID-19 related tweet attention at the beginning of the pandemic across Italian, Spanish, and United States regions is significantly related (p < 0.001) to the extent to which these regions had been affected by the pandemic a month later. This association is most striking in Italy as when at its peak of TI in late February 2020 only two of its regions had reported mortality. The collective wisdom of the crowds at early stages of the pandemic, when information on the number of infections was not broadly available, strikingly predicted the extent of mortality reflecting the regional severity of the pandemic almost a month later. Our findings could underpin the creation of real-time novelty detection systems aimed at early reporting of the severity of crises impacting a territory leading to early activation of control measures at a stage when available data is extremely limited.


Assuntos
COVID-19/epidemiologia , Mídias Sociais , Previsões , Humanos , Itália/epidemiologia , Pandemias , Saúde Pública , SARS-CoV-2/isolamento & purificação , Espanha/epidemiologia , Estados Unidos/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34204286

RESUMO

BACKGROUND: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the countries of southern Europe such as Spain. This article sets out to take a more in-depth look at the experiences of midwives who were on the frontline of care during the early months of the COVID-19 pandemic as well as to identify new needs and resilience strategies that can help midwives. METHODS: A qualitative methodology of phenomenological tradition was used, interviewing 10 midwives from primary care, hospital and independent care. RESULTS: After content analysis, three central categories emerged: (a) cascade of emotions; (b) professional occupation and concern for the women; (c) resisting the day-to-day; resilience and resistance strategies. CONCLUSIONS: Despite the difficulties, midwives are concerned about the loss of rights and autonomy and about the increased vulnerability of women. Midwives have become aware of the power they have in their actions both in health management and administration, as well as in the care of women, creating strategies to provide dignified care to their users.


Assuntos
COVID-19 , Tocologia , Atenção à Saúde , Europa (Continente) , Feminino , Humanos , Pandemias , Gravidez , Pesquisa Qualitativa , SARS-CoV-2 , Espanha/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34204383

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in December 2019 and still is a major global health challenge. Lockdown measures and social distancing sparked a global shift towards online learning, which deeply impacted universities' daily life, and the University of Barcelona (UB) was not an exception. Accordingly, we aimed to determine the impact of the SARS-CoV-2 pandemic at the UB. To that end, we performed a cross-sectional study on a sample of 2784 UB members (n = 52,529). Participants answered a brief, ad hoc, online epidemiological questionnaire and provided a nasal swab for reverse transcription polymerase chain reaction (RT-PCR) SARS-CoV-2 analysis and a venous blood sample for SARS-CoV-2 IgG antibody assay. Total prevalence of SARS-CoV-2 infection (positive RT-PCR or positive IgG) was 14.9% (95%CI 13.3 to 17.0%). Forty-four participants (1.6%, 95%CI: 1.2-2.1%) were positive for SARS-CoV-2 RT-PCR. IgG against SARS-CoV-2 was observed in 12.8% (95%CI: 11.6-14.1%) of participants. Overall, while waiting for population vaccination and/or increased herd immunity, we should concentrate on identifying and isolating new cases and their contacts.


Assuntos
COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Prevalência , SARS-CoV-2 , Espanha/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34205348

RESUMO

It is essential to understand the impact of social inequalities on the risk of COVID-19 infection in order to mitigate the social consequences of the pandemic. With this aim, the objective of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. We conducted a retrospective cohort study and included data from all individuals tested for COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals) in Aragón (Spain). We studied the effect of inequalities on the risk of having a COVID-19 confirmed diagnosis after being tested using multilevel analyses with two levels of aggregation: individuals and basic healthcare area of residence (deprivation level and type of zone). Inequalities in the risk of COVID-19 confirmed infection were observed at both the individual and area level. There was a predominance of low-paid employees living in deprived areas. Workers with low salaries, unemployed and people on minimum integration income or who no longer receive the unemployment allowance, had a higher probability of COVID-19 infection than workers with salaries ≥ €18,000 per year. Inequalities were greater in women and in the second wave. The deprivation level of areas of residence influenced the risk of COVID-19 infection, especially in the second wave. It is necessary to develop individual and area coordinated measures by areas in the control, diagnosis and treatment of the epidemic, in order to avoid an increase in the already existing inequalities.


Assuntos
COVID-19 , Feminino , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Fatores Socioeconômicos , Espanha/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34206849

RESUMO

Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.


Assuntos
COVID-19 , Gestantes , Ansiedade/epidemiologia , Estudos Transversais , Depressão , Feminino , Humanos , Análise Multinível , Pandemias , Parto , Gravidez , SARS-CoV-2 , Espanha/epidemiologia , Estresse Psicológico
9.
Artigo em Inglês | MEDLINE | ID: mdl-34208274

RESUMO

BACKGROUND: To assess gender differences in the prevalence of self-reported mental disorders, psychological distress and psychotropic drug consumption, and to identify sociodemographic and health-related variables associated with these conditions in the male and female population (aged ≥ 18 years). METHODS: A cross-sectional study was carried on 22,141 subjects aged 18 and over, using data from the Spanish National Health Interview Survey 2017. RESULTS: We found an overall prevalence of mental disorders, psychological distress and psychotropic drug consumption of 13.8%, 18.3% and 13.9%, respectively. After multivariable adjustment, women showed significantly increased probabilities of 1.74-fold for mental disorders, 1.26-fold for psychological distress and 1.26-fold for psychotropic drug consumption compared to men. Variables such as gender, age, nationality, marital status, educational level, self-rated health, the presence of different chronic disorders, alcohol consumption and smoking habit were independently associated with mental disorders, psychological distress and psychotropic drug consumption. Several variables showed a differential effect on mental health status and psychotropic drug consumption according to gender. CONCLUSIONS: Women suffer from mental disorders, experience psychological distress and consume psychotropic drugs significantly more than men in Spain. Possible explanations for these results may be related to differences in emotional processing, willingness to report diseases and even intrinsic biological traits. Screening for mental health status and psychotropic drug consumption should be considered, particularly in Spanish women, younger adults and individuals who are not married, are obese, have poor self-rated health, suffer from chronic diseases or have a smoking habit.


Assuntos
Saúde Mental , Angústia Psicológica , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Psicotrópicos , Caracteres Sexuais , Espanha/epidemiologia , Estresse Psicológico/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34209328

RESUMO

BACKGROUND: The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. OBJECTIVE: To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. METHODOLOGY: Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. RESULTS: Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. CONCLUSION: Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.


Assuntos
COVID-19 , Busca de Comunicante , Análise Custo-Benefício , Humanos , SARS-CoV-2 , Espanha/epidemiologia
11.
Int J Mol Sci ; 22(11)2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34199930

RESUMO

Endometriosis is a common gynecological disorder that has been associated with endometrial, breast and epithelial ovarian cancers in epidemiological studies. Since complex diseases are a result of multiple environmental and genetic factors, we hypothesized that the biological mechanism underlying their comorbidity might be explained, at least in part, by shared genetics. To assess their potential genetic relationship, we performed a two-sample mendelian randomization (2SMR) analysis on results from public genome-wide association studies (GWAS). This analysis confirmed previously reported genetic pleiotropy between endometriosis and endometrial cancer. We present robust evidence supporting a causal genetic association between endometriosis and ovarian cancer, particularly with the clear cell and endometrioid subtypes. Our study also identified genetic variants that could explain those associations, opening the door to further functional experiments. Overall, this work demonstrates the value of genomic analyses to support epidemiological data, and to identify targets of relevance in multiple disorders.


Assuntos
Neoplasias do Endométrio/epidemiologia , Endometriose/epidemiologia , Endométrio/patologia , Predisposição Genética para Doença , Neoplasias Hormônio-Dependentes/epidemiologia , Neoplasias Ovarianas/epidemiologia , Polimorfismo de Nucleotídeo Único , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/patologia , Endometriose/genética , Endometriose/patologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Neoplasias Hormônio-Dependentes/genética , Neoplasias Hormônio-Dependentes/patologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Fatores de Risco , Espanha/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-34281004

RESUMO

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.


Assuntos
COVID-19 , Pandemias , Idoso , Controle de Doenças Transmissíveis , Comportamentos Relacionados com a Saúde , Humanos , Masculino , SARS-CoV-2 , Espanha/epidemiologia
13.
Front Public Health ; 9: 693956, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34291033

RESUMO

Monitoring transmission is a prerequisite for containing COVID-19. We report on effective potential growth (EPG) as a novel measure for the early identification of local outbreaks based on primary care electronic medical records (EMR) and PCR-confirmed cases. Secondly, we studied whether increasing EPG precedes local hospital and intensive care (ICU) admissions and mortality. Population-based cohort including all Catalan citizens' PCR tests, hospitalization, intensive care (ICU) and mortality between 1/07/2020 and 13/09/2020; linked EMR covering 88.6% of the Catalan population was obtained. Nursing home residents were excluded. COVID-19 counts were ascertained based on EMR and PCRs separately. Weekly empirical propagation (ρ7) and 14-day cumulative incidence (A14) and 95% confidence intervals were estimated at care management area (CMA) level, and combined as EPG = ρ7 × A14. Overall, 7,607,201 and 6,798,994 people in 43 CMAs were included for PCR and EMR measures, respectively. A14, ρ7, and EPG increased in numerous CMAs during summer 2020. EMR identified 2.70-fold more cases than PCRs, with similar trends, a median (interquartile range) 2 (1) days earlier, and better precision. Upticks in EPG preceded increases in local hospital admissions, ICU occupancy, and mortality. Increasing EPG identified localized outbreaks in Catalonia, and preceded local hospital and ICU admissions and subsequent mortality. EMRs provided similar estimates to PCR, but some days earlier and with better precision. EPG is a useful tool for the monitoring of community transmission and for the early identification of COVID-19 local outbreaks.


Assuntos
COVID-19 , Surtos de Doenças , Registros Eletrônicos de Saúde , Humanos , Atenção Primária à Saúde , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2 , Espanha/epidemiologia
14.
J Int Med Res ; 49(7): 3000605211029058, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34251275

RESUMO

OBJECTIVE: We aimed to assess the relationship between major air pollutants and the natural history and mortality of idiopathic pulmonary fibrosis (IPF). METHODS: We conducted a retrospective cohort study from 2013 to 2019 among 52 patients with IPF from the pneumology department of a tertiary hospital. According to their geocoded residential address, each patient was assigned a mean concentration of carbon monoxide (CO), nitrogen dioxide, particulate matter 2.5 and 10, ozone, and sulfur dioxide, as measured at a single surveillance station in central Madrid, Spain. We analyzed forced vital capacity (FVC), CO diffusing capacity, 6-minute walking test, degree of dyspnea, radiologic pattern, and signs of pulmonary hypertension in all patients. RESULTS: Patients' mean age was 66 ± 10 years, and 79% were men. The mean predicted FVC was 78.9 ± 0.5%. Forty-two patients met the criteria for severe disease, and 18 patients died. Mortality was significantly associated with increased CO exposure (for each 0.1 mg/m2 increase: odds ratio 2.45, 95% confidence interval 1.39-4.56). We observed no association between any of the other investigated contaminants and IPF mortality or severity. CONCLUSIONS: Air pollution, specifically that caused by carbon monoxide, can increase mortality in patients with IPF.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Fibrose Pulmonar Idiopática , Idoso , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Humanos , Masculino , Pessoa de Meia-Idade , Material Particulado/efeitos adversos , Material Particulado/análise , Estudos Retrospectivos , Espanha/epidemiologia
16.
Prev Med ; 150: 106718, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34242667

RESUMO

Lifestyle impacts morbidity and mortality worldwide. Herein, we evaluated the association of a multidimensional lifestyle measure and its domains (diet/nutrition, substance use, physical activity, social, stress management, sleep, environmental exposure) with risky drinking. Also, we analyzed the cumulative effect of unhealthy domains in the likelihood of presenting risky drinking. To reach these objectives, data from a web survey conducted in Brazil and Spain was analyzed. The main outcome was risky drinking assessed by the AUDIT-C. Lifestyle was measured using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). Fixed logistic models were used to evaluate associations between lifestyle and risky drinking. Between April and May 2020, 22,785 individuals answered the survey. The prevalence of risky drinking was 45.6% in Brazil and 30.8% in Spain. The SMILE score was lower (unhealthier lifestyle) among at-risk drinkers. Worse scores on Diet, Substance use, Stress management and Environment were associated with an increased likelihood of risky drinking. The higher the number of unhealthy domains, the higher the likelihood of presenting risky drinking: adjusted odds ratio (aOR) for risky drinking was 1.15 (IC95% 0.98-1.35) and 23.42 (IC95% 3.08-178.02) for those presenting worse lifestyle in 1 and 5 domains, respectively. Finally, interactions suggest that improvement in lifestyle domains would have a larger effect in Spain than in Brazil. Our results suggest that future interventions aiming at reducing Risky drinking may benefit from strategies targeting multiple domains of lifestyle.


Assuntos
COVID-19 , Pandemias , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Humanos , Estilo de Vida , Assunção de Riscos , SARS-CoV-2 , Espanha/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-34200056

RESUMO

BACKGROUND: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. METHODS: A case-controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. RESULTS: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. CONCLUSIONS: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.


Assuntos
Diabetes Mellitus , Transtornos Mentais , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental , Prevalência , Espanha/epidemiologia , Estresse Psicológico/epidemiologia
18.
BMJ Open ; 11(7): e048818, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244275

RESUMO

INTRODUCTION: Studies which focus on the process of acculturation in the lifestyles, nutritional status and health of immigrants from the Community of Portuguese-Speaking Countries (CPLP) in the Iberian Peninsula are still scarce. This study aims to explore the influence of the acculturation process and dietary acculturation on the lifestyle and nutritional and health status of CPLP immigrants in Portugal and Spain, focusing on two Iberian contexts: Lisbon Metropolitan Area and the Basque Country. METHODS AND ANALYSIS: A mixed methods sequential explanatory design, combining cross-sectional studies and semistructured interviews. Official data will also be analysed. Primary data will be collected through a questionnaire and assessment of nutritional status and body composition. The estimated samples sizes are 1061 adults (≥18 years old) in the Lisbon Metropolitan Area and 573 in the Basque Country. Time-location sampling will be used for the quantitative component and non-probabilistic sampling for the qualitative component. If safety conditions are not guaranteed due to the COVID-19 pandemic, online studies will be conducted. The semistructured interviews will complement the questionnaire data and extend knowledge about the process of acculturation of CPLP immigrants and their relationship with eating habits and physical activity. Thematic analysis will be used for qualitative data. Triangulation of data derived from different methods will be carried out. An integrative approach will be used to address potential discrepancies in findings and limitations inherent to the study design. As inter-method discrepancies may occur, triangulation protocol will be used, elaborating a 'convergence coding matrix' to display findings emerging from each component of the study. ETHICS AND DISSEMINATION: Ethical approval was obtained through the IHMT Ethics Council (Doc No 20/2020), Portugal, and it was submitted to the Ethics Committee of the UPV/EHU (Doc No under revision), Spain.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Aculturação , Adolescente , Adulto , Estudos Transversais , Humanos , Estilo de Vida , Pandemias , Portugal/epidemiologia , SARS-CoV-2 , Espanha/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-34199702

RESUMO

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229-6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551-5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332-3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.


Assuntos
Delitos Sexuais , Estudantes de Enfermagem , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Espanha/epidemiologia , Universidades
20.
BMJ Open ; 11(7): e051278, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215614

RESUMO

INTRODUCTION: Cough is a common symptom of COVID-19 and other respiratory illnesses. However, objectively measuring its frequency and evolution is hindered by the lack of reliable and scalable monitoring systems. This can be overcome by newly developed artificial intelligence models that exploit the portability of smartphones. In the context of the ongoing COVID-19 pandemic, cough detection for respiratory disease syndromic surveillance represents a simple means for early outbreak detection and disease surveillance. In this protocol, we evaluate the ability of population-based digital cough surveillance to predict the incidence of respiratory diseases at population level in Navarra, Spain, while assessing individual determinants of uptake of these platforms. METHODS AND ANALYSIS: Participants in the Cendea de Cizur, Zizur Mayor or attending the local University of Navarra (Pamplona) will be invited to monitor their night-time cough using the smartphone app Hyfe Cough Tracker. Detected coughs will be aggregated in time and space. Incidence of COVID-19 and other diagnosed respiratory diseases within the participants cohort, and the study area and population will be collected from local health facilities and used to carry out an autoregressive moving average analysis on those independent time series. In a mixed-methods design, we will explore barriers and facilitators of continuous digital cough monitoring by evaluating participation patterns and sociodemographic characteristics. Participants will fill an acceptability questionnaire and a subgroup will participate in focus group discussions. ETHICS AND DISSEMINATION: Ethics approval was obtained from the ethics committee of the Centre Hospitalier de l'Université de Montréal, Canada and the Medical Research Ethics Committee of Navarre, Spain. Preliminary findings will be shared with civil and health authorities and reported to individual participants. Results will be submitted for publication in peer-reviewed scientific journals and international conferences. TRIAL REGISTRATION NUMBER: NCT04762693.


Assuntos
COVID-19 , Pandemias , Acústica , Inteligência Artificial , Canadá , Surtos de Doenças , Humanos , Estudos Observacionais como Assunto , SARS-CoV-2 , Espanha/epidemiologia
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