Metabolic profiling of pea (Pisum sativum) cultivars in changing environments: Implications for nutritional quality in animal feed.

Field pea seeds have long been recognized as valuable feed ingredients for animal diets, due to their high-quality protein and starch digestibility. However, the chemical composition of pea cultivars can vary across different growing locations, consequently impacting their nutrient profiles. This study employs untargeted metabolomics in conjunction with the quantification of fatty acids and amino acids to explore the influence of three different growing locations in Spain (namely Andalusia, Aragon and Asturias), on the nutritional characteristics of seeds of various pea cultivars. Significant interactions between cultivar and environment were observed, with 121 metabolites distinguishing pea profiles. Lipids, lipid-like molecules, phenylpropanoids, polyketides, carbohydrates, and amino acids were the most affected metabolites. Fatty acid profiles varied across locations, with higher C16:0, C18:0, and 18:1 n-9 concentration in Aragón, while C18:2 n-6 predominated in Asturias and C18:3 n-3 in Andalusia. Amino acid content was also location-dependent, with higher levels in Asturias. These findings underscore the impact of environmental factors on pea metabolite profiles and emphasize the importance of selecting pea cultivars based on specific locations and animal requirements. Enhanced collaboration between research and industry is crucial for optimizing pea cultivation for animal feed production.

Biological variation of methylmalonic acid in urine in spanish population.

BACKGROUND-AIM: Methylmalonic acid (MMA) is currently the best biomarker of functional vitamin B12 deficiency. However, for a correct interpretation of the patient's results it is necessary to know its biological variation (BV). No BV data are available for urine MMA values, as measured by mass spectrometry. Hence, the aim of this study was to estimate the within- and between-person coefficients of variation (CVw, CVg) for MMA in a healthy population, and the associated index of individuality (II), as well as to define quality specifications based on BV and the reference change value (RCV). METHODS: Random urine samples from 34 healthy volunteers were collected over four consecutive weeks. Samples were stored at -80 °C until analysis in a single analytical run. MMA excretion was quantified by tandem liquid chromatography coupled to mass spectrometry (HPLC-MS/MS). Results were normalized to urine creatinine. The coefficients of variation were estimated by CV-ANOVA. Confidence intervals (95 %) were calculated. Quality specifications were defined according to international recommendations. RESULTS: A total of 128 samples were included. The coefficients of variation were CVw = 35.7 % (26.1-45.3) and CVg = 67.7 % (58.3-77.0). The associated II was 0.5 and the RCV was 88.1 %. CONCLUSION: Considering the II obtained, MMA in urine has high individuality, therefore, RCV is better to evaluate serial clinical results. Our results will contribute to a better clinical interpretation of this biomarker and will represent a great aid when defining analytical performance specifications for this magnitude.

Beneficios y limitaciones de la planificación centrada en la persona en el campo de la discapacidad intelectual y del desarrollo: una revisión sistemática según las directrices de PRISMA / Benefits and limitations of person-centered planning in the field of intellectual and developmental disabilities: a systematic review according to PRISMA guidelines

La metodología de Planificación Centrada en la Persona (PCP) cada vez tiene mayor impacto en España. Comenzando desde las distintas legislaciones que regulan la atención a este colectivo en las diferentes autonomías y terminando en los centros que proveen este servicio. No obstante, existe escasa literatura internacional de estudios empíricos a grandes escalas que sitúen este enfoque metodológico en una posición relevante que garantice la eficacia de la PCP. El objetivo principal de este estudio es conocer el estado del uso de la metodología de PCP a través de estudios avalados empíricamente que sostengan tanto beneficios como limitaciones durante los últimos 10 años (2012-2022). Para ello, se ha realizado una revisión sistemática desde las directrices de PRISMA (2020), que incluye un total de 31 artículos. Como conclusión, se han descubierto más beneficios que limitaciones entre las que destacan las ventajas en su uso para las personas con discapacidad intelectual y del desarrollo y las mejoras de aspectos relacionados con la autodeterminación. No obstante, las limitaciones prevalecen por la falta de apoyos y recursos adecuados de las organizaciones para responder a una planificación centrada en la persona y la necesidad de formación de las personas implicadas en la elaboración de la PCP, lo que genera la incógnita de si se están realizando buenas prácticas en el uso de dicha metodología. (AU)

The methodology of Person Centered Planning (PCP) is having an increasing impact in Spain. Starting from the different legislations that regulate the attention to this group in the different autonomous regions and ending in the centers that provide this service. However, there is little international literature on large-scale empirical studies that place this methodological approach in a relevant position to guarantee the efficacy of PCP. The main objective of this study is to know the status of the use of PCP methodology through empirically supported studies that sustain both benefits and limitations during the last 10 years (2012-2022). For this purpose, a systematic review has been conducted since the PRISMA guidelines (2020), including a total of 31 articles. As a conclusion, more benefits than limitations have been found, among which the advantages in its use for people with intellectual and developmental disabilities and improvements in aspects related to self-determination stand out. However, limitations prevail due to the lack of adequate support and resources from organizations to respond to person-centered planning and the need for training of the people involved in the development of the PCP, which raises the question of whether good practices are being carried out in the use of this methodology. (AU)

Beneficios y limitaciones de la planificación centrada en la persona en el campo de la discapacidad intelectual y del desarrollo: una revisión sistemática según las directrices de PRISMA / Benefits and limitations of person-centered planning in the field of intellectual and developmental disabilities: a systematic review according to PRISMA guidelines

La metodología de Planificación Centrada en la Persona (PCP) cada vez tiene mayor impacto en España. Comenzando desde las distintas legislaciones que regulan la atención a este colectivo en las diferentes autonomías y terminando en los centros que proveen este servicio. No obstante, existe escasa literatura internacional de estudios empíricos a grandes escalas que sitúen este enfoque metodológico en una posición relevante que garantice la eficacia de la PCP. El objetivo principal de este estudio es conocer el estado del uso de la metodología de PCP a través de estudios avalados empíricamente que sostengan tanto beneficios como limitaciones durante los últimos 10 años (2012-2022). Para ello, se ha realizado una revisión sistemática desde las directrices de PRISMA (2020), que incluye un total de 31 artículos. Como conclusión, se han descubierto más beneficios que limitaciones entre las que destacan las ventajas en su uso para las personas con discapacidad intelectual y del desarrollo y las mejoras de aspectos relacionados con la autodeterminación. No obstante, las limitaciones prevalecen por la falta de apoyos y recursos adecuados de las organizaciones para responder a una planificación centrada en la persona y la necesidad de formación de las personas implicadas en la elaboración de la PCP, lo que genera la incógnita de si se están realizando buenas prácticas en el uso de dicha metodología. (AU)

The methodology of Person Centered Planning (PCP) is having an increasing impact in Spain. Starting from the different legislations that regulate the attention to this group in the different autonomous regions and ending in the centers that provide this service. However, there is little international literature on large-scale empirical studies that place this methodological approach in a relevant position to guarantee the efficacy of PCP. The main objective of this study is to know the status of the use of PCP methodology through empirically supported studies that sustain both benefits and limitations during the last 10 years (2012-2022). For this purpose, a systematic review has been conducted since the PRISMA guidelines (2020), including a total of 31 articles. As a conclusion, more benefits than limitations have been found, among which the advantages in its use for people with intellectual and developmental disabilities and improvements in aspects related to self-determination stand out. However, limitations prevail due to the lack of adequate support and resources from organizations to respond to person-centered planning and the need for training of the people involved in the development of the PCP, which raises the question of whether good practices are being carried out in the use of this methodology. (AU)

Co-introduction into a delicate island ecosystem: metastrongyloid nematodes (superfamily Metastrongyloidea) of veterinary and medical importance circulating in aquatic and terrestrial environments of Tenerife (Canary Islands).

Metastrongyloid nematodes typically reside as adults in the cardiopulmonary systems of their mammalian definitive hosts, potentially causing severe diseases. Of particular concern are Angiostrongylus cantonensis and A. costaricensis, which can cause eosinophilic meningitis and abdominal angiostrongyliasis, respectively, in their accidental human hosts. Several metastrongyloid species of medical and veterinary importance have been documented in the Canary Islands. However, the gastropod species acting as intermediate hosts for some of these nematodes in the archipelago remained unknown. This study aimed to investigate the occurrence of metastrongyloid nematodes in terrestrial and aquatic gastropods, including both endemic and non-native species, on Tenerife. Foot samples from terrestrial and aquatic gastropods were analyzed using a multiplex PCR targeting the Internal Transcribed Spacer 1 (ITS1), allowing the specific detection of A. cantonensis, A. vasorum, Aelurostrongylus abstrusus, Crenosoma striatum, Troglostrongylus brevior, and Crenosoma vulpis. Five metastrongyloid species, namely C. striatum, A. cantonensis, Ae. abstrusus, A. vasorum, and an unidentified metastrongyloid, were identified within both non-native and endemic terrestrial gastropods. In the aquatic snail Physella acuta, only A. cantonensis and C. striatum were detected. This study confirms the introduction of various metastrongyloids associated with non-native mammalian fauna and provides new data on the occurrence of these nematodes in non-native and endemic gastropod species, including their presence in aquatic environments on the Canary Islands.

Nutritional and Culinary Habits to Empower Families (n-CHEF): a feasibility study to increase consumption and home cooking of plant-based foods.

OBJECTIVE: To analyse the feasibility and acceptability of a culinary nutritional intervention aimed at increasing plant-based foods consumption in the context of the Mediterranean diet in parent-child dyads. DESIGN: The Nutritional and Culinary Habits to Empower Families (n-CHEF) is a 9-month feasibility study that included four culinary nutritional workshops (two face to face, two online) led by a chef and a dietitian-nutritionist. These workshops combined cooking with plant-based foods, with nutritional advice and experimental activities. The main outcomes were retention, quality of the intervention (monitoring workshops, acceptability and perceived impact) and changes in dietary and cooking habits. SETTING: Parent-child dyads, Spain. PARTICIPANTS: Parent-child (aged 10-14 years) dyads. RESULTS: Fifteen parent-child dyads were recruited, of which thirteen were retained during the 6-month follow-up. All but one parent-child dyads attended the four workshops. The overall assessment of the workshops was positive, although the online workshops were rated lower than the face to face. In general, parent-child dyads reported benefits in terms of nutrition and cooking aspects. Parents significantly increased their adherence to the Mediterranean diet, but non-significant changes were observed in children. However, children increased their consumption of vegetables and legumes and reduced snacks and ready meals. Parents also changed some of their culinary habits and increased their confidence in cooking at home. CONCLUSIONS: The n-CHEF showed that the culinary nutritional intervention had good levels of recruitment, retention and acceptability among parent-child dyads. In addition, dietary and culinary knowledge and habits can be improved, although further studies are needed to know the long-term effects in larger populations.

[A multifaceted implementation strategy to enhance the uptake of evidence-based nursing recommendations in Spain: implementation project protocol]. / Estrategia de implantación multifacética para promover los cuidados basados en la evidencia: protocolo de investigación en implantación.

OBJECTIVE: It is necessary to facilitate the implementation of evidence-based practice in clinical practice to improve patients' health results. Sumamos Excelencia® is an implementation project led by nurses that aims to improve the evidence-based practice uptake. Building on the first edition, we have improved the project design and proposed new intervention topics. The objective is to evaluate the effects of the implementation of evidence-based recommendations through a multifaceted implementation strategy. METHODS: This study is an implementation research with a quasi-experimental, multicentre, before-and-after design and audits for data collection at baseline, 3, 6, and 12 months. It will be developed in hospital units, primary care centres, and nursing homes. Units choose to implement recommendations of one of these topics: assessment and management of pain, conservative management of urinary incontinence, prevention of childhood obesity, or breastfeeding promotion. All units will implement recommendations about hand hygiene. Audits will assess changes in process and patient outcomes, barriers and strategies, and evidence-based practice competencies through specific questionnaires and clinical records data. Analysis will be descriptive and inferential. CONCLUSIONS: Sumamos Excelencia® will aim to improve the use of evidence-based practice in the Spanish National Health System and to advance implementation science. This study will also provide important insight into the barriers that nurses face to implementing evidence-based practice in clinical practice and the strategies that they can use to overcome them. This generated knowledge can be used in other evidence-based practice implementation projects in a similar context to enhance adherence to evidence-based recommendations.

OBJECTIVE: Es necesario facilitar la implantación de la evidencia científica en la práctica clínica para mejorar los resultados de salud de los pacientes. Sumamos Excelencia® es un proyecto de implantación liderado por enfermeras para aumentar el uso de prácticas basadas en la evidencia en la práctica clínica. En base a la primera edición, se ha mejorado el diseño del proyecto y desarrollado nuevos paquetes de intervención clínica. El objetivo es evaluar los efectos de la implantación de recomendaciones basadas en evidencia en la práctica clínica mediante una estrategia de implantación multifacética. METHODS: Investigación en implantación con diseño cuasi-experimental multicéntrico antes-después sin grupo control, auditorías a los 0, 3, 6 y 12 meses. Realizado en unidades hospitalarias, centros de atención primaria y centros sociosanitarios. Las unidades eligen buenas prácticas sobre una intervención clínica: evaluación y manejo del dolor, manejo conservador de la incontinencia urinaria, prevención de la obesidad infantil o promoción de la lactancia materna. Todas implantarán recomendaciones sobre higiene de manos. Las auditorías evaluarán cambios en procesos y resultados, barreras y estrategias, y competencias de práctica basada en evidencia mediante cuestionarios específicos y registros clínicos. Análisis descriptivo e inferencial. CONCLUSIONS: Sumamos Excelencia® pretende mejorar el uso de la práctica basada en evidencia y aportar conocimiento a la ciencia de la implantación. Proporcionará información sobre las barreras para implantar prácticas basadas en evidencia en la práctica clínica y las estrategias para superarlas. El conocimiento generado puede utilizarse en otros proyectos de implantación para mejorar la adherencia a las recomendaciones basadas en evidencia.

[Outbreak of Raoultella ornithinolytica infection in patients cared at a hemodialysis center]. / Brote de infección por Raoultella ornithinolytica en pacientes atendidos en un centro de hemodiálisis.

OBJECTIVE: In July 2022, an outbreak of Raoultella ornithinolytica infection was detected in users of a hemodialysis center in Granada and central venous catheter (CVC) users. The aim of this study was to describe the development of the outbreak and the control measures implemented as well as to identify the risk factors that may have been related to its origin. METHODS: A study of a series of thirteen cases with positive blood culture for Raoultella ornithinolytica was conducted during July 2022. Two hypotheses were considered: direct transmission through contamination of the antiseptic product or cross-contamination through the hands of healthcare personnel. A descriptive data analysis was carried out, with the calculation of attack rates and attributable risk in the exposed group (CVC users). RESULTS: The center performed dialysis on 117 patients. 36 patients had a CVC, and 81 had an arteriovenous fistula (AVF). The total number of infected cases was 13. The attack rate was 11.1%, being 36.1% in patients with CVC and 0% in patients with AVF. The symptoms occurred between 1 and 3 hours after the start of dialysis, except in three cases that occurred after receiving dialysis in other centers. Samples of water, liquids and antiseptics were negative. CONCLUSIONS: An outbreak of Raoultella ornithinolytica bacteraemia is confirmed, due to possible cross-contamination in the CVC handling and antisepsis process. Possibly, the germ was carried by a container of alcoholic chlorhexidine that contaminated the catheter and caused bacteremia during the hemodialysis process.

OBJETIVO: En julio de 2022 se detectó un brote de infección por Raoultella ornithinolytica en usuarios de un centro de hemodiálisis de Granada y portadores de catéter venoso central (CVC). El objetivo del estudio fue describir el desarrollo del brote y las medidas de control que se implantaron al respecto, así como identificar los factores de riesgo que pudieron estar relacionados con su origen. METODOS: Se realizó un estudio de una serie de trece casos con hemocultivo positivo para Raoultella ornithinolytica durante julio de 2022. Se plantearon dos hipótesis: transmisión directa a través de la contaminación del producto antiséptico o transmisión cruzada a través de las manos del personal sanitario del centro. Se llevó a cabo un análisis descriptivo de los datos y se calcularon tasas de ataque y riesgo atribuible en expuestos (portadores de CVC). RESULTADOS: El centro realizó diálisis a 117 pacientes. 36 enfermos portaban un CVC y 81 tenían una fístula arterio-venosa (FAV). El número total de casos infectados fue de 13. La tasa de ataque fue del 11,1%, siendo del 36,1% en pacientes portadores de CVC y del 0% en pacientes con FAV. La sintomatología se presentó entre 1 a 3 horas tras el inicio de la diálisis, salvo en tres casos que fue posterior a recibir diálisis en otros centros. Las muestras de agua, líquidos y antisépticos fueron negativas. CONCLUSIONES: Se confirma un brote de bacteriemia por Raoultella ornithinolytica debido a posible contaminación cruzada durante la manipulación y antisepsia del CVC. Posiblemente, el germen fue vehiculizado por un envase de clorhexidina alcohólica que contaminó el catéter y provocó la bacteriemia en el proceso de hemodiálisis.

A short version of the Alcohol Consumption Consequences Evaluation Scale (ACCE10).

A brief version of the Alcohol Consumption Consequences Evaluation Scale (ACCE) [38] was developed to promptly detect possible risks related to alcohol consumption, such as Binge Drinking (BD), in university students. Using the "snowball" method, a sample of 595 students aged 18 to 20 (65.4% women) from the University of Valencia (Spain) was obtained during the 2019-2020 academic year. Items with the highest values of the discrimination parameter in the original version (ACCE) were selected and the Rasch model was applied. To verify the usefulness of this version, ROC analyses were conducted separately for men and women using the Audit score as the criterion. In the overall sample, the analysis had an area of 0.812 (SE = 0.018). In men, the area was 0.796 (SE = 0.032) and for women, it was 0.823 (SE = 0.021). In addition, a logistic regression analysis was performed, using a cut-off point of 3 based on the ROC analysis, to assess the utility of this version in classifying BD and non-BD. The odds ratio was 3.812 (p = 0.000), correctly classifying 89.2% of the young people and indicating that the probability of engaging in BD is 3.8 times higher for individuals obtaining more than 3 points on this scale. This result confirms the usefulness of this brief version (ACCE10) as a screening tool for early intervention, especially in clinical or university settings, since it allows young people to be situated within a range of severity according to their consumption patterns. Furthermore, it may help stop the progression of the addictive process, create awareness of the need for change, and facilitate access to the most suitable interventions.

Effectiveness of influenza vaccines in children aged 6 to 59 months: a test-negative case-control study at primary care and hospital level, Spain 2023/24.

During 2023/24, all children aged 6 to 59 months were targeted for seasonal influenza vaccination in Spain nationally. Using a test-negative case-control design with sentinel surveillance data, we estimated adjusted influenza vaccine effectiveness (IVE) against any influenza type to be 70% (95% confidence interval (CI): 51 to 81%) for primary care patients with acute respiratory illness (ARI) and 77% (95% CI: 21 to 93%) for hospitalised patients with severe ARI. In primary care, where most subtyped viruses (61%; 145/237) were A(H1N1), adjusted IVE was 77% (95% CI: 56 to 88%) against A(H1N1)pdm09.

Care-related quality of life of informal caregivers of stroke survivors: Cross-sectional analysis of a randomized clinical trial.

PURPOSE: We aimed to describe the intensity of care and its consequences on informal caregivers of stroke survivors according to the degree of care receivers' functional dependence for activities of daily living; and to identify the factors associated with caregivers' care-related quality of life. METHODS: Cross-sectional analysis of prospective data collected in a cost-utility study alongside the RACECAT trial in Catalonia (Spain). One-hundred and thirty-two care receiver-caregiver pairs were interviewed six months after stroke. Functional dependence for activities of daily living was measured with the Barthel index. We assessed caregivers care-related quality of life with the CarerQoL, which measures seven dimensions of subjective burden (CarerQoL-7D) and a happiness score (CarerQoL-VAS). We evaluated the association between characteristics of informal caregivers, characteristics of care receivers, and intensity of care, and the caregiver's care-related quality of life (subjective burden and happiness) in a hypothesized model using a structural equation model. RESULTS: Of the 132 caregivers, 74,2% were women with an average age of 59.4 ± 12.5 years. The 56.8% of them were spouses. The care intensity ranged from a mean of 24h/week for mild to 40h/week for severe dependence. Most caregivers (76.3%) were satisfied with their task, regardless of dependence, but showed increasing problems in caring for severely dependent persons. Being a woman (coeff. -0.23; 95%CI: -0.40, -0.07), spending more time in care tasks (coeff -0.37; -0.53, -0.21) and care receiver need of constant supervision (coeff 0.31; -0.47, -0.14) were associated with higher burden of care, irrespective of the degree of dependence. Caregiver burden (coeff 0.46; 0.30-0.61) and care receiver anxiety or depression (coeff -0.19; -0.34, -0.03) were associated with lower caregiver happiness. CONCLUSIONS: The findings suggest the importance of developing mainly two types of support interventions for caregivers: respite and psychosocial support. Especially for women with high caring burden and/or caring for persons with high levels of anxiety or depression.

Psychometric properties of the Spanish version of the media health literacy questionnaire (MeHLit-SV).

Introduction: Media health literacy emerges as a response to the vast array of informational disorders prevalent in media communications. Given the absence of a measurement tool for this type of literacy in Spanish-speaking communities, the aim of the present study is to conduct a cross-cultural adaptation of the Media Health Literacy (MeHLit) questionnaire into Spanish and to analyze its psychometric properties in a sample of nursing students. Methods: The Spanish version of the MeHLit questionnaire (MeHLit-SV) was obtained through a process involving translation, back-translation, evaluation of the proposed items by a group of 22 experts, and a pilot study with 80 Spanish nursing students. Content validity was assessed using each item's content validity index (CVI) and Aiken's V (VdA), while internal consistency was evaluated through Cronbach's Alpha. Results: Following the translation and adaptation process, the final version of the MeHLit-SV comprised 21 items organized into five dimensions. The CVI values exceeded 0.82 for all items, and the overall content validity index (S-CVI) was 0.9. Furthermore, the results of Aiken's V surpassed the threshold considered acceptable (0.70). After piloting, the questionnaire demonstrated high internal consistency with a Cronbach's alpha value of 0.936. Conclusion: The findings of this research support the reliability and validity of the MeHLit-SV for use among nursing students to measure their level of media health literacy. This questionnaire, with satisfactory psychometric properties and ease of administration, is an useful tool for assessing whether individuals possess the necessary skills to accurately analyze health information they encounter on a daily basis.

Health impact of the COVID-19 in Spanish non-healthcare workers by gender: Use of sickness absence for surveillance.

INTRODUCTION: At the beginning of the pandemic, the identification of transmission chains was biased towards more closely monitored sectors, such as healthcare and sociosanitary centers. OBJECTIVE: The objective of our research is to describe the impact of the pandemic on the Spanish non-healthcare workers measured through health-related workplace absences. METHODS: A descriptive study of the cases of COVID-19-related temporary disability (TD) between February 15th and September 17th, 2020, was carried out. TD quarantine/infection ratios were calculated for every economic sector of activity. Rates of COVID-19 TDs per 100,000 affiliated workers were obtained, by gender, age, economic activity of the company or occupation of the worker. RESULTS: A total of 1,126,755 TDs were recorded, 45.4% in women. The overall TD rates were 5,465 quarantines and 1,878 illnesses per 100,000 women, and 4,883 quarantines and 1,690 illnesses per 100,000 men. The highest incidence rates of TD due to illness were observed in younger age groups, under 30. The median TD quarantine/infection ratio was 2.6 (Interquartile range [IQR] 1.5-3.9), and Postal and Courier activities had the highest value: 4.7 quarantines per case (IQR: 3.75-6.12). The TD rates were higher in female workers in most sectors of activity and occupations compared to men in the same sectors and with the same occupations. The results show the uneven impact of COVID-19 by occupation, with a higher rates in less qualified occupations (unskilled workers and laborers) versus the first categories of the table (directors, managers, technicians, and professionals). CONCLUSIONS: The results confirmed the high impact of COVID-19 on Spanish non-healthcare workers and it's inequalities. They also confirmed the potential use of TDs as an alternative source for epidemiological, public health surveillance and early warning of new emerging infections.

Leishmania infantum infection in European badgers (Meles meles) from northeastern Spain: a histopathological and immunohistochemical investigation.

The European badger (Meles meles) is a common mustelid species known as a significant reservoir for various human and animal diseases. Studies investigating Leishmania infection in European badgers across Mediterranean regions have yielded inconsistent findings. In Spain, results are particularly controversial: some studies confirm the presence of Leishmania in badgers, while others do not. Our study aimed to conduct a retrospective histopathological and immunohistochemical analysis to detect Leishmania in tissues of nine European badgers from northeastern Spain, a region previously unevaluated for Leishmania infection in this species. Microscopic examination revealed lesions indicative of leishmaniosis in the lymph nodes and spleens of six badgers. In one of them, Leishmania-like structures were identified in multiple organs and confirmed via immunohistochemistry. Parasites were detected in the lymph nodes, spleen, adrenal glands, and pancreas. The parasite load was high in the adrenal glands, moderate in the lymph nodes and spleen, and low in the pancreas. No parasites were found in other examined organs. This finding represents a frequency of 11.11% (1/9) of Leishmania infection among the badgers we studied. Further investigation of wildlife and atypical reservoirs can enhance our understanding of the pathogenesis of this significant zoonotic disease.

Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers.

BACKGROUND: Immigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services. METHODS: An exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach. RESULTS: Language barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles. CONCLUSION: This study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.

Efficacy of Bismuth Therapy in Eradicating Helicobacter pylori in Children-Data From the RENIHp Registry.

OBJECTIVES: To evaluate the efficacy of colloidal bismuth subcitrate (CBS) therapy for the eradication of H. pylori in patients from a national pediatric registry of H. pylori infection. METHODS: The Spanish Registry of Children with H. pylori Infection (RENIHp) is a national, multi-center, prospective, non-interventional registry that includes children aged 5-18 years with H. pylori infection diagnosed by endoscopy. All patients in the registry who were treated with CBS between the period 2020 and 2023 were included in this study. The primary outcome was the eradication rate, which was assessed using a 13C-urea breath test or monoclonal antigen in the stool 6-8 weeks post-treatment. RESULTS: The registry included 682 patients, 38 (5.6%) of whom underwent treatment with CBS. Fifty percent (19/38) of patients had previously undergone unsuccessful eradication treatment. In 78.9% (30/38) of patients, treatment was guided by an antibiotic sensitivity test. In the remaining patients, an empirical approach was employed. The CBS therapies used were as follows: quadruple therapy with proton pump inhibitors (PPIs), CBS, amoxicillin, and metronidazole (MET) [18/38 (47.3%)]; quadruple therapy with PPIs, CBS, tetracycline, and MET [13/38 (34.2%)]; and other therapies [7/38 (18.4%)]. Thirty-two patients (84.2%) treated with CBS were followed-up with eradication monitoring. The overall eradication rate in patients treated with CBS was 93.8% (30/32, [95% CI: 85.4%-100%]), whereas it was 86.7% in patients in the registry who were not on CBS treatment (430/496, [95% CI: 83.3%-89.5%], p = 0.208). In the six patients with dual resistance to clarithromycin (CLA) and MET who were treated with quadruple therapy with CBS, the eradication rate was 100% (n = 6/6, [95% CI: 61.0%-100%]). CONCLUSION: CBS therapies in our registry, although only used in selected cases and at lower than recommended levels, were very effective and showed an eradication rate of > 90%.

Telomere length and 4-year changes in cognitive function in an older Mediterranean population at high risk of cardiovascular disease.

BACKGROUND: Cognitive decline, a common process of brain ageing, has been associated with telomere length (TL). Delving into the identification of reliable biomarkers of brain ageing is essential to prevent accelerated cognitive impairment. METHODS: We selected 317 non-smoking 'Prevención con Dieta Mediterránea-Plus' (PREDIMED-Plus) participants (mean age, 65.8 ± 5.0 years) with metabolic syndrome from two trial centres who were following a lifestyle intervention. We measured TL and cognitive function at baseline and after 3 and 4 years of follow-up, respectively. Associations between baseline or 3-year changes in TL and baseline or 4-year changes in cognitive function were analysed using multivariable regression models. RESULTS: Baseline TL was not associated with baseline cognitive performance. Nevertheless, longer baseline TL was associated with improved 4-year changes in the Executive Function domain (ß: 0.29; 95%CI: 0.12 to 0.44; P < 0.001) and the Global Cognitive Function domain (ß: 0.19; 95%CI: 0.05 to 0.34; P = 0.010). Besides, a positive association was found between longer baseline TL and improved 4-year changes in the animal version of the Verbal Fluency Test (ß: 0.33; 95%CI: 0.12 to 0.52; P = 0.002). By contrast, 3-year changes in TL were not associated with changes in cognitive function after 4 years. CONCLUSIONS: Longer baseline TL could protect from cognitive decline and be used as a useful biomarker of brain ageing function in an older Mediterranean population at risk of cardiovascular disease and cognitive impairment.

The care of non-institutionalized ADL-dependent people in the Orcasitas neighborhood of Madrid (Spain) during the Covid-19 pandemic and its relationship with social inequalities, intergenerational dependency and survival.

Background: Mortality among people with dependency to perform basic activities of daily living (ADL) is higher than that of non-dependent people of the same age. Understanding the evolutionary course and factors involved in non-institutionalized ADL dependency, including the influence of the family structure that supports this population, would contribute to improved health planning. Methods: A longitudinal study carried out in the ADL-dependent population of the Orcasitas neighborhood, Madrid (Spain), between June 2020, when the nationwide COVID-19 lockdown ended, and June 2023. A total of 127 patients participated in the study, 78.7% of whom were women and 21.3% were men. Risk analysis was performed via odds ratios (OR) and hazard ratios (HR). Survival analysis was performed using Cox regression. Results: A total of 54.33% of the ADL-dependent persons did not live with their adult children and 45.67% did, being associated living independently with economic capacity and the married marital status but not with the dependency level. In women, being married increased the probability of living independently of their adult children (OR = 12.632; 95% CI = 3.312-48.178). Loss of mobility (OR = 0.398; 95% CI = 0.186-0.853), economic capacity of the dependent (HR = 0.596; 95% CI = 0.459-0.774), and living independently and having better economic capacity (HR = 0.471; 95% CI = 0.234-0.935) were associated with 3-year survival. Those who lived with their adult children had a worse autonomy profile and higher mortality (HR = 1.473; 95% CI = 1.072-2.024). Not being employed, not being married, and not owning a home were significantly associated with being an essential family caregiver. Caregivers were mostly women (OR = 1.794; 95% CI = 1.011-3.182). Conclusion: Among ADL-dependent persons, economic capacity influenced the ability to living independently and affected survival after 3 years. Loss of mobility (wheelchair use) was a predictor of mortality. Social inequalities promote that adult children end up as essential family caregivers. This generates reverse dependency and maintains a vulnerability that is transmitted from generation to generation, perpetuating social and gender inequalities. Dependent parent care in this cohort maintained an archaic pattern in which the eldest daughter cared for her parents. This study made it possible to show that ADL dependence is accompanied by complex interrelationships that must be considered in socio-health planning.

Prevalence of chronic postsurgical hypoparathyroidism not adequately controlled: an analysis of a nationwide cohort of 337 patients.

Purpose: The identification of patients with chronic hypoparathyroidism who are adequately (AC) or not adequately controlled (NAC) has clinical interest, since poor disease control is related to complications and mortality. We aimed to assess the prevalence of NAC patients in a cohort of subjects with postsurgical hypoparathyroidism. Methods: We performed a multicenter, retrospective, cohort study including patients from 16 Spanish hospitals with chronic hypoparathyroidism lasting ≥3 years. We analyzed disease control including biochemical profile and clinical wellness. For biochemical assessment we considered three criteria: criterion 1, normal serum calcium, phosphorus and calcium x phosphorus product; criterion 2, the above plus estimated glomerular filtration rate ≥60 ml/min/1.73 m2; and criterion 3, the above plus normal 24-hour urinary calcium excretion. A patient was considered AC if he or she met the biochemical criteria and was clinically well. Results: We included 337 patients with postsurgical hypoparathyroidism (84.3% women, median age 45[36-56] years, median time of follow-up 8.9[6.0-13.0] years). The proportions of NAC patients with criteria 1, 2 and 3 were, respectively, 45.9%, 49.2% and 63.1%. Patients who had dyslipidemia at the time of diagnosis presented a significantly higher risk of NAC disease (criterion 3; OR 7.05[1.44-34.45]; P=0.016). NAC patients (criterion 2) had a higher proportion of subjects with incident chronic kidney disease and eye disorders, and NAC patients (criterion 3) had a higher proportion of incident chronic kidney disease, nephrolithiasis and dyslipidemia than AC patients. Conclusion: The present study shows a strikingly high prevalence of NAC patients in the clinical practice of Spanish endocrinologists. Results suggest that NAC disease might be associated with some prevalent and incident comorbidities.