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Gajardo G, Córdoba A, Forero A, Fuentealba D, Ramírez O, Bonardd S, Toro-Labbé A, Leiva A, Díaz DD, Saldías C. Photoswitching/back-switching assessment of biobased cellulose acetate/azobenzene handleable films under visible-light LED irradiation. Int J Biol Macromol 2023:124883. [PMID: 37201890 DOI: 10.1016/j.ijbiomac.2023.124883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
The light-induced processes performed by photofunctional polymer films are crucial aspects of developing integrated energy storage devices properly. Herein, we report the preparation, characterization, and study of the optical properties of a series of biobased cellulose acetate/azobenzene (CA/Az1) handleable films at different compositions. The photoswitching/back-switching behavior of the samples was investigated using varied LED irradiation sources. Additionally, poly(ethylene glycol) (PEG) was deposited onto cellulose acetate/azobenzene films to study the back-switching process's effect and nature in the fabricated films. Interestingly, the melting enthalpies of PEG before and after being irradiated with blue LED light were 2.5 mJ and 0.8 mJ, respectively. Conveniently, FTIR and UV-visible spectroscopy, thermogravimetry (TGA), contact angle, differential scanning calorimetry (DSC), polarized light microscopy (PLM), and atomic force microscopy (AFM) were used for the characterization of the sample films. Complementarily, theoretical electronic calculations provided a consistent approach to the energetic change in the dihedral angles and non-covalent interaction for the trans and cis isomer in the presence of cellulose acetate monomer. The results of this study revealed that CA/Az1 films are viable photoactive materials displaying handleability attributes with potential uses in harvesting, converting, and storing light energy.
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Affiliation(s)
- G Gajardo
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - A Córdoba
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - A Forero
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - D Fuentealba
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - O Ramírez
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile; Instituto Universitario de Bio-Organica Antonio Gonzalez, Universidad de La Laguna, Avda. Astrofísico Francisco Sanchez 2, 38206 La Laguna, Tenerife, Spain; Departamento de Química Organica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - S Bonardd
- Instituto Universitario de Bio-Organica Antonio Gonzalez, Universidad de La Laguna, Avda. Astrofísico Francisco Sanchez 2, 38206 La Laguna, Tenerife, Spain; Departamento de Química Organica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - A Toro-Labbé
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - A Leiva
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - D Díaz Díaz
- Instituto Universitario de Bio-Organica Antonio Gonzalez, Universidad de La Laguna, Avda. Astrofísico Francisco Sanchez 2, 38206 La Laguna, Tenerife, Spain; Departamento de Química Organica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile; Institut für Organische Chemie, Universitat Regensburg, Universitatsstr. 31, 93053 Regensburg, Germany.
| | - C Saldías
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile.
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Moliner-Calderón E, Verd S, Leiva A, Ginovart G, Moll-McCarthy P, Figueras-Aloy J. The role of human milk feeds on inotrope use in newborn infants with sepsis. Front Pediatr 2023; 11:1172799. [PMID: 37138570 PMCID: PMC10150957 DOI: 10.3389/fped.2023.1172799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 05/05/2023] Open
Abstract
Background Regarding neonatal hypotension, there is no certainty as to whether inotrope properties are beneficial or whether they may be harmful. However, given that the antioxidant content of human milk plays a compensatory role in neonatal sepsis and that human milk feeding has direct effects in modulating the cardiovascular function of sick neonates, this research hypothesized that human milk feeds might predict lower requirements of vasopressors in the management of neonatal septic shock. Method Between January 2002 and December 2017, all late preterm and full-term infants attending a neonatal intensive care unit, with clinical and laboratory findings of bacterial or viral sepsis, were identified in a retrospective study. During their first month of life, data on feeding type and early clinical characteristics were collected. A multivariable logistic regression model was constructed to determine the impact of human milk on the use of vasoactive drugs in septic newborns. Results 322 newborn infants were eligible to participate in this analysis. Exclusively formula-fed infants were more likely to be delivered via C-section, to have a lower birth weight and a lower 1-minute Apgar score than their counterparts. Human milk-fed newborns had 77% (adjusted OR = 0.231; 95% CI: 0.07-0.75) lower odds of receiving vasopressors than exclusively formula-fed newborns. Conclusion We report that any human milk feeding is associated with a decrease in the need for vasoactive medications in sepsis-affected newborns. This observation encourages us to undertake further research to determine whether human milk feeds mitigate the use of vasopressors in neonates with sepsis.
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Affiliation(s)
| | - Sergio Verd
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, Palma de Mallorca, Spain
- Group of Cell Therapy and Tissue Engineering, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain
- Correspondence: Sergio Verd
| | - Alfonso Leiva
- Research Unit, Department of Primary Care, Palma de Mallorca, Spain
| | - Gemma Ginovart
- Neonatal Unit, Department of Paediatrics, Germans Trias I Pujol Hospital, Badalona, Spain
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Galmes-Panades AM, Angullo E, Mira-Martínez S, Bennasar-Veny M, Zamanillo-Campos R, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol-deRoque MA, Miralles J, Yañez AM, Romaguera D, Vidal-Thomas MC, Llobera-Canaves J, García-Toro M, Vicens C, Gervilla-García E, Oña JI, Malih N, Leiva A, Bulilete O, Montaño JJ, Gili M, Roca M, Ricci-Cabello I. Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial. Int J Environ Res Public Health 2022; 19:14706. [PMID: 36429423 PMCID: PMC9690330 DOI: 10.3390/ijerph192214706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.
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Affiliation(s)
- Aina M. Galmes-Panades
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Escarlata Angullo
- Escola Graduada Primary Health Care Center, Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07120 Palma de Mallorca, Spain
| | - Sofía Mira-Martínez
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Rocío Gómez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Rafael Jiménez
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Maria Antonia Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Jerónima Miralles
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Aina M. Yañez
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Maria Clara Vidal-Thomas
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Joan Llobera-Canaves
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Catalina Vicens
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Son Serra-La Vileta Primary Health Care Center, Balearic Health Service, 07013 Palma, Spain
| | - Elena Gervilla-García
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - José Iván Oña
- Dra. Teresa Piqué Primary Health Care Center, Balearic Health Service, 07003 Palma, Spain
| | - Narges Malih
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Oana Bulilete
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Juan José Montaño
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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Reus X, Sastre ML, Leiva A, Sánchez B, García-Serra C, Ioakeim-Skoufa I, Vicens C. LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care. Int J Environ Res Public Health 2022; 19:13241. [PMID: 36293832 PMCID: PMC9603607 DOI: 10.3390/ijerph192013241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Potentially inappropriate medication (PIM) increases adverse drug reactions and mortality, especially in excessively polymedicated patients. General practitioners are often in charge of this process. Some tools have been created to support them in this matter. This study aimed to measure the amount of potentially inappropriate medication among excessively polymedicated patients using several supporting tools and assess the feasibility of these tools in primary care. Several explicit deprescribing criteria were used to identify potentially inappropriate medications. The level of agreement between all the criteria and the acceptance by the general practitioner (GP) was also measured. We analysed whether the drugs proposed for deprescribing were eventually withdrawn after twelve months. The total number of drugs prescribed was 2038. Six hundred and forty-nine drugs (31.8%) were considered potentially inappropriate by at least one of the tools. GPs agreed with the tools in 56.7% of the cases. In a 12-month period, 109 drugs, representing 29.6% of the drugs that GPs agreed to deprescribe, were withdrawn. Elderly excessively polymedicated patients accumulated a great number of PIMs. The use of deprescribing supporting tools, such as explicit criteria, is feasible in primary care, and these tools are well accepted by the GPs. However, eventual withdrawal was carried out in less than half of the cases.
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Affiliation(s)
- Xisco Reus
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
| | - Maria Lluisa Sastre
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
| | - Alfonso Leiva
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
- Balearic Health Service IbSalut, Reseach Unit Primary Care Mallorca, 07013 Palma, Spain
| | - Belén Sánchez
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
| | - Cristina García-Serra
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
| | - Ignatios Ioakeim-Skoufa
- Department of Drug Statistics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, 0213 Oslo, Norway
- Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), 08009 Barcelona, Spain
- EpiChron Research Group, IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
| | - Caterina Vicens
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
- Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), 08009 Barcelona, Spain
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Moliner-Calderón E, Verd S, Leiva A, Ponce-Taylor J, Ginovart G, Moll-McCarthy P, Gelabert C, Figueras-Aloy J. Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy. Children (Basel) 2022; 9:children9101450. [PMID: 36291386 PMCID: PMC9600066 DOI: 10.3390/children9101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
Background. It has been well established that human milk feeding contributes to limiting lung diseases in vulnerable neonates. The primary aim of this study was to compare the need for mechanical ventilation between human milk-fed neonates with sepsis and formula-fed neonates with sepsis. Methods. All late preterm and full-term infants from a single center with sepsis findings from 2002 to 2017 were identified. Data on infant feeding during hospital admission were also recorded. Multivariate logistic regression analyses were performed to assess the impact of feeding type on ventilation support and main neonatal morbidities. Results. The total number of participants was 322 (human milk group = 260; exclusive formula group = 62). In the bivariate analysis, 72% of human milk-fed neonates did not require oxygen therapy or respiratory support versus 55% of their formula-fed counterparts (p < 0.0001). Accordingly, invasive mechanical ventilation was required in 9.2% of any human milk-fed infants versus 32% of their exclusively formula-fed counterparts (p = 0.0085). These results held true in multivariate analysis; indeed, any human milk-fed neonates were more likely to require less respiratory support (OR = 0.44; 95% CI:0.22, 0.89) than those who were exclusively formula-fed. Conclusion. Human milk feeding may minimize exposure to mechanical ventilation.
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Affiliation(s)
- Elisenda Moliner-Calderón
- Neonatal Unit, Department of Paediatrics, Santa Creu i Sant Pau Hospital, 90 Mas Casanovas Street, 08041 Barcelona, Spain
| | - Sergio Verd
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos Street, 07013 Palma de Mallorca, Spain
- Balearic Islands Health Research Institute (IdISBa), 79 Valldemossa Road, 07120 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-600-505-246; Fax: +34-(9)-71-799534
| | - Alfonso Leiva
- Research Unit, Department of Primary Care, Escola Graduada Street, 07002 Palma de Mallorca, Spain
| | - Jaume Ponce-Taylor
- A & E Unit, Department of Primary Care, Illes Balears Street, 07014 Palma de Mallorca, Spain
| | - Gemma Ginovart
- Neonatal Unit, Department of Paediatrics, Germans Trias i Pujol Hospital, Canyet Road, 08916 Badalona, Spain
| | - Pia Moll-McCarthy
- A & E Division, Manacor Hospital, Alcudia Road, 07500 Manacor, Spain
| | - Catian Gelabert
- Department of Paediatrics, Son Espases Hospital, 79 Valldemossa Road, 07120 Palma de Mallorca, Spain
| | - Josep Figueras-Aloy
- Neonatal Unit, ICGON, Clinic Hospital, Sabino Arana Street, 08028 Barcelona, Spain
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Esteva M, Leiva A, Ramos-Monserrat M, Espí A, González-Luján L, Macià F, Murta-Nascimento C, Sánchez-Calavera MA, Magallón R, Balboa-Barreiro V, Seoane-Pillado T, Pertega-Díaz S. Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer. BMC Cancer 2022; 22:910. [PMID: 35996104 PMCID: PMC9394014 DOI: 10.1186/s12885-022-09990-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department. METHODS This multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor. RESULTS A total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant. CONCLUSIONS Our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes.
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Affiliation(s)
- Magdalena Esteva
- Department of Primary Care, Primary Care Research Unit, Majorca, Baleares Health Service [IbSalut]. Escola Graduada 3, 07001, Palma, Spain. .,Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, Edificio S, Carretera de Valldemossa, 79, 07120, Palma, Majorca, Spain. .,Preventive Activities and Health Promotion Research Network (REDIAPP), Barcelona, Spain.
| | - Alfonso Leiva
- Department of Primary Care, Primary Care Research Unit, Majorca, Baleares Health Service [IbSalut]. Escola Graduada 3, 07001, Palma, Spain.,Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, Edificio S, Carretera de Valldemossa, 79, 07120, Palma, Majorca, Spain.,Preventive Activities and Health Promotion Research Network (REDIAPP), Barcelona, Spain.,Research Network On Chronicity, Primary Care, and Health Promotion (RICAPPS) , Madrid, Spain.,University of the Balearic Islands (UIB), Carretera de Valldemossa, km 7.5, 07122, Palma, Spain
| | - María Ramos-Monserrat
- Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, Edificio S, Carretera de Valldemossa, 79, 07120, Palma, Majorca, Spain.,Preventive Activities and Health Promotion Research Network (REDIAPP), Barcelona, Spain.,Research Network On Chronicity, Primary Care, and Health Promotion (RICAPPS) , Madrid, Spain.,Balearic Islands Public Health Department, C/ Jesus 38A, 07010, Palma, Spain
| | - Alejandro Espí
- Department of Surgery, University of Valencia, Avenida Blasco Ibáñez 15, 46010, Valencia, Spain
| | - Luis González-Luján
- Serrería II Primary Care Centre, Valencia Institute of Health, Pedro de Valencia 26, 46022, Valencia, Spain
| | - Francesc Macià
- Epidemiology and Evaluation Unit, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | | | - María A Sánchez-Calavera
- Department of Medicine, University of Zaragoza, Building A, 50009, Saragossa, Spain.,Las Fuentes Norte Health Center, Calle Dr. Iranzo 69, 50002, Saragossa, Spain
| | - Rosa Magallón
- University of the Balearic Islands (UIB), Carretera de Valldemossa, km 7.5, 07122, Palma, Spain.,Department of Medicine, University of Zaragoza, Building A, 50009, Saragossa, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain.,Centro de Salud Arrabal, Andador Aragüés del Puerto, 3, 50015, Saragossa, Spain
| | - Vanesa Balboa-Barreiro
- Nursing and Healthcare Research Group, Rheumatology and Health Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. Universidade da Coruña (UDC), As Xubias, 15006. A, Coruña, Spain
| | - Teresa Seoane-Pillado
- Nursing and Healthcare Research Group, Rheumatology and Health Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. Universidade da Coruña (UDC), As Xubias, 15006. A, Coruña, Spain
| | - Sonia Pertega-Díaz
- Nursing and Healthcare Research Group, Rheumatology and Health Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. Universidade da Coruña (UDC), As Xubias, 15006. A, Coruña, Spain
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7
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Contreras-Duarte S, Cantin C, Carvajal L, Escalona R, Gonzalez Mancilla P, Zapata D, Gutierrez J, Leiva A. Small extracellular vesicles from pregnant women with maternal supraphysiological hypercholesterolemia impair the function of endothelial cells. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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8
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Torres-Quesada M, Leiva A, Lupiáñez J, Humphreys G, Funes MJ. A process-specific approach in the study of normal aging deficits in cognitive control: What deteriorates with age? Acta Psychol (Amst) 2022; 227:103625. [PMID: 35644074 DOI: 10.1016/j.actpsy.2022.103625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 04/27/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
Bearing in mind that cognitive control is a complex function that includes several processes, it is not clear exactly which ones deteriorate with age. In fact, controversial results have been found. For example, some studies indicate that age-related deficits are observed in proactive and not in reactive control, others show that it is reactive control that is impaired and not proactive control, and some studies find no deficits at all (e.g., Kopp, Lange, Howe, & Wessel, 2014; Xiang et al., 2016). One possible reason is that the contribution of different processes to the deterioration of cognitive control was investigated separately, i.e., without testing all processes within the same paradigm. Therefore, the main goal of the present experiment was to study the impact of normal aging on several processes related to cognitive control within the same task, which included both Simon and Spatial Stroop trials. The study focused on the following processes: generation of conflict measured by automatic response capture (i.e., stronger task-irrelevant information processing compared to task-relevant information processing); conflict detection; and control implementation (which can be reactive control, both within trials and across trials, and proactive control, as a task-set strategy). The results showed larger automatic response capture for older adults when facing a stimulus-response conflict (Simon) but not a stimulus-stimulus conflict (Spatial Stroop). Similarly, older adults also showed larger detection effects for both conflicts. However, regarding control implementation, they only showed difficulties in inhibiting the early automatic response capture (within-trial reactive control) but not reactive control across trials or proactive control. In conclusion, it seems that older adults are more affected by the presence of task-irrelevant information, especially when it comes to resolving stimulus-response conflict. However, they showed no impairments in their ability to implement cognitive control both across trials and as a task-set strategy.
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Affiliation(s)
- M Torres-Quesada
- Mind, Brain and Behaviour Research Center and Department of Experimental Psychology, University of Granada, Campus Universitario de Cartuja, 18011 Granada, Spain.
| | - A Leiva
- Faculty of Education, Translation, Sports and Psychology, University of Vic- Central University of Catalonia, Campus de Miramarges, Carrer de La Sagrada Familia, 7, 08500 Vic, Catalonia, Spain
| | - J Lupiáñez
- Mind, Brain and Behaviour Research Center and Department of Experimental Psychology, University of Granada, Campus Universitario de Cartuja, 18011 Granada, Spain
| | | | - M J Funes
- Mind, Brain and Behaviour Research Center and Department of Experimental Psychology, University of Granada, Campus Universitario de Cartuja, 18011 Granada, Spain
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9
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Galmes-Panades AM, Abbate M, Bennasar-Veny M, López-González AA, Vicente-Herrero MT, Busquets-Cortés C, Leiva A, Yañez AM. Occupational and Leisure Physical Activity on Cardiovascular Risk and Body Composition Among Courier Workers. Biol Res Nurs 2022; 24:560-572. [PMID: 35613699 DOI: 10.1177/10998004221105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is some controversy about the beneficial effects of occupational physical activity (OPA) on cardiovascular risk (CVR). The main aim of this study was to explore the effect of the combination of different frequencies of leisure-time physical activity (LTPA) and two types of OPA on CVR and body composition, and whether the association between physical activity (PA) and CVR was mediated by visceral adipose tissue (VAT). METHODS This cross-sectional study included data from 2516 couriers living in Spain, delivering either by motorbike or foot, and practicing LTPA never, occasionally, or regularly. Couriers were classified into six categories according to LTPA and OPA; body composition was assessed by Bioelectrical Impedance, and CVR by the Framingham equation. General linear models were performed to explore the association between different categories with each outcome (CVR and body composition) and the possible role of VAT as a mediator between PA and CVR. RESULTS Compared with the most sedentary group (motorbike couriers that never practice PA), walking couriers who practice regular PA presented the lowest CVR [β -1.58 (95% CI -2.31; -0.85)] and the lowest VAT [β -2.86 (95% CI -3.74; -1.98) followed by the motorbike couriers who practiced regular PA [β -0.51 (95% CI -1.00; -0.03) for CVR and β -2.33 (95% CI -2.91; -1.75) for VAT]. The association between PA and CVR was partially mediated by VAT. CONCLUSION The present results indicated that both OPA and LTPA are protective factors for CVR and play an important role on VAT accumulation.
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Affiliation(s)
- Aina Maria Galmes-Panades
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain
| | - Manuela Abbate
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain
| | - Miquel Bennasar-Veny
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain.,Nursing and Physiotherapy Department, 16745Universitat de les Illes Balears, Palma, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), 117368Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Angel Arturo López-González
- Prevention of Occupational Risks in Health Services, 88144Balearic Islands Health Service, Palma, Spain.,Escuela Universitaria ADEMA, Palma, Illes Balears, Spain.,Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), 16745Universitat de les Illes Balears, Palma, Spain
| | | | - Carla Busquets-Cortés
- Escuela Universitaria ADEMA, Palma, Illes Balears, Spain.,Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), 16745Universitat de les Illes Balears, Palma, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, 88144Balearic Islands Health Services (IbSalut), Palma, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Palma, Spain
| | - Aina María Yañez
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain.,Nursing and Physiotherapy Department, 16745Universitat de les Illes Balears, Palma, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Palma, Spain
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10
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Vicens C, Leiva A, Bejarano F, Sempere-Verdú E, Rodríguez-Rincón RM, Fiol F, Mengual M, Ajenjo-Navarro A, Do Pazo F, Mateu C, Folch S, Alegret S, Coll JM, Martín-Rabadán M, Socias I. Evaluation of a multicomponent intervention consisting of education and feedback to reduce benzodiazepine prescriptions by general practitioners: The BENZORED hybrid type 1 cluster randomized controlled trial. PLoS Med 2022; 19:e1003983. [PMID: 35522626 PMCID: PMC9075619 DOI: 10.1371/journal.pmed.1003983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Current benzodiazepine (BZD) prescription guidelines recommend short-term use to minimize the risk of dependence, cognitive impairment, and falls and fractures. However, many clinicians overprescribe BZDs and chronic use by patients is common. There is limited evidence on the effectiveness of interventions delivered by general practitioners (GPs) on reducing prescriptions and long-term use of BZDs. We aimed to evaluate the effectiveness of a multicomponent intervention for GPs that seeks to reduce BZD prescriptions and the prevalence of long-term users. METHODS AND FINDINGS We conducted a multicenter two-arm, cluster randomized controlled trial in 3 health districts in Spain (primary health centers [PHCs] in Balearic Islands, Catalonia, and Valencian Community) from September 2016 to May 2018. The 81 PHCs were randomly allocated to the intervention group (n = 41; 372 GPs) or the control group (n = 40; 377 GPs). GPs were not blinded to the allocation; however, pharmacists, researchers, and trial statisticians were blinded to the allocation arm. The intervention consisted of a workshop about the appropriate prescribing of BZDs and tapering-off long-term BZD use using a tailored stepped dose reduction with monthly BZD prescription feedback and access to a support web page. The primary outcome, based on 700 GPs (351 in the control group and 349 in the intervention group), compared changes in BZD prescriptions in defined daily doses (DDDs) per 1,000 inhabitants per day after 12 months. The 2 secondary outcomes were the proportion of long-term users (≥6 months) and the proportion of long-term users over age 65 years. Intention-to-treat (ITT) analysis was used to assess all clinical outcomes. Forty-nine GPs (21 intervention group and 28 control group) were lost to follow-up. However, all GPs were included in the ITT analysis. After 12 months, there were a statistically significant decline in total BZD prescription in the intervention group compared to the control group (mean difference: -3.24 DDDs per 1,000 inhabitants per day, 95% confidence interval (CI): -4.96, -1.53, p < 0.001). The intervention group also had a smaller number of long-term users. The adjusted absolute difference overall was -0.36 (95% CI: -0.55, -0.16, p > 0.001), and the adjusted absolute difference in long-term users over age 65 years was -0.87 (95% CI: -1.44, -0.30, p = 0.003). A key limitation of this clustered design clinical trial is the imbalance of some baseline characteristics. The control groups have a higher rate of baseline BZD prescription, and more GPs in the intervention group were women, GPs with a doctorate degree, and trainers of GP residents. CONCLUSIONS A multicomponent intervention that targeted GPs and included educational meeting, feedback about BZD prescriptions, and a support web page led to a statistically significant reduction of BZD prescriptions and fewer long-term users. Although the effect size was small, the high prevalence of BZD use in the general population suggests that large-scale implementation of this intervention could have positive effects on the health of many patients. TRIAL REGISTRATION ISRCTN ISRCTN28272199.
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Affiliation(s)
- Caterina Vicens
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, Palma, Illes Balears, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS)-Balearic Islands Health Research Institute (IdISBa), Mallorca, Spain
| | - Alfonso Leiva
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS)-Balearic Islands Health Research Institute (IdISBa), Mallorca, Spain
- Balearic Health Service IbSalut, Reseach Unit Primary care Mallorca, Palma, Illes Balears, Spain
- * E-mail:
| | - Ferran Bejarano
- Catalan Institute of Health Cat-salut, DAP Camp de Tarragona, Tarragona, Catalunya, Spain
| | - Ermengol Sempere-Verdú
- Conselleria de Sanitat Universal i Salut Pública, Paterna Healthcare Centre, Valencia, Comunitat Valenciana, Spain
| | - Raquel María Rodríguez-Rincón
- Balearic Health Service IbSalut Hospital Universitari Son Espases, Pharmacy Department,Palma de Mallorca, Illes Balears, Spain
| | - Francisca Fiol
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, Palma, Illes Balears, Spain
| | - Marta Mengual
- Catalan Institute of Health Cat-salut, DAP Camp de Tarragona, Tarragona, Catalunya, Spain
| | - Asunción Ajenjo-Navarro
- Conselleria de Sanitat Universal i Salut Pública, Paterna Healthcare Centre, Valencia, Comunitat Valenciana, Spain
| | - Fernando Do Pazo
- Balearic Health Service IbSalut Hospital Universitari Son Espases, Pharmacy Department,Palma de Mallorca, Illes Balears, Spain
| | - Catalina Mateu
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, Palma, Illes Balears, Spain
| | - Silvia Folch
- Catalan Institute of Health Cat-salut, DAP Camp de Tarragona, Tarragona, Catalunya, Spain
| | - Santiago Alegret
- Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, Palma, Illes Balears, Spain
| | - Jose Maria Coll
- Balearic Health Service IbSalut, Menorca Primary Care Management, Maó, Illes Baleares, Spain
| | - María Martín-Rabadán
- Balearic Health Service IbSalut, Can Misses Healthcare Centre Ibiza, Illes Baleares, Spain
| | - Isabel Socias
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS)-Balearic Islands Health Research Institute (IdISBa), Mallorca, Spain
- Balearic Health Service IbSalut, Manacor Healthcare Centre, Manacor, Illes Baleares, Spain
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11
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Chela-Alvarez X, Leiva A, Gallardo-Alfaro L, Bulilete O, Vidal-Thomas MC, Llobera J. Anxiety, Depression, and Concern About Employment Status of Hotel Housekeepers in the Balearic Islands During the COVID-19 Pandemic: A Longitudinal Study. Front Psychol 2022; 13:842335. [PMID: 35478734 PMCID: PMC9037287 DOI: 10.3389/fpsyg.2022.842335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Tourism is a crucial economic sector in the Balearic Islands (Spain). COVID-19 pandemic might severely impact hotel housekeepers (HHs) due to their already precarious employment situation. The purpose is to assess the evolution of the concern about employment status, anxiety, and depression of HHs. This is a longitudinal study conducted with a subset of participants from a primary care, health promotion intervention study. Two additional visits were added (March–April and October–December 2020) for the purpose of this study. We recruited 290 HHs in March–April 2020; 237 were again interviewed during October–December 2020. In the first visit, high level of concern about employment was associated with age under 50, temporary contracts and external locus of control (LOC). Moderate–severe anxiety was associated with low social support and external LOC; moderate–severe depression was associated with low social support. Regarding the second visit, age, years working as HH, type of contract, social support, and LOC were not associated with concern about employment status, anxiety, and depression. There was a larger proportion of HHs with moderate–severe anxiety and depression among HHs with high degree of concern. Concern increased significantly among HHs: over 50 years of age; with more than 15 years in the job, a recurring seasonal contract and normal social support. After adjusting by age, type of contract, LOC, and social support, we found a statistically significant increase (12.0%) of HHs highly concerned about their job situation: compared to the first visit, HHs were 2.3 more likely to have a high degree of concern in December 2020. In contrast, increases in moderate–severe anxiety (0.3%) and depression (4.3%) between the two periods were not significant. In HHs, the COVID-19 pandemic has caused significant concern about employment status and symptoms of depression and anxiety. In the uncertain times of the pandemic, mental wellbeing benefits from variables that confer stability, such as internal LOC, perception of social support, and a stable job. Longitudinal results point at long lasting effects of the COVID-19 pandemic on mental health. It is crucial to allocate additional resources in primary care to adequately address the anticipated influx of needs.
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Affiliation(s)
- Xenia Chela-Alvarez
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,RICAPPS- Red de Investigación Cooperativa de Atención Primaria y Promoción de la Salud - Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,RICAPPS- Red de Investigación Cooperativa de Atención Primaria y Promoción de la Salud - Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Laura Gallardo-Alfaro
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Oana Bulilete
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,RICAPPS- Red de Investigación Cooperativa de Atención Primaria y Promoción de la Salud - Carlos III Health Institute (ISCIII), Madrid, Spain
| | - MClara Vidal-Thomas
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,RICAPPS- Red de Investigación Cooperativa de Atención Primaria y Promoción de la Salud - Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain.,GrAPP-caIB - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,RICAPPS- Red de Investigación Cooperativa de Atención Primaria y Promoción de la Salud - Carlos III Health Institute (ISCIII), Madrid, Spain
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12
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Mendez-López M, Ramos-Hernández A, Moreno-Serna V, Bonardd S, Ramírez O, Silva H, Inostroza-Rivera R, Diaz DD, Leiva A, Saldías C. A facile approach for tuning optical and surface properties of novel biobased Alginate/POTE handleable films via solvent vapor exposure. Int J Biol Macromol 2021; 193:258-268. [PMID: 34655589 DOI: 10.1016/j.ijbiomac.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/20/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
Novel biobased films consisting of alginate blends with poly (octanoic acid 2-thiophen-3-yl-ethyl ester) (POTE), a conducting polymer, were prepared by solution casting, and their optical, morphological, thermal, and surface properties were studied. Using UV-visible spectroscopy, atomic force microscopy (AFM), and scanning electron microscopy (SEM), the effects of tetrahydrofuran solvent vapors on the optical properties and surface morphology of biobased films with different POTE contents were studied. Results indicate that morphological rearrangements of POTE take place during the process of solvent exposure. Specifically, the solvent vapor induced the formation of POTE small crystalline domains, which allows envisioning the potential of tuning UV-visible absorbance and wettability behavior of biobased films. Finally, theoretical electronic calculations (specifically frontier molecular orbitals analysis) provided consistent evidence on POTE's preferential orientation and selectivity toward the THF-vapor medium.
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Affiliation(s)
- M Mendez-López
- Departamento de Química y Biología, Universidad el Norte, km 5 vía Pto Colombia, P. O. Box 1569-51820, Barranquilla, Atlántico, Colombia
| | - A Ramos-Hernández
- Grupo de investigación Química Supramolecular Aplicada, Programa de Química, Facultad de Ciencias Básicas, Universidad del Atlántico, Cra 30# 8-49 Pto Colombia, Atlántico, Colombia
| | - V Moreno-Serna
- Universidad de Santiago de Chile (USACH), Facultad de Química y Biología, Departamento de Ciencias del Ambiente, Grupo de Polímeros, Chile
| | - S Bonardd
- Departamento de Química Orgánica, Universidad de La Laguna, Avda. Astrofísico Francisco Sánchez S/N, 38206 La Laguna, Tenerife, Spain; Instituto Universitario de Bio-Orgánica Antonio González, Universidad de La Laguna, Avda. Astrofísico Francisco Sánchez 2, 38206 La Laguna, Tenerife, Spain
| | - O Ramírez
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - Hernán Silva
- Departamento de Estadística, Facultad de Matemáticas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ricardo Inostroza-Rivera
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - D Diaz Diaz
- Departamento de Química Orgánica, Universidad de La Laguna, Avda. Astrofísico Francisco Sánchez S/N, 38206 La Laguna, Tenerife, Spain; Instituto Universitario de Bio-Orgánica Antonio González, Universidad de La Laguna, Avda. Astrofísico Francisco Sánchez 2, 38206 La Laguna, Tenerife, Spain; Institut für Organische Chemie, Universität Regensburg, Universitätsstr. 31, 93053 Regensburg, Germany
| | - A Leiva
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile
| | - C Saldías
- Departamento de Química Física, Facultad de Química y Farmacia, Pontificia Universidad Católica de Chile, Macul, 7820436 Santiago, Chile.
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13
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Zabaleta-Del-Olmo E, Casajuana-Closas M, López-Jiménez T, Pombo H, Pons-Vigués M, Pujol-Ribera E, Cabezas-Peña C, Llobera J, Martí-Lluch R, Vicens C, Motrico E, Gómez-Gómez I, Maderuelo-Fernández JÁ, Recio-Rodriguez JI, Masluk B, Contreras-Martos S, Jacques-Aviñó C, Aznar-Lou I, Gil-Girbau M, Clavería A, Magallón-Botaya R, Bellón JÁ, Ramos R, Sanchez-Perez A, Moreno-Peral P, Leiva A, González-Formoso C, Bolíbar B. Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial. BMC Public Health 2021; 21:2208. [PMID: 34863136 PMCID: PMC8642878 DOI: 10.1186/s12889-021-11982-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45-75 years compared to usual care; and b) an implementation strategy. METHODS A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. RESULTS 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. CONCLUSIONS Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 . Registered 2 May 2017, "retrospectively registered".
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Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, Balmes 22, 08007, Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Marc Casajuana-Closas
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
| | - Haizea Pombo
- Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation-Biocruces Bizkaia Health Research Institute Innovation Unit, Plaza de Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
- Deputy Directorate of Healthcare Assistance, Osakidetza-Servicio Vasco de Salud, C/ Araba 45, 01006, Vitoria, Araba, Spain
| | - Mariona Pons-Vigués
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Àrea Assistencial. Servei Català de la Salut (CatSalut), Travessera de les Corts 131-159, Edifici Olímpia, 08228, Barcelona, Spain
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Carmen Cabezas-Peña
- Department of Health, Deputy Directorate of Health Promotion, Public Health Agency, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005, Barcelona, Spain
| | - Joan Llobera
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Ruth Martí-Lluch
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
- Unitat de suport a la recerca de Girona. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Carrer Maluquer Salvador 11, 17002, Girona, Spain
- Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí Julià - Edifici M2, Carrer del Dr. Castany, s/n, 17190, Salt, Spain
| | - Caterina Vicens
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
- Centro de Salud Son Serra-La Vileta (Ibsalut), Masanella 22, 07013, Palma, Balearic Islands, Spain
- Facultat de Medicina. Universitat de les Illes Balears, Carretera de Valldemossa, km 7.5, 07122, Palma, Balearic Islands, Spain
| | - Emma Motrico
- Universidad Loyola Andalucía, Avda. de las Universidades, s/n, 41704, Dos Hermanas, Sevilla, Spain
| | - Irene Gómez-Gómez
- Universidad Loyola Andalucía, Avda. de las Universidades, s/n, 41704, Dos Hermanas, Sevilla, Spain
| | - José-Ángel Maderuelo-Fernández
- Institute of Biomedical Research of Salamanca (IBSAL), Edificio Virgen de la Vega, 10.a planta. Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Avda. Portugal 83, 37005, Salamanca, Spain
- Health Service of Castilla y León (SACyL), C/ Arapiles, 25 - 33, 37007, Salamanca, Spain
| | - José I Recio-Rodriguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Avda. Portugal 83, 37005, Salamanca, Spain
- Departamento de Enfermería y Fisioterapia, Universidad de Salamanca, Calle Donantes de Sangre, s/n, 37007, Salamanca, Spain
| | - Barbara Masluk
- Departamento de Psicología y Sociología, Universidad de Zaragoza, C/Pedro Cerbuna 12, 50009, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria (GAIAP), Instituto de Investigación Sanitaria, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain
| | - Sara Contreras-Martos
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Ignacio Aznar-Lou
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, C\ Doctor Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain
| | - Montserrat Gil-Girbau
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, C\ Doctor Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Ana Clavería
- Área de Xestión Integrada de Vigo, Servizio Galego de Saúde, c/Rosalía Castro 21-23, 36201, Vigo, Spain
- Instituto de Investigación Sanitaria Galicia Sur, Hospital Álvaro Cunqueiro, Bloque Técnico, Planta 2, Carretera Clara Campoamor n° 341, Beade, 36213, Vigo, Spain
| | - Rosa Magallón-Botaya
- Facultad de Medicina, Universidad de Zaragoza, c/ Domingo Miral s/n, 50009, Zaragoza, Spain
- Arrabal Health Centre, Servicio Aragonés de Salud, Andador Aragüés del Puerto 3, 50015, Zaragoza, Spain
- Institute of health research of Aragon (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Juan-Ángel Bellón
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Civil Pabellón 5. 2a Planta, Plaza del Hospital Civil, s/n, 29009, Málaga, Spain
- El Palo Health Centre', Andalusian Health Service (SAS), Avenida Salvador Allende 159, 29018, Málaga, Spain
- Department of Public Health and Psychiatry, Facultad de Medicina, University of Málaga (UMA), Campus de Teatinos, 29071, Málaga, Spain
| | - Rafel Ramos
- Unitat de suport a la recerca de Girona. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Carrer Maluquer Salvador 11, 17002, Girona, Spain
- Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí Julià - Edifici M2, Carrer del Dr. Castany, s/n, 17190, Salt, Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
| | - Alvaro Sanchez-Perez
- Primary Care Research Unit, Deputy Directorate of Healthcare Assistance- BioCruces Bizkaia Health Research Institute, Basque Healthcare Service -Osakidetza, Plaza Cruces s/n, E-48903, Barakaldo, Spain
| | - Patricia Moreno-Peral
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Civil Pabellón 5. 2a Planta, Plaza del Hospital Civil, s/n, 29009, Málaga, Spain
| | - Alfonso Leiva
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Clara González-Formoso
- Instituto de Investigación Sanitaria Galicia Sur, Hospital Álvaro Cunqueiro, Bloque Técnico, Planta 2, Carretera Clara Campoamor n° 341, Beade, 36213, Vigo, Spain
- Unidade de Calidade de Coidados, Área sanitaria de Vigo. Hospital Álvaro Cunqueiro, Estrada Clara Campoamor n° 341, 36312, Vigo, Spain
| | - Bonaventura Bolíbar
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
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14
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Garcia-Sangenís A, Morros R, Aguilar-Sánchez M, Medina-Perucha L, Leiva A, Ripoll J, Martínez-Pecharromán M, Bartolomé-Moreno CB, Magallon Botaya R, Marín-Cañada J, Molero JM, Moragas A, Troncoso A, Monfà R, Llor C. Clinical effectiveness and bacteriological eradication of three different Short-COurse antibiotic regimens and single-dose fosfomycin for uncomplicated lower Urinary Tract infections in adult women (SCOUT study): study protocol for a randomised clinical trial. BMJ Open 2021; 11:e055898. [PMID: 34824124 PMCID: PMC8627395 DOI: 10.1136/bmjopen-2021-055898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Uncomplicated lower urinary tract infections (uLUTI) are a common problem in primary care. Current local guidelines recommend the use of a single 3 g dose of fosfomycin. However, most general practitioners (GP) prefer short-course therapies to single-dose therapy. No study has compared head-to-head short-course antimicrobial agents for uLUTIs. Therefore, the aim of this randomised clinical trial is to compare three different short-course antibiotic therapies with a single-dose of fosfomycin for these infections. METHODS AND ANALYSIS This will be a pragmatic, multicentre, parallel group, open trial. Women aged 18 or older and with symptoms of uLUTI and a positive urine dipstick analysis will be randomised to one of the following four groups: a single dose of 3 g of fosfomycin, 2 days of 3 g of fosfomycin o.d., 3 days of pivmecillinam 400 mg three times per day (t.i.d) or 5 days of nitrofurantoin 100 mg t.i.d. A total sample of 1120 patients was calculated. The primary endpoint is clinical effectiveness at day 7, defined as cure of symptoms reported by the patients in a diary including four symptoms: dysuria, urgency, frequency and suprapubic pain, which will be scored on a 4-point severity scale (not present/mild/moderate/severe). Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed. If positive, antibiograms for the three antibiotics studied will be performed. Bacterial eradication will be measured at days 14 and 28. ETHICS AND DISSEMINATION The study was approved by the Ethical Board of IDIAP Jordi Gol (reference number: 21/173-AC) and Spanish Agency of Medicines and Medical Devices. The findings of this trial will be disseminated through research conferences and peer-review journals. TRIAL REGISTRATION NUMBER NCT04959331; EudraCT Number: 2021-001332-26. TIME SCHEDULE January 2022 to April 2023.
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Affiliation(s)
- Ana Garcia-Sangenís
- Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, Spain
- UICEC de IDIAP Jordi Gol-Plataforma ScREN, Barcelona, Catalonia, Spain
- Medicines Research Unit, Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, Spain
| | - Rosa Morros
- Medicines Research Unit, Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, Spain
- Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Catalonia, Spain
| | - Mercedes Aguilar-Sánchez
- Microbiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
| | | | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services; Health Research Institute of the Balearic Islands (IdISBa), Palma De Mallorca, Balearic Islands, Spain
| | - Joana Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services; Health Research Institute of the Balearic Islands (IdISBa), Palma De Mallorca, Balearic Islands, Spain
| | | | - Cruz B Bartolomé-Moreno
- Health Research Institute of Aragón; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Aragon, Spain
- Parque Goya Health Centre, Family and Community Care Teaching Unit of Zaragoza Sector I, Zaragoza, Aragon, Spain
| | - Rosa Magallon Botaya
- Health Research Institute of Aragón; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Aragon, Spain
- Arrabal Health Centre, University of Zaragoza, Zaragoza, Aragon, Spain
| | - Jaime Marín-Cañada
- Villarejo de Salvanés Health Centre, Villarejo de Salvané, Madrid, Spain
| | - José M Molero
- Primary Healthcare Centre San Andrés, Comunidad de Madrid Servicio Madrileno de Salud, Madrid, Spain
| | - Ana Moragas
- Universitat Rovira i Virgili, Tarragona, Catalonia, Spain
- Primary Healthcare Centre Jaume I, Tarragona, Spain
| | - Amelia Troncoso
- Primary Care Pharmacy Unit, Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Ramon Monfà
- Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, Spain
- UICEC de IDIAP Jordi Gol-Plataforma ScREN, Barcelona, Catalonia, Spain
- Medicines Research Unit, Institut de Recerca en Atencio Primaria Jordi Gol, Barcelona, Catalonia, Spain
| | - Carl Llor
- Via Roma Health Centre, Institut de Recerca en Atencio Primaria Jordi Gol, CIBER de Enfermedades Infecciosas, Barcelona, Catalonia, Spain
- Department of Public Health, General Practice, University of Southern Denmark, Odense, Funen, Denmark
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15
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Socias I, Leiva A, Pombo-Ramos H, Bejarano F, Sempere-Verdú E, Rodríguez-Rincón RM, Fiol F, Mengual M, Ajenjo-Navarro A, Do Pazo F, Mateu C, Folch S, Alegret S, Coll JM, Martín-Rabadán M, Vicens C. Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18:7964. [PMID: 34360267 PMCID: PMC8345522 DOI: 10.3390/ijerph18157964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited, and this results in a significant number of chronic users. Long-term BZD use is associated with cognitive impairment, falls with hip fractures, traffic accidents, and increased mortality. The BENZORED IV trial was a hybrid type-1 trial conducted to evaluate the effectiveness and implementation of an intervention to reduce BZD prescription in primary care. The purpose of this qualitative study was to analyze the facilitators and barriers regarding the implementation of the intervention in primary care settings. METHODS A qualitative interview study with 40 GPs from three Spanish health districts. Focus group meetings with GPs from the intervention arm of the BENZORED IV trial were held at primary healthcare centers in the three districts. For sampling purposes, the GPs were classified as high or low implementers according to the success of the intervention measured at 12 months. The Consolidated Framework for Implementation Research (CFIR) was used to conduct the meetings and to code, rate, and analyze the data. RESULTS Three of the 41 CFIR constructs strongly distinguished between high and low implementers: the complexity of the intervention, the individual Stage of Change, and the key stakeholder's engagement. Seven constructs weakly discriminated between the two groups: adaptability in the intervention, external policy and incentives, implementation climate, relative priority, self-efficacy, compatibility, and engaging a formally appointed implementation leader. Fourteen constructs did not discriminate between the two groups, six had insufficient data for evaluation, and eleven had no data for evaluation. CONCLUSIONS We identified constructs that could explain differences in the efficacy in implementation of the intervention. This information is relevant for the design of successful strategies for implementation of the intervention.
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Affiliation(s)
- Isabel Socias
- Healthcare Centre Manacor, Balearic Health Service IbSalut, 07500 Manacor, Spain;
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
| | - Alfonso Leiva
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
- Reseach Unit Mallorca, Balearic Health Service IbSalut, 07003 Palma, Spain
| | - Haizea Pombo-Ramos
- Primary Care Research Unit of Biscaia, Basque HealthCare Service Osakidetza, BioCruces Health Research Institute, 48903 Bizkaia, Spain;
| | - Ferran Bejarano
- Catalunya Health Services-CatSalut, DAP Camp de Tarragona, 43002 Tarragona, Spain; (F.B.); (M.M.); (S.F.)
| | - Ermengol Sempere-Verdú
- Paterna Healthcare Centre, Conselleria de Sanitat Universal i Salut Pública, 46980 Valencia, Spain; (E.S.-V.); (A.A.-N.)
| | - Raquel María Rodríguez-Rincón
- Pharmacy Department, Hospital Universitari Son Espases, Balearic Health Service IbSalut, 07120 Palma, Spain; (R.M.R.-R.); (F.D.P.)
| | - Francisca Fiol
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service IbSalut, 07013 Palma, Spain; (F.F.); (C.M.); (S.A.); (C.V.)
| | - Marta Mengual
- Catalunya Health Services-CatSalut, DAP Camp de Tarragona, 43002 Tarragona, Spain; (F.B.); (M.M.); (S.F.)
| | - Asunción Ajenjo-Navarro
- Paterna Healthcare Centre, Conselleria de Sanitat Universal i Salut Pública, 46980 Valencia, Spain; (E.S.-V.); (A.A.-N.)
| | - Fernando Do Pazo
- Pharmacy Department, Hospital Universitari Son Espases, Balearic Health Service IbSalut, 07120 Palma, Spain; (R.M.R.-R.); (F.D.P.)
| | - Catalina Mateu
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service IbSalut, 07013 Palma, Spain; (F.F.); (C.M.); (S.A.); (C.V.)
| | - Silvia Folch
- Catalunya Health Services-CatSalut, DAP Camp de Tarragona, 43002 Tarragona, Spain; (F.B.); (M.M.); (S.F.)
| | - Santiago Alegret
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service IbSalut, 07013 Palma, Spain; (F.F.); (C.M.); (S.A.); (C.V.)
| | - Jose Maria Coll
- Menorca Primary Care Management, Balearic Health Service IbSalut, 07701 Maó, Spain;
| | - María Martín-Rabadán
- Can Misses Healthcare Centre Ibiza, Balearic Health Service IbSalut, 07800 Ibiza, Spain;
| | - Caterina Vicens
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service IbSalut, 07013 Palma, Spain; (F.F.); (C.M.); (S.A.); (C.V.)
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16
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Carrascosa MDC, Navas A, Artigues C, Ortas S, Portells E, Soler A, Bennasar-Veny M, Leiva A. Effect of aerobic water exercise during pregnancy on epidural use and pain: A multi-centre, randomised, controlled trial. Midwifery 2021; 103:103105. [PMID: 34352600 DOI: 10.1016/j.midw.2021.103105] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 05/28/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The physical and psychological benefits of exercise during pregnancy are well established. However, the impact of exercise on pain during labour and the use of epidural analgesia has been less explored. The main aim of this study was to analyse the effectiveness and safety of moderate aerobic water exercise by pregnant women on the subsequent use of epidural analgesia during labour, induction of labour, mode of delivery, and pain perception. DESIGN A multi-centre, parallel, randomised, evaluator blinded, controlled trial in a primary care setting. SETTING Primary care centres in a health district of a tertiary obstetric metropolitan hospital in Mallorca, Spain. PARTICIPANTS Pregnant women (14 to 20 weeks' gestation) who had low risk of complications. METHODS Three hundred and twenty pregnant women were randomly assigned to two groups: women who practiced moderate aquatic aerobic exercise with usual antenatal care, and those who received usual prenatal care alone. The gynaecologist, anaesthesiologist and midwife who assisted the women during labour were blinded to group allocations. Principal outcome: use of epidural analgesia during labour. Other outcomes: use of epidural analgesia before 6 cm cervical dilation, labour pain, type of delivery, time of active labour, episiotomy or perineal tear, and induction of labour. RESULTS The exercise program did not affect the use of epidural analgesia (OR = 0.79, 95% CI = 0.44 to 1.40), vaginal delivery (OR = 1.35, 95% CI = 0.73 to 2.41), or caesarean section (OR = 0.94, 95% CI = 0.47 to 1.89). However, women in the exercise group reported less pain during labour (mean difference: -0.6, 95% CI = -1.11 to -0.09). The two groups (moderate aquatic aerobic exercise versus usual antenatal care) showed no significant differences in maternal or newborn adverse events. CONCLUSION Aquatic aerobic exercise during pregnancy had no effect on the use of epidural analgesia during labour, whereas pain perception was lower after aquatic exercise compared to usual care in pregnancy. The intervention was safe for pregnant women and their newborns.
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Affiliation(s)
- María Del Carmen Carrascosa
- Mallorca Primary Health Care, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain.
| | - Araceli Navas
- Hospital Comarcal de Inca, Servei de Salut de les Illes Balears (Ib-salut), Carretera Vella de Llubí, s/n, Inca 07300, Spain
| | - Catalina Artigues
- Mallorca Primary Health Care, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain.
| | - Silvia Ortas
- Mallorca Primary Health Care, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain
| | - Elena Portells
- Mallorca Primary Health Care, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain.
| | - Aina Soler
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain; Insitut d'Investigació Sanitària Illes Balears (IdISBa), Carretera de Valldemossa, 79, Palma 07120, Spain.
| | - Miquel Bennasar-Veny
- Insitut d'Investigació Sanitària Illes Balears (IdISBa), Carretera de Valldemossa, 79, Palma 07120, Spain; Nursing and Physiotherapy Department, Balearic Islands University, Carrertera de Valldemosa, Km 7,5, Palma 07122, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, Madrid 28029, Spain.
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Calle Escuela Graduada, 3, Palma 07002, Spain; Insitut d'Investigació Sanitària Illes Balears (IdISBa), Carretera de Valldemossa, 79, Palma 07120, Spain.
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17
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Contreras-Duarte S, Claudette C, Farias M, Leiva A. High total cholesterol and triglycerides levels increase arginases metabolism, impairing nitric oxide signaling and worsening fetoplacental endothelial dysfunction in gestational diabetes mellitus pregnancies. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166216. [PMID: 34314821 DOI: 10.1016/j.bbadis.2021.166216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022]
Abstract
During human pregnancy, maternal physiological dyslipidemia (MPD) supports fetal development. However, some women develop maternal supraphysiological dyslipidemia (MSPD: increased total cholesterol (TC) and triglycerides (TG) levels). MSPD is present in normal and pregnancies with gestational diabetes mellitus (GDM). Both pathologies associate with fetoplacental endothelial dysfunction, producing alterations in nitric oxide (NO)-L-arginine/arginase metabolism. Nevertheless, the effect of MSPD on GDM, and how this synergy alters fetoplacental endothelial function is unknown, which is the aim of this study. 123 women at term of pregnancy were classified as MPD (n=40), MSPD (n=35), GDM with normal lipids (GDM- MPD, n=23) and with increased lipids (GDM-MSPD, n=25). TC ≥291 mg/dL and TG ≥275 mg/dL were considered as MSPD. Endothelial NO synthase (eNOS), human cationic amino acid transporter 1 (hCat1), and arginase II protein abundance and activity, were assayed in umbilical vein endothelial cells. In MSPD and MSPD-GDM, TC and TG increased respect to MPD and MPD-GDM. eNOS activity was reduced in MSPD and MSPD-GDM, but increased in MPD-GDM compared with MPD. No changes were observed in eNOS protein. However, decreased tetrahydrobiopterin levels were observed in all groups compared with MPD. Increased hCat1 protein and L-arginine transport were observed in both GDM groups compared with MPD. However, the transport was higher in GDM-MSPD compared to GDM-MPD. Higher Arginase II protein and activity were observed in MSPD-GDM compared with MPD. Thus, MSPD in GDM pregnancies alters fetal endothelial function associated with NO metabolism.
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Affiliation(s)
- S Contreras-Duarte
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile.
| | - C Claudette
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile
| | - M Farias
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile
| | - A Leiva
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
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18
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Rodríguez I, Leiva A, Mesa A, González D. Evaluation of productive parameters in pig carcasses marketed in the District of Fram - Department of Itapúa, Paraguay. Compend cienc vet 2021. [DOI: 10.18004/compend.cienc.vet.2021.11.01.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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19
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Navas A, Carrascosa MDC, Artigues C, Ortas S, Portells E, Soler A, Yañez AM, Bennasar-Veny M, Leiva A. Effectiveness of Moderate-Intensity Aerobic Water Exercise during Pregnancy on Quality of Life and Postpartum Depression: A Multi-Center, Randomized Controlled Trial. J Clin Med 2021; 10:jcm10112432. [PMID: 34070842 PMCID: PMC8198819 DOI: 10.3390/jcm10112432] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/03/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The global prevalence of postpartum depression is about 20%. This disease has serious consequences for women, their infants, and their families. The aim of this randomized clinical trial was to analyze the effectiveness and safety of a moderate-intensity aerobic water exercise program on postpartum depression, sleep problems, and quality of life in women at one month after delivery. Methods: This was a multi-center, parallel, randomized, evaluator blinded, controlled trial in a primary care setting. Pregnant women (14–20 weeks gestational age) who had low risk of complications and were from five primary care centers in the area covered by the obstetrics unit of Son Llatzer Hospital (Mallorca, Spain) were invited to participate. A total of 320 pregnant women were randomly assigned to two groups, an intervention group (moderate aquatic aerobic exercise) and a control group (usual prenatal care). One month after birth, sleep quality (MOS sleep), quality of life (EQ-5D), and presence of anxiety or depression (EPDS) were recorded. Findings: Women in the intervention group were less likely to report anxiety or depression on the EQ5D (11.5% vs. 22.7%; p < 0.05) and had a lower mean EPDS score (6.1 ± 1.9 vs. 6.8 ± 2.4, p < 0.010). The two groups had no significant differences in other outcomes, maternal adverse events, and indicators of the newborn status. Conclusion: Moderate-intensity aquatic exercise during pregnancy decreased postpartum anxiety and depressive symptoms in mothers and was safe for mothers and their newborns.
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Affiliation(s)
- Araceli Navas
- Hospital Comarcal de Inca, Balearic Islands Health Services, 07300 Inca, Spain;
| | - María del Carmen Carrascosa
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Catalina Artigues
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Silvia Ortas
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Elena Portells
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Aina Soler
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain; (A.S.); (A.L.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Aina M. Yañez
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Nursing and Physiotherapy Department, Balearic Islands University, 07122 Palma, Spain
- Correspondence: (A.M.Y.); (M.B.-V.); Tel.: +34-9711-72914 (A.M.Y.); Tel.: +34-9711-72367 (M.B.-V.)
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Nursing and Physiotherapy Department, Balearic Islands University, 07122 Palma, Spain
- Correspondence: (A.M.Y.); (M.B.-V.); Tel.: +34-9711-72914 (A.M.Y.); Tel.: +34-9711-72367 (M.B.-V.)
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain; (A.S.); (A.L.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
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20
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Fiol-DeRoque MA, Serrano-Ripoll MJ, Jiménez R, Zamanillo-Campos R, Yáñez-Juan AM, Bennasar-Veny M, Leiva A, Gervilla E, García-Buades ME, García-Toro M, Alonso-Coello P, Pastor-Moreno G, Ruiz-Pérez I, Sitges C, García-Campayo J, Llobera-Cánaves J, Ricci-Cabello I. A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e27039. [PMID: 33909587 PMCID: PMC8133164 DOI: 10.2196/27039] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to health care workers, who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features, despite the lack of evidence about their efficacy in this specific population and context. OBJECTIVE The aim of this trial is to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in health care workers during the COVID-19 pandemic. METHODS We conducted a blinded, parallel-group, controlled trial in Spain. Health care workers providing face-to-face health care to patients with COVID-19 were randomly assigned (1:1) to receive the PsyCovidApp intervention (an app targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control app (general recommendations about mental health care) for 2 weeks. The participants were blinded to their group allocation. Data were collected telephonically at baseline and after 2 weeks by trained health psychologists. The primary outcome was a composite of depression, anxiety, and stress (overall score on the Depression Anxiety Stress Scale-21 [DASS-21]). Secondary outcomes were insomnia (Insomnia Severity Index), burnout (Maslach Burnout Inventory Human Services Survey), posttraumatic stress (Davidson Trauma Scale), self-efficacy (General Self-Efficacy Scale), and DASS-21 individual scale scores. Differences between groups were analyzed using general linear modeling according to an intention-to-treat protocol. Additionally, we measured the usability of the PsyCovidApp (System Usability Scale). The outcome data collectors and trial statisticians were unaware of the treatment allocation. RESULTS Between May 14 and July 25, 2020, 482 health care workers were recruited and randomly assigned to PsyCovidApp (n=248) or the control app (n=234). At 2 weeks, complete outcome data were available for 436/482 participants (90.5%). No significant differences were observed between the groups at 2 weeks in the primary outcome (standardized mean difference -0.04; 95% CI -0.11 to 0.04; P=.15) or in the other outcomes. In our prespecified subgroup analyses, we observed significant improvements among health care workers consuming psychotropic medications (n=79) in the primary outcome (-0.29; 95% CI -0.48 to -0.09; P=.004), and in posttraumatic stress, insomnia, anxiety, and stress. Similarly, among health care workers receiving psychotherapy (n=43), we observed improvements in the primary outcome (-0.25; 95% CI -0.49 to -0.02; P=.02), and in insomnia, anxiety, and stress. The mean usability score of PsyCovidApp was high (87.21/100, SD 12.65). After the trial, 208/221 participants in the intervention group (94.1%) asked to regain access to PsyCovidApp, indicating high acceptability. CONCLUSIONS In health care workers assisting patients with COVID-19 in Spain, PsyCovidApp, compared with a control app, reduced mental health problems at 2 weeks only among health care workers receiving psychotherapy or psychotropic medications. TRIAL REGISTRATION ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818.
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Affiliation(s)
- Maria Antònia Fiol-DeRoque
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rafael Jiménez
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Health, Valencian International University (VIU), Valencia, Spain
| | - Aina María Yáñez-Juan
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Research Group on Global Health & Human Development, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Elena Gervilla
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - M Esther García-Buades
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
| | - Pablo Alonso-Coello
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Iberoamerican Cochrane Centre, Barcelona, Spain
| | - Guadalupe Pastor-Moreno
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Isabel Ruiz-Pérez
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
- Department of Psychology, Research Institute of Health Sciences, Palma de Mallorca, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
- Aragon Institute for Health Research, Miguel Servet University Hospital, Zaragoza, Spain
| | - Joan Llobera-Cánaves
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
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21
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Ricci-Cabello I, Yañez-Juan AM, Fiol-deRoque MA, Leiva A, Llobera Canaves J, Parmentier FBR, Valderas JM. Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data. J Clin Med 2021; 10:1782. [PMID: 33923906 PMCID: PMC8073542 DOI: 10.3390/jcm10081782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.
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Affiliation(s)
- Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, 07002 Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Aina María Yañez-Juan
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Department of Nursing and Physiotherapy and Global Health Research Group, University of the Balearic Islands, 07122 Palma, Spain
| | - Maria A. Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, 07002 Palma, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, 07002 Palma, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - Joan Llobera Canaves
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, 07002 Palma, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - Fabrice B. R. Parmentier
- Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79 Hospital Universitario Son Espases, Edificio S, 07120 Palma, Spain; (I.R.-C.); (A.M.Y.-J.); (M.A.F.-d.); (A.L.); (J.L.C.); (F.B.R.P.)
- Department of Psychology and Institute of Health Sciences (iUNICS), University of the Balearic Islands, 07122 Palma, Spain
- School of Psychology, The University of Western Australia, Perth, WA 6009, Australia
| | - Jose M. Valderas
- Health Services & Policy Research Group, Exeter Collaboration for Academic Primary Care, NIHR School for Primary Care Research, University of Exeter, Exeter EX1 2HZ, UK
- NIHR South West Peninsula Applied Research Collaboration, University of Exeter, Exeter EX1 2HZ, UK
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
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Serrano-Ripoll MJ, Ricci-Cabello I, Jiménez R, Zamanillo-Campos R, Yañez-Juan AM, Bennasar-Veny M, Sitges C, Gervilla E, Leiva A, García-Campayo J, García-Buades ME, García-Toro M, Pastor-Moreno G, Ruiz-Perez I, Alonso-Coello P, Llobera J, Fiol-deRoque MA. Effect of a mobile-based intervention on mental health in frontline healthcare workers against COVID-19: Protocol for a randomized controlled trial. J Adv Nurs 2021; 77:2898-2907. [PMID: 33675247 PMCID: PMC8250879 DOI: 10.1111/jan.14813] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/20/2022]
Abstract
Aim To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness‐based approaches on the mental health of healthcare workers at the frontline against COVID‐19 in Spain. Design We will carry out a two‐week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention or control App intervention. Methods The PsyCovidApp intervention will include five modules: emotional skills, lifestyle behaviour, work stress and burnout, social support, and practical tools. Healthcare workers having attended patients with COVID‐19 will be randomized to receive the PsyCovidApp intervention (intervention group) or a control App intervention (control group). A total of 440 healthcare workers will be necessary to assure statistical power. Measures will be collected telephonically by a team of psychologists at baseline and immediately after the 2 weeks intervention period. Measures will include stress, depression and anxiety (DASS‐21 questionnaire—primary endpoint), insomnia (ISI), burnout (MBI‐HSS), post‐traumatic stress disorder (DTS), and self‐efficacy (GSE). The study was funded in May 2020, and was ethically approved in June 2020. Trial participants, outcome assessors and data analysts will be blinded to group allocation. Discussion Despite the increasing use of mobile health interventions to deliver mental health care, this area of research is still on its infancy. This study will help increase the scientific evidence about the effectiveness of this type of intervention on this specific population and context. Impact Despite the lack of solid evidence about their effectiveness, mobile‐based health interventions are already being widely implemented because of their low cost and high scalability. The findings from this study will help health services and organizations to make informed decisions in relation to the development and implementation of this type of interventions, allowing them pondering not only their attractive implementability features, but also empirical data about its benefits. Clinical trial registration NCT04393818 (ClinicalTrials.gov identifier). Approved funding May 2020.
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Affiliation(s)
- Maria J Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Jiménez
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Health, Valencian International University (VIU), Valencia, Spain
| | - Aina M Yañez-Juan
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Research Group on Global Health & Human Development, University of the Balearic Islands, Palma, Illes Balears, Spain
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Illes Balears, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Psychology, Research Institute of Health Sciences (IUNICS), UIB, Palma, Balearic Islands, Spain
| | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain.,Aragon Institute for Health Research (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Aragón, Spain
| | - M Esther García-Buades
- Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain
| | - Guadalupe Pastor-Moreno
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Andalusian School of Public Health (EASP), Granada, Andalucía, Spain
| | - Isabel Ruiz-Perez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Andalusian School of Public Health (EASP), Granada, Andalucía, Spain
| | - Pablo Alonso-Coello
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Joan Llobera
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Maria A Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain
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Bulilete O, Lorente P, Leiva A, Carandell E, Oliver A, Rojo E, Pericas P, Llobera J. Panbio™ rapid antigen test for SARS-CoV-2 has acceptable accuracy in symptomatic patients in primary health care. J Infect 2021; 82:391-398. [PMID: 33592253 PMCID: PMC7881288 DOI: 10.1016/j.jinf.2021.02.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 02/10/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES We aimed to evaluate the accuracy of the Panbio™ Ag-RDT at primary health care (PHC) centers and test sites in symptomatic patients and close contacts, using the Reverse-Transcription Polymerase Chain Reaction (RT-PCR) test as the gold standard. METHODS The study was conducted in four PHC centers and two test sites in Mallorca, Spain. Consecutive patients older than 18 years, attending the sites for RT-PCR testing were included. Two nasopharyngeal samples were collected, one for RT-PCR and the other was processed on-site using the Panbio™ rapid antigen test kit for SARS-CoV-2. The sensitivity and specificity were calculated using RT-PCR as the reference, and the predictive values using the pretest probability results for each analyzed group. FINDINGS A total of 1369 participants were included; mean age 42.5 ± 14.9 years and 54.3% women. The overall prevalence was 10.2%. Most participants (70.6%) presented within 5 days of the onset of symptoms. The overall sensitivity was of 71.4% (95% CI: 63.1%, 78.7%), the specificity of 99.8% (95% CI: 99.4%, 99.9%), the positive predictive value of 98.0% (95% CI: 93.0%, 99.7%) and a negative predictive value of 96.8% (95% CI: 95.7%, 97.7%). The sensitivity was higher in symptomatic patients, in those arriving within 5 days since symptom onset and in those with high viral load. INTERPRETATION Ag-RDT had relatively good performance characteristics in suspected symptomatic patients within five days since the onset of symptoms. However, our data do not support the sole use of Panbio™ Ag-RDT in asymptomatic individuals. FUNDING None.
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Affiliation(s)
- Oana Bulilete
- Primary Health Care Research Unit, Balearic Public Health Service (Ib-Salut), Escola Graduada n9, 07002 Palma, Illes Balears, Spain; Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain.
| | - Patricia Lorente
- Primary Health Care Research Unit, Balearic Public Health Service (Ib-Salut), Escola Graduada n9, 07002 Palma, Illes Balears, Spain; Santa Ponça Primary Health Care Center, Balearic Public Health Service (Ib-Salut), Carrer del Riu Síl, 25, 07180 Santa Ponça, Illes Balears, Spain.
| | - Alfonso Leiva
- Primary Health Care Research Unit, Balearic Public Health Service (Ib-Salut), Escola Graduada n9, 07002 Palma, Illes Balears, Spain; Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain.
| | - Eugenia Carandell
- Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain; Directorate of General Health Service, Balearic Public Health Service (Ib-Salut), Reina Esclaramunda n9, 07005 Palma, Illes Balears, Spain.
| | - Antonio Oliver
- Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain; Microbiology Service, Son Espases University Hospital, Balearic Public Health Service (Ib-Salut), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain.
| | - Estrella Rojo
- Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain; Microbiology Service, Son Espases University Hospital, Balearic Public Health Service (Ib-Salut), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain.
| | - Pau Pericas
- Primary Health Care Research Unit, Balearic Public Health Service (Ib-Salut), Escola Graduada n9, 07002 Palma, Illes Balears, Spain.
| | - Joan Llobera
- Primary Health Care Research Unit, Balearic Public Health Service (Ib-Salut), Escola Graduada n9, 07002 Palma, Illes Balears, Spain; Balearic Islands Health Research Institute (IdISBa), Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain.
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Jessop I, Albornoz J, Ramírez O, Durán B, Molero L, Bonardd S, Kortaberria G, Diaz Diaz D, Leiva A, Saldías C. Optical, morphological and photocatalytic properties of biobased tractable films of chitosan/donor-acceptor polymer blends. Carbohydr Polym 2020; 249:116822. [DOI: 10.1016/j.carbpol.2020.116822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 12/16/2022]
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Trépel D, Ali S, Gilbody S, Leiva A, Mcmillan D, Bejarano F, Sempere E, Vicens C. Cost-effectiveness of brief structured interventions to discontinue long-term benzodiazepine use: an economic analysis alongside a randomised controlled trial. HRB Open Res 2020; 3:33. [PMID: 32743341 PMCID: PMC7372528 DOI: 10.12688/hrbopenres.13049.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background: In Spain, long-term use of benzodiazepine is prevalent in 7% of the population; however, this longer-term use lacks clinical benefits, costs €90million per year and side-effects further add extra cost through adverse health outcomes. This study aims to estimate the cost-effectiveness of primary care services stepped dose reduction of long-term benzodiazepines using either Structured Interview with Follow-up (SIF) or Without Follow-up (SIW), compared to Treatment as Usual (TAU). Design: Cost-effectiveness analysis was conducted alongside randomised control utilizing data from three arm cluster randomized trial. Setting: Primary care. Participants: 75 general practitioners were randomised to one of the three arms (TAU, SIW, SIF). Measurements: Cost and Cost per Quality-Adjusted Life Year (QALY) Results: Compared to usual care, providing SIW per participant costs an additional €117.94 and adding patient follow-up, €218.4. As a result of intervention, participants showed a gain of, on average, for SIW 0.0144 QALY (95% CI -0.0137 to 0.0425) and for SIF 0.0340 QALYs (0.0069 to 0.0612). The Incremental Cost Effectiveness Ratio was €8190.28/QALY (SIW) and €6423.53/QALY (SIF). At the Spanish reimbursement threshold (€45,000 per QALY) the chance interventions are cost effective is 79.8% for SIW and 97.7% for SIF. Conclusions: Brief structured interventions to discontinue long-term benzodiazepine use represent value for money, particularly with scheduled follow-up appointments, and would represent a cost-effective investment by the Spanish healthcare to reduce prevalence of long-term use.
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Affiliation(s)
- Dominic Trépel
- School of Medicine, Trinity College Dublin, Dublin, D02 PN40, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, D02 PN40, Ireland
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Shehzad Ali
- Mental Health and Additions Research Group, Department of Health Sciences, University of York, UK, Heslington, York,, YO10 5DD, UK
| | - Simon Gilbody
- Mental Health and Additions Research Group, Department of Health Sciences, University of York, UK, Heslington, York,, YO10 5DD, UK
| | - Alfonso Leiva
- Instituto de Investigación Sanitaria de Palma, Palma, 07120, Spain
| | - Dean Mcmillan
- Mental Health and Additions Research Group, Department of Health Sciences, University of York, UK, Heslington, York,, YO10 5DD, UK
| | - Ferran Bejarano
- Institut Català de la Salut, DAP Camp de Tarragona, Catalunya, Catalunya, Spain
| | - Ermengol Sempere
- Conselleria de Sanitat Universal i Salut Pública, Paterna Health Care Centre, Valencia, 46010, Spain
| | - Caterina Vicens
- Instituto de Investigación Sanitaria de Palma, Palma, 07120, Spain
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Yañez AM, Bennasar-Veny M, Leiva A, García-Toro M. Implications of personality and parental education on healthy lifestyles among adolescents. Sci Rep 2020; 10:7911. [PMID: 32404935 PMCID: PMC7220907 DOI: 10.1038/s41598-020-64850-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/20/2020] [Indexed: 12/17/2022] Open
Abstract
Several studies have shown an association between personality and health status. The aim of this study was to evaluate the association between personality traits, parental education and health-related lifestyles in a cohort of Spanish adolescents. This is a longitudinal study with a source population of 1,123 third-year students (aged 14-15) in secondary schools in Spain. At the baseline evaluation sociodemographic variables, parental education and personality (Big Five Questionnaire for Children) were collected. At 18 months of follow-up health related lifestyles, including adherence to a healthy diet (KidMed index), tobacco and alcohol consumption, physical exercise, sleep problems and recreative screen and social network time were collected. A total of 824 adolescents (73.4%) completed the 18 months assessment and 695 (84.3%) presented valid data. Higher conscientiousness was associated to a lower risk for non-adherence to Mediterranean diet (OR = 0.7, 95% CIs=0.5-0.9), tobacco (OR = 0.5, 95% CIs=0.3-0.7) and alcohol consumption (OR = 0.6, 95% CIs=0.5-0.8), excessive use of screens (OR = 0.7, 95% CIs=0.5-0.9) and social network sites (OR = 0.7, 95% CIs=0.5-0.8). Higher levels of extraversion was significantly related to a lower risk of physical inactivity (OR = 0.7, 95% CIs=0.6-0.9), but they are at a higher risk of low adherence to Mediterranean diet (OR = 1.3, 95% CIs=1.0-1.7), tobacco (OR = 2.7, 95% CIs=1.7-4.3) and alcohol consumption (OR = 1.9, 95% CIs=1.5-2.4) and excessive use of social network sites (OR = 1.6, 95% CIs=1.3-1.9). High levels of emotional instability were associated with tobacco consumption (OR = 1.5, 95% CIs=1.0-2.2) and sleep problems (OR = 2.0, 95% CIs=1.5-2.7). Finally, we found an association with lower parental education and adolescents' low adherence to Mediterranean diet (OR = 1.6, 95% CIs=1.0-2.4) and sleep problems (OR = 1.8, 95% CIs=1.0-3.0). Cluster analysis of health-related behaviours indicated the presence of two different clusters (unhealthy and healthy adolescents) that were associated with personality traits. Conscientiousness, extraversion, emotional instability and parental education are independent factors associated with the acquisition of adolescent healthy lifestyles.
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Affiliation(s)
- Aina M Yañez
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain.,Research Group on Global Health & Human Development, Balearic Islands University, Palma, Illes Balears, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain. .,Research Group on Global Health & Human Development, Balearic Islands University, Palma, Illes Balears, Spain.
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Instituto de Investigación Sanitaria Illes Balears, Palma, Illes Balears, Spain
| | - Mauro García-Toro
- Department of Medicine, University of the Balearic Islands, Palma, Illes Balears, Spain
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Unda Villafuerte F, Llobera Cànaves J, Lorente Montalvo P, Moreno Sancho ML, Oliver Oliver B, Bassante Flores P, Estela Mantolan A, Pou Bordoy J, Rodríguez Ruiz T, Requena Hernández A, Leiva A, Torrent Quetglas M, Coll Benejam JM, D’Agosto Forteza P, Rigo Carratalà F. Effectiveness of a multifactorial intervention, consisting of self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs: The MEDICHY study. Medicine (Baltimore) 2020; 99:e19769. [PMID: 32332617 PMCID: PMC7220514 DOI: 10.1097/md.0000000000019769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. METHODS/DESIGN This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90 mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). DISCUSSION This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise).
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Affiliation(s)
| | - Joan Llobera Cànaves
- Primary Care Research Unit of Mallorca, Balearic Health Services (IB-Salut)
- Institut d’investigació Sanitària Illes Balears
| | | | | | | | | | | | | | - Tomás Rodríguez Ruiz
- Primary Care Research Unit of Menorca, Balearic Health Services (IB-Salut), Menorca, Balearic Islands, Spain
| | | | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Health Services (IB-Salut)
- Institut d’investigació Sanitària Illes Balears
| | - Matíes Torrent Quetglas
- Institut d’investigació Sanitària Illes Balears
- Primary Care Research Unit of Menorca, Balearic Health Services (IB-Salut), Menorca, Balearic Islands, Spain
| | - José María Coll Benejam
- Institut d’investigació Sanitària Illes Balears
- Menorca Primary care management, Menorca, Balearic Health Services (IB-Salut)
| | | | - Fernando Rigo Carratalà
- Institut d’investigació Sanitària Illes Balears
- San Agustín Healthcare Centre, Institut d’investigació Sanitària Illes Balears
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28
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Sheppard JP, Tucker KL, Davison WJ, Stevens R, Aekplakorn W, Bosworth HB, Bove A, Earle K, Godwin M, Green BB, Hebert P, Heneghan C, Hill N, Hobbs FDR, Kantola I, Kerry SM, Leiva A, Magid DJ, Mant J, Margolis KL, McKinstry B, McLaughlin MA, McNamara K, Omboni S, Ogedegbe O, Parati G, Varis J, Verberk WJ, Wakefield BJ, McManus RJ. Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis. Am J Hypertens 2020; 33:243-251. [PMID: 31730171 PMCID: PMC7162426 DOI: 10.1093/ajh/hpz182] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (−3.12 mm Hg, [95% confidence intervals −4.78, −1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.
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Affiliation(s)
- J P Sheppard
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - K L Tucker
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - W J Davison
- Ageing and Stroke Medicine, Norwich Medical School, University of East Anglia, United Kingdom
| | - R Stevens
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - W Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University Bangkok, Thailand
| | - H B Bosworth
- Center for Health Services Research in Primary Care, Department of Population Health Sciences, Duke University, Durham, North Carolina, USA
| | - A Bove
- Cardiology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - K Earle
- Thomas Addison Diabetes Unit, St. George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - M Godwin
- Family Medicine, Memorial University of Newfoundland, St. John’s, Canada
| | - B B Green
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - P Hebert
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
| | - C Heneghan
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - N Hill
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - F D R Hobbs
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - I Kantola
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - S M Kerry
- Centre for Primary Care and Public Health, Queen Mary University of London, London, United Kingdom
| | - A Leiva
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Mallorca, Spain
| | - D J Magid
- Colorado School of Public Health, University of Colorado, Denver, Colorado, USA
| | - J Mant
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - K L Margolis
- HealthPartners Institute, Minneapolis, Minnesota, USA
| | - B McKinstry
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - M A McLaughlin
- Icahn School of Medicine at Mount Sinai New York, New York, New York, USA
| | - K McNamara
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
- School of Medicine, Deakin University, Geelong, Australia
| | - S Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - O Ogedegbe
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, Langone School of Medicine, New York University, New York, USA
| | - G Parati
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - J Varis
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - W J Verberk
- Cardiovascular Research Institute Maastricht and Departments of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - B J Wakefield
- Department of Veterans (VA) Health Services Research and Development Centre for Comprehensive Access and Delivery Research and Evaluation (CADRE), VA Medical Centre, Iowa City, USA
| | - R J McManus
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
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Rodríguez-Enríquez M, Bennasar-Veny M, Leiva A, Garaigordobil M, Yañez AM. Cybervictimization among secondary students: social networking time, personality traits and parental education. BMC Public Health 2019; 19:1499. [PMID: 31711467 PMCID: PMC6849165 DOI: 10.1186/s12889-019-7876-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 10/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cyberbullying among children and adolescents is a major public health concern. However, research has not yet definitively identified the risk factors associated with cybervictimization. The purpose of this study was to determine the association of cybervictimization with use of social networks, personality traits and parental education in secondary students. Methods The study population consisted of 765 secondary students (56.5% girls) from Majorca (Spain) who were aged 15.99 years (grade 4). The data were from the 16 secondary school centers that participated in the ITACA Project, a multi-center, cluster randomized controlled trial. Cybervictimization was measured by the Garaigordobil Cybervictimization Scale, and the Big Five Questionnaire for Children was used to assess personality traits. Results Results showed that 39.9% of the students were cybervictims. Univariate analysis indicated that more girls than boys were cybervictimized (43.1% vs 35.7%). Cybervictims spent more time in social networking sites than non-victims (6 h 30 min vs. 5 h 16 min) and had greater emotional instability (0.16 vs. -0.23) and extraversion (0.11 vs. -0.09) and were less conscientious (− 0.001 vs. 0.20). Multivariable analysis indicated that social networking time was not significantly associated with cybervictimization after controlling for personality traits, but the same personality traits remained significantly associated. Conclusions Our findings indicate that cyberbullying is a frequent and relevant problem in adolescents. Big Five personality traits are related with cybervictimization. Possible ways to design interventions include promoting social leisure activities, encourage responsible attitudes and provide stress coping tools.
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Affiliation(s)
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma, Balearic Islands, Spain. .,Research Group on Global Health & Human Development, Balearic Islands University, Mallorca, Spain.
| | - Alfonso Leiva
- Research Group on Global Health & Human Development, Balearic Islands University, Mallorca, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain
| | - Maite Garaigordobil
- Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of the Basque Country, Leioa, Spain
| | - Aina M Yañez
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma, Balearic Islands, Spain.,Research Group on Global Health & Human Development, Balearic Islands University, Mallorca, Spain
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Rodríguez-Enríquez M, Bennasar-Veny M, Leiva A, Yañez AM. Alcohol and Tobacco Consumption, Personality, and Cybervictimization among Adolescents. Int J Environ Res Public Health 2019; 16:ijerph16173123. [PMID: 31466216 PMCID: PMC6747350 DOI: 10.3390/ijerph16173123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/18/2019] [Accepted: 08/25/2019] [Indexed: 01/18/2023]
Abstract
Cyberbullying has emerged as a public health problem. Personality may play an important role in substance use and cybervictimization. The aim of this study was to examine whether tobacco and alcohol consumption and personality traits are associated with cybervictimization in Spanish adolescents. A cross-sectional study was conducted with 765 secondary students (aged 14–16) from 16 secondary schools in Spain. Participants completed a questionnaire assessing sociodemographic characteristics; tobacco and alcohol consumption; cybervictimization (Garaigordobil Scale); and personality traits (Big Five Questionnaire). A logistic regression model controlling for sex, age, parental education and personality traits was used to determine the independent associations and interactions between tobacco and alcohol consumption and cybervictimization. The results indicate that a total of 305 adolescents (39.9%) reported that they were cyberbullied in the past year. Girls were more likely to be cyberbullied than boys. Cybervictims had a significantly greater monthly alcohol consumption (OR = 1.51; 95% CI = 1.05–2.15), higher scores for extraversion (OR = 1.31; 95% CI = 1.06–1.63) and emotional instability (OR = 1.53; 95% CI = 1.27–1.83); as well as lower scores for conscientiousness (OR = 0.78; 95% CI = 0.63–0.95). These results suggest that personality traits and alcohol consumption are independently associated with cybervictimization. Our study suggests the existence of underlying common personality factors for cybervictimization and alcohol and tobacco use.
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Affiliation(s)
- Mónica Rodríguez-Enríquez
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Paseig de Sant Joan de Déu, 2, 08950 Barcelona, Spain
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, University of the Balearic Islands, Cra. de Valldemossa, Km 7,5, 07122 Palma, Spain.
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, C/Escuela Graduada, 3, 07002 Palma, Spain
| | - Aina M Yañez
- Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Spain
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Guzman E, Gonzalez M, Fuenzalida B, Leiva A, Castro E, Guzman-Gutierrez E. Deiodinases expression is altered in human trophoblast from gestational diabetes mellitus pregnancies. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guzman-Gutierrez E, Gutierrez-Vega S, Castro E, Gonzalez M, Leiva A. Low levels of free thyroxine in umbilical cord blood is associated with a reduce in deiodinase 2 activity in human trophoblast from gestational diabetes pregnancies. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leal MS, Briones X, Villalobos V, Queneau Y, Leiva A, Ríos HE, Pavez J, Silva CP, Carrasco C, Neira-Carrillo A, Roth AD, Tamayo L, Urzúa MD. Amino Acid-Functionalized Polyelectrolyte Films as Bioactive Surfaces for Cell Adhesion. ACS Appl Mater Interfaces 2019; 11:19751-19762. [PMID: 31074956 DOI: 10.1021/acsami.9b02503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Surfaces were prepared with polyelectrolyte derivatives of poly(styrene- alt-maleic anhydride) (PSMA) functionalized with amino acids of different hydropathy indices, with the aim of evaluating the effect of the chemical functionality of polyelectrolytes on SH-SY5Y neuroblastoma cell adhesion. Functionalizing PSMA derivatives with l-glutamine, l-methionine, and l-tyrosine yielded PSMA-Gln, PSMA-Met, and PSMA-Tyr polyelectrolytes, respectively. We first studied the adsorption behavior of PSMA functionalized with amino acids on silicon wafer surfaces modified with 3-aminopropyltriethoxysilane at pH 4.0 and 7.0 and at low and high ionic strengths. The highest rate of polyelectrolyte adsorption was at pH 4.0 and high ionic strength and was higher with the glutamine and tyrosine films. The advance contact angles (θA) of the polyelectrolyte surfaces showed a moderate effect of ionic strength and pH on polyelectrolyte film wettability, with PSMA-Tyr being slightly more hydrophobic. Atomic force microscopy images of the polyelectrolyte surfaces showed two types of morphology: the well-defined globular nanostructure of PSMA-Met and PSMA-Tyr and densely packed nanofibrous-like structure of PSMA-Gln. The highest level of ionic strength caused a slight decrease in the size of the nanostructure that formed the surface domains, which was reflected in the degree of surface roughness. Cell adhesion assays with the polyelectrolyte film showed that SH-SY5Y neuroblastoma cells cultured on PSMA-Met present a well-extended morphology characterized by a stellate shape, with five or more actin-rich thin processes, whereas SH-SY5Y cells that were seeded on PSMA-Gln and PSMA-Tyr have a round morphology, with fewer and shorter processes. These results indicate that it is possible to modulate the surface characteristics of polyelectrolyte films based on their chemical functionality and environmental parameters such as pH and ionic strength in order to evaluate their effect on cell adhesion. Thus, surfaces prepared from polyelectrolytes functionalized with amino acids are an attractive and simple platform for cell adhesion, which can be used in developing biomaterials with modulated surface properties.
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Affiliation(s)
- M S Leal
- Departamento de Química, Facultad de Ciencias , Universidad de Chile , Las Palmeras , 3425 Santiago , Chile
| | - X Briones
- Departamento de Química, Facultad de Ciencias , Universidad de Chile , Las Palmeras , 3425 Santiago , Chile
| | - V Villalobos
- Instituto de Ciencias Químicas Aplicadas, Facultad de Ingeniería , Universidad Autónoma de Chile , El Llano Subercaseaux , 2801 San Miguel , Chile
| | - Y Queneau
- Université de Lyon, ICBMS, UMR 5246, CNRS, UCBL, INSA Lyon, CPE Lyon, Bât. Lederer , 1 Rue Victor Grignard , 69622 Villeurbanne Cedex , France
| | - A Leiva
- Departamento Química Física, Facultad de Química , Pontificia Universidad Católica de Chile , Macul , 7820436 Santiago , Chile
| | - H E Ríos
- Departamento de Química, Facultad de Ciencias , Universidad de Chile , Las Palmeras , 3425 Santiago , Chile
| | - J Pavez
- Departamento de Química de los Materiales, Fac. de Química-Biología , Universidad de Santiago de Chile , Av. B. O'Higgins , 3363 Santiago , Chile
| | - C P Silva
- Departamento de Química de los Materiales, Fac. de Química-Biología , Universidad de Santiago de Chile , Av. B. O'Higgins , 3363 Santiago , Chile
| | - C Carrasco
- Departamento de Biología, Facultad de Ciencias , Universidad de Chile , P. C. 780-0023 Santiago , Chile
| | - Andrónico Neira-Carrillo
- Faculty de Ciencias Veterinarias y Pecuarias , Universidad de Chile , Av. Sta. Rosa , 11735 Santiago , Chile
| | - A D Roth
- Departamento de Biología, Facultad de Ciencias , Universidad de Chile , P. C. 780-0023 Santiago , Chile
| | - L Tamayo
- Departamento de Química, Facultad de Ciencias , Universidad de Chile , Las Palmeras , 3425 Santiago , Chile
| | - M D Urzúa
- Departamento de Química, Facultad de Ciencias , Universidad de Chile , Las Palmeras , 3425 Santiago , Chile
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Soler A, Amer G, Leiva A, Ripoll J, Llorente MA, Leiva A, Taltavull JM, Molina R, Llobera J. Continuation versus discontinuation of treatment for severe dementia: randomized, pragmatic, open-label, clinical trial to evaluate the efficacy of continuing drug treatment in patients with severe dementia (STOP-DEM). BMC Geriatr 2019; 19:101. [PMID: 30971215 PMCID: PMC6458648 DOI: 10.1186/s12877-019-1122-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/27/2019] [Indexed: 01/26/2023] Open
Abstract
Background Previous observational studies and clinical trials have shown that cholinesterase inhibitors (with or without memantine) provide benefit for patients with mild-to-moderate Alzheimer’s disease. However, the impact of treatment continuation after progression to severe disease is unknown. The main aim of this study is to evaluate the effect and safety of continuing treatment with ChEIs (with or without memantine) for patients with severe dementia. Methods This randomized, pragmatic, open-label clinical trial with blinded evaluators will evaluate the efficacy of continuing drug treatment in patients with advanced dementia. A total of 302 community-dwelling patients with severe dementia, Alzheimer’s disease, with or without a coexisting diagnosis of vascular dementia, and a score of 10 or less on the Mini-Mental State Examination who received previous treatment with a cholinesterase inhibitor (with or without memantine) for at least 3 months, will be randomized to continue or discontinue drug treatment. Follow-up will be 12 months or until the primary endpoint is achieved. The primary endpoint is entry into institutional care and progression of disability, defined as a loss of 2 of 4 basic functions, or 6 of 11 instrumental functions, according to the Bristol Activities of Daily Living Scale at 12 months. The secondary outcomes are patient changes in functional and cognitive state, quality of life, and caregiver burden. Discussion We expect that the results of our study will allow to identify if there is clinical relevant impact for patients and caregivers between maintaining or halting pharmacological treatment. Trial registration The study was prospectively registered in the REec (2017–000042-22) on May 11 2017 and ID ISRCTN12134230 on February 25 2019.
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Affiliation(s)
- Aina Soler
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain. .,Instituto de Investigación Sanitaria de Palma, Palma, Spain.
| | - Guillem Amer
- Son Espases Hospital, Baleares Health Services-IbSalut, Palma, Spain
| | - Alicia Leiva
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | - Joana Ripoll
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | | | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | - Joana Maria Taltavull
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | - Rosa Molina
- Manacor Hospital, Baleares Health Services-IbSalut, Mallorca, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
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Vicens C, Leiva A, Bejarano F, Sempere E, Rodríguez-Rincón RM, Fiol F, Mengual M, Ajenjo A, Do Pazo F, Mateu C, Folch S, Alegret S, Coll JM, Martín-Rabadán M, Socias I. Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study. BMJ Open 2019; 9:e022046. [PMID: 30705235 PMCID: PMC6359733 DOI: 10.1136/bmjopen-2018-022046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Benzodiazepines (BZDs) are mainly used to treat anxiety and sleep disorders, and are often prescribed for long durations, even though prescription guidelines recommend short-term use due to the risk of dependence, cognitive impairment, and falls and fractures. Education of general practitioners (GPs) regarding the prescription of BZDs may reduce the overuse and of these drugs.The aims of this study are to analyse the effectiveness of an intervention targeted to GPs to reduce BZD prescription and evaluate the implementation process. METHODS AND ANALYSIS The healthcare centres in three regions of Spain (Balearic Islands, Catalonia and Community of Valencia) will be randomly allocated to receive a multifactorial intervention or usual care (control). GPs in the intervention group will receive a 2-hour workshop about best-practice regarding BZD prescription and BZD deprescribing, monthly feedback about their BZD prescribing practices and access to a support web page. Outcome measures for each GP are the defined daily dosage per 1000 inhabitants per day and the proportion of long-term BZD users at 12 months. Data will be collected from the electronic prescription database of the public health system, and will be subjected to intention-to-treat analysis. Implementation will be evaluated by mixed methods following the five domains of the Consolidated Framework For Implementation Research. ETHICS AND DISSEMINATION This study was approved by the Balearic Islands Ethical Committee of Clinical Research (IB3065/15), l'IDIAP Jordi Gol Ethical Committee of Clinical Research (PI 15/0148) and Valencia Primary Care Ethical Committee of Clinical Research (P16/024). The results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN28272199.
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Affiliation(s)
- Caterina Vicens
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service Ib-Salut, Palma, Spain
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Spain
| | - Alfonso Leiva
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Spain
- Primary Care Reseach Unit, Balearic Health Service Ib-Salut, Palma, Spain
| | - Ferran Bejarano
- DAP Camp de Tarragona, Catalunya Health Services-CatSalut, Tarragona, Spain
| | - Ermengol Sempere
- Paterna Healthcare Centre, Conselleria de Sanitat Universal, Agència Valenciana de Salut, Valencia, Spain
| | | | - Francisca Fiol
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service Ib-Salut, Palma, Spain
| | - Marta Mengual
- DAP Camp de Tarragona, Catalunya Health Services-CatSalut, Tarragona, Spain
| | - Asunción Ajenjo
- Paterna Healthcare Centre, Conselleria de Sanitat Universal, Agència Valenciana de Salut, Valencia, Spain
| | - Fernando Do Pazo
- Pharmacy Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Catalina Mateu
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service Ib-Salut, Palma, Spain
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Spain
| | - Silvia Folch
- DAP Camp de Tarragona, Catalunya Health Services-CatSalut, Tarragona, Spain
| | - Santiago Alegret
- Son Serra-La Vileta Healthcare Centre, Balearic Health Service Ib-Salut, Palma, Spain
| | - Jose Maria Coll
- Menorca Primary Care Management, Balearic Health Service Ib-Salut, Mahón, Spain
| | | | - Isabel Socias
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Spain
- Manacor Healthcare Centre, Balearic Health Service Ib-Salut, Manacor, Spain
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36
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Esteva M, Ruidíaz M, Sánchez MA, Pértega S, Pita-Fernández S, Macià F, Posso M, González-Luján L, Boscá-Wats MM, Leiva A, Ripoll J. Correction: Emergency presentation of colorectal patients in Spain. PLoS One 2018; 13:e0207143. [PMID: 30388189 PMCID: PMC6214565 DOI: 10.1371/journal.pone.0207143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0203556.].
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37
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Méndez-López M, Moreno-Serna V, Inostroza-Rivera R, Ramos A, Molero L, Bonardd S, Diaz Diaz D, Leiva A, Saldías C. Optical and electronic activities of biobased films of chitosan/POTE containing gold nanoparticles: Experimental and theoretical analyses. Eur Polym J 2018. [DOI: 10.1016/j.eurpolymj.2018.08.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Esteva M, Ruiz-Díaz M, Sánchez MA, Pértega S, Pita-Fernández S, Macià F, Posso M, González-Luján L, Boscá-Wats MM, Leiva A, Ripoll J. Emergency presentation of colorectal patients in Spain. PLoS One 2018; 13:e0203556. [PMID: 30273339 PMCID: PMC6166931 DOI: 10.1371/journal.pone.0203556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background Colorectal cancer (CRC) is the leading cause of cancer deaths in Europe. Survival is poorer in patients admitted to hospitals through the emergency department than in electively admitted patients. Knowledge of factors associated with a cancer diagnosis through presentation at an emergency department may reduce the likelihood of an emergency diagnosis. This study evaluated factors influencing the diagnosis of CRC in the emergency department. Methods and findings This is a cross-sectional study in 5 Spanish regions; subjects were incident cases of CRC diagnosed in 9 public hospitals, between 2006 and 2008. Data were obtained from patient interviews and primary care and hospital clinical records. We found that approximately 40% of CRC patients first contacted a hospital for CRC through an emergency service. Women were more likely than men to be emergency presenters. The type of symptom associated with emergency presentation differed between patients with colon cancer and those with rectal cancer, in that the frequency of “alarm symptoms” was significantly lower in colon than in rectal cancer patients who initially presented to emergency services. Soon after symptom onset, some patients went to a hospital emergency service, whereas others contacted their GP. Lack of contact with a GP for CRC-related symptoms was consistently related to emergency presentation. Among patients who contacted a GP, a higher number of consultations for CRC symptoms and any referral to outpatient consultations reduced the likelihood of emergency presentation. All diagnostic time intervals were shorter in emergency presenters than in elective patients. Conclusions Emergency presenters are not a uniform category and can be divided into categories according to their symptoms, help seeking behavior trajectory and interaction with their GPs. Time constraints for testing and delays in obtaining outpatient appointments led patients to visit a hospital service either on their own or after referral by their GP.
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Affiliation(s)
- Magdalena Esteva
- Primary Care Research Unit, Majorca Department of Primary Care; Baleares Health Service [IbSalut], Balearic Islands Health Research Institute (IdISBa), Majorca, Spain
- * E-mail:
| | | | - M. Antonia Sánchez
- Centro de Salud Fuentes Norte Zaragoza, Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Sonia Pértega
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, España
| | - Salvador Pita-Fernández
- Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, España
| | - Francesc Macià
- Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain
| | - Margarita Posso
- Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain
| | - Luis González-Luján
- Serreria II Primary Care Centre, Valencia Institute of Health, Valencia, Spain
| | - Marta M. Boscá-Wats
- Digestive Medicine Unit, Hospital Clinic Universitari de València, València, Spain
| | - Alfonso Leiva
- Primary Care Research Unit, Majorca Department of Primary Care; Baleares Health Service [IbSalut], Balearic Islands Health Research Institute (IdISBa), Majorca, Spain
| | - Joana Ripoll
- Primary Care Research Unit, Majorca Department of Primary Care; Baleares Health Service [IbSalut], Balearic Islands Health Research Institute (IdISBa), Majorca, Spain
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Leiva A, Granados-Chinchilla F, Redondo-Solano M, Arrieta-González M, Pineda-Salazar E, Molina A. Characterization of the animal by-product meal industry in Costa Rica: Manufacturing practices through the production chain and food safety. Poult Sci 2018; 97:2159-2169. [PMID: 29562297 PMCID: PMC5972599 DOI: 10.3382/ps/pey058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022] Open
Abstract
Animal by-product rendering establishments are still relevant industries worldwide. Animal by-product meal safety is paramount to protect feed, animals, and the rest of the food chain from unwanted contamination. As microbiological contamination may arise from inadequate processing of slaughterhouse waste and deficiencies in good manufacturing practices within the rendering facilities, we conducted an overall establishment's inspection, including the product in several parts of the process.An evaluation of the Good Manufacturing Practices (GMP) was carried out, which included the location and access (i.e., admission) to the facilities, integrated pest management programs, physical condition of the facilities (e.g., infrastructure), equipments, vehicles and transportation, as well as critical control points (i.e., particle size and temperature set at 50 mm, 133°C at atmospheric pressure for 20 min, respectively) recommended by the OIE and the European Commission. The most sensitive points according to the evaluation are physical structure of the facilities (avg 42.2%), access to the facilities (avg 48.6%), and cleaning procedures (avg 51.4%).Also, indicator microorganisms (Salmonella spp., Clostridium spp., total coliforms, E. coli, E. coli O157:H7) were used to evaluate the safety in different parts of the animal meal production process. There was a prevalence of Salmonella spp. of 12.9, 14.3, and 33.3% in Meat and Bone Meal (MBM), poultry by-products, and fish meal, respectively. However, there were no significant differences (P = 0.73) in the prevalence between the different animal meals, according to the data collected.It was also observed that renderings associated with the poultry industry (i.e., 92.0%) obtained the best ratings overall, which reflects a satisfactory development of this sector and the integration of its production system as a whole.
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Affiliation(s)
- A Leiva
- Research Center in Animal Nutrition (CINA), University of Costa Rica
| | | | - M Redondo-Solano
- Research Center in Tropical Diseases (CIET) and Department of Microbiology, University of Costa Rica
| | - M Arrieta-González
- Research Center in Tropical Diseases (CIET) and Department of Microbiology, University of Costa Rica
| | - E Pineda-Salazar
- Research Center in Tropical Diseases (CIET) and Department of Microbiology, University of Costa Rica
| | - A Molina
- Research Center in Animal Nutrition (CINA), University of Costa Rica.,Department of Animal Science, University of Costa Rica
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Leiva A, Estela A, Bennasar-Veny M, Aguiló A, Llobera J, Yáñez AM. Effectiveness of a complex intervention on smoking in adolescents: A cluster-randomized controlled trial. Prev Med 2018; 114:88-94. [PMID: 29940292 DOI: 10.1016/j.ypmed.2018.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
UNLABELLED Tobacco smoking is a major preventable cause of death, and a significant public health problem worldwide. Most smokers begin in adolescence, age at which they are more susceptible to nicotine addiction. The prevalence of smoking in adolescence is considerable. Therefore, it would be convenient to incorporate smoking prevention programs in the school environment. It is necessary to provide evidence of its effectiveness. The primary objective of the study was to evaluate the effectiveness of a teacher-delivered school-based intervention on the initiation of smoking in adolescents (ITACA smoking prevention education program). A multi-center cluster randomized trial was designed. Twenty-two secondary schools from Spain were enrolled in 2 successive cohorts, from 2010 to 2011. The intervention consisted in the application of the ITACA smoking prevention education program. A 4-year cognitive-behavioral intervention that is based on the social-influences model and is integrated into schools' regular curricular activities. A total of 1055 students were surveyed before the intervention (age: 12-13 years-old), and at the third year of the intervention (age: 14-15 years-old) of a 4-year education program. The outcome measures were daily and weekly use of cigarettes, and initiation of smoking. There was no evidence that the intervention impacted the incidence of regular smoking (OR = 1.08; 95% CI: 0.50-2.33) or the initiation of smoking (OR = 1.09; 95% CI: 0.56-1.72). This trial provides evidence supporting the non-effectiveness of a complex educational smoking prevention program at 3 years after the intervention. TRIAL REGISTRATION NUMBER Current Controlled Trials: NCT01602796.
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Affiliation(s)
- Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain; Balearic Islands Health Research Institute (IdISPA), Palma, Spain; Primary Care Preventive and Health Promotion Research Network (redIAPP), Spain
| | - Andreu Estela
- Dalt Sant Joan Primary Health Care Centre, Balearic Islands Health Service, Menorca, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain.
| | - Antoni Aguiló
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain; Balearic Islands Health Research Institute (IdISPA), Palma, Spain; Primary Care Preventive and Health Promotion Research Network (redIAPP), Spain
| | - Aina M Yáñez
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain; Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Balearic Islands University, Palma, Spain
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Zabaleta-Del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vicens C, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Correction to: Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:1004. [PMID: 30103723 PMCID: PMC6088411 DOI: 10.1186/s12889-018-5905-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain. .,Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007, Barcelona, Spain. .,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. .,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain.
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014, Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005, Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022, Barcelona, Spain.,Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/ Padilla 326-332, 08025, Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Alfonso Leiva
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Caterina Vicens
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Clara Vidal
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023, Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023, Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain.,Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla, 23, Málaga, Spain.,Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla, 23, Málaga, Spain.,El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018, Málaga, Spain.,Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071, Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla, 23, Málaga, Spain.,Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla, 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201, Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201, Vigo, Spain.,Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201, Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Zabaleta-del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:874. [PMID: 30005705 PMCID: PMC6045838 DOI: 10.1186/s12889-018-5805-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.
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Affiliation(s)
- Edurne Zabaleta-del-Olmo
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014 Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005 Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022 Barcelona, Spain
- Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/Padilla 326-332, 08025 Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Alfonso Leiva
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Clara Vidal
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
- El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018 Málaga, Spain
- Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
- Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Navas A, Artigues C, Leiva A, Portells E, Soler A, Cladera A, Ortas S, Alomar M, Gual M, Manzanares C, Brunet M, Julià M, López L, Granda L, Bennasar-Veny M, Carrascosa MC. Effectiveness and safety of moderate-intensity aerobic water exercise during pregnancy for reducing use of epidural analgesia during labor: protocol for a randomized clinical trial. BMC Pregnancy Childbirth 2018; 18:94. [PMID: 29642862 PMCID: PMC5896064 DOI: 10.1186/s12884-018-1715-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/23/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Epidural analgesia during labor can provide effective pain relief, but can also lead to adverse effects. The practice of moderate exercise during pregnancy is associated with an increased level of endorphins in the blood, and this could also provide pain relief during labor. Aerobic water exercises, rather than other forms of exercise, do not negatively impact articulations, reduce edema, blood pressure, and back pain, and increase diuresis. We propose a randomized controlled trial (RCT) to evaluate the effectiveness and safety of a moderate water exercise program during pregnancy on the need for epidural analgesia during labor. METHODS A multi-center, parallel, randomized, evaluator blinded, controlled trial in a primary care setting. We will randomised 320 pregnant women (14 to 20 weeks gestation) who have low risk of complications to a moderate water exercise program or usual care. DISCUSSION The findings of this research will contribute toward understanding of the effects of a physical exercise program on pain and the need for analgesia during labor. TRIAL REGISTRATION ISRCTN Registry identifier: 14097513 register on 04 September 2017. Retrospectively registered.
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Affiliation(s)
- Araceli Navas
- Baleares Health Services-IbSalut, Hospital de Son Espases, 07005 Palma, Spain
| | - Catalina Artigues
- Pont D’Inca- Marratxí Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca. Baleares Health Services-IbSalut, 07005 Palma, Spain
- Instituto de Investigación Sanitaria de Palma(IdISPa), 07010 Palma, Spain
| | - Elena Portells
- Muntanya- Marratxí Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Aina Soler
- Primary Care Research Unit of Mallorca. Baleares Health Services-IbSalut, 07005 Palma, Spain
- Instituto de Investigación Sanitaria de Palma(IdISPa), 07010 Palma, Spain
| | - Antonia Cladera
- Santa María Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Silvia Ortas
- S’Excorxador Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Margarita Alomar
- Can Pastilla Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Marina Gual
- Soller Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | | | - Marina Brunet
- Santa Ponça Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Magdalena Julià
- Alcudia Health Care Center. Baleares Health Services-IbSalut, 07005 Palma, Spain
| | - Lidia López
- Baleares Health Services-IbSalut, Hospital Comarcal de Inca, 07005 Palma, Spain
| | - Lorena Granda
- Baleares Health Services-IbSalut, Hospital de Manacor, 07005 Palma, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Research Group on Evidence, Lifestyles & Health, University of the Balearic Islands, 07122 Palma, Spain
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Schmidt M, Saavedra M, Alegría L, Alvarado N, Fuentes I, Menares P, Kortaberría G, Gargallo L, Saldías C, Leiva A, Radić D. Host-guest interactions of non-steroidal anti-inflammatory drugs on the functionalized dendronized polymeric nanocomposite, Poly(N-tris[((cyano-ethoxy)methyl] methylacrylamide). Journal of Macromolecular Science, Part A 2018. [DOI: 10.1080/10601325.2018.1426389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Schmidt
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
| | - M. Saavedra
- Laboratorio de Química Teórica, Facultad de Química y Biología, Universidad de Santiago de Chile (USACH), Casilla 40, Correo 33, Santiago, Chile
| | - L. Alegría
- Centro de Docencia de Ciencias Básicas para Ingeniería, Facultad de Ciencias de la Ingeniería, Universidad Austral de Chile, Casilla 567, Valdivia, Chile
| | - N. Alvarado
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
| | - I. Fuentes
- Centro de Materiales Poliméricos y Macromoléculas, Instituto de Ciencias Químicas Aplicadas, Facultad de Ingeniería. Centro de Investigación Multidisciplinario de La Araucanía (CIMA), Universidad Autónoma de Chile, Av. Alemania, Temuco, Chile
| | - P. Menares
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
| | - G. Kortaberría
- Group “Material+Technologies”, Dept Ingeniería Química y M. Ambiente, Escuela Politécnica, Universidad País Vasco/Euskal Herriko Unibersitatea, Donostia, San Sebastián, España
| | - L. Gargallo
- Facultad de Ciencias, Departamento de Química Universidad de Tarapacá, General Velásquez, Arica, Chile
| | - C. Saldías
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
| | - A. Leiva
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
| | - D. Radić
- Laboratorio de Química Física de Macromoléculas, Depto Química Física, Facultad de Química, Pontificia Universidad Católica de Chile, Casilla 306, Santiago 22, Chile
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Llobera J, Sansó N, Ruiz A, Llagostera M, Serratusell E, Serrano C, Roselló MLM, Benito E, Castaño EJ, Leiva A. Strengthening primary health care teams with palliative care leaders: protocol for a cluster randomized clinical trial. BMC Palliat Care 2017; 17:4. [PMID: 28693520 PMCID: PMC5504625 DOI: 10.1186/s12904-017-0217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/23/2017] [Indexed: 12/12/2022] Open
Abstract
Background The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs. Methods Design: A two-arm cluster randomized clinical trial of 30 Primary Health Care Centers (PHCC) in Mallorca (Spain), in which each center was randomized to an intervention arm or a usual care arm. We expect that the number of patients identified as suitable for PC (including non-oncological PC) is at least 5% greater in the intervention arm. Sample size: A total of 4640 deceased patients. Outcomes will be assessed by a blinded external review of the electronic records. Interventions: General practitioners (GPs) and nurse leaders in PC for each PHCC will be appointed. These leaders will help promote PC training of colleagues, improve symptom management and psychological support of patients, and evaluate the complexity of individual cases so that these cases receive assistance from PC home-based teams. Measurements: Early identification (>90 days before death), evaluation of case complexity, level of case complexity (with referral to a home-based PC team), use and cost of hospital and primary care services, and quality of life during the last month of life (≥2 emergency room visits, ≥2 hospital admissions, ≥14 days of hospitalization). Discusion PC leaders in primary care teams will improve the early identification of patients eligible for PC. This initiative could improve the quality of end-of-life care and utilization of hospital resources. Trial registration ISRCTN Registry identifier: ISRCTN92479122. Retrospectively registered on 28 February 2017.
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Affiliation(s)
- Joan Llobera
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, 07005, Palma, Spain.,Instituto de Investigación Sanitaria de Palma (IdISPa), 07010, Palma, Spain
| | - Noemí Sansó
- Department of Nursing and Physiotherapy, University of Balearic Islands, Valldemossa road 7,5 Km, 07122, Palma, Spain.
| | - Amador Ruiz
- Sta Catalina Health care centre, Baleares Health Services-IbSalut, Camí de son Cladera 6, 07009, Palma, Spain
| | - Merce Llagostera
- Equipo de Soporte a la Atención Domiciliaria Mallorca (ESAD-Mallorca), Baleares Health Services-IbSalut, UBS Es Molinar, c/ Guayaquil 9, Palma, Spain
| | | | - Carlos Serrano
- Equipo de Soporte a la Atención Domiciliaria Mallorca (ESAD-Mallorca), Baleares Health Services-IbSalut, UBS Es Molinar, c/ Guayaquil 9, Palma, Spain
| | | | - Enric Benito
- Balearic Islands Palliative Care Regional Program, Baleares Health Services-IbSalut, C/ Jesús 40, 07010, Palma, Spain
| | - Eusebio J Castaño
- Service of Health Planning of the Health counseling of the Government of the Balearic Islands, Plaza España 9, 07002, Palma de Mallorca, Islas Baleares, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, 07005, Palma, Spain.,Instituto de Investigación Sanitaria de Palma (IdISPa), 07010, Palma, Spain
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Riera-Sampol A, Tauler P, Bennasar-Veny M, Leiva A, Artigues-Vives G, De Pedro-Gómez J, Pericàs J, Moreno C, Arbos M, Aguilo A. Physical activity prescription by primary care nurses using health assets: Study design of a randomized controlled trial in patients with cardiovascular risk factors. J Adv Nurs 2017; 73:2191-2200. [DOI: 10.1111/jan.13318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Aina Riera-Sampol
- Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Pedro Tauler
- Department of Fundamental Biology and Health Sciences; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca; Balearic Islands Health Service; Palma de Mallorca Spain
| | | | - Joan De Pedro-Gómez
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Jordi Pericàs
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Carlos Moreno
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Maite Arbos
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
| | - Antoni Aguilo
- Department of Nursing and Physiotherapy; Research Group on Evidence, Lifestyles & Health; University of the Balearic Islands; Palma de Mallorca Spain
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Yáñez AM, Leiva A, Estela A, Čukić I. The associations of personality traits and parental education with smoking behaviour among adolescents. PLoS One 2017; 12:e0174211. [PMID: 28333969 PMCID: PMC5363906 DOI: 10.1371/journal.pone.0174211] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/06/2017] [Indexed: 11/21/2022] Open
Abstract
We examined whether personality traits and parental education are associated with smoking initiation in a sample of Spanish secondary school students. Participants, taken from the ITACA study (842 adolescents aged 14–15 years), completed a questionnaire assessing personality traits of the Five Factor Model, smoking behaviours and parental education. Multinomial logistic regression models controlling for age and sex were used to determine the independent associations and interactions of personality traits and parental education with risk of ever trying smoking, as well as with being a regular smoker in adolescence. Higher conscientiousness was related to a lower chance of trying smoking at least once (OR = 0.57, 95% CIs = 0.46, 0.71) as well as being a regular smoker (OR = 0.39, 95% CIs = 0.27, 0.55). Higher emotional instability (neuroticism) was associated with higher risk of being in either smoking category (OR = 1.33, 95% CIs = 1.10, 1.60 and OR = 1.76, 95% CIs = 1.31, 2.35, respectively). Higher extraversion was also associated with a higher risk of both types of smoking behaviour (OR = 1.38, 95% CIs = 1.12, 1.70 and OR = 2.43 (1.67, 3.55, respectively). Higher parental education was significantly related to lower risk of being a regular smoker (OR = 0.70, 95% CIs = 0.54, 0.89), but not with trying smoking in the past. Finally, we found no evidence of the interactions between adolescents’ personality and parental education in predicting adolescent smoking behaviours. We conclude that personality factors and parental education are important and independent factors associated with smoking behaviour in adolescents.
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Affiliation(s)
- Aina M. Yáñez
- Instituto de Investigación Sanitaria de Palma (IdISPa), Mallorca, Spain
- Research Group on Evidence, Lifestyles and Health, Universitat Illes Balears, Mallorca, Spain
| | - Alfonso Leiva
- Instituto de Investigación Sanitaria de Palma (IdISPa), Mallorca, Spain
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Mallorca, Spain
| | - Andreu Estela
- Dalt Sant Joan Health Centre, Baleares Health services-IbSalut, Menorca, Spain
| | - Iva Čukić
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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Fuenzalida B, Cantin C, Carvajal L, Contreras-Duarte S, Pardo F, Chiarello D, Sobrevia L, Leiva A. Human maternal supraphysiological hypercholesterolemia increases the efflux of cholesterol from placental trophoblast and microvascular endothelial cells. Placenta 2017. [DOI: 10.1016/j.placenta.2017.01.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pardo F, Aedo A, Silva L, Chiarello D, Leiva A, Sobrevia L. Excessive gestational weight gain reduces the response to vasoactive molecules in human fetoplacental microvessels. Placenta 2017. [DOI: 10.1016/j.placenta.2017.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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50
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Silva L, Subiabre M, Villalobos-Labra R, Salsoso R, López A, Paulo M, Pardo F, Leiva A, Sobrevia L. Insulin therapy restores the equilibrative nucleoside transporter 1 expression in human umbilical vein endothelial cells from gestational diabetes mellitus. Placenta 2017. [DOI: 10.1016/j.placenta.2017.01.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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