2023

• 
  1.

  Neves AL, Esteva M, Hoffman R, Harris M. Primary care practitioners’ priorities for improving the timeliness of cancer diagnosis in primary care: a European cluster-based analysis. BMC Health Serv Res. 2023;23(1):997.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Diagnosing cancer at an early stage increases the likelihood of survival, and more advanced cancers are more difficult to treat successfully. Primary care practitioners (PCPs) play a key role in timely diagnosis of cancer. PCPs' knowledge of their own patient populations and health systems could help improve the planning of more effective approaches to earlier cancer recognition and referral. How PCPs act when faced with patients who may have cancer is likely to depend on how their health systems are organised, and this may be one explanation for the wide variation on cancer survival rates across Europe. OBJECTIVES: To identify and characterise clusters of countries whose PCPs perceive the same factors as being important in improving the timeliness of cancer diagnosis. METHODS: A cluster analysis of qualitative data from an online survey was carried out. PCPs answered an open-ended survey question on how the speed of diagnosis of cancer in primary care could be improved. Following coding and thematic analysis, we identified the number of times per country that an item in a theme was mentioned. k-means clustering identified clusters of countries whose PCPs perceived the same themes as most important. Post-hoc testing explored differences between these clusters. SETTING: Twenty-five primary care centres in 20 European countries. Each centre was asked to recruit at least 50 participants. PARTICIPANTS: Primary care practitioners of each country. RESULTS: In all, 1,351 PCPs gave free-text answers. We identified eighteen themes organising the content of the responses. Based on the frequency of the themes, k-means clustering identified three groups of countries. There were significant differences between clusters regarding the importance of: access to tests (p = 0.010); access to specialists (p = 0.014), screening (p < 0.001); and finances, quotas & limits (p < 0.001). CONCLUSIONS: Our study identified three distinct clusters of European countries within which PCPs had similar views on the factors that would improve the timeliness of cancer diagnosis. Further work is needed to understand what it is about the clusters that have produced these patterns, allowing healthcare systems to share best practice and to reduce disparities.

  @article{RN51,
  abstract = {BACKGROUND: Diagnosing cancer at an early stage increases the likelihood of survival, and more advanced cancers are more difficult to treat successfully. Primary care practitioners (PCPs) play a key role in timely diagnosis of cancer. PCPs' knowledge of their own patient populations and health systems could help improve the planning of more effective approaches to earlier cancer recognition and referral. How PCPs act when faced with patients who may have cancer is likely to depend on how their health systems are organised, and this may be one explanation for the wide variation on cancer survival rates across Europe. OBJECTIVES: To identify and characterise clusters of countries whose PCPs perceive the same factors as being important in improving the timeliness of cancer diagnosis. METHODS: A cluster analysis of qualitative data from an online survey was carried out. PCPs answered an open-ended survey question on how the speed of diagnosis of cancer in primary care could be improved. Following coding and thematic analysis, we identified the number of times per country that an item in a theme was mentioned. k-means clustering identified clusters of countries whose PCPs perceived the same themes as most important. Post-hoc testing explored differences between these clusters. SETTING: Twenty-five primary care centres in 20 European countries. Each centre was asked to recruit at least 50 participants. PARTICIPANTS: Primary care practitioners of each country. RESULTS: In all, 1,351 PCPs gave free-text answers. We identified eighteen themes organising the content of the responses. Based on the frequency of the themes, k-means clustering identified three groups of countries. There were significant differences between clusters regarding the importance of: access to tests (p = 0.010); access to specialists (p = 0.014), screening (p < 0.001); and finances, quotas & limits (p < 0.001). CONCLUSIONS: Our study identified three distinct clusters of European countries within which PCPs had similar views on the factors that would improve the timeliness of cancer diagnosis. Further work is needed to understand what it is about the clusters that have produced these patterns, allowing healthcare systems to share best practice and to reduce disparities.},
  author = {Neves, A. L. and Esteva, M. and Hoffman, R. and Harris, M.},
  journal = {BMC Health Serv Res},
  keywords = {grapp-caib},
  number = 1,
  pages = 997,
  title = {Primary care practitioners' priorities for improving the timeliness of cancer diagnosis in primary care: a European cluster-based analysis},
  type = {Journal Article},
  volume = 23,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN51
  %A Neves, A. L.
  %A Esteva, M.
  %A Hoffman, R.
  %A Harris, M.
  %D 2023
  %J BMC Health Serv Res
  %N 1
  %P 997
  %R 10.1186/s12913-023-09891-w
  %T Primary care practitioners' priorities for improving the timeliness of cancer diagnosis in primary care: a European cluster-based analysis
  %V 23
  %X BACKGROUND: Diagnosing cancer at an early stage increases the likelihood of survival, and more advanced cancers are more difficult to treat successfully. Primary care practitioners (PCPs) play a key role in timely diagnosis of cancer. PCPs' knowledge of their own patient populations and health systems could help improve the planning of more effective approaches to earlier cancer recognition and referral. How PCPs act when faced with patients who may have cancer is likely to depend on how their health systems are organised, and this may be one explanation for the wide variation on cancer survival rates across Europe. OBJECTIVES: To identify and characterise clusters of countries whose PCPs perceive the same factors as being important in improving the timeliness of cancer diagnosis. METHODS: A cluster analysis of qualitative data from an online survey was carried out. PCPs answered an open-ended survey question on how the speed of diagnosis of cancer in primary care could be improved. Following coding and thematic analysis, we identified the number of times per country that an item in a theme was mentioned. k-means clustering identified clusters of countries whose PCPs perceived the same themes as most important. Post-hoc testing explored differences between these clusters. SETTING: Twenty-five primary care centres in 20 European countries. Each centre was asked to recruit at least 50 participants. PARTICIPANTS: Primary care practitioners of each country. RESULTS: In all, 1,351 PCPs gave free-text answers. We identified eighteen themes organising the content of the responses. Based on the frequency of the themes, k-means clustering identified three groups of countries. There were significant differences between clusters regarding the importance of: access to tests (p = 0.010); access to specialists (p = 0.014), screening (p < 0.001); and finances, quotas & limits (p < 0.001). CONCLUSIONS: Our study identified three distinct clusters of European countries within which PCPs had similar views on the factors that would improve the timeliness of cancer diagnosis. Further work is needed to understand what it is about the clusters that have produced these patterns, allowing healthcare systems to share best practice and to reduce disparities.
  

• 
  1.

  Parvanova A, Abbate M, Yañez AM, Bennasar-Veny M, López-González Á A, Ramírez-Manent JI, Iliev IP, Fresneda S, Arias-Fernandez M, Remuzzi G, Ruggenenti P. MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and "preserved" kidney function: A cross-sectional study. Diabetes Res Clin Pract. 2023;201:110729.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  AIMS: To investigate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) in prediabetes, visceral obesity, and preserved kidney function, and explore whether MAFLD is associated with hyperfiltration. METHODS: We analyzed data from 6697 Spanish civil servants, aged 18-65 years, with fasting plasma glucose ≥ 100 and ≤ 125 mg/dL (prediabetes, ADA), waist circumference ≥ 94 cm in men and ≥ 80 cm in women (visceral obesity, IDF) and de-indexed estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, collected during occupational health visits. The association between MAFLD and hyperfiltration (eGFR > age- and sex-specific 95th percentile) was tested by multivariable logistic regression analyses. RESULTS: Overall, 4213 patients (62.9%) had MAFLD, and 330 (4.9%) were hyperfiltering. MAFLD was more frequent in hyperfiltering than in non-hyperfiltering subjects (86.4% vs 61.7%, P < 0.001). BMI, waist circumference, systolic, diastolic, mean arterial pressure, and prevalence of hypertension were higher in hyperfiltering than in non-hyperfiltering subjects (P < 0.05). MAFLD was independently associated with hyperfiltration, even after adjusting for common confounders [OR (95% CI): 3.36 (2.33-4.84), P < 0.001]. In stratified analyses MAFLD potentiated age-related eGFR decline vs. non-MAFLD (P < 0.001). CONCLUSIONS: More than half of subjects with prediabetes, visceral obesity and eGFR ≥ 60 ml/min presented MAFLD that was associated with hyperfiltration and potentiated the age-related eGFR decline.

  @article{RN121,
  abstract = {AIMS: To investigate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) in prediabetes, visceral obesity, and preserved kidney function, and explore whether MAFLD is associated with hyperfiltration. METHODS: We analyzed data from 6697 Spanish civil servants, aged 18-65 years, with fasting plasma glucose ≥ 100 and ≤ 125 mg/dL (prediabetes, ADA), waist circumference ≥ 94 cm in men and ≥ 80 cm in women (visceral obesity, IDF) and de-indexed estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, collected during occupational health visits. The association between MAFLD and hyperfiltration (eGFR > age- and sex-specific 95th percentile) was tested by multivariable logistic regression analyses. RESULTS: Overall, 4213 patients (62.9%) had MAFLD, and 330 (4.9%) were hyperfiltering. MAFLD was more frequent in hyperfiltering than in non-hyperfiltering subjects (86.4% vs 61.7%, P < 0.001). BMI, waist circumference, systolic, diastolic, mean arterial pressure, and prevalence of hypertension were higher in hyperfiltering than in non-hyperfiltering subjects (P < 0.05). MAFLD was independently associated with hyperfiltration, even after adjusting for common confounders [OR (95% CI): 3.36 (2.33-4.84), P < 0.001]. In stratified analyses MAFLD potentiated age-related eGFR decline vs. non-MAFLD (P < 0.001). CONCLUSIONS: More than half of subjects with prediabetes, visceral obesity and eGFR ≥ 60 ml/min presented MAFLD that was associated with hyperfiltration and potentiated the age-related eGFR decline.},
  author = {Parvanova, A. and Abbate, M. and Yañez, A. M. and Bennasar-Veny, M. and López-González Á, A. and Ramírez-Manent, J. I. and Iliev, I. P. and Fresneda, S. and Arias-Fernandez, M. and Remuzzi, G. and Ruggenenti, P.},
  journal = {Diabetes Res Clin Pract},
  keywords = {grapp-caib},
  pages = 110729,
  title = {MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and "preserved" kidney function: A cross-sectional study},
  type = {Journal Article},
  volume = 201,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN121
  %A Parvanova, A.
  %A Abbate, M.
  %A Yañez, A. M.
  %A Bennasar-Veny, M.
  %A López-González Á, A.
  %A Ramírez-Manent, J. I.
  %A Iliev, I. P.
  %A Fresneda, S.
  %A Arias-Fernandez, M.
  %A Remuzzi, G.
  %A Ruggenenti, P.
  %D 2023
  %J Diabetes Res Clin Pract
  %P 110729
  %R 10.1016/j.diabres.2023.110729
  %T MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and "preserved" kidney function: A cross-sectional study
  %V 201
  %X AIMS: To investigate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) in prediabetes, visceral obesity, and preserved kidney function, and explore whether MAFLD is associated with hyperfiltration. METHODS: We analyzed data from 6697 Spanish civil servants, aged 18-65 years, with fasting plasma glucose ≥ 100 and ≤ 125 mg/dL (prediabetes, ADA), waist circumference ≥ 94 cm in men and ≥ 80 cm in women (visceral obesity, IDF) and de-indexed estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, collected during occupational health visits. The association between MAFLD and hyperfiltration (eGFR > age- and sex-specific 95th percentile) was tested by multivariable logistic regression analyses. RESULTS: Overall, 4213 patients (62.9%) had MAFLD, and 330 (4.9%) were hyperfiltering. MAFLD was more frequent in hyperfiltering than in non-hyperfiltering subjects (86.4% vs 61.7%, P < 0.001). BMI, waist circumference, systolic, diastolic, mean arterial pressure, and prevalence of hypertension were higher in hyperfiltering than in non-hyperfiltering subjects (P < 0.05). MAFLD was independently associated with hyperfiltration, even after adjusting for common confounders [OR (95% CI): 3.36 (2.33-4.84), P < 0.001]. In stratified analyses MAFLD potentiated age-related eGFR decline vs. non-MAFLD (P < 0.001). CONCLUSIONS: More than half of subjects with prediabetes, visceral obesity and eGFR ≥ 60 ml/min presented MAFLD that was associated with hyperfiltration and potentiated the age-related eGFR decline.
  

• 
  1.

  González-Herrera A, Pujol-Ribera E, Esteva M, Ruiz-Marcos L, March S. Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants. Arch Public Health. 2023;81(1):111.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS: Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS: We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS: Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.

  @article{RN4,
  abstract = {BACKGROUND: Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS: Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS: We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS: Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.},
  author = {González-Herrera, A. and Pujol-Ribera, E. and Esteva, M. and Ruiz-Marcos, L. and March, S.},
  journal = {Arch Public Health},
  keywords = {grapp-caib},
  number = 1,
  pages = 111,
  title = {Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants},
  type = {Journal Article},
  volume = 81,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN4
  %A González-Herrera, A.
  %A Pujol-Ribera, E.
  %A Esteva, M.
  %A Ruiz-Marcos, L.
  %A March, S.
  %D 2023
  %J Arch Public Health
  %N 1
  %P 111
  %R 10.1186/s13690-023-01104-4
  %T Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants
  %V 81
  %X BACKGROUND: Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS: Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS: We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS: Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.
  

• 
  1.

  Hajdarevic S, Högberg C, Marzo-Castillejo M, Siliņa V, Sawicka-Powierza J, Esteva M, Koskela T, Petek D, Contreras-Martos S, Mangione M, Ožvačić Adžić Z, Asenova R, Gašparović Babić S, Brekke M, Buczkowski K, Buono N, Çifçili Saliha S, Dinant GJ, Doorn B, Hoffman RD, Kuodza G, Murchie P, Pilv L, Puia A, Rapalavicius A, Smyrnakis E, Weltermann B, Harris M. Why do European primary care physicians sometimes not think of, or act on, a possible cancer diagnosis? A qualitative study. BJGP Open. 2023;.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: While Primary Care Physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. AIM: This study explores European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN & SETTING: A multicentre European qualitative study, based on an online survey with open-ended questions asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. METHOD: Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. RESULTS: A total of 158 PCPs completed the questionnaire. The main themes were: where patients' descriptions did not suggest cancer; when distracting factors reduced PCPs' suspicions of cancer; when patients' hesitancy delayed the diagnosis; where system factors hampered the diagnostic process; when PCPs felt that they had made a mistake; and inadequate communication. CONCLUSION: The study identified six overarching themes which need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation shows how the themes relate to each other.

  @article{RN24,
  abstract = {BACKGROUND: While Primary Care Physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. AIM: This study explores European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN & SETTING: A multicentre European qualitative study, based on an online survey with open-ended questions asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. METHOD: Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. RESULTS: A total of 158 PCPs completed the questionnaire. The main themes were: where patients' descriptions did not suggest cancer; when distracting factors reduced PCPs' suspicions of cancer; when patients' hesitancy delayed the diagnosis; where system factors hampered the diagnostic process; when PCPs felt that they had made a mistake; and inadequate communication. CONCLUSION: The study identified six overarching themes which need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation shows how the themes relate to each other.},
  author = {Hajdarevic, S. and Högberg, C. and Marzo-Castillejo, M. and Siliņa, V. and Sawicka-Powierza, J. and Esteva, M. and Koskela, T. and Petek, D. and Contreras-Martos, S. and Mangione, M. and Ožvačić Adžić, Z. and Asenova, R. and Gašparović Babić, S. and Brekke, M. and Buczkowski, K. and Buono, N. and Çifçili Saliha, S. and Dinant, G. J. and Doorn, B. and Hoffman, R. D. and Kuodza, G. and Murchie, P. and Pilv, L. and Puia, A. and Rapalavicius, A. and Smyrnakis, E. and Weltermann, B. and Harris, M.},
  journal = {BJGP Open},
  keywords = {grapp-caib},
  title = {Why do European primary care physicians sometimes not think of, or act on, a possible cancer diagnosis? A qualitative study},
  type = {Journal Article},
  year = 2023
  }
  

  %0 Journal Article
  %1 RN24
  %A Hajdarevic, S.
  %A Högberg, C.
  %A Marzo-Castillejo, M.
  %A Siliņa, V.
  %A Sawicka-Powierza, J.
  %A Esteva, M.
  %A Koskela, T.
  %A Petek, D.
  %A Contreras-Martos, S.
  %A Mangione, M.
  %A Ožvačić Adžić, Z.
  %A Asenova, R.
  %A Gašparović Babić, S.
  %A Brekke, M.
  %A Buczkowski, K.
  %A Buono, N.
  %A Çifçili Saliha, S.
  %A Dinant, G. J.
  %A Doorn, B.
  %A Hoffman, R. D.
  %A Kuodza, G.
  %A Murchie, P.
  %A Pilv, L.
  %A Puia, A.
  %A Rapalavicius, A.
  %A Smyrnakis, E.
  %A Weltermann, B.
  %A Harris, M.
  %D 2023
  %J BJGP Open
  %R 10.3399/bjgpo.2023.0029
  %T Why do European primary care physicians sometimes not think of, or act on, a possible cancer diagnosis? A qualitative study
  %X BACKGROUND: While Primary Care Physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. AIM: This study explores European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN & SETTING: A multicentre European qualitative study, based on an online survey with open-ended questions asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. METHOD: Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. RESULTS: A total of 158 PCPs completed the questionnaire. The main themes were: where patients' descriptions did not suggest cancer; when distracting factors reduced PCPs' suspicions of cancer; when patients' hesitancy delayed the diagnosis; where system factors hampered the diagnostic process; when PCPs felt that they had made a mistake; and inadequate communication. CONCLUSION: The study identified six overarching themes which need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation shows how the themes relate to each other.
  

• 
  1.

  Young-Silva Y, Berenguera A, Jacques-Aviñó C, Gil-Girbau M, Arroyo-Uriarte P, Chela-Alvarez X, Ripoll J, Martí-Lluch R, Ramos R, Elizondo-Alzola U, Garcia-Martinez S, Méndez-López F, Tamayo-Morales O, Martínez-Andrés M, Motrico E, Gómez-Gómez I, Fernández-Alvarez R, Juvinyà-Canal D. Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis. Front Public Health. 2023;11:1069957.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity. OBJECTIVES: This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status. METHOD AND ANALYSIS: This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program. DISCUSSION: We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135.

  @article{RN25,
  abstract = {INTRODUCTION: Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity. OBJECTIVES: This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status. METHOD AND ANALYSIS: This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program. DISCUSSION: We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135.},
  author = {Young-Silva, Y. and Berenguera, A. and Jacques-Aviñó, C. and Gil-Girbau, M. and Arroyo-Uriarte, P. and Chela-Alvarez, X. and Ripoll, J. and Martí-Lluch, R. and Ramos, R. and Elizondo-Alzola, U. and Garcia-Martinez, S. and Méndez-López, F. and Tamayo-Morales, O. and Martínez-Andrés, M. and Motrico, E. and Gómez-Gómez, I. and Fernández-Alvarez, R. and Juvinyà-Canal, D.},
  journal = {Front Public Health},
  keywords = {grapp-caib},
  pages = 1069957,
  title = {Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis},
  type = {Journal Article},
  volume = 11,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN25
  %A Young-Silva, Y.
  %A Berenguera, A.
  %A Jacques-Aviñó, C.
  %A Gil-Girbau, M.
  %A Arroyo-Uriarte, P.
  %A Chela-Alvarez, X.
  %A Ripoll, J.
  %A Martí-Lluch, R.
  %A Ramos, R.
  %A Elizondo-Alzola, U.
  %A Garcia-Martinez, S.
  %A Méndez-López, F.
  %A Tamayo-Morales, O.
  %A Martínez-Andrés, M.
  %A Motrico, E.
  %A Gómez-Gómez, I.
  %A Fernández-Alvarez, R.
  %A Juvinyà-Canal, D.
  %D 2023
  %J Front Public Health
  %P 1069957
  %R 10.3389/fpubh.2023.1069957
  %T Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis
  %V 11
  %X INTRODUCTION: Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity. OBJECTIVES: This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status. METHOD AND ANALYSIS: This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program. DISCUSSION: We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135.
  

• 
  1.

  Lorente-Montalvo P, Cañellas MA, Carandell E, Esteva M. Specific healthcare services for the paediatric population during the COVID-19 pandemic in the Balearic Islands (Spain). Aten Primaria. 2023;55(9):102700.

  BibTeXEndNoteDOIBibSonomyDownload

  @article{RN190,
  author = {Lorente-Montalvo, P. and Cañellas, M. A. and Carandell, E. and Esteva, M.},
  journal = {Aten Primaria},
  keywords = {grapp-caib},
  number = 9,
  pages = 102700,
  title = {Specific healthcare services for the paediatric population during the COVID-19 pandemic in the Balearic Islands (Spain)},
  type = {Journal Article},
  volume = 55,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN190
  %A Lorente-Montalvo, P.
  %A Cañellas, M. A.
  %A Carandell, E.
  %A Esteva, M.
  %D 2023
  %J Aten Primaria
  %N 9
  %P 102700
  %R 10.1016/j.aprim.2023.102700
  %T Specific healthcare services for the paediatric population during the COVID-19 pandemic in the Balearic Islands (Spain)
  %V 55
  

• 
  1.

  Bolibar Ribas B, Llobera-Cànaves J, García-Ortiz L, Bellón J, Ramos R, García-Campayo J, Sánchez-Pérez Á, Claveria A, Martínez V, Vicens E, Minué C, Gil-Guillen V, Berenguera A, Moleras-Serra A. [The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]. Aten Primaria. 2023;55(11):102694.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.

  @article{RN75,
  abstract = {The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.},
  author = {Bolibar Ribas, B. and Llobera-Cànaves, J. and García-Ortiz, L. and Bellón, JÁ and Ramos, R. and García-Campayo, J. and Sánchez-Pérez, Á and Claveria, A. and Martínez, V. and Vicens, E. and Minué, C. and Gil-Guillen, V. and Berenguera, A. and Moleras-Serra, A.},
  journal = {Aten Primaria},
  keywords = {grapp-caib},
  number = 11,
  pages = 102694,
  title = {[The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]},
  type = {Journal Article},
  volume = 55,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN75
  %A Bolibar Ribas, B.
  %A Llobera-Cànaves, J.
  %A García-Ortiz, L.
  %A Bellón, JÁ
  %A Ramos, R.
  %A García-Campayo, J.
  %A Sánchez-Pérez, Á
  %A Claveria, A.
  %A Martínez, V.
  %A Vicens, E.
  %A Minué, C.
  %A Gil-Guillen, V.
  %A Berenguera, A.
  %A Moleras-Serra, A.
  %D 2023
  %J Aten Primaria
  %N 11
  %P 102694
  %R 10.1016/j.aprim.2023.102694
  %T [The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]
  %V 55
  %X The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.
  

• 
  1.

  Paublini H, López González AA, Busquets-Cortés C, Tomas-Gil P, Riutord-Sbert P, Ramírez-Manent JI. Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance. Nutrients. 2023;15(9).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. METHODS: A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. RESULTS: The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. CONCLUSIONS: A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.

  @article{RN188,
  abstract = {BACKGROUND: Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. METHODS: A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. RESULTS: The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. CONCLUSIONS: A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.},
  author = {Paublini, H. and López González, A. A. and Busquets-Cortés, C. and Tomas-Gil, P. and Riutord-Sbert, P. and Ramírez-Manent, J. I.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 9,
  title = {Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance},
  type = {Journal Article},
  volume = 15,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN188
  %A Paublini, H.
  %A López González, A. A.
  %A Busquets-Cortés, C.
  %A Tomas-Gil, P.
  %A Riutord-Sbert, P.
  %A Ramírez-Manent, J. I.
  %D 2023
  %J Nutrients
  %N 9
  %R 10.3390/nu15092105
  %T Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance
  %V 15
  %X BACKGROUND: Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. METHODS: A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. RESULTS: The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. CONCLUSIONS: A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.
  

• 
  1.

  Lugones-Sánchez C, Santos-Mínguez S, Salvado R, González-Sánchez S, Tamayo-Morales O, Hoya-González A, Ramírez-Manent JI, Magallón-Botaya R, Quesada-Rico JA, Garcia-Cubillas MD, Rodríguez-Sánchez E, Gómez-Marcos MA, Benito-Sanchez R, Mira A, Hernandez-Rivas JM, Garcia-Ortiz L. Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study. Front Public Health. 2023;11:1164453.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function. METHODS AND ANALYSIS: MIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000(®)) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR-200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis. DISCUSSION: Lifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota. TRIAL REGISTRATION: clinicaltrials.gov/ct2/show/NCT04924907, ClinicalTrials.gov, identifier: NCT04924907. Registered on 21 April 2021.

  @article{RN1,
  abstract = {BACKGROUND: The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function. METHODS AND ANALYSIS: MIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000(®)) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR-200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis. DISCUSSION: Lifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota. TRIAL REGISTRATION: clinicaltrials.gov/ct2/show/NCT04924907, ClinicalTrials.gov, identifier: NCT04924907. Registered on 21 April 2021.},
  author = {Lugones-Sánchez, C. and Santos-Mínguez, S. and Salvado, R. and González-Sánchez, S. and Tamayo-Morales, O. and Hoya-González, A. and Ramírez-Manent, J. I. and Magallón-Botaya, R. and Quesada-Rico, J. A. and Garcia-Cubillas, M. D. and Rodríguez-Sánchez, E. and Gómez-Marcos, M. A. and Benito-Sanchez, R. and Mira, A. and Hernandez-Rivas, J. M. and Garcia-Ortiz, L.},
  journal = {Front Public Health},
  keywords = {grapp-caib},
  pages = 1164453,
  title = {Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study},
  type = {Journal Article},
  volume = 11,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN1
  %A Lugones-Sánchez, C.
  %A Santos-Mínguez, S.
  %A Salvado, R.
  %A González-Sánchez, S.
  %A Tamayo-Morales, O.
  %A Hoya-González, A.
  %A Ramírez-Manent, J. I.
  %A Magallón-Botaya, R.
  %A Quesada-Rico, J. A.
  %A Garcia-Cubillas, M. D.
  %A Rodríguez-Sánchez, E.
  %A Gómez-Marcos, M. A.
  %A Benito-Sanchez, R.
  %A Mira, A.
  %A Hernandez-Rivas, J. M.
  %A Garcia-Ortiz, L.
  %D 2023
  %J Front Public Health
  %P 1164453
  %R 10.3389/fpubh.2023.1164453
  %T Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study
  %V 11
  %X BACKGROUND: The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function. METHODS AND ANALYSIS: MIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000(®)) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR-200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis. DISCUSSION: Lifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota. TRIAL REGISTRATION: clinicaltrials.gov/ct2/show/NCT04924907, ClinicalTrials.gov, identifier: NCT04924907. Registered on 21 April 2021.
  

• 
  1.

  Zamanillo-Campos R, Fiol deRoque MA, Serrano-Ripoll MJ, Mira-Martínez S, Ricci-Cabello I. Development and evaluation of DiabeText, a personalized mHealth intervention to support medication adherence and lifestyle change behaviour in patients with type 2 diabetes in Spain: A mixed-methods phase II pragmatic randomized controlled clinical trial. Int J Med Inform. 2023;176:105103.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Despite the increasing interest in text-messaging interventions to support healthcare delivery, the available evidence about their effectiveness is still limited. OBJECTIVES: 1) to develop DiabeText, an intervention delivering automated, tailored brief text messages to support diabetes self-management; 2) to explore the potential impact of DiabeText on self-management behavior and glycaemic control, and; 3) to examine the feasibility of conducting a future phase III randomized clinical trial to evaluate the effectiveness of DiabeText. METHODS: 3-month, two-arm, randomized feasibility trial (ClinicalTrials.gov: NCT04738591) with patients with type 2 diabetes (HbA1c > 8%). Participants were allocated to the control (usual care) or DiabeText group (usual care + five text messages per week). Outcomes were: recruitment rate; follow-up rate, missing data; medication adherence; adherence to Mediterranean diet; physical activity; and HbA1c. In addition, after delivering the intervention, we conducted a qualitative study involving 14 semi-structured interviews with participants allocated to the DiabeText group, to understand their views about the intervention. RESULTS: From 444 screened people, we recruited 207 participants (recruitment rate = 47%), of which 179 completed the post-intervention interview (follow-up rate = 86%). We sent 7,355 SMS during the intervention period, of which 99% successfully reached the participants. At post-intervention, DiabeText was associated with non-statistically significant (p > 0.05) improvements in adherence to medication (OR = 2.0; 95%CI 1.0 to 4.2), Mediterranean diet (1.7; 0.9 to 3.2), and physical activity (1.7; 0.9 to 3.1). No between-group differences were observed in mean HbA1c (p = 0.670). The qualitative study indicated that participants perceived DiabeText as a helpful resource because it increased their awareness about the importance of adequate self-management and the sense of being cared for. CONCLUSIONS: DiabeText is the first system in Spain to integrate patient-generated and routinely collected clinical data to deliver tailored text messages to support diabetes self-management. More robust trials are needed to determine its effectiveness and cost-efficacy.

  @article{RN1,
  abstract = {BACKGROUND: Despite the increasing interest in text-messaging interventions to support healthcare delivery, the available evidence about their effectiveness is still limited. OBJECTIVES: 1) to develop DiabeText, an intervention delivering automated, tailored brief text messages to support diabetes self-management; 2) to explore the potential impact of DiabeText on self-management behavior and glycaemic control, and; 3) to examine the feasibility of conducting a future phase III randomized clinical trial to evaluate the effectiveness of DiabeText. METHODS: 3-month, two-arm, randomized feasibility trial (ClinicalTrials.gov: NCT04738591) with patients with type 2 diabetes (HbA1c > 8%). Participants were allocated to the control (usual care) or DiabeText group (usual care + five text messages per week). Outcomes were: recruitment rate; follow-up rate, missing data; medication adherence; adherence to Mediterranean diet; physical activity; and HbA1c. In addition, after delivering the intervention, we conducted a qualitative study involving 14 semi-structured interviews with participants allocated to the DiabeText group, to understand their views about the intervention. RESULTS: From 444 screened people, we recruited 207 participants (recruitment rate = 47%), of which 179 completed the post-intervention interview (follow-up rate = 86%). We sent 7,355 SMS during the intervention period, of which 99% successfully reached the participants. At post-intervention, DiabeText was associated with non-statistically significant (p > 0.05) improvements in adherence to medication (OR = 2.0; 95%CI 1.0 to 4.2), Mediterranean diet (1.7; 0.9 to 3.2), and physical activity (1.7; 0.9 to 3.1). No between-group differences were observed in mean HbA1c (p = 0.670). The qualitative study indicated that participants perceived DiabeText as a helpful resource because it increased their awareness about the importance of adequate self-management and the sense of being cared for. CONCLUSIONS: DiabeText is the first system in Spain to integrate patient-generated and routinely collected clinical data to deliver tailored text messages to support diabetes self-management. More robust trials are needed to determine its effectiveness and cost-efficacy.},
  author = {Zamanillo-Campos, R. and Fiol deRoque, M. A. and Serrano-Ripoll, M. J. and Mira-Martínez, S. and Ricci-Cabello, I.},
  journal = {Int J Med Inform},
  keywords = {grapp-caib},
  pages = 105103,
  title = {Development and evaluation of DiabeText, a personalized mHealth intervention to support medication adherence and lifestyle change behaviour in patients with type 2 diabetes in Spain: A mixed-methods phase II pragmatic randomized controlled clinical trial},
  type = {Journal Article},
  volume = 176,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN1
  %A Zamanillo-Campos, R.
  %A Fiol deRoque, M. A.
  %A Serrano-Ripoll, M. J.
  %A Mira-Martínez, S.
  %A Ricci-Cabello, I.
  %D 2023
  %J Int J Med Inform
  %P 105103
  %R 10.1016/j.ijmedinf.2023.105103
  %T Development and evaluation of DiabeText, a personalized mHealth intervention to support medication adherence and lifestyle change behaviour in patients with type 2 diabetes in Spain: A mixed-methods phase II pragmatic randomized controlled clinical trial
  %V 176
  %X BACKGROUND: Despite the increasing interest in text-messaging interventions to support healthcare delivery, the available evidence about their effectiveness is still limited. OBJECTIVES: 1) to develop DiabeText, an intervention delivering automated, tailored brief text messages to support diabetes self-management; 2) to explore the potential impact of DiabeText on self-management behavior and glycaemic control, and; 3) to examine the feasibility of conducting a future phase III randomized clinical trial to evaluate the effectiveness of DiabeText. METHODS: 3-month, two-arm, randomized feasibility trial (ClinicalTrials.gov: NCT04738591) with patients with type 2 diabetes (HbA1c > 8%). Participants were allocated to the control (usual care) or DiabeText group (usual care + five text messages per week). Outcomes were: recruitment rate; follow-up rate, missing data; medication adherence; adherence to Mediterranean diet; physical activity; and HbA1c. In addition, after delivering the intervention, we conducted a qualitative study involving 14 semi-structured interviews with participants allocated to the DiabeText group, to understand their views about the intervention. RESULTS: From 444 screened people, we recruited 207 participants (recruitment rate = 47%), of which 179 completed the post-intervention interview (follow-up rate = 86%). We sent 7,355 SMS during the intervention period, of which 99% successfully reached the participants. At post-intervention, DiabeText was associated with non-statistically significant (p > 0.05) improvements in adherence to medication (OR = 2.0; 95%CI 1.0 to 4.2), Mediterranean diet (1.7; 0.9 to 3.2), and physical activity (1.7; 0.9 to 3.1). No between-group differences were observed in mean HbA1c (p = 0.670). The qualitative study indicated that participants perceived DiabeText as a helpful resource because it increased their awareness about the importance of adequate self-management and the sense of being cared for. CONCLUSIONS: DiabeText is the first system in Spain to integrate patient-generated and routinely collected clinical data to deliver tailored text messages to support diabetes self-management. More robust trials are needed to determine its effectiveness and cost-efficacy.
  

• 
  1.

  Gallardo-Alfaro L, Lorente-Montalvo P, Cañellas M, Carandell E, Oliver A, Rojo E, Riera B, Llobera J, Bulilete O. Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population. BMC Pediatr. 2023;23(1):433.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Rapid antigen-detection tests (Ag-RDTs) are used to diagnose SARS-CoV-2 infection. Real-world studies of Ag-RDTs are necessary to evaluate their diagnostic yield in paediatric patients. Our aim was to evaluate the accuracy of the Panbio™ Rapid Antigen Test for SARS-CoV-2 in the setting of a primary health care centre (PHC), with use of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) as gold standard. METHODS: This prospective diagnostic study was conducted at PHCs in Mallorca, Spain. Patients were ≤ 18 years-old that attended sites for RT-PCR testing due to symptoms suggestive of infection (fever, headache, nasal congestion and dry cough, among others) or epidemiological exposure (close contacts). Two samples were collected: a nasal mid-turbinate sample for Ag-RDTs and a nasopharyngeal swab for RT-PCR testing. The sensitivity, specificity, and predictive values of the AgRDT were calculated using the RT-PCR results as the reference. RESULTS: We examined 1142 participants from 0 to 18 years (47.5% female, mean age 8.9 ± 4.8 years, median 9.0 [5.0-13.0]). There were 84 positive RT-PCR results (pre-test probability of 7.3%) and 52 positive Ag-RDT results. The sensitivity of the Ag-RDT was 59.5% (95% Confidence Interval (CI): 48.2-69.9%), the specificity was 99.8% (95%CI: 99.2-99.9%), the positive predictive value was 96.1% (95%CI: 85.6-99.4%), and the negative predictive value was 96.8% (95%CI: 95.6-97.7%). The sensitivity for individuals referred by a general practitioner (GP) or paediatrician due to symptoms was 71.4% (95%CI: 51.5-86.0%) and for asymptomatic individuals was 50.0% (95%CI: 9.1-90.8%). The specificity was greater than 98.9% overall and in all subgroups. The sensitivity was 73.0% (95%CI: 52.0-87.5%) for referred patients due to symptoms and who were tested within 5 days since symptom onset. No significant statistical differences between any groups were found. There were 34 false-negative Ag-RDT results (40.5%) and 2 false-positive Ag-RDT results (0.2%). CONCLUSION: The sensitivity of the Panbio™ Test in paediatric individuals is below the minimum of 80% recommended by the World Health Organization for Ag-RDTs. This test had better accuracy in individuals referred by a GP or paediatrician due to symptoms, rather than those who were asymptomatic or referred due to epidemiological exposure. The RT-PCR test using a nasopharyngeal swab is accurate, but a less invasive alternative that has better sensitivity than the Panbio™ Test is needed for paediatric populations.

  @article{RN50,
  abstract = {BACKGROUND: Rapid antigen-detection tests (Ag-RDTs) are used to diagnose SARS-CoV-2 infection. Real-world studies of Ag-RDTs are necessary to evaluate their diagnostic yield in paediatric patients. Our aim was to evaluate the accuracy of the Panbio™ Rapid Antigen Test for SARS-CoV-2 in the setting of a primary health care centre (PHC), with use of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) as gold standard. METHODS: This prospective diagnostic study was conducted at PHCs in Mallorca, Spain. Patients were ≤ 18 years-old that attended sites for RT-PCR testing due to symptoms suggestive of infection (fever, headache, nasal congestion and dry cough, among others) or epidemiological exposure (close contacts). Two samples were collected: a nasal mid-turbinate sample for Ag-RDTs and a nasopharyngeal swab for RT-PCR testing. The sensitivity, specificity, and predictive values of the AgRDT were calculated using the RT-PCR results as the reference. RESULTS: We examined 1142 participants from 0 to 18 years (47.5% female, mean age 8.9 ± 4.8 years, median 9.0 [5.0-13.0]). There were 84 positive RT-PCR results (pre-test probability of 7.3%) and 52 positive Ag-RDT results. The sensitivity of the Ag-RDT was 59.5% (95% Confidence Interval (CI): 48.2-69.9%), the specificity was 99.8% (95%CI: 99.2-99.9%), the positive predictive value was 96.1% (95%CI: 85.6-99.4%), and the negative predictive value was 96.8% (95%CI: 95.6-97.7%). The sensitivity for individuals referred by a general practitioner (GP) or paediatrician due to symptoms was 71.4% (95%CI: 51.5-86.0%) and for asymptomatic individuals was 50.0% (95%CI: 9.1-90.8%). The specificity was greater than 98.9% overall and in all subgroups. The sensitivity was 73.0% (95%CI: 52.0-87.5%) for referred patients due to symptoms and who were tested within 5 days since symptom onset. No significant statistical differences between any groups were found. There were 34 false-negative Ag-RDT results (40.5%) and 2 false-positive Ag-RDT results (0.2%). CONCLUSION: The sensitivity of the Panbio™ Test in paediatric individuals is below the minimum of 80% recommended by the World Health Organization for Ag-RDTs. This test had better accuracy in individuals referred by a GP or paediatrician due to symptoms, rather than those who were asymptomatic or referred due to epidemiological exposure. The RT-PCR test using a nasopharyngeal swab is accurate, but a less invasive alternative that has better sensitivity than the Panbio™ Test is needed for paediatric populations.},
  author = {Gallardo-Alfaro, L. and Lorente-Montalvo, P. and Cañellas, M. and Carandell, E. and Oliver, A. and Rojo, E. and Riera, B. and Llobera, J. and Bulilete, O.},
  journal = {BMC Pediatr},
  keywords = {grapp-caib},
  number = 1,
  pages = 433,
  title = {Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population},
  type = {Journal Article},
  volume = 23,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN50
  %A Gallardo-Alfaro, L.
  %A Lorente-Montalvo, P.
  %A Cañellas, M.
  %A Carandell, E.
  %A Oliver, A.
  %A Rojo, E.
  %A Riera, B.
  %A Llobera, J.
  %A Bulilete, O.
  %D 2023
  %J BMC Pediatr
  %N 1
  %P 433
  %R 10.1186/s12887-023-04201-z
  %T Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population
  %V 23
  %X BACKGROUND: Rapid antigen-detection tests (Ag-RDTs) are used to diagnose SARS-CoV-2 infection. Real-world studies of Ag-RDTs are necessary to evaluate their diagnostic yield in paediatric patients. Our aim was to evaluate the accuracy of the Panbio™ Rapid Antigen Test for SARS-CoV-2 in the setting of a primary health care centre (PHC), with use of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) as gold standard. METHODS: This prospective diagnostic study was conducted at PHCs in Mallorca, Spain. Patients were ≤ 18 years-old that attended sites for RT-PCR testing due to symptoms suggestive of infection (fever, headache, nasal congestion and dry cough, among others) or epidemiological exposure (close contacts). Two samples were collected: a nasal mid-turbinate sample for Ag-RDTs and a nasopharyngeal swab for RT-PCR testing. The sensitivity, specificity, and predictive values of the AgRDT were calculated using the RT-PCR results as the reference. RESULTS: We examined 1142 participants from 0 to 18 years (47.5% female, mean age 8.9 ± 4.8 years, median 9.0 [5.0-13.0]). There were 84 positive RT-PCR results (pre-test probability of 7.3%) and 52 positive Ag-RDT results. The sensitivity of the Ag-RDT was 59.5% (95% Confidence Interval (CI): 48.2-69.9%), the specificity was 99.8% (95%CI: 99.2-99.9%), the positive predictive value was 96.1% (95%CI: 85.6-99.4%), and the negative predictive value was 96.8% (95%CI: 95.6-97.7%). The sensitivity for individuals referred by a general practitioner (GP) or paediatrician due to symptoms was 71.4% (95%CI: 51.5-86.0%) and for asymptomatic individuals was 50.0% (95%CI: 9.1-90.8%). The specificity was greater than 98.9% overall and in all subgroups. The sensitivity was 73.0% (95%CI: 52.0-87.5%) for referred patients due to symptoms and who were tested within 5 days since symptom onset. No significant statistical differences between any groups were found. There were 34 false-negative Ag-RDT results (40.5%) and 2 false-positive Ag-RDT results (0.2%). CONCLUSION: The sensitivity of the Panbio™ Test in paediatric individuals is below the minimum of 80% recommended by the World Health Organization for Ag-RDTs. This test had better accuracy in individuals referred by a GP or paediatrician due to symptoms, rather than those who were asymptomatic or referred due to epidemiological exposure. The RT-PCR test using a nasopharyngeal swab is accurate, but a less invasive alternative that has better sensitivity than the Panbio™ Test is needed for paediatric populations.
  

• 
  1.

  Martí-Lluch R, Bolíbar B, Llobera J, Maderuelo-Fernández JA, Magallón-Botaya R, Sánchez-Pérez Á, Fernández-Domínguez MJ, Motrico E, Vicens-Pons E, Notario-Pacheco B, Alves-Cabratosa L, Ramos R. Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis. Front Public Health. 2023;11:1067249.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. METHODS: This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. DISCUSSION: The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

  @article{RN189,
  abstract = {INTRODUCTION: The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. METHODS: This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. DISCUSSION: The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.},
  author = {Martí-Lluch, R. and Bolíbar, B. and Llobera, J. and Maderuelo-Fernández, J. A. and Magallón-Botaya, R. and Sánchez-Pérez, Á and Fernández-Domínguez, M. J. and Motrico, E. and Vicens-Pons, E. and Notario-Pacheco, B. and Alves-Cabratosa, L. and Ramos, R.},
  journal = {Front Public Health},
  keywords = {grapp-caib},
  pages = 1067249,
  title = {Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis},
  type = {Journal Article},
  volume = 11,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN189
  %A Martí-Lluch, R.
  %A Bolíbar, B.
  %A Llobera, J.
  %A Maderuelo-Fernández, J. A.
  %A Magallón-Botaya, R.
  %A Sánchez-Pérez, Á
  %A Fernández-Domínguez, M. J.
  %A Motrico, E.
  %A Vicens-Pons, E.
  %A Notario-Pacheco, B.
  %A Alves-Cabratosa, L.
  %A Ramos, R.
  %D 2023
  %J Front Public Health
  %P 1067249
  %R 10.3389/fpubh.2023.1067249
  %T Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis
  %V 11
  %X INTRODUCTION: The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. METHODS: This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. DISCUSSION: The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
  

• 
  1.

  Aguilar-Latorre A, Oliván-Blázquez B, Algorta GP, Serrano-Ripoll MJ, Olszewski LE, Turón-Lanuza A. One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care: A randomised clinical trial. J Affect Disord. 2023;332:231-7.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). METHODS: We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. RESULTS: LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = -2.68, 95 % CI = [-4.239, -1.133] p = .001) and sedentarism (b = -37.38, 95 % CI [-62.930, -11.833], p = .004) compared to TAU. LIMITATIONS: Most of the dropouts were due to time restrictions. CONCLUSIONS: In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03951350).

  @article{RN8,
  abstract = {BACKGROUND: An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). METHODS: We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. RESULTS: LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = -2.68, 95 % CI = [-4.239, -1.133] p = .001) and sedentarism (b = -37.38, 95 % CI [-62.930, -11.833], p = .004) compared to TAU. LIMITATIONS: Most of the dropouts were due to time restrictions. CONCLUSIONS: In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03951350).},
  author = {Aguilar-Latorre, A. and Oliván-Blázquez, B. and Algorta, G. P. and Serrano-Ripoll, M. J. and Olszewski, L. E. and Turón-Lanuza, A.},
  journal = {J Affect Disord},
  keywords = {grapp-caib},
  pages = {231-237},
  title = {One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care: A randomised clinical trial},
  type = {Journal Article},
  volume = 332,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN8
  %A Aguilar-Latorre, A.
  %A Oliván-Blázquez, B.
  %A Algorta, G. P.
  %A Serrano-Ripoll, M. J.
  %A Olszewski, L. E.
  %A Turón-Lanuza, A.
  %D 2023
  %J J Affect Disord
  %P 231-237
  %R 10.1016/j.jad.2023.04.007
  %T One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care: A randomised clinical trial
  %V 332
  %X BACKGROUND: An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). METHODS: We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. RESULTS: LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = -2.68, 95 % CI = [-4.239, -1.133] p = .001) and sedentarism (b = -37.38, 95 % CI [-62.930, -11.833], p = .004) compared to TAU. LIMITATIONS: Most of the dropouts were due to time restrictions. CONCLUSIONS: In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03951350).
  

• 
  1.

  Ricci-Cabello I, Carvallo-Castañeda D, Vásquez-Mejía A, Alonso-Coello P, Saz-Parkinson Z, Parmelli E, Morgano GP, Rigau D, Solà I, Neamtiu L, Niño-de Guzmán E. Characteristics and impact of interventions to support healthcare providers’ compliance with guideline recommendations for breast cancer: a systematic literature review. Implement Sci. 2023;18(1):17.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Breast cancer clinical practice guidelines (CPGs) offer evidence-based recommendations to improve quality of healthcare for patients. Suboptimal compliance with breast cancer guideline recommendations remains frequent, and has been associated with a decreased survival. The aim of this systematic review was to characterize and determine the impact of available interventions to support healthcare providers' compliance with CPGs recommendations in breast cancer healthcare. METHODS: We searched for systematic reviews and primary studies in PubMed and Embase (from inception to May 2021). We included experimental and observational studies reporting on the use of interventions to support compliance with breast cancer CPGs. Eligibility assessment, data extraction and critical appraisal was conducted by one reviewer, and cross-checked by a second reviewer. Using the same approach, we synthesized the characteristics and the effects of the interventions by type of intervention (according to the EPOC taxonomy), and applied the GRADE framework to assess the certainty of evidence. RESULTS: We identified 35 primary studies reporting on 24 different interventions. Most frequently described interventions consisted in computerized decision support systems (12 studies); educational interventions (seven), audit and feedback (two), and multifaceted interventions (nine). There is low quality evidence that educational interventions targeted to healthcare professionals may improve compliance with recommendations concerning breast cancer screening, diagnosis and treatment. There is moderate quality evidence that reminder systems for healthcare professionals improve compliance with recommendations concerning breast cancer screening. There is low quality evidence that multifaceted interventions may improve compliance with recommendations concerning breast cancer screening. The effectiveness of the remaining types of interventions identified have not been evaluated with appropriate study designs for such purpose. There is very limited data on the costs of implementing these interventions. CONCLUSIONS: Different types of interventions to support compliance with breast cancer CPGs recommendations are available, and most of them show positive effects. More robust trials are needed to strengthen the available evidence base concerning their efficacy. Gathering data on the costs of implementing the proposed interventions is needed to inform decisions about their widespread implementation. TRIAL REGISTRATION: CRD42018092884 (PROSPERO).

  @article{RN122,
  abstract = {BACKGROUND: Breast cancer clinical practice guidelines (CPGs) offer evidence-based recommendations to improve quality of healthcare for patients. Suboptimal compliance with breast cancer guideline recommendations remains frequent, and has been associated with a decreased survival. The aim of this systematic review was to characterize and determine the impact of available interventions to support healthcare providers' compliance with CPGs recommendations in breast cancer healthcare. METHODS: We searched for systematic reviews and primary studies in PubMed and Embase (from inception to May 2021). We included experimental and observational studies reporting on the use of interventions to support compliance with breast cancer CPGs. Eligibility assessment, data extraction and critical appraisal was conducted by one reviewer, and cross-checked by a second reviewer. Using the same approach, we synthesized the characteristics and the effects of the interventions by type of intervention (according to the EPOC taxonomy), and applied the GRADE framework to assess the certainty of evidence. RESULTS: We identified 35 primary studies reporting on 24 different interventions. Most frequently described interventions consisted in computerized decision support systems (12 studies); educational interventions (seven), audit and feedback (two), and multifaceted interventions (nine). There is low quality evidence that educational interventions targeted to healthcare professionals may improve compliance with recommendations concerning breast cancer screening, diagnosis and treatment. There is moderate quality evidence that reminder systems for healthcare professionals improve compliance with recommendations concerning breast cancer screening. There is low quality evidence that multifaceted interventions may improve compliance with recommendations concerning breast cancer screening. The effectiveness of the remaining types of interventions identified have not been evaluated with appropriate study designs for such purpose. There is very limited data on the costs of implementing these interventions. CONCLUSIONS: Different types of interventions to support compliance with breast cancer CPGs recommendations are available, and most of them show positive effects. More robust trials are needed to strengthen the available evidence base concerning their efficacy. Gathering data on the costs of implementing the proposed interventions is needed to inform decisions about their widespread implementation. TRIAL REGISTRATION: CRD42018092884 (PROSPERO).},
  author = {Ricci-Cabello, I. and Carvallo-Castañeda, D. and Vásquez-Mejía, A. and Alonso-Coello, P. and Saz-Parkinson, Z. and Parmelli, E. and Morgano, G. P. and Rigau, D. and Solà, I. and Neamtiu, L. and Niño-de Guzmán, E.},
  journal = {Implement Sci},
  keywords = {grapp-caib},
  number = 1,
  pages = 17,
  title = {Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review},
  type = {Journal Article},
  volume = 18,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN122
  %A Ricci-Cabello, I.
  %A Carvallo-Castañeda, D.
  %A Vásquez-Mejía, A.
  %A Alonso-Coello, P.
  %A Saz-Parkinson, Z.
  %A Parmelli, E.
  %A Morgano, G. P.
  %A Rigau, D.
  %A Solà, I.
  %A Neamtiu, L.
  %A Niño-de Guzmán, E.
  %D 2023
  %J Implement Sci
  %N 1
  %P 17
  %R 10.1186/s13012-023-01267-2
  %T Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review
  %V 18
  %X BACKGROUND: Breast cancer clinical practice guidelines (CPGs) offer evidence-based recommendations to improve quality of healthcare for patients. Suboptimal compliance with breast cancer guideline recommendations remains frequent, and has been associated with a decreased survival. The aim of this systematic review was to characterize and determine the impact of available interventions to support healthcare providers' compliance with CPGs recommendations in breast cancer healthcare. METHODS: We searched for systematic reviews and primary studies in PubMed and Embase (from inception to May 2021). We included experimental and observational studies reporting on the use of interventions to support compliance with breast cancer CPGs. Eligibility assessment, data extraction and critical appraisal was conducted by one reviewer, and cross-checked by a second reviewer. Using the same approach, we synthesized the characteristics and the effects of the interventions by type of intervention (according to the EPOC taxonomy), and applied the GRADE framework to assess the certainty of evidence. RESULTS: We identified 35 primary studies reporting on 24 different interventions. Most frequently described interventions consisted in computerized decision support systems (12 studies); educational interventions (seven), audit and feedback (two), and multifaceted interventions (nine). There is low quality evidence that educational interventions targeted to healthcare professionals may improve compliance with recommendations concerning breast cancer screening, diagnosis and treatment. There is moderate quality evidence that reminder systems for healthcare professionals improve compliance with recommendations concerning breast cancer screening. There is low quality evidence that multifaceted interventions may improve compliance with recommendations concerning breast cancer screening. The effectiveness of the remaining types of interventions identified have not been evaluated with appropriate study designs for such purpose. There is very limited data on the costs of implementing these interventions. CONCLUSIONS: Different types of interventions to support compliance with breast cancer CPGs recommendations are available, and most of them show positive effects. More robust trials are needed to strengthen the available evidence base concerning their efficacy. Gathering data on the costs of implementing the proposed interventions is needed to inform decisions about their widespread implementation. TRIAL REGISTRATION: CRD42018092884 (PROSPERO).
  

• 
  1.

  López-González Á A, González San Miguel HM, Arroyo Bote S, Riutord Sbert P, Rigo Vives MDM, Ramírez Manent JI. Determination of cardiovascular risk in Spanish veterinarians using different scaling methods. Rev Bras Med Trab. 2023;21(1):e2023826.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Cardiovascular diseases are responsible for a significant morbimortality rate around the world. Due to the characteristics of their work, health care professionals, including veterinarians, are more prone to present this type of pathology. OBJECTIVES: To determine the level of cardiovascular risk using different scales in a group of veterinarians. METHODS: A descriptive and cross-sectional study of 610 Spanish veterinarians was conducted to assess cardiovascular risk scores, including 14 overweight and obesity scales, six fatty liver scales, six cardiovascular risk scales, four atherogenic indices, and three metabolic syndrome scales. RESULTS: The prevalence of obesity among women was 7.95%, and 17.53% among men. Hypertension was present in 15.23% of women and 24.68% of men. Dyslipidemia affected 45% of women and 58.64% of men. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was slightly over 10% while 10.90% of women and 14.93% of men showed moderate to high values on the Registre Gironí del Cor scale. CONCLUSIONS: There is a moderate to high level of cardiovascular risk among veterinarians in this group.

  @article{RN120,
  abstract = {INTRODUCTION: Cardiovascular diseases are responsible for a significant morbimortality rate around the world. Due to the characteristics of their work, health care professionals, including veterinarians, are more prone to present this type of pathology. OBJECTIVES: To determine the level of cardiovascular risk using different scales in a group of veterinarians. METHODS: A descriptive and cross-sectional study of 610 Spanish veterinarians was conducted to assess cardiovascular risk scores, including 14 overweight and obesity scales, six fatty liver scales, six cardiovascular risk scales, four atherogenic indices, and three metabolic syndrome scales. RESULTS: The prevalence of obesity among women was 7.95%, and 17.53% among men. Hypertension was present in 15.23% of women and 24.68% of men. Dyslipidemia affected 45% of women and 58.64% of men. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was slightly over 10% while 10.90% of women and 14.93% of men showed moderate to high values on the Registre Gironí del Cor scale. CONCLUSIONS: There is a moderate to high level of cardiovascular risk among veterinarians in this group.},
  author = {López-González Á, A. and González San Miguel, H. M. and Arroyo Bote, S. and Riutord Sbert, P. and Rigo Vives, M. D. M. and Ramírez Manent, J. I.},
  journal = {Rev Bras Med Trab},
  keywords = {grapp-caib},
  number = 1,
  pages = {e2023826},
  title = {Determination of cardiovascular risk in Spanish veterinarians using different scaling methods},
  type = {Journal Article},
  volume = 21,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN120
  %A López-González Á, A.
  %A González San Miguel, H. M.
  %A Arroyo Bote, S.
  %A Riutord Sbert, P.
  %A Rigo Vives, M. D. M.
  %A Ramírez Manent, J. I.
  %D 2023
  %J Rev Bras Med Trab
  %N 1
  %P e2023826
  %R 10.47626/1679-4435-2023-826
  %T Determination of cardiovascular risk in Spanish veterinarians using different scaling methods
  %V 21
  %X INTRODUCTION: Cardiovascular diseases are responsible for a significant morbimortality rate around the world. Due to the characteristics of their work, health care professionals, including veterinarians, are more prone to present this type of pathology. OBJECTIVES: To determine the level of cardiovascular risk using different scales in a group of veterinarians. METHODS: A descriptive and cross-sectional study of 610 Spanish veterinarians was conducted to assess cardiovascular risk scores, including 14 overweight and obesity scales, six fatty liver scales, six cardiovascular risk scales, four atherogenic indices, and three metabolic syndrome scales. RESULTS: The prevalence of obesity among women was 7.95%, and 17.53% among men. Hypertension was present in 15.23% of women and 24.68% of men. Dyslipidemia affected 45% of women and 58.64% of men. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was slightly over 10% while 10.90% of women and 14.93% of men showed moderate to high values on the Registre Gironí del Cor scale. CONCLUSIONS: There is a moderate to high level of cardiovascular risk among veterinarians in this group.
  

• 
  1.

  de Dios-Rodríguez E, Patino-Alonso C, González-Sánchez S, Tamayo-Morales O, Ripoll J, Mora-Simón S, Unzueta-Arce J, Gómez-Marcos MA, García-Ortiz L, Rodríguez-Sánchez E. Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers. Healthcare (Basel). 2023;11(9).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.

  @article{RN119,
  abstract = {People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.},
  author = {de Dios-Rodríguez, E. and Patino-Alonso, C. and González-Sánchez, S. and Tamayo-Morales, O. and Ripoll, J. and Mora-Simón, S. and Unzueta-Arce, J. and Gómez-Marcos, M. A. and García-Ortiz, L. and Rodríguez-Sánchez, E.},
  journal = {Healthcare (Basel)},
  keywords = {grapp-caib},
  number = 9,
  title = {Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers},
  type = {Journal Article},
  volume = 11,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN119
  %A de Dios-Rodríguez, E.
  %A Patino-Alonso, C.
  %A González-Sánchez, S.
  %A Tamayo-Morales, O.
  %A Ripoll, J.
  %A Mora-Simón, S.
  %A Unzueta-Arce, J.
  %A Gómez-Marcos, M. A.
  %A García-Ortiz, L.
  %A Rodríguez-Sánchez, E.
  %D 2023
  %J Healthcare (Basel)
  %N 9
  %R 10.3390/healthcare11091255
  %T Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers
  %V 11
  %X People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.
  

• 
  1.

  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.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN118,
  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.},
  author = {Moliner-Calderón, E. and Verd, S. and Leiva, A. and Ginovart, G. and Moll-McCarthy, P. and Figueras-Aloy, J.},
  journal = {Front Pediatr},
  keywords = {grapp-caib},
  pages = 1172799,
  title = {The role of human milk feeds on inotrope use in newborn infants with sepsis},
  type = {Journal Article},
  volume = 11,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN118
  %A Moliner-Calderón, E.
  %A Verd, S.
  %A Leiva, A.
  %A Ginovart, G.
  %A Moll-McCarthy, P.
  %A Figueras-Aloy, J.
  %D 2023
  %J Front Pediatr
  %P 1172799
  %R 10.3389/fped.2023.1172799
  %T The role of human milk feeds on inotrope use in newborn infants with sepsis
  %V 11
  %X 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.
  

• 
  1.

  Gómez-Gómez I, Motrico E, Moreno-Peral P, Casajuana-Closas M, López-Jiménez T, Zabaleta-Del-Olmo E, Clavería A, J LL, Martí-Lluch R, Ramos R, Maderuelo-Fernández J, Vicens C, Domínguez-García M, Bartolomé-Moreno C, Recio-Rodriguez JI, Bellón J. A multiple health behaviour change intervention to prevent depression: A randomized controlled trial. Gen Hosp Psychiatry. 2023;82:86-94.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVE: To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC). METHODS: Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. RESULTS: 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI -0.77 to 1.36]; p = 0.726) during follow-up. CONCLUSIONS: As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03136211.

  @article{RN131,
  abstract = {OBJECTIVE: To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC). METHODS: Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. RESULTS: 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI -0.77 to 1.36]; p = 0.726) during follow-up. CONCLUSIONS: As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03136211.},
  author = {Gómez-Gómez, I. and Motrico, E. and Moreno-Peral, P. and Casajuana-Closas, M. and López-Jiménez, T. and Zabaleta-Del-Olmo, E. and Clavería, A. and J, L. Lobera and Martí-Lluch, R. and Ramos, R. and Maderuelo-Fernández, JÁ and Vicens, C. and Domínguez-García, M. and Bartolomé-Moreno, C. and Recio-Rodriguez, J. I. and Bellón, JÁ},
  journal = {Gen Hosp Psychiatry},
  keywords = {grapp-caib},
  pages = {86-94},
  title = {A multiple health behaviour change intervention to prevent depression: A randomized controlled trial},
  type = {Journal Article},
  volume = 82,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN131
  %A Gómez-Gómez, I.
  %A Motrico, E.
  %A Moreno-Peral, P.
  %A Casajuana-Closas, M.
  %A López-Jiménez, T.
  %A Zabaleta-Del-Olmo, E.
  %A Clavería, A.
  %A J, L. Lobera
  %A Martí-Lluch, R.
  %A Ramos, R.
  %A Maderuelo-Fernández, JÁ
  %A Vicens, C.
  %A Domínguez-García, M.
  %A Bartolomé-Moreno, C.
  %A Recio-Rodriguez, J. I.
  %A Bellón, JÁ
  %D 2023
  %J Gen Hosp Psychiatry
  %P 86-94
  %R 10.1016/j.genhosppsych.2023.02.004
  %T A multiple health behaviour change intervention to prevent depression: A randomized controlled trial
  %V 82
  %X OBJECTIVE: To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC). METHODS: Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. RESULTS: 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI -0.77 to 1.36]; p = 0.726) during follow-up. CONCLUSIONS: As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03136211.
  

• 
  1.

  Garcia-Toro M, Aguilar-Latorre A, Garcia A, Navarro-Guzmán C, Gervilla E, Seguí A, Gazquez F, Marino JA, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván-Blázquez B, Garcia-Campayo J, Maloney S, Montero-Marin J. Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification. Front Psychol. 2023;14:1008891.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND/OBJECTIVE: The COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients. METHODS: The three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation. RESULTS: Mindfulness skills mediated the effect of MBCT on depressive symptoms (ab = -4.69, 95% CI = -12.93 to-0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = -3.22, 95% CI = -7.03 to-0.14). CONCLUSION: Strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.

  @article{RN134,
  abstract = {BACKGROUND/OBJECTIVE: The COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients. METHODS: The three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation. RESULTS: Mindfulness skills mediated the effect of MBCT on depressive symptoms (ab = -4.69, 95% CI = -12.93 to-0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = -3.22, 95% CI = -7.03 to-0.14). CONCLUSION: Strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.},
  author = {Garcia-Toro, M. and Aguilar-Latorre, A. and Garcia, A. and Navarro-Guzmán, C. and Gervilla, E. and Seguí, A. and Gazquez, F. and Marino, J. A. and Gomez-Juanes, R. and Serrano-Ripoll, M. J. and Oliván-Blázquez, B. and Garcia-Campayo, J. and Maloney, S. and Montero-Marin, J.},
  journal = {Front Psychol},
  keywords = {grapp-caib},
  pages = 1008891,
  title = {Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification},
  type = {Journal Article},
  volume = 14,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN134
  %A Garcia-Toro, M.
  %A Aguilar-Latorre, A.
  %A Garcia, A.
  %A Navarro-Guzmán, C.
  %A Gervilla, E.
  %A Seguí, A.
  %A Gazquez, F.
  %A Marino, J. A.
  %A Gomez-Juanes, R.
  %A Serrano-Ripoll, M. J.
  %A Oliván-Blázquez, B.
  %A Garcia-Campayo, J.
  %A Maloney, S.
  %A Montero-Marin, J.
  %D 2023
  %J Front Psychol
  %P 1008891
  %R 10.3389/fpsyg.2023.1008891
  %T Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification
  %V 14
  %X BACKGROUND/OBJECTIVE: The COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients. METHODS: The three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation. RESULTS: Mindfulness skills mediated the effect of MBCT on depressive symptoms (ab = -4.69, 95% CI = -12.93 to-0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = -3.22, 95% CI = -7.03 to-0.14). CONCLUSION: Strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.
  

• 
  1.

  Chela-Alvarez X, Garcia-Buades ME, Ferrer-Perez VA, Bulilete O, Llobera J. Work-family conflict among hotel housekeepers in the Balearic Islands (Spain). PLoS One. 2023;18(3):e0269074.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.

  @article{RN132,
  abstract = {The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.},
  author = {Chela-Alvarez, X. and Garcia-Buades, M. E. and Ferrer-Perez, V. A. and Bulilete, O. and Llobera, J.},
  journal = {PLoS One},
  keywords = {grapp-caib},
  number = 3,
  pages = {e0269074},
  title = {Work-family conflict among hotel housekeepers in the Balearic Islands (Spain)},
  type = {Journal Article},
  volume = 18,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN132
  %A Chela-Alvarez, X.
  %A Garcia-Buades, M. E.
  %A Ferrer-Perez, V. A.
  %A Bulilete, O.
  %A Llobera, J.
  %D 2023
  %J PLoS One
  %N 3
  %P e0269074
  %R 10.1371/journal.pone.0269074
  %T Work-family conflict among hotel housekeepers in the Balearic Islands (Spain)
  %V 18
  %X The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.
  

• 
  1.

  Alonso-Bernáldez M, Palou-March A, Zamanillo-Campos R, Palou A, Palou M, Serra F. A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women. Nutrients. 2023;15(6).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.

  @article{RN133,
  abstract = {Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.},
  author = {Alonso-Bernáldez, M. and Palou-March, A. and Zamanillo-Campos, R. and Palou, A. and Palou, M. and Serra, F.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 6,
  title = {A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women},
  type = {Journal Article},
  volume = 15,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN133
  %A Alonso-Bernáldez, M.
  %A Palou-March, A.
  %A Zamanillo-Campos, R.
  %A Palou, A.
  %A Palou, M.
  %A Serra, F.
  %D 2023
  %J Nutrients
  %N 6
  %R 10.3390/nu15061337
  %T A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women
  %V 15
  %X Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.
  

• 
  1.

  Ramírez-Manent JI, Tomás-Gil P, Martí-Lliteras P, Coll Villalonga JL, Martínez-Almoyna Rifá E, López-González Á A. Dietary Intervention on Overweight and Obesity after Confinement by COVID-19. Nutrients. 2023;15(4).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Obesity has become a public health problem in our society and is associated with many diseases, including type 2 diabetes mellitus, cardiovascular diseases, dyslipidemia, respiratory diseases, and cancer. Several studies relate weight loss in obese patients to improved anthropometric measurements and cardiometabolic risk. The objective of our study was to evaluate anthropometric changes, analytical parameters, insulin resistance, fatty liver, and metabolic scales, after a personalized weight loss program, through dietary advice to increase adherence to the Mediterranean diet and a motivational booster via mobile SMS messaging. METHODS: Intervention study on a sample of 1964 workers, in which different anthropometric parameters were evaluated before and after dietary intervention: the metabolic score of insulin resistance; non-alcoholic fatty liver disease using different scales; metabolic syndrome; atherogenic dyslipidemia; and the cardiometabolic index. A descriptive analysis of the categorical variables was performed, by calculating the frequency and distribution of the responses for each one. For quantitative variables, the mean and standard deviation were calculated, since they followed a normal distribution. Bivariate association analysis was performed by applying the chi-squared test (corrected by Fisher's exact statistic when conditions required it) and Student's t-test for independent samples (for comparison of means). RESULTS: The population subjected to the Mediterranean diet improved in all the variables evaluated at 12 months of follow-up and compliance with the diet. CONCLUSIONS: Dietary advice on a Mediterranean diet and its reinforcement with reminder messages through the use of mobile phones may be useful to improve the parameters evaluated in this study and reduce the cardiometabolic risk of patients.

  @article{RN23,
  abstract = {BACKGROUND: Obesity has become a public health problem in our society and is associated with many diseases, including type 2 diabetes mellitus, cardiovascular diseases, dyslipidemia, respiratory diseases, and cancer. Several studies relate weight loss in obese patients to improved anthropometric measurements and cardiometabolic risk. The objective of our study was to evaluate anthropometric changes, analytical parameters, insulin resistance, fatty liver, and metabolic scales, after a personalized weight loss program, through dietary advice to increase adherence to the Mediterranean diet and a motivational booster via mobile SMS messaging. METHODS: Intervention study on a sample of 1964 workers, in which different anthropometric parameters were evaluated before and after dietary intervention: the metabolic score of insulin resistance; non-alcoholic fatty liver disease using different scales; metabolic syndrome; atherogenic dyslipidemia; and the cardiometabolic index. A descriptive analysis of the categorical variables was performed, by calculating the frequency and distribution of the responses for each one. For quantitative variables, the mean and standard deviation were calculated, since they followed a normal distribution. Bivariate association analysis was performed by applying the chi-squared test (corrected by Fisher's exact statistic when conditions required it) and Student's t-test for independent samples (for comparison of means). RESULTS: The population subjected to the Mediterranean diet improved in all the variables evaluated at 12 months of follow-up and compliance with the diet. CONCLUSIONS: Dietary advice on a Mediterranean diet and its reinforcement with reminder messages through the use of mobile phones may be useful to improve the parameters evaluated in this study and reduce the cardiometabolic risk of patients.},
  author = {Ramírez-Manent, J. I. and Tomás-Gil, P. and Martí-Lliteras, P. and Coll Villalonga, J. L. and Martínez-Almoyna Rifá, E. and López-González Á, A.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 4,
  title = {Dietary Intervention on Overweight and Obesity after Confinement by COVID-19},
  type = {Journal Article},
  volume = 15,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN23
  %A Ramírez-Manent, J. I.
  %A Tomás-Gil, P.
  %A Martí-Lliteras, P.
  %A Coll Villalonga, J. L.
  %A Martínez-Almoyna Rifá, E.
  %A López-González Á, A.
  %D 2023
  %J Nutrients
  %N 4
  %R 10.3390/nu15040912
  %T Dietary Intervention on Overweight and Obesity after Confinement by COVID-19
  %V 15
  %X BACKGROUND: Obesity has become a public health problem in our society and is associated with many diseases, including type 2 diabetes mellitus, cardiovascular diseases, dyslipidemia, respiratory diseases, and cancer. Several studies relate weight loss in obese patients to improved anthropometric measurements and cardiometabolic risk. The objective of our study was to evaluate anthropometric changes, analytical parameters, insulin resistance, fatty liver, and metabolic scales, after a personalized weight loss program, through dietary advice to increase adherence to the Mediterranean diet and a motivational booster via mobile SMS messaging. METHODS: Intervention study on a sample of 1964 workers, in which different anthropometric parameters were evaluated before and after dietary intervention: the metabolic score of insulin resistance; non-alcoholic fatty liver disease using different scales; metabolic syndrome; atherogenic dyslipidemia; and the cardiometabolic index. A descriptive analysis of the categorical variables was performed, by calculating the frequency and distribution of the responses for each one. For quantitative variables, the mean and standard deviation were calculated, since they followed a normal distribution. Bivariate association analysis was performed by applying the chi-squared test (corrected by Fisher's exact statistic when conditions required it) and Student's t-test for independent samples (for comparison of means). RESULTS: The population subjected to the Mediterranean diet improved in all the variables evaluated at 12 months of follow-up and compliance with the diet. CONCLUSIONS: Dietary advice on a Mediterranean diet and its reinforcement with reminder messages through the use of mobile phones may be useful to improve the parameters evaluated in this study and reduce the cardiometabolic risk of patients.
  

• 
  1.

  Richardson-Parry A, Baas C, Donde S, Ferraiolo B, Karmo M, Maravic Z, Münter L, Ricci-Cabello I, Silva M, Tinianov S, Valderas JM, Woodruff S, van Vugt J. Interventions to reduce cancer screening inequities: the perspective and role of patients, advocacy groups, and empowerment organizations. Int J Equity Health. 2023;22(1):19.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Health inequities lead to low rates of cancer screening in certain populations, such as low-income and ethnic minority groups. Different interventions to address this have been developed with mixed results. However, interventions are not always developed in collaboration with the people they target. The aim of our article is to present the viewpoint of patients, survivors, advocates, and lay persons on interventions to increase cancer screening from a health inequity perspective. METHODS: We prepared talking points to guide discussions between coauthors, who included representatives from nine patient and survivor advocacy groups, organizations working for citizen/patient empowerment, and health equity experts. Perspectives and opinions were first collected through video conferencing meetings and a first draft of the paper was prepared. All authors, read through, revised, and discussed the contents to reach an agreement on the final perspectives to be presented. RESULTS: Several themes were identified: it is important to not view screening as a discrete event; barriers underlying an individual's access and willingness to undergo screening span across a continuum; individually tailored interventions are likely to be more effective than a one-size fits-all approach because they may better accommodate the person's personal beliefs, knowledge, behaviors, and preferences; targeting people who are unknown to medical services and largely unreachable is a major challenge; including professional patient advocacy groups and relevant lay persons in the cocreation of interventions at all stages of design, implementation, and evaluation is essential along with relevant stakeholders (healthcare professionals, researchers, local government and community organizations etc). CONCLUSIONS: Interventions to address cancer screening inequity currently do not adequately solve the issue, especially from the viewpoint of patients, survivors, and lay persons. Several core pathways should be focused on when designing and implementing interventions: advancing individually tailored interventions; digital tools and social media; peer-based approaches; empowerment; addressing policy and system barriers; better design of interventions; and collaboration, including the involvement of patients and patient advocacy organizations.

  @article{RN129,
  abstract = {BACKGROUND: Health inequities lead to low rates of cancer screening in certain populations, such as low-income and ethnic minority groups. Different interventions to address this have been developed with mixed results. However, interventions are not always developed in collaboration with the people they target. The aim of our article is to present the viewpoint of patients, survivors, advocates, and lay persons on interventions to increase cancer screening from a health inequity perspective. METHODS: We prepared talking points to guide discussions between coauthors, who included representatives from nine patient and survivor advocacy groups, organizations working for citizen/patient empowerment, and health equity experts. Perspectives and opinions were first collected through video conferencing meetings and a first draft of the paper was prepared. All authors, read through, revised, and discussed the contents to reach an agreement on the final perspectives to be presented. RESULTS: Several themes were identified: it is important to not view screening as a discrete event; barriers underlying an individual's access and willingness to undergo screening span across a continuum; individually tailored interventions are likely to be more effective than a one-size fits-all approach because they may better accommodate the person's personal beliefs, knowledge, behaviors, and preferences; targeting people who are unknown to medical services and largely unreachable is a major challenge; including professional patient advocacy groups and relevant lay persons in the cocreation of interventions at all stages of design, implementation, and evaluation is essential along with relevant stakeholders (healthcare professionals, researchers, local government and community organizations etc). CONCLUSIONS: Interventions to address cancer screening inequity currently do not adequately solve the issue, especially from the viewpoint of patients, survivors, and lay persons. Several core pathways should be focused on when designing and implementing interventions: advancing individually tailored interventions; digital tools and social media; peer-based approaches; empowerment; addressing policy and system barriers; better design of interventions; and collaboration, including the involvement of patients and patient advocacy organizations.},
  author = {Richardson-Parry, A. and Baas, C. and Donde, S. and Ferraiolo, B. and Karmo, M. and Maravic, Z. and Münter, L. and Ricci-Cabello, I. and Silva, M. and Tinianov, S. and Valderas, J. M. and Woodruff, S. and van Vugt, J.},
  journal = {Int J Equity Health},
  keywords = {grapp-caib},
  number = 1,
  pages = 19,
  title = {Interventions to reduce cancer screening inequities: the perspective and role of patients, advocacy groups, and empowerment organizations},
  type = {Journal Article},
  volume = 22,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN129
  %A Richardson-Parry, A.
  %A Baas, C.
  %A Donde, S.
  %A Ferraiolo, B.
  %A Karmo, M.
  %A Maravic, Z.
  %A Münter, L.
  %A Ricci-Cabello, I.
  %A Silva, M.
  %A Tinianov, S.
  %A Valderas, J. M.
  %A Woodruff, S.
  %A van Vugt, J.
  %D 2023
  %J Int J Equity Health
  %N 1
  %P 19
  %R 10.1186/s12939-023-01841-6
  %T Interventions to reduce cancer screening inequities: the perspective and role of patients, advocacy groups, and empowerment organizations
  %V 22
  %X BACKGROUND: Health inequities lead to low rates of cancer screening in certain populations, such as low-income and ethnic minority groups. Different interventions to address this have been developed with mixed results. However, interventions are not always developed in collaboration with the people they target. The aim of our article is to present the viewpoint of patients, survivors, advocates, and lay persons on interventions to increase cancer screening from a health inequity perspective. METHODS: We prepared talking points to guide discussions between coauthors, who included representatives from nine patient and survivor advocacy groups, organizations working for citizen/patient empowerment, and health equity experts. Perspectives and opinions were first collected through video conferencing meetings and a first draft of the paper was prepared. All authors, read through, revised, and discussed the contents to reach an agreement on the final perspectives to be presented. RESULTS: Several themes were identified: it is important to not view screening as a discrete event; barriers underlying an individual's access and willingness to undergo screening span across a continuum; individually tailored interventions are likely to be more effective than a one-size fits-all approach because they may better accommodate the person's personal beliefs, knowledge, behaviors, and preferences; targeting people who are unknown to medical services and largely unreachable is a major challenge; including professional patient advocacy groups and relevant lay persons in the cocreation of interventions at all stages of design, implementation, and evaluation is essential along with relevant stakeholders (healthcare professionals, researchers, local government and community organizations etc). CONCLUSIONS: Interventions to address cancer screening inequity currently do not adequately solve the issue, especially from the viewpoint of patients, survivors, and lay persons. Several core pathways should be focused on when designing and implementing interventions: advancing individually tailored interventions; digital tools and social media; peer-based approaches; empowerment; addressing policy and system barriers; better design of interventions; and collaboration, including the involvement of patients and patient advocacy organizations.
  

• 
  1.

  Ramírez-Manent JI, Jover AM, Martinez CS, Tomás-Gil P, Martí-Lliteras P, López-González Á A. Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults. Nutrients. 2023;15(2).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and insulin resistance (IR). Based on the information mentioned above in which there seems to be a relationship between IR and Met-S, the objective of this work was twofold: on the one hand, to assess the relationship between the values of different insulin resistance risk scales and Met-S determined with three different scales, and on the other, to determine whether any of the components of Met-S predispose more to the appearance of IR. METHODS: A descriptive cross-sectional study of 418,343 workers. Waist circumference was measured and evaluated together with six formulas to assess the insulin resistance index. Categorical variables were evaluated by calculating the frequency and distribution of each one. For quantitative variables, mean and standard deviation were determined, and Student's t-test was applied, while for qualitative variables, the chi-square test was performed. The usefulness of the different risk scales for insulin resistance for predicting metabolic syndrome was evaluated using ROC curves, the area under the curve (AUC), as well as their cut-off points for sensitivity, specificity, and the Youden index. RESULTS: People with metabolic syndrome applying any criteria had higher values in the IR risk scales. The different IR scales made it possible to adequately classify people with metabolic syndrome. Of the three definitions of Met-S, the one that showed the greatest relationship with IR was IDF. CONCLUSIONS: Most risk scales for insulin resistance enable the presence of metabolic syndrome to be adequately classified, finding the best ones if the International Diabetes Federation (IDF) criteria are applied. Of the elements included in the Met-S, the one that seems to increase the risk of presenting IR the most is waist circumference; hence, the Met-S definition that is most related to IR is that of the IDF, which is the only one of the three in which a high value of waist circumference is necessary to be able to diagnose Met-S. Waist circumference can be considered the central essential component for detecting insulin resistance and, therefore, the early detection of metabolic syndrome.

  @article{RN126,
  abstract = {BACKGROUND: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and insulin resistance (IR). Based on the information mentioned above in which there seems to be a relationship between IR and Met-S, the objective of this work was twofold: on the one hand, to assess the relationship between the values of different insulin resistance risk scales and Met-S determined with three different scales, and on the other, to determine whether any of the components of Met-S predispose more to the appearance of IR. METHODS: A descriptive cross-sectional study of 418,343 workers. Waist circumference was measured and evaluated together with six formulas to assess the insulin resistance index. Categorical variables were evaluated by calculating the frequency and distribution of each one. For quantitative variables, mean and standard deviation were determined, and Student's t-test was applied, while for qualitative variables, the chi-square test was performed. The usefulness of the different risk scales for insulin resistance for predicting metabolic syndrome was evaluated using ROC curves, the area under the curve (AUC), as well as their cut-off points for sensitivity, specificity, and the Youden index. RESULTS: People with metabolic syndrome applying any criteria had higher values in the IR risk scales. The different IR scales made it possible to adequately classify people with metabolic syndrome. Of the three definitions of Met-S, the one that showed the greatest relationship with IR was IDF. CONCLUSIONS: Most risk scales for insulin resistance enable the presence of metabolic syndrome to be adequately classified, finding the best ones if the International Diabetes Federation (IDF) criteria are applied. Of the elements included in the Met-S, the one that seems to increase the risk of presenting IR the most is waist circumference; hence, the Met-S definition that is most related to IR is that of the IDF, which is the only one of the three in which a high value of waist circumference is necessary to be able to diagnose Met-S. Waist circumference can be considered the central essential component for detecting insulin resistance and, therefore, the early detection of metabolic syndrome.},
  author = {Ramírez-Manent, J. I. and Jover, A. M. and Martinez, C. S. and Tomás-Gil, P. and Martí-Lliteras, P. and López-González Á, A.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 2,
  title = {Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults},
  type = {Journal Article},
  volume = 15,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN126
  %A Ramírez-Manent, J. I.
  %A Jover, A. M.
  %A Martinez, C. S.
  %A Tomás-Gil, P.
  %A Martí-Lliteras, P.
  %A López-González Á, A.
  %D 2023
  %J Nutrients
  %N 2
  %R 10.3390/nu15020257
  %T Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults
  %V 15
  %X BACKGROUND: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and insulin resistance (IR). Based on the information mentioned above in which there seems to be a relationship between IR and Met-S, the objective of this work was twofold: on the one hand, to assess the relationship between the values of different insulin resistance risk scales and Met-S determined with three different scales, and on the other, to determine whether any of the components of Met-S predispose more to the appearance of IR. METHODS: A descriptive cross-sectional study of 418,343 workers. Waist circumference was measured and evaluated together with six formulas to assess the insulin resistance index. Categorical variables were evaluated by calculating the frequency and distribution of each one. For quantitative variables, mean and standard deviation were determined, and Student's t-test was applied, while for qualitative variables, the chi-square test was performed. The usefulness of the different risk scales for insulin resistance for predicting metabolic syndrome was evaluated using ROC curves, the area under the curve (AUC), as well as their cut-off points for sensitivity, specificity, and the Youden index. RESULTS: People with metabolic syndrome applying any criteria had higher values in the IR risk scales. The different IR scales made it possible to adequately classify people with metabolic syndrome. Of the three definitions of Met-S, the one that showed the greatest relationship with IR was IDF. CONCLUSIONS: Most risk scales for insulin resistance enable the presence of metabolic syndrome to be adequately classified, finding the best ones if the International Diabetes Federation (IDF) criteria are applied. Of the elements included in the Met-S, the one that seems to increase the risk of presenting IR the most is waist circumference; hence, the Met-S definition that is most related to IR is that of the IDF, which is the only one of the three in which a high value of waist circumference is necessary to be able to diagnose Met-S. Waist circumference can be considered the central essential component for detecting insulin resistance and, therefore, the early detection of metabolic syndrome.
  

• 
  1.

  López-González Á A, Albaladejo Blanco M, Vidal Ribas C, Tomás-Gil P, Riutord Sbert P, Ramírez-Manent JI. Determination of the Level of Cardiovascular Risk in 172,282 Spanish Working Women. Diagnostics (Basel). 2023;13(17).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. MATERIAL, METHODS: A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. RESULTS: An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. CONCLUSIONS: Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.

  @article{RN2,
  abstract = {Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. MATERIAL, METHODS: A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. RESULTS: An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. CONCLUSIONS: Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.},
  author = {López-González Á, A. and Albaladejo Blanco, M. and Vidal Ribas, C. and Tomás-Gil, P. and Riutord Sbert, P. and Ramírez-Manent, J. I.},
  journal = {Diagnostics (Basel)},
  keywords = {grapp-caib},
  number = 17,
  title = {Determination of the Level of Cardiovascular Risk in 172,282 Spanish Working Women},
  type = {Journal Article},
  volume = 13,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN2
  %A López-González Á, A.
  %A Albaladejo Blanco, M.
  %A Vidal Ribas, C.
  %A Tomás-Gil, P.
  %A Riutord Sbert, P.
  %A Ramírez-Manent, J. I.
  %D 2023
  %J Diagnostics (Basel)
  %N 17
  %R 10.3390/diagnostics13172734
  %T Determination of the Level of Cardiovascular Risk in 172,282 Spanish Working Women
  %V 13
  %X Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. MATERIAL, METHODS: A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. RESULTS: An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. CONCLUSIONS: Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.
  

• 
  1.

  Aguilar-Latorre A, Oliván-Blázquez B, Porroche-Escudero A, Serrano-Ripoll MJ, Magallón-Botaya R. Editorial: Mental health in primary health care. Front Psychol. 2023;14:1190410.

  BibTeXEndNoteDOIBibSonomyDownload

  @article{RN2,
  author = {Aguilar-Latorre, A. and Oliván-Blázquez, B. and Porroche-Escudero, A. and Serrano-Ripoll, M. J. and Magallón-Botaya, R.},
  journal = {Front Psychol},
  keywords = {grapp-caib},
  pages = 1190410,
  title = {Editorial: Mental health in primary health care},
  type = {Journal Article},
  volume = 14,
  year = 2023
  }
  

  %0 Journal Article
  %1 RN2
  %A Aguilar-Latorre, A.
  %A Oliván-Blázquez, B.
  %A Porroche-Escudero, A.
  %A Serrano-Ripoll, M. J.
  %A Magallón-Botaya, R.
  %D 2023
  %J Front Psychol
  %P 1190410
  %R 10.3389/fpsyg.2023.1190410
  %T Editorial: Mental health in primary health care
  %V 14
  

2022

• 
  1.

  Gómez-Gómez I, Benítez I, Bellón J, Moreno-Peral P, Oliván-Blázquez B, Clavería A, Zabaleta-Del-Olmo E, Llobera J, Serrano-Ripoll MJ, Tamayo-Morales O, Motrico E. Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain. Psychol Med. 2022;:1-11.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. METHODS: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. RESULTS: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. CONCLUSIONS: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.

  @article{RN115,
  abstract = {BACKGROUND: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. METHODS: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. RESULTS: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. CONCLUSIONS: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.},
  author = {Gómez-Gómez, I. and Benítez, I. and Bellón, J. and Moreno-Peral, P. and Oliván-Blázquez, B. and Clavería, A. and Zabaleta-Del-Olmo, E. and Llobera, J. and Serrano-Ripoll, M. J. and Tamayo-Morales, O. and Motrico, E.},
  journal = {Psychol Med},
  keywords = {grapp-caib},
  pages = {1-11},
  title = {Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain},
  type = {Journal Article},
  year = 2022
  }
  

  %0 Journal Article
  %1 RN115
  %A Gómez-Gómez, I.
  %A Benítez, I.
  %A Bellón, J.
  %A Moreno-Peral, P.
  %A Oliván-Blázquez, B.
  %A Clavería, A.
  %A Zabaleta-Del-Olmo, E.
  %A Llobera, J.
  %A Serrano-Ripoll, M. J.
  %A Tamayo-Morales, O.
  %A Motrico, E.
  %D 2022
  %J Psychol Med
  %P 1-11
  %R 10.1017/s0033291722002835
  %T Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain
  %X BACKGROUND: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. METHODS: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. RESULTS: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. CONCLUSIONS: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.
  

• 
  1.

  Galmes-Panades AM, Bennasar-Veny M, Oliver P, Garcia-Coll N, Chaplin A, Fresneda S, Gallardo-Alfaro L, García-Ruano C, Konieczna J, Leiva A, Masmiquel L, Pico C, Ricci-Cabello I, Romaguera D, Rivera R, Sanchis P, Vidal-Conti J, Yañez AM. Efficacy of Different Modalities and Frequencies of Physical Exercise on Glucose Control in People with Prediabetes (GLYCEX Randomised Trial). Metabolites. 2022;12(12).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  To assess the efficacy of different modalities and frequencies of physical exercise on glycaemic control in adults with prediabetes. A two-phase, parallel, randomised, controlled clinical trial will be carried out, in 210 participants. In phase 1, 120 participants will be randomized into four arms: (1) aerobic exercise, (2) aerobic exercise combined with resistance, (3) high-intensity intervallic exercise and (4) control group. In phase 2, 90 new participants will be randomized into three arms, using the exercise modality that showed the best glycaemic control in phase 1 in the following manner: (1) frequency of 5 days/week, (2) frequency of 3 days/week and (3) frequency of 2 days/week. The control group (n = 30) will be included in phase 1 to evaluate the effect of any type of intervention versus no intervention. Data collection will be performed at baseline and after 15 weeks of follow up. Sociodemographic data, medication, comorbidity, blood biochemical parameters, blood pressure, anthropometric measurements, body composition, physical activity, sedentary lifestyle, diet, smoking, alcohol consumption, quality of life and sleep questionnaires will be collected. Physical activity, sedentary behaviour and sleep will be further determined with an accelerometer, and continuous glycaemia will be determined with a glycaemic monitor, both during seven days, at two time points. The main dependent variable will be the reduction in the mean amplitude of glycaemic excursions. The impact of these interventions on health will also be evaluated through gene expression analysis in peripheral blood cells. The results of this study will contribute to a better understanding of the mechanisms behind the glucose response to physical exercise in a population with prediabetes as well as improve physical exercise prescriptions for diabetes prevention. Increasing glycaemic control in people with prediabetes through physical exercise offers an opportunity to prevent diabetes and reduce associated comorbidities and health costs.

  @article{RN1,
  abstract = {To assess the efficacy of different modalities and frequencies of physical exercise on glycaemic control in adults with prediabetes. A two-phase, parallel, randomised, controlled clinical trial will be carried out, in 210 participants. In phase 1, 120 participants will be randomized into four arms: (1) aerobic exercise, (2) aerobic exercise combined with resistance, (3) high-intensity intervallic exercise and (4) control group. In phase 2, 90 new participants will be randomized into three arms, using the exercise modality that showed the best glycaemic control in phase 1 in the following manner: (1) frequency of 5 days/week, (2) frequency of 3 days/week and (3) frequency of 2 days/week. The control group (n = 30) will be included in phase 1 to evaluate the effect of any type of intervention versus no intervention. Data collection will be performed at baseline and after 15 weeks of follow up. Sociodemographic data, medication, comorbidity, blood biochemical parameters, blood pressure, anthropometric measurements, body composition, physical activity, sedentary lifestyle, diet, smoking, alcohol consumption, quality of life and sleep questionnaires will be collected. Physical activity, sedentary behaviour and sleep will be further determined with an accelerometer, and continuous glycaemia will be determined with a glycaemic monitor, both during seven days, at two time points. The main dependent variable will be the reduction in the mean amplitude of glycaemic excursions. The impact of these interventions on health will also be evaluated through gene expression analysis in peripheral blood cells. The results of this study will contribute to a better understanding of the mechanisms behind the glucose response to physical exercise in a population with prediabetes as well as improve physical exercise prescriptions for diabetes prevention. Increasing glycaemic control in people with prediabetes through physical exercise offers an opportunity to prevent diabetes and reduce associated comorbidities and health costs.},
  author = {Galmes-Panades, A. M. and Bennasar-Veny, M. and Oliver, P. and Garcia-Coll, N. and Chaplin, A. and Fresneda, S. and Gallardo-Alfaro, L. and García-Ruano, C. and Konieczna, J. and Leiva, A. and Masmiquel, L. and Pico, C. and Ricci-Cabello, I. and Romaguera, D. and Rivera, R. and Sanchis, P. and Vidal-Conti, J. and Yañez, A. M.},
  journal = {Metabolites},
  keywords = {grapp-caib},
  number = 12,
  title = {Efficacy of Different Modalities and Frequencies of Physical Exercise on Glucose Control in People with Prediabetes (GLYCEX Randomised Trial)},
  type = {Journal Article},
  volume = 12,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN1
  %A Galmes-Panades, A. M.
  %A Bennasar-Veny, M.
  %A Oliver, P.
  %A Garcia-Coll, N.
  %A Chaplin, A.
  %A Fresneda, S.
  %A Gallardo-Alfaro, L.
  %A García-Ruano, C.
  %A Konieczna, J.
  %A Leiva, A.
  %A Masmiquel, L.
  %A Pico, C.
  %A Ricci-Cabello, I.
  %A Romaguera, D.
  %A Rivera, R.
  %A Sanchis, P.
  %A Vidal-Conti, J.
  %A Yañez, A. M.
  %D 2022
  %J Metabolites
  %N 12
  %R 10.3390/metabo12121286
  %T Efficacy of Different Modalities and Frequencies of Physical Exercise on Glucose Control in People with Prediabetes (GLYCEX Randomised Trial)
  %V 12
  %X To assess the efficacy of different modalities and frequencies of physical exercise on glycaemic control in adults with prediabetes. A two-phase, parallel, randomised, controlled clinical trial will be carried out, in 210 participants. In phase 1, 120 participants will be randomized into four arms: (1) aerobic exercise, (2) aerobic exercise combined with resistance, (3) high-intensity intervallic exercise and (4) control group. In phase 2, 90 new participants will be randomized into three arms, using the exercise modality that showed the best glycaemic control in phase 1 in the following manner: (1) frequency of 5 days/week, (2) frequency of 3 days/week and (3) frequency of 2 days/week. The control group (n = 30) will be included in phase 1 to evaluate the effect of any type of intervention versus no intervention. Data collection will be performed at baseline and after 15 weeks of follow up. Sociodemographic data, medication, comorbidity, blood biochemical parameters, blood pressure, anthropometric measurements, body composition, physical activity, sedentary lifestyle, diet, smoking, alcohol consumption, quality of life and sleep questionnaires will be collected. Physical activity, sedentary behaviour and sleep will be further determined with an accelerometer, and continuous glycaemia will be determined with a glycaemic monitor, both during seven days, at two time points. The main dependent variable will be the reduction in the mean amplitude of glycaemic excursions. The impact of these interventions on health will also be evaluated through gene expression analysis in peripheral blood cells. The results of this study will contribute to a better understanding of the mechanisms behind the glucose response to physical exercise in a population with prediabetes as well as improve physical exercise prescriptions for diabetes prevention. Increasing glycaemic control in people with prediabetes through physical exercise offers an opportunity to prevent diabetes and reduce associated comorbidities and health costs.
  

• 
  1.

  Chela-Alvarez X, Bulilete O, Garcia-Illan E, Vidal-Thomàs M, Llobera J. Hotel housekeepers and occupational health: experiences and perceived risks. Ann Occup Environ Med. 2022;34:e29.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Hotel housekeepers are one of the most important occupational group within tourism hotel sector; various health problems related to their job have been described, above all musculoskeletal disorders. The objective of this study is to understand the experiences and perceptions of hotel housekeepers and key informants from the Balearic Islands (Spain) regarding occupational health conditions and the strategies employed to mitigate them. METHODS: A qualitative study was carried out. Six focus groups with hotel housekeepers and 10 semi-structured interviews with key informants were conducted. Next, we carried out a content analysis. RESULTS: Hotel housekeepers reported musculoskeletal disorders, anxiety and stress as main occupational health problems; health professionals underscored the physical problems. Hotel housekeepers perceived that their work (physically demanding and with repetitive movements) caused their health conditions. To solve health issues, they used medication (anti-inflammatory agents, painkillers, sedatives and anxiolytics), which allowed them to continue working; health public services, generally rated as satisfactory; individual protective equipment; ergonomics (with difficulties due to high work pace and hotel facilities) and physical activity. Two contrasting attitudes were identified regarding sick leave: HHs who refused to accept a doctor-prescribed sick leave (due to fear of being fired, sense of responsibility, ...), and those who accepted it (because they could not continue working, they prioritised health before work). CONCLUSIONS: Our results might contribute to plan improvement strategies and programs to address health problems among hotel housekeepers. These programs should include interventions, such as coping strategies for the work-related risk factors (i.e., stress) and strategies to reduce medicine consumption. Additionally, hotel facilities should adopt policies focused on making workplaces more ergonomic (i.e., furniture) and to diminish the work pace.

  @article{RN121,
  abstract = {BACKGROUND: Hotel housekeepers are one of the most important occupational group within tourism hotel sector; various health problems related to their job have been described, above all musculoskeletal disorders. The objective of this study is to understand the experiences and perceptions of hotel housekeepers and key informants from the Balearic Islands (Spain) regarding occupational health conditions and the strategies employed to mitigate them. METHODS: A qualitative study was carried out. Six focus groups with hotel housekeepers and 10 semi-structured interviews with key informants were conducted. Next, we carried out a content analysis. RESULTS: Hotel housekeepers reported musculoskeletal disorders, anxiety and stress as main occupational health problems; health professionals underscored the physical problems. Hotel housekeepers perceived that their work (physically demanding and with repetitive movements) caused their health conditions. To solve health issues, they used medication (anti-inflammatory agents, painkillers, sedatives and anxiolytics), which allowed them to continue working; health public services, generally rated as satisfactory; individual protective equipment; ergonomics (with difficulties due to high work pace and hotel facilities) and physical activity. Two contrasting attitudes were identified regarding sick leave: HHs who refused to accept a doctor-prescribed sick leave (due to fear of being fired, sense of responsibility, ...), and those who accepted it (because they could not continue working, they prioritised health before work). CONCLUSIONS: Our results might contribute to plan improvement strategies and programs to address health problems among hotel housekeepers. These programs should include interventions, such as coping strategies for the work-related risk factors (i.e., stress) and strategies to reduce medicine consumption. Additionally, hotel facilities should adopt policies focused on making workplaces more ergonomic (i.e., furniture) and to diminish the work pace.},
  author = {Chela-Alvarez, X. and Bulilete, O. and Garcia-Illan, E. and Vidal-Thomàs, M. and Llobera, J.},
  journal = {Ann Occup Environ Med},
  keywords = {grapp-caib},
  pages = {e29},
  title = {Hotel housekeepers and occupational health: experiences and perceived risks},
  type = {Journal Article},
  volume = 34,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN121
  %A Chela-Alvarez, X.
  %A Bulilete, O.
  %A Garcia-Illan, E.
  %A Vidal-Thomàs, M.
  %A Llobera, J.
  %D 2022
  %J Ann Occup Environ Med
  %P e29
  %R 10.35371/aoem.2022.34.e29
  %T Hotel housekeepers and occupational health: experiences and perceived risks
  %V 34
  %X BACKGROUND: Hotel housekeepers are one of the most important occupational group within tourism hotel sector; various health problems related to their job have been described, above all musculoskeletal disorders. The objective of this study is to understand the experiences and perceptions of hotel housekeepers and key informants from the Balearic Islands (Spain) regarding occupational health conditions and the strategies employed to mitigate them. METHODS: A qualitative study was carried out. Six focus groups with hotel housekeepers and 10 semi-structured interviews with key informants were conducted. Next, we carried out a content analysis. RESULTS: Hotel housekeepers reported musculoskeletal disorders, anxiety and stress as main occupational health problems; health professionals underscored the physical problems. Hotel housekeepers perceived that their work (physically demanding and with repetitive movements) caused their health conditions. To solve health issues, they used medication (anti-inflammatory agents, painkillers, sedatives and anxiolytics), which allowed them to continue working; health public services, generally rated as satisfactory; individual protective equipment; ergonomics (with difficulties due to high work pace and hotel facilities) and physical activity. Two contrasting attitudes were identified regarding sick leave: HHs who refused to accept a doctor-prescribed sick leave (due to fear of being fired, sense of responsibility, ...), and those who accepted it (because they could not continue working, they prioritised health before work). CONCLUSIONS: Our results might contribute to plan improvement strategies and programs to address health problems among hotel housekeepers. These programs should include interventions, such as coping strategies for the work-related risk factors (i.e., stress) and strategies to reduce medicine consumption. Additionally, hotel facilities should adopt policies focused on making workplaces more ergonomic (i.e., furniture) and to diminish the work pace.
  

• 
  1.

  Gómez-Sánchez L, Gómez-Sánchez M, Lugones-Sánchez C, Rodríguez-Sánchez E, Tamayo-Morales O, Gonzalez-Sánchez S, Magallón-Botaya R, Ramirez-Manent JI, Recio-Rodriguez JI, Agudo-Conde C, García-Ortiz L, Gómez-Marcos MA. Long-Term Effectiveness of a Smartphone App and a Smart Band on Arterial Stiffness and Central Hemodynamic Parameters in a Population with Overweight and Obesity (Evident 3 Study): Randomised Controlled Trial. Nutrients. 2022;14(22).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: mHealth technologies could help to improve cardiovascular health; however, their effect on arterial stiffness and hemodynamic parameters has not been explored to date. OBJECTIVE: To evaluate the effect of a mHealth intervention, at 3 and 12 months, on arterial stiffness and central hemodynamic parameters in a sedentary population with overweight and obesity. METHODS: Randomised controlled clinical trial (Evident 3 study). 253 subjects were included: 127 in the intervention group (IG) and 126 in the control group (CG). The IG subjects were briefed on the use of the Evident 3 app and a smart band (Mi Band 2, Xiaomi) for 3 months to promote healthy lifestyles. All measurements were recorded in the baseline visit and at 3 and 12 months. The carotid-femoral pulse wave velocity (cfPWV) and the central hemodynamic parameters were measured using a SphigmoCor System(®) device, whereas the brachial-ankle pulse wave velocity (baPWV) and the Cardio Ankle Vascular Index (CAVI) were measured using a VaSera VS-2000(®) device. RESULTS: Of the 253 subjects who attended the initial visit, 237 (93.7%) completed the visit at 3 months of the intervention, and 217 (85.3%) completed the visit at 12 months of the intervention. At 12 months, IG showed a decrease in peripheral augmentation index (PAIx) (-3.60; 95% CI -7.22 to -0.00) and ejection duration (ED) (-0.82; 95% CI -1.36 to -0.27), and an increase in subendocardial viability ratio (SEVR) (5.31; 95% CI 1.18 to 9.44). In CG, cfPWV decreased at 3 months (-0.28 m/s; 95% CI -0.54 to -0.02) and at 12 months (-0.30 m/s, 95% CI -0.54 to -0.05), central diastolic pressure (cDBP) decreased at 12 months (-1.64 mm/Hg; 95% CI -3.19 to -0.10). When comparing the groups we found no differences between any variables analyzed. CONCLUSIONS: In sedentary adults with overweight or obesity, the multicomponent intervention (Smartphone app and an activity-tracking band) for 3 months did not modify arterial stiffness or the central hemodynamic parameters, with respect to the control group. However, at 12 months, CG presented a decrease of cfPWV and cDBP, whereas IG showed a decrease of PAIx and ED and an increase of SEVR.

  @article{RN42,
  abstract = {BACKGROUND: mHealth technologies could help to improve cardiovascular health; however, their effect on arterial stiffness and hemodynamic parameters has not been explored to date. OBJECTIVE: To evaluate the effect of a mHealth intervention, at 3 and 12 months, on arterial stiffness and central hemodynamic parameters in a sedentary population with overweight and obesity. METHODS: Randomised controlled clinical trial (Evident 3 study). 253 subjects were included: 127 in the intervention group (IG) and 126 in the control group (CG). The IG subjects were briefed on the use of the Evident 3 app and a smart band (Mi Band 2, Xiaomi) for 3 months to promote healthy lifestyles. All measurements were recorded in the baseline visit and at 3 and 12 months. The carotid-femoral pulse wave velocity (cfPWV) and the central hemodynamic parameters were measured using a SphigmoCor System(®) device, whereas the brachial-ankle pulse wave velocity (baPWV) and the Cardio Ankle Vascular Index (CAVI) were measured using a VaSera VS-2000(®) device. RESULTS: Of the 253 subjects who attended the initial visit, 237 (93.7%) completed the visit at 3 months of the intervention, and 217 (85.3%) completed the visit at 12 months of the intervention. At 12 months, IG showed a decrease in peripheral augmentation index (PAIx) (-3.60; 95% CI -7.22 to -0.00) and ejection duration (ED) (-0.82; 95% CI -1.36 to -0.27), and an increase in subendocardial viability ratio (SEVR) (5.31; 95% CI 1.18 to 9.44). In CG, cfPWV decreased at 3 months (-0.28 m/s; 95% CI -0.54 to -0.02) and at 12 months (-0.30 m/s, 95% CI -0.54 to -0.05), central diastolic pressure (cDBP) decreased at 12 months (-1.64 mm/Hg; 95% CI -3.19 to -0.10). When comparing the groups we found no differences between any variables analyzed. CONCLUSIONS: In sedentary adults with overweight or obesity, the multicomponent intervention (Smartphone app and an activity-tracking band) for 3 months did not modify arterial stiffness or the central hemodynamic parameters, with respect to the control group. However, at 12 months, CG presented a decrease of cfPWV and cDBP, whereas IG showed a decrease of PAIx and ED and an increase of SEVR.},
  author = {Gómez-Sánchez, L. and Gómez-Sánchez, M. and Lugones-Sánchez, C. and Rodríguez-Sánchez, E. and Tamayo-Morales, O. and Gonzalez-Sánchez, S. and Magallón-Botaya, R. and Ramirez-Manent, J. I. and Recio-Rodriguez, J. I. and Agudo-Conde, C. and García-Ortiz, L. and Gómez-Marcos, M. A.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 22,
  title = {Long-Term Effectiveness of a Smartphone App and a Smart Band on Arterial Stiffness and Central Hemodynamic Parameters in a Population with Overweight and Obesity (Evident 3 Study): Randomised Controlled Trial},
  type = {Journal Article},
  volume = 14,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN42
  %A Gómez-Sánchez, L.
  %A Gómez-Sánchez, M.
  %A Lugones-Sánchez, C.
  %A Rodríguez-Sánchez, E.
  %A Tamayo-Morales, O.
  %A Gonzalez-Sánchez, S.
  %A Magallón-Botaya, R.
  %A Ramirez-Manent, J. I.
  %A Recio-Rodriguez, J. I.
  %A Agudo-Conde, C.
  %A García-Ortiz, L.
  %A Gómez-Marcos, M. A.
  %D 2022
  %J Nutrients
  %N 22
  %R 10.3390/nu14224758
  %T Long-Term Effectiveness of a Smartphone App and a Smart Band on Arterial Stiffness and Central Hemodynamic Parameters in a Population with Overweight and Obesity (Evident 3 Study): Randomised Controlled Trial
  %V 14
  %X BACKGROUND: mHealth technologies could help to improve cardiovascular health; however, their effect on arterial stiffness and hemodynamic parameters has not been explored to date. OBJECTIVE: To evaluate the effect of a mHealth intervention, at 3 and 12 months, on arterial stiffness and central hemodynamic parameters in a sedentary population with overweight and obesity. METHODS: Randomised controlled clinical trial (Evident 3 study). 253 subjects were included: 127 in the intervention group (IG) and 126 in the control group (CG). The IG subjects were briefed on the use of the Evident 3 app and a smart band (Mi Band 2, Xiaomi) for 3 months to promote healthy lifestyles. All measurements were recorded in the baseline visit and at 3 and 12 months. The carotid-femoral pulse wave velocity (cfPWV) and the central hemodynamic parameters were measured using a SphigmoCor System(®) device, whereas the brachial-ankle pulse wave velocity (baPWV) and the Cardio Ankle Vascular Index (CAVI) were measured using a VaSera VS-2000(®) device. RESULTS: Of the 253 subjects who attended the initial visit, 237 (93.7%) completed the visit at 3 months of the intervention, and 217 (85.3%) completed the visit at 12 months of the intervention. At 12 months, IG showed a decrease in peripheral augmentation index (PAIx) (-3.60; 95% CI -7.22 to -0.00) and ejection duration (ED) (-0.82; 95% CI -1.36 to -0.27), and an increase in subendocardial viability ratio (SEVR) (5.31; 95% CI 1.18 to 9.44). In CG, cfPWV decreased at 3 months (-0.28 m/s; 95% CI -0.54 to -0.02) and at 12 months (-0.30 m/s, 95% CI -0.54 to -0.05), central diastolic pressure (cDBP) decreased at 12 months (-1.64 mm/Hg; 95% CI -3.19 to -0.10). When comparing the groups we found no differences between any variables analyzed. CONCLUSIONS: In sedentary adults with overweight or obesity, the multicomponent intervention (Smartphone app and an activity-tracking band) for 3 months did not modify arterial stiffness or the central hemodynamic parameters, with respect to the control group. However, at 12 months, CG presented a decrease of cfPWV and cDBP, whereas IG showed a decrease of PAIx and ED and an increase of SEVR.
  

• 
  1.

  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(22).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN41,
  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.},
  author = {Galmes-Panades, A. M. and Angullo, E. and Mira-Martínez, S. and Bennasar-Veny, M. and Zamanillo-Campos, R. and Gómez-Juanes, R. and Konieczna, J. and Jiménez, R. and Serrano-Ripoll, M. J. and Fiol deRoque, M. A. and Miralles, J. and Yañez, A. M. and Romaguera, D. and Vidal-Thomas, M. C. and Llobera-Canaves, J. and García-Toro, M. and Vicens, C. and Gervilla-García, E. and Oña, J. I. and Malih, N. and Leiva, A. and Bulilete, O. and Montaño, J. J. and Gili, M. and Roca, M. and Ricci-Cabello, I.},
  journal = {Int J Environ Res Public Health},
  keywords = {grapp-caib},
  number = 22,
  title = {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},
  type = {Journal Article},
  volume = 19,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN41
  %A Galmes-Panades, A. M.
  %A Angullo, E.
  %A Mira-Martínez, S.
  %A Bennasar-Veny, M.
  %A Zamanillo-Campos, R.
  %A Gómez-Juanes, R.
  %A Konieczna, J.
  %A Jiménez, R.
  %A Serrano-Ripoll, M. J.
  %A Fiol deRoque, M. A.
  %A Miralles, J.
  %A Yañez, A. M.
  %A Romaguera, D.
  %A Vidal-Thomas, M. C.
  %A Llobera-Canaves, J.
  %A García-Toro, M.
  %A Vicens, C.
  %A Gervilla-García, E.
  %A Oña, J. I.
  %A Malih, N.
  %A Leiva, A.
  %A Bulilete, O.
  %A Montaño, J. J.
  %A Gili, M.
  %A Roca, M.
  %A Ricci-Cabello, I.
  %D 2022
  %J Int J Environ Res Public Health
  %N 22
  %R 10.3390/ijerph192214706
  %T 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
  %V 19
  %X 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.
  

• 
  1.

  Córdoba García R, Camarelles Guillem F, Muñoz Seco E, Gómez Puente JM, San José Arango J, Ramírez Manent JI, Martín Cantera C, Del Campo Giménez M, Revenga Frauca J, Egea Ronda A, Cervigón Portaencasa R, Rodríguez Benito L. [PAPPS expert group: Lifestyle recommendations]. Aten Primaria. 2022;54 Suppl 1:102442.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.

  @article{RN43,
  abstract = {We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.},
  author = {Córdoba García, R. and Camarelles Guillem, F. and Muñoz Seco, E. and Gómez Puente, J. M. and San José Arango, J. and Ramírez Manent, J. I. and Martín Cantera, C. and Del Campo Giménez, M. and Revenga Frauca, J. and Egea Ronda, A. and Cervigón Portaencasa, R. and Rodríguez Benito, L.},
  journal = {Aten Primaria},
  keywords = {grapp-caib},
  pages = 102442,
  title = {[PAPPS expert group: Lifestyle recommendations]},
  type = {Journal Article},
  volume = {54 Suppl 1},
  year = 2022
  }
  

  %0 Journal Article
  %1 RN43
  %A Córdoba García, R.
  %A Camarelles Guillem, F.
  %A Muñoz Seco, E.
  %A Gómez Puente, J. M.
  %A San José Arango, J.
  %A Ramírez Manent, J. I.
  %A Martín Cantera, C.
  %A Del Campo Giménez, M.
  %A Revenga Frauca, J.
  %A Egea Ronda, A.
  %A Cervigón Portaencasa, R.
  %A Rodríguez Benito, L.
  %D 2022
  %J Aten Primaria
  %P 102442
  %R 10.1016/j.aprim.2022.102442
  %T [PAPPS expert group: Lifestyle recommendations]
  %V 54 Suppl 1
  %X We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.
  

• 
  1.

  Ramírez-Manent JI, Altisench Jané B, Arroyo Bote S, López Roig C, González San Miguel H, López-González AA. Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption. BMC Geriatr. 2022;22(1):872.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.

  @article{RN37,
  abstract = {BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.},
  author = {Ramírez-Manent, J. I. and Altisench Jané, B. and Arroyo Bote, S. and López Roig, C. and González San Miguel, H. and López-González, A. A.},
  journal = {BMC Geriatr},
  keywords = {grapp-caib},
  number = 1,
  pages = 872,
  title = {Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption},
  type = {Journal Article},
  volume = 22,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN37
  %A Ramírez-Manent, J. I.
  %A Altisench Jané, B.
  %A Arroyo Bote, S.
  %A López Roig, C.
  %A González San Miguel, H.
  %A López-González, A. A.
  %D 2022
  %J BMC Geriatr
  %N 1
  %P 872
  %R 10.1186/s12877-022-03547-w
  %T Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption
  %V 22
  %X BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.
  

• 
  1.

  Recio-Rodriguez JI, Garcia-Ortiz L, Garcia-Yu IA, Lugones-Sanchez C, Olmo EZ, Bolibar B, Casajuana-Closas M, Lopez-Jimenez T, Llobera J, Ramos R, Pombo H, Motrico E, Gil-Girbau M, Lopez-Mendez F, Represas-Carrera F, Maderuelo-Fernandez JA. Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial. BMC Public Health. 2022;22(1):2127.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD).  METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. RESULTS: Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. CONCLUSIONS: A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211.

  @article{RN36,
  abstract = {BACKGROUND: The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD).  METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. RESULTS: Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. CONCLUSIONS: A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211.},
  author = {Recio-Rodriguez, J. I. and Garcia-Ortiz, L. and Garcia-Yu, I. A. and Lugones-Sanchez, C. and Olmo, E. Z. and Bolibar, B. and Casajuana-Closas, M. and Lopez-Jimenez, T. and Llobera, J. and Ramos, R. and Pombo, H. and Motrico, E. and Gil-Girbau, M. and Lopez-Mendez, F. and Represas-Carrera, F. and Maderuelo-Fernandez, J. A.},
  journal = {BMC Public Health},
  keywords = {grapp-caib},
  number = 1,
  pages = 2127,
  title = {Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial},
  type = {Journal Article},
  volume = 22,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN36
  %A Recio-Rodriguez, J. I.
  %A Garcia-Ortiz, L.
  %A Garcia-Yu, I. A.
  %A Lugones-Sanchez, C.
  %A Olmo, E. Z.
  %A Bolibar, B.
  %A Casajuana-Closas, M.
  %A Lopez-Jimenez, T.
  %A Llobera, J.
  %A Ramos, R.
  %A Pombo, H.
  %A Motrico, E.
  %A Gil-Girbau, M.
  %A Lopez-Mendez, F.
  %A Represas-Carrera, F.
  %A Maderuelo-Fernandez, J. A.
  %D 2022
  %J BMC Public Health
  %N 1
  %P 2127
  %R 10.1186/s12889-022-14590-y
  %T Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial
  %V 22
  %X BACKGROUND: The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD).  METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. RESULTS: Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. CONCLUSIONS: A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211.
  

• 
  1.

  Ramírez-Manent JI, Martínez-Almoyna E, López C, Busquets-Cortés C, González San Miguel H, López-González Á A. Relationship between Insulin Resistance Risk Scales and Non-Alcoholic Fatty Liver Disease and Liver Fibrosis Scales in 219,477 Spanish Workers. Metabolites. 2022;12(11).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Insulin resistance (IR) has been identified as a key factor in the appearance of non-alcoholic fatty liver disease (NAFLD) as it is related through a complex molecular biochemical and immunological mechanism. Our aim was to evaluate the relationship between different scales that estimate the risk of IR and scales that determine the risk of NAFLD. This descriptive and cross-sectional study was performed in 219,477 Spanish workers from different sectors and Spanish regions. The prevalence of high values of all the IR scales increases as the values of the NAFLD and liver fibrosis scales increase. In the multivariate analysis, the risk of presenting high values in the IR scales increases greatly as the values of the NAFLD and hepatic fibrosis scales increase, with particularly high OR values when using the Metabolic Score for Insulin Resistance (METS-IR) scale (LAP high OR 42.20 (95% CI (39.10-45.56) and FLI high OR 32.35 (95% CI 31.10-33.61)). We can conclude that there is a direct relationship between the values of the IR scales and the NAFLD and liver fibrosis scales in our population.

  @article{RN2,
  abstract = {Insulin resistance (IR) has been identified as a key factor in the appearance of non-alcoholic fatty liver disease (NAFLD) as it is related through a complex molecular biochemical and immunological mechanism. Our aim was to evaluate the relationship between different scales that estimate the risk of IR and scales that determine the risk of NAFLD. This descriptive and cross-sectional study was performed in 219,477 Spanish workers from different sectors and Spanish regions. The prevalence of high values of all the IR scales increases as the values of the NAFLD and liver fibrosis scales increase. In the multivariate analysis, the risk of presenting high values in the IR scales increases greatly as the values of the NAFLD and hepatic fibrosis scales increase, with particularly high OR values when using the Metabolic Score for Insulin Resistance (METS-IR) scale (LAP high OR 42.20 (95% CI (39.10-45.56) and FLI high OR 32.35 (95% CI 31.10-33.61)). We can conclude that there is a direct relationship between the values of the IR scales and the NAFLD and liver fibrosis scales in our population.},
  author = {Ramírez-Manent, J. I. and Martínez-Almoyna, E. and López, C. and Busquets-Cortés, C. and González San Miguel, H. and López-González Á, A.},
  journal = {Metabolites},
  keywords = {grapp-caib},
  number = 11,
  title = {Relationship between Insulin Resistance Risk Scales and Non-Alcoholic Fatty Liver Disease and Liver Fibrosis Scales in 219,477 Spanish Workers},
  type = {Journal Article},
  volume = 12,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN2
  %A Ramírez-Manent, J. I.
  %A Martínez-Almoyna, E.
  %A López, C.
  %A Busquets-Cortés, C.
  %A González San Miguel, H.
  %A López-González Á, A.
  %D 2022
  %J Metabolites
  %N 11
  %R 10.3390/metabo12111093
  %T Relationship between Insulin Resistance Risk Scales and Non-Alcoholic Fatty Liver Disease and Liver Fibrosis Scales in 219,477 Spanish Workers
  %V 12
  %X Insulin resistance (IR) has been identified as a key factor in the appearance of non-alcoholic fatty liver disease (NAFLD) as it is related through a complex molecular biochemical and immunological mechanism. Our aim was to evaluate the relationship between different scales that estimate the risk of IR and scales that determine the risk of NAFLD. This descriptive and cross-sectional study was performed in 219,477 Spanish workers from different sectors and Spanish regions. The prevalence of high values of all the IR scales increases as the values of the NAFLD and liver fibrosis scales increase. In the multivariate analysis, the risk of presenting high values in the IR scales increases greatly as the values of the NAFLD and hepatic fibrosis scales increase, with particularly high OR values when using the Metabolic Score for Insulin Resistance (METS-IR) scale (LAP high OR 42.20 (95% CI (39.10-45.56) and FLI high OR 32.35 (95% CI 31.10-33.61)). We can conclude that there is a direct relationship between the values of the IR scales and the NAFLD and liver fibrosis scales in our population.
  

• 
  1.

  Jané BA, Ramírez-Manent JI, Bote SA, Sbert PR, González San Mıguel HM, Lopez González Á A. Determination of cardiovascular risk in 192,711 underweight and normal weight workers. Turk J Med Sci. 2022;52(4):926-33.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The aim of this study was to determine the prevalence of cardiovascular risk factors (CVRF) and the level of cardiovascular risk (CVR), determined with different scales (REGICOR, SCORE, ERICE, vascular age...) in people with low and normal weight. METHODS: A total of 192,711 underweight and normal weight Spanish workers participated. CVR parameters included were weight, abdominal circumference, blood pressure, glycemia (high >125 mg/dL or under hypoglycemic treatment) and lipids (cutoff points: total cholesterol 200 mg/dL, LDL 130 mg/dL, triglycerides 150 mg/dL) were obtained by automated enzymatic methods. Body mass index (BMI) was calculated, considering underweight 18.5 and normal weight 18.5-24.9. A descriptive analysis of the categorical variables was carried out. RESULTS: The values of analytical, anthropometric and clinical parameters were more unfavorable in the normal weight group. Also, the prevalence of alterated values of CVR seen with different scales show higher risk in this group and in all cases the values in men are worse. It was seen that the variable with the greatest influence on the appearance of altered values of the cardiovascular risk scales (CVRS), influencing all of them was the age. DISCUSSION: All the CVRS analyzed showed higher values in the group of people with normal weight compared to those with underweight. Age, followed by sex, were the variables that most influence the appearance of high CVR values.

  @article{RN1,
  abstract = {BACKGROUND: The aim of this study was to determine the prevalence of cardiovascular risk factors (CVRF) and the level of cardiovascular risk (CVR), determined with different scales (REGICOR, SCORE, ERICE, vascular age...) in people with low and normal weight. METHODS: A total of 192,711 underweight and normal weight Spanish workers participated. CVR parameters included were weight, abdominal circumference, blood pressure, glycemia (high >125 mg/dL or under hypoglycemic treatment) and lipids (cutoff points: total cholesterol 200 mg/dL, LDL 130 mg/dL, triglycerides 150 mg/dL) were obtained by automated enzymatic methods. Body mass index (BMI) was calculated, considering underweight 18.5 and normal weight 18.5-24.9. A descriptive analysis of the categorical variables was carried out. RESULTS: The values of analytical, anthropometric and clinical parameters were more unfavorable in the normal weight group. Also, the prevalence of alterated values of CVR seen with different scales show higher risk in this group and in all cases the values in men are worse. It was seen that the variable with the greatest influence on the appearance of altered values of the cardiovascular risk scales (CVRS), influencing all of them was the age. DISCUSSION: All the CVRS analyzed showed higher values in the group of people with normal weight compared to those with underweight. Age, followed by sex, were the variables that most influence the appearance of high CVR values.},
  author = {Jané, B. A. and Ramírez-Manent, J. I. and Bote, S. A. and Sbert, P. R. and González San Mıguel, H. M. and Lopez González Á, A.},
  journal = {Turk J Med Sci},
  keywords = {grapp-caib},
  number = 4,
  pages = {926-933},
  title = {Determination of cardiovascular risk in 192,711 underweight and normal weight workers},
  type = {Journal Article},
  volume = 52,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN1
  %A Jané, B. A.
  %A Ramírez-Manent, J. I.
  %A Bote, S. A.
  %A Sbert, P. R.
  %A González San Mıguel, H. M.
  %A Lopez González Á, A.
  %D 2022
  %J Turk J Med Sci
  %N 4
  %P 926-933
  %R 10.55730/1300-0144.5392
  %T Determination of cardiovascular risk in 192,711 underweight and normal weight workers
  %V 52
  %X BACKGROUND: The aim of this study was to determine the prevalence of cardiovascular risk factors (CVRF) and the level of cardiovascular risk (CVR), determined with different scales (REGICOR, SCORE, ERICE, vascular age...) in people with low and normal weight. METHODS: A total of 192,711 underweight and normal weight Spanish workers participated. CVR parameters included were weight, abdominal circumference, blood pressure, glycemia (high >125 mg/dL or under hypoglycemic treatment) and lipids (cutoff points: total cholesterol 200 mg/dL, LDL 130 mg/dL, triglycerides 150 mg/dL) were obtained by automated enzymatic methods. Body mass index (BMI) was calculated, considering underweight 18.5 and normal weight 18.5-24.9. A descriptive analysis of the categorical variables was carried out. RESULTS: The values of analytical, anthropometric and clinical parameters were more unfavorable in the normal weight group. Also, the prevalence of alterated values of CVR seen with different scales show higher risk in this group and in all cases the values in men are worse. It was seen that the variable with the greatest influence on the appearance of altered values of the cardiovascular risk scales (CVRS), influencing all of them was the age. DISCUSSION: All the CVRS analyzed showed higher values in the group of people with normal weight compared to those with underweight. Age, followed by sex, were the variables that most influence the appearance of high CVR values.
  

• 
  1.

  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(20).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN116,
  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.},
  author = {Reus, X. and Sastre, M. L. and Leiva, A. and Sánchez, B. and García-Serra, C. and Ioakeim-Skoufa, I. and Vicens, C.},
  journal = {Int J Environ Res Public Health},
  keywords = {grapp-caib},
  number = 20,
  title = {LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care},
  type = {Journal Article},
  volume = 19,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN116
  %A Reus, X.
  %A Sastre, M. L.
  %A Leiva, A.
  %A Sánchez, B.
  %A García-Serra, C.
  %A Ioakeim-Skoufa, I.
  %A Vicens, C.
  %D 2022
  %J Int J Environ Res Public Health
  %N 20
  %R 10.3390/ijerph192013241
  %T LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care
  %V 19
  %X 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.
  

• 
  1.

  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(10).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN117,
  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.},
  author = {Moliner-Calderón, E. and Verd, S. and Leiva, A. and Ponce-Taylor, J. and Ginovart, G. and Moll-McCarthy, P. and Gelabert, C. and Figueras-Aloy, J.},
  journal = {Children (Basel)},
  keywords = {grapp-caib},
  number = 10,
  title = {Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy},
  type = {Journal Article},
  volume = 9,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN117
  %A Moliner-Calderón, E.
  %A Verd, S.
  %A Leiva, A.
  %A Ponce-Taylor, J.
  %A Ginovart, G.
  %A Moll-McCarthy, P.
  %A Gelabert, C.
  %A Figueras-Aloy, J.
  %D 2022
  %J Children (Basel)
  %N 10
  %R 10.3390/children9101450
  %T Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy
  %V 9
  %X 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.
  

• 
  1.

  López-González AA, Ramírez Manent JI, Vicente-Herrero MT, García Ruiz E, Albaladejo Blanco M, López Safont N. Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption. Anales del Sistema Sanitario de Navarra [Internet]. Gobierno de Navarra; 2022 Nov.;. https://doi.org/10.23938%2Fassn.0977

  URLBibTeXEndNoteDOIBibSonomyDownload

  @article{L_pez_Gonz_lez_2021,
  author = {López-González, A. A. and Ramírez Manent, J. I. and Vicente-Herrero, M. T. and García Ruiz, E. and Albaladejo Blanco, M. and López Safont, N.},
  journal = {Anales del Sistema Sanitario de Navarra},
  keywords = {grapp-caib},
  month = {nov},
  publisher = {Gobierno de Navarra},
  title = {Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption},
  year = 2022
  }
  

  %0 Journal Article
  %1 L_pez_Gonz_lez_2021
  %A López-González, A. A.
  %A Ramírez Manent, J. I.
  %A Vicente-Herrero, M. T.
  %A García Ruiz, E.
  %A Albaladejo Blanco, M.
  %A López Safont, N.
  %D 2022
  %I Gobierno de Navarra
  %J Anales del Sistema Sanitario de Navarra
  %R 10.23938/assn.0977
  %T Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption
  %U https://doi.org/10.23938%2Fassn.0977
  

• 
  1.

  León-Salas B, Álvarez-Pérez Y, Ramos-García V, Del Mar Trujillo-Martín M, de Pascual YMAM, Esteva M, Brito-García N, González-Hernández N, Bohn-Sarmiento U, Biurrun-Martínez MC, Serrano-Aguilar P. Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals’ perspectives. Eur J Cancer Care (Engl). 2022;:e13730.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS: Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS: The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS: Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS: Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.

  @article{RN113,
  abstract = {OBJECTIVE: The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS: Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS: The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS: Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS: Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.},
  author = {León-Salas, B. and Álvarez-Pérez, Y. and Ramos-García, V. and Del Mar Trujillo-Martín, M. and de Pascual, Y. Medina A. M. and Esteva, M. and Brito-García, N. and González-Hernández, N. and Bohn-Sarmiento, U. and Biurrun-Martínez, M. C. and Serrano-Aguilar, P.},
  journal = {Eur J Cancer Care (Engl)},
  keywords = {grapp-caib},
  pages = {e13730},
  title = {Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives},
  type = {Journal Article},
  year = 2022
  }
  

  %0 Journal Article
  %1 RN113
  %A León-Salas, B.
  %A Álvarez-Pérez, Y.
  %A Ramos-García, V.
  %A Del Mar Trujillo-Martín, M.
  %A de Pascual, Y. Medina A. M.
  %A Esteva, M.
  %A Brito-García, N.
  %A González-Hernández, N.
  %A Bohn-Sarmiento, U.
  %A Biurrun-Martínez, M. C.
  %A Serrano-Aguilar, P.
  %D 2022
  %J Eur J Cancer Care (Engl)
  %P e13730
  %R 10.1111/ecc.13730
  %T Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives
  %X OBJECTIVE: The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS: Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS: The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS: Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS: Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.
  

• 
  1.

  Ramírez-Manent JI, Altisench Jané B, Tomás Salvà M, Arroyo Bote S, González San Miguel HM, López-González Á A. Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population. Nutrients. 2022;14(19).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. METHODS: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student's t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer-Lemeshow goodness-of-fit test was also performed. RESULTS: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3-0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2-8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. CONCLUSIONS: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.

  @article{RN112,
  abstract = {BACKGROUND: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. METHODS: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student's t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer-Lemeshow goodness-of-fit test was also performed. RESULTS: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3-0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2-8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. CONCLUSIONS: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.},
  author = {Ramírez-Manent, J. I. and Altisench Jané, B. and Tomás Salvà, M. and Arroyo Bote, S. and González San Miguel, H. M. and López-González Á, A.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 19,
  title = {Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population},
  type = {Journal Article},
  volume = 14,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN112
  %A Ramírez-Manent, J. I.
  %A Altisench Jané, B.
  %A Tomás Salvà, M.
  %A Arroyo Bote, S.
  %A González San Miguel, H. M.
  %A López-González Á, A.
  %D 2022
  %J Nutrients
  %N 19
  %R 10.3390/nu14194101
  %T Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population
  %V 14
  %X BACKGROUND: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. METHODS: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student's t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer-Lemeshow goodness-of-fit test was also performed. RESULTS: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3-0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2-8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. CONCLUSIONS: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.
  

• 
  1.

  López-González AA, Jover AM, Martínez CS, Artal PM, Bote SA, Jané BA, Ramírez-Manent JI. The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults. Sci Rep. 2022;12(1):15486.

  AbstractBibTeXEndNoteDOIBibSonomy

  There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.

  @article{RN1,
  abstract = {There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.},
  author = {López-González, A. A. and Jover, A. M. and Martínez, C. S. and Artal, P. M. and Bote, S. A. and Jané, B. A. and Ramírez-Manent, J. I.},
  journal = {Sci Rep},
  keywords = {grapp-caib},
  number = 1,
  pages = 15486,
  title = {The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults},
  type = {Journal Article},
  volume = 12,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN1
  %A López-González, A. A.
  %A Jover, A. M.
  %A Martínez, C. S.
  %A Artal, P. M.
  %A Bote, S. A.
  %A Jané, B. A.
  %A Ramírez-Manent, J. I.
  %D 2022
  %J Sci Rep
  %N 1
  %P 15486
  %R 10.1038/s41598-022-19343-w
  %T The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults
  %V 12
  %X There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.
  

• 
  1.

  Zamanillo-Campos R, Chaplin A, Romaguera D, Abete I, Salas-Salvadó J, Martín V, Estruch R, Vidal J, Ruiz-Canela M, Babio N, Fiol F, de Paz JA, Casas R, Olbeyra R, Martínez-González MA, García-Gavilán JF, Goday A, Fernandez-Lazaro CI, Martínez JA, Hu FB, Konieczna J. Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators. Clin Nutr. 2022;41(10):2264-7.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

  @article{RN110,
  abstract = {BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.},
  author = {Zamanillo-Campos, R. and Chaplin, A. and Romaguera, D. and Abete, I. and Salas-Salvadó, J. and Martín, V. and Estruch, R. and Vidal, J. and Ruiz-Canela, M. and Babio, N. and Fiol, F. and de Paz, J. A. and Casas, R. and Olbeyra, R. and Martínez-González, M. A. and García-Gavilán, J. F. and Goday, A. and Fernandez-Lazaro, C. I. and Martínez, J. A. and Hu, F. B. and Konieczna, J.},
  journal = {Clin Nutr},
  keywords = {grapp-caib},
  number = 10,
  pages = {2264-2274},
  title = {Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators},
  type = {Journal Article},
  volume = 41,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN110
  %A Zamanillo-Campos, R.
  %A Chaplin, A.
  %A Romaguera, D.
  %A Abete, I.
  %A Salas-Salvadó, J.
  %A Martín, V.
  %A Estruch, R.
  %A Vidal, J.
  %A Ruiz-Canela, M.
  %A Babio, N.
  %A Fiol, F.
  %A de Paz, J. A.
  %A Casas, R.
  %A Olbeyra, R.
  %A Martínez-González, M. A.
  %A García-Gavilán, J. F.
  %A Goday, A.
  %A Fernandez-Lazaro, C. I.
  %A Martínez, J. A.
  %A Hu, F. B.
  %A Konieczna, J.
  %D 2022
  %J Clin Nutr
  %N 10
  %P 2264-2274
  %R 10.1016/j.clnu.2022.08.008
  %T Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators
  %V 41
  %X BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
  

• 
  1.

  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(1):910.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN99,
  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.},
  author = {Esteva, M. and Leiva, A. and Ramos-Monserrat, M. and Espí, A. and González-Luján, L. and Macià, F. and Murta-Nascimento, C. and Sánchez-Calavera, M. A. and Magallón, R. and Balboa-Barreiro, V. and Seoane-Pillado, T. and Pertega-Díaz, S.},
  journal = {BMC Cancer},
  keywords = {grapp-caib},
  number = 1,
  pages = 910,
  title = {Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer},
  type = {Journal Article},
  volume = 22,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN99
  %A Esteva, M.
  %A Leiva, A.
  %A Ramos-Monserrat, M.
  %A Espí, A.
  %A González-Luján, L.
  %A Macià, F.
  %A Murta-Nascimento, C.
  %A Sánchez-Calavera, M. A.
  %A Magallón, R.
  %A Balboa-Barreiro, V.
  %A Seoane-Pillado, T.
  %A Pertega-Díaz, S.
  %D 2022
  %J BMC Cancer
  %N 1
  %P 910
  %R 10.1186/s12885-022-09990-7
  %T Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer
  %V 22
  %X 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.
  

• 
  1.

  Gómez-Sánchez L, Rodríguez-Sánchez E, Ramos R, Marti R, Gómez-Sánchez M, Lugones-Sánchez C, Tamayo-Morales O, Sánchez SG, Rigo F, García-Ortiz L, Gómez-Marcos MA. Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study. Biol Sex Differ. 2022;13(1):46.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk. METHODS: Cross-sectional study. A total of 2475 individuals aged 35-75 years participated in the study. Brachial-ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500(®) device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). RESULTS: The mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = - 0.045; 95% CI - 0.080 to - 0.009). Intense physical activity showed a negative relationship with baPWV (β = - 0.084; 95% CI - 0.136 to - 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity. CONCLUSIONS: The results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men.

  @article{RN97,
  abstract = {BACKGROUND: The aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk. METHODS: Cross-sectional study. A total of 2475 individuals aged 35-75 years participated in the study. Brachial-ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500(®) device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). RESULTS: The mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = - 0.045; 95% CI - 0.080 to - 0.009). Intense physical activity showed a negative relationship with baPWV (β = - 0.084; 95% CI - 0.136 to - 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity. CONCLUSIONS: The results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men.},
  author = {Gómez-Sánchez, L. and Rodríguez-Sánchez, E. and Ramos, R. and Marti, R. and Gómez-Sánchez, M. and Lugones-Sánchez, C. and Tamayo-Morales, O. and Sánchez, S. G. and Rigo, F. and García-Ortiz, L. and Gómez-Marcos, M. A.},
  journal = {Biol Sex Differ},
  keywords = {grapp-caib},
  number = 1,
  pages = 46,
  title = {Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study},
  type = {Journal Article},
  volume = 13,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN97
  %A Gómez-Sánchez, L.
  %A Rodríguez-Sánchez, E.
  %A Ramos, R.
  %A Marti, R.
  %A Gómez-Sánchez, M.
  %A Lugones-Sánchez, C.
  %A Tamayo-Morales, O.
  %A Sánchez, S. G.
  %A Rigo, F.
  %A García-Ortiz, L.
  %A Gómez-Marcos, M. A.
  %D 2022
  %J Biol Sex Differ
  %N 1
  %P 46
  %R 10.1186/s13293-022-00456-w
  %T Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study
  %V 13
  %X BACKGROUND: The aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk. METHODS: Cross-sectional study. A total of 2475 individuals aged 35-75 years participated in the study. Brachial-ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500(®) device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). RESULTS: The mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = - 0.045; 95% CI - 0.080 to - 0.009). Intense physical activity showed a negative relationship with baPWV (β = - 0.084; 95% CI - 0.136 to - 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity. CONCLUSIONS: The results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men.
  

• 
  1.

  Busquets-Cortés C, López C, Paublini H, Arroyo Bote S, López-González Á A, Ramírez-Manent JI. Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers. J Nutr Metab. 2022;2022:9946255.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.

  @article{RN98,
  abstract = {Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.},
  author = {Busquets-Cortés, C. and López, C. and Paublini, H. and Arroyo Bote, S. and López-González Á, A. and Ramírez-Manent, J. I.},
  journal = {J Nutr Metab},
  keywords = {grapp-caib},
  pages = 9946255,
  title = {Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers},
  type = {Journal Article},
  volume = 2022,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN98
  %A Busquets-Cortés, C.
  %A López, C.
  %A Paublini, H.
  %A Arroyo Bote, S.
  %A López-González Á, A.
  %A Ramírez-Manent, J. I.
  %D 2022
  %J J Nutr Metab
  %P 9946255
  %R 10.1155/2022/9946255
  %T Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers
  %V 2022
  %X Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.
  

• 
  1.

  Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne). 2022;9:954644.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. METHODS: We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. RESULTS: Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = -3.38, 95% CI= [-5.286, -1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = -4.05, 95% CI = [-5.919, -2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = -1.24). CONCLUSION: TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.

  @article{RN199,
  abstract = {BACKGROUND: Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. METHODS: We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. RESULTS: Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = -3.38, 95% CI= [-5.286, -1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = -4.05, 95% CI = [-5.919, -2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = -1.24). CONCLUSION: TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.},
  author = {Aguilar-Latorre, A. and Pérez Algorta, G. and Navarro-Guzmán, C. and Serrano-Ripoll, M. J. and Oliván-Blázquez, B.},
  journal = {Front Med (Lausanne)},
  keywords = {grapp-caib},
  pages = 954644,
  title = {Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care},
  type = {Journal Article},
  volume = 9,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN199
  %A Aguilar-Latorre, A.
  %A Pérez Algorta, G.
  %A Navarro-Guzmán, C.
  %A Serrano-Ripoll, M. J.
  %A Oliván-Blázquez, B.
  %D 2022
  %J Front Med (Lausanne)
  %P 954644
  %R 10.3389/fmed.2022.954644
  %T Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care
  %V 9
  %X BACKGROUND: Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. METHODS: We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. RESULTS: Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = -3.38, 95% CI= [-5.286, -1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = -4.05, 95% CI = [-5.919, -2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = -1.24). CONCLUSION: TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
  

• 
  1.

  López-González Á A, Altisench Jané B, Masmiquel Comas L, Arroyo Bote S, González San Miguel HM, Ramírez Manent JI. Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study. Nutrients [Internet]. MDPI AG; 2022 Jul.;14(14):2795. https://doi.org/10.3390%2Fnu14142795

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the "coronavirus disease 2019" (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. METHODS: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. RESULTS: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. CONCLUSIONS: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.

  @article{lopezgonzaleza2022impact,
  abstract = {BACKGROUND: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the "coronavirus disease 2019" (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. METHODS: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. RESULTS: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. CONCLUSIONS: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.},
  author = {López-González Á, A. and Altisench Jané, B. and Masmiquel Comas, L. and Arroyo Bote, S. and González San Miguel, H. M. and Ramírez Manent, J. I.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {jul},
  number = 14,
  pages = 2795,
  publisher = {MDPI AG},
  title = {Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study},
  volume = 14,
  year = 2022
  }
  

  %0 Journal Article
  %1 lopezgonzaleza2022impact
  %A López-González Á, A.
  %A Altisench Jané, B.
  %A Masmiquel Comas, L.
  %A Arroyo Bote, S.
  %A González San Miguel, H. M.
  %A Ramírez Manent, J. I.
  %D 2022
  %I MDPI AG
  %J Nutrients
  %N 14
  %P 2795
  %R 10.3390/nu14142795
  %T Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study
  %U https://doi.org/10.3390%2Fnu14142795
  %V 14
  %X BACKGROUND: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the "coronavirus disease 2019" (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. METHODS: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. RESULTS: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. CONCLUSIONS: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.
  

• 
  1.

  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;:10998004221105535.

  AbstractBibTeXEndNoteDOIBibSonomy

  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.

  @article{RN190,
  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.},
  author = {Galmes-Panades, A. M. and Abbate, M. and Bennasar-Veny, M. and López-González, A. A. and Vicente-Herrero, M. T. and Busquets-Cortés, C. and Leiva, A. and Yañez, A. M.},
  journal = {Biol Res Nurs},
  keywords = {grapp-caib},
  pages = 10998004221105535,
  title = {Occupational and Leisure Physical Activity on Cardiovascular Risk and Body Composition Among Courier Workers},
  type = {Journal Article},
  year = 2022
  }
  

  %0 Journal Article
  %1 RN190
  %A Galmes-Panades, A. M.
  %A Abbate, M.
  %A Bennasar-Veny, M.
  %A López-González, A. A.
  %A Vicente-Herrero, M. T.
  %A Busquets-Cortés, C.
  %A Leiva, A.
  %A Yañez, A. M.
  %D 2022
  %J Biol Res Nurs
  %P 10998004221105535
  %R 10.1177/10998004221105535
  %T Occupational and Leisure Physical Activity on Cardiovascular Risk and Body Composition Among Courier Workers
  %X 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.
  

• 
  1.

  Garcia A, Yáñez AM, Bennasar-Veny M, Navarro C, Salva J, Ibarra O, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván B, Gili M, Roca M, Riera-Serra P, Aguilar-Latorre A, Montero-Marin J, Garcia-Toro M. Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial. Psychiatry Res. 2022;319:114975.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS: This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS: Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS: Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS: There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.

  @article{RN122,
  abstract = {BACKGROUND: The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS: This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS: Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS: Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS: There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.},
  author = {Garcia, A. and Yáñez, A. M. and Bennasar-Veny, M. and Navarro, C. and Salva, J. and Ibarra, O. and Gomez-Juanes, R. and Serrano-Ripoll, M. J. and Oliván, B. and Gili, M. and Roca, M. and Riera-Serra, P. and Aguilar-Latorre, A. and Montero-Marin, J. and Garcia-Toro, M.},
  journal = {Psychiatry Res},
  keywords = {grapp-caib},
  pages = 114975,
  title = {Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial},
  type = {Journal Article},
  volume = 319,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN122
  %A Garcia, A.
  %A Yáñez, A. M.
  %A Bennasar-Veny, M.
  %A Navarro, C.
  %A Salva, J.
  %A Ibarra, O.
  %A Gomez-Juanes, R.
  %A Serrano-Ripoll, M. J.
  %A Oliván, B.
  %A Gili, M.
  %A Roca, M.
  %A Riera-Serra, P.
  %A Aguilar-Latorre, A.
  %A Montero-Marin, J.
  %A Garcia-Toro, M.
  %D 2022
  %J Psychiatry Res
  %P 114975
  %R 10.1016/j.psychres.2022.114975
  %T Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial
  %V 319
  %X BACKGROUND: The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS: This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS: Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS: Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS: There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.
  

2021

• 
  1.

  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(11).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN169,
  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.},
  author = {Navas, A. and Carrascosa, M. D. C. and Artigues, C. and Ortas, S. and Portells, E. and Soler, A. and Yañez, A. M. and Bennasar-Veny, M. and Leiva, A.},
  journal = {J Clin Med},
  keywords = {grapp-caib},
  number = 11,
  title = {Effectiveness of Moderate-Intensity Aerobic Water Exercise during Pregnancy on Quality of Life and Postpartum Depression: A Multi-Center, Randomized Controlled Trial},
  type = {Journal Article},
  volume = 10,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN169
  %A Navas, A.
  %A Carrascosa, M. D. C.
  %A Artigues, C.
  %A Ortas, S.
  %A Portells, E.
  %A Soler, A.
  %A Yañez, A. M.
  %A Bennasar-Veny, M.
  %A Leiva, A.
  %D 2021
  %J J Clin Med
  %N 11
  %R 10.3390/jcm10112432
  %T Effectiveness of Moderate-Intensity Aerobic Water Exercise during Pregnancy on Quality of Life and Postpartum Depression: A Multi-Center, Randomized Controlled Trial
  %V 10
  %X 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.
  

• 
  1.

  Xu C-J, Gruzieva O, Qi C, Esplugues A, Gehring U, Bergström A, Mason D, Chatzi L, Porta D, Lodrup Carlsen KC, Baïz N, Madore A-M, Alenius H, van Rijkom B, Jankipersadsing SA, van der Vlies P, Kull I, van Hage M, Bustamante M, Lertxundi A, Torrent M, Santorelli G, Fantini MP, Hovland V, Pesce G, Fyhrquist N, Laatikainen T, Nawijn MC, Li Y, Wijmenga C, Netea MG, Bousquet J, Anto JM, Laprise C, Haahtela T, Annesi-Maesano I, Carlsen K-H, Gori D, Kogevinas M, Wright J, Söderhäll C, Vonk JM, Sunyer J, Melén E, Koppelman GH. Shared DNA methylation signatures in childhood allergy: The MeDALL study. Journal of Allergy and Clinical Immunology [Internet]. 2021;147(3):1031-40. https://www.sciencedirect.com/science/article/pii/S0091674920317668

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Differential DNA methylation associated with allergy might provide novel insights into the shared or unique etiology of asthma, rhinitis, and eczema. Objective We sought to identify DNA methylation profiles associated with childhood allergy. Methods Within the European Mechanisms of the Development of Allergy (MeDALL) consortium, we performed an epigenome-wide association study of whole blood DNA methylation by using a cross-sectional design. Allergy was defined as having symptoms from at least 1 allergic disease (asthma, rhinitis, or eczema) and positive serum-specific IgE to common aeroallergens. The discovery study included 219 case patients and 417 controls at age 4 years and 228 case patients and 593 controls at age 8 years from 3 birth cohorts, with replication analyses in 325 case patients and 1111 controls. We performed additional analyses on 21 replicated sites in 785 case patients and 2124 controls by allergic symptoms only from 8 cohorts, 3 of which were not previously included in analyses. Results We identified 80 differentially methylated CpG sites that showed a 1% to 3% methylation difference in the discovery phase, of which 21 (including 5 novel CpG sites) passed genome-wide significance after meta-analysis. All 21 CpG sites were also significantly differentially methylated with allergic symptoms and shared between asthma, rhinitis, and eczema. The 21 CpG sites mapped to relevant genes, including ACOT7, LMAN3, and CLDN23. All 21 CpG sties were differently methylated in asthma in isolated eosinophils, and 10 were replicated in respiratory epithelium. Conclusion Reduced whole blood DNA methylation at 21 CpG sites was significantly associated with childhood allergy. The findings provide novel insights into the shared molecular mechanisms underlying asthma, rhinitis, and eczema.

  @article{XU20211031,
  abstract = {Background Differential DNA methylation associated with allergy might provide novel insights into the shared or unique etiology of asthma, rhinitis, and eczema. Objective We sought to identify DNA methylation profiles associated with childhood allergy. Methods Within the European Mechanisms of the Development of Allergy (MeDALL) consortium, we performed an epigenome-wide association study of whole blood DNA methylation by using a cross-sectional design. Allergy was defined as having symptoms from at least 1 allergic disease (asthma, rhinitis, or eczema) and positive serum-specific IgE to common aeroallergens. The discovery study included 219 case patients and 417 controls at age 4 years and 228 case patients and 593 controls at age 8 years from 3 birth cohorts, with replication analyses in 325 case patients and 1111 controls. We performed additional analyses on 21 replicated sites in 785 case patients and 2124 controls by allergic symptoms only from 8 cohorts, 3 of which were not previously included in analyses. Results We identified 80 differentially methylated CpG sites that showed a 1% to 3% methylation difference in the discovery phase, of which 21 (including 5 novel CpG sites) passed genome-wide significance after meta-analysis. All 21 CpG sites were also significantly differentially methylated with allergic symptoms and shared between asthma, rhinitis, and eczema. The 21 CpG sites mapped to relevant genes, including ACOT7, LMAN3, and CLDN23. All 21 CpG sties were differently methylated in asthma in isolated eosinophils, and 10 were replicated in respiratory epithelium. Conclusion Reduced whole blood DNA methylation at 21 CpG sites was significantly associated with childhood allergy. The findings provide novel insights into the shared molecular mechanisms underlying asthma, rhinitis, and eczema.},
  author = {Xu, Cheng-Jian and Gruzieva, Olena and Qi, Cancan and Esplugues, Ana and Gehring, Ulrike and Bergström, Anna and Mason, Dan and Chatzi, Leda and Porta, Daniela and Lodrup Carlsen, Karin C. and Baïz, Nour and Madore, Anne-Marie and Alenius, Harri and van Rijkom, Bianca and Jankipersadsing, Soesma A. and van der Vlies, Pieter and Kull, Inger and van Hage, Marianne and Bustamante, Mariona and Lertxundi, Aitana and Torrent, Matias and Santorelli, Gillian and Fantini, Maria Pia and Hovland, Vegard and Pesce, Giancarlo and Fyhrquist, Nanna and Laatikainen, Tiina and Nawijn, Martijn C. and Li, Yang and Wijmenga, Cisca and Netea, Mihai G. and Bousquet, Jean and Anto, Josep M. and Laprise, Catherine and Haahtela, Tari and Annesi-Maesano, Isabella and Carlsen, Kai-Håkon and Gori, Davide and Kogevinas, Manolis and Wright, John and Söderhäll, Cilla and Vonk, Judith M. and Sunyer, Jordi and Melén, Erik and Koppelman, Gerard H.},
  journal = {Journal of Allergy and Clinical Immunology},
  keywords = {grapp-caib},
  number = 3,
  pages = {1031-1040},
  title = {Shared DNA methylation signatures in childhood allergy: The MeDALL study},
  volume = 147,
  year = 2021
  }
  

  %0 Journal Article
  %1 XU20211031
  %A Xu, Cheng-Jian
  %A Gruzieva, Olena
  %A Qi, Cancan
  %A Esplugues, Ana
  %A Gehring, Ulrike
  %A Bergström, Anna
  %A Mason, Dan
  %A Chatzi, Leda
  %A Porta, Daniela
  %A Lodrup Carlsen, Karin C.
  %A Baïz, Nour
  %A Madore, Anne-Marie
  %A Alenius, Harri
  %A van Rijkom, Bianca
  %A Jankipersadsing, Soesma A.
  %A van der Vlies, Pieter
  %A Kull, Inger
  %A van Hage, Marianne
  %A Bustamante, Mariona
  %A Lertxundi, Aitana
  %A Torrent, Matias
  %A Santorelli, Gillian
  %A Fantini, Maria Pia
  %A Hovland, Vegard
  %A Pesce, Giancarlo
  %A Fyhrquist, Nanna
  %A Laatikainen, Tiina
  %A Nawijn, Martijn C.
  %A Li, Yang
  %A Wijmenga, Cisca
  %A Netea, Mihai G.
  %A Bousquet, Jean
  %A Anto, Josep M.
  %A Laprise, Catherine
  %A Haahtela, Tari
  %A Annesi-Maesano, Isabella
  %A Carlsen, Kai-Håkon
  %A Gori, Davide
  %A Kogevinas, Manolis
  %A Wright, John
  %A Söderhäll, Cilla
  %A Vonk, Judith M.
  %A Sunyer, Jordi
  %A Melén, Erik
  %A Koppelman, Gerard H.
  %D 2021
  %J Journal of Allergy and Clinical Immunology
  %N 3
  %P 1031-1040
  %R https://doi.org/10.1016/j.jaci.2020.11.044
  %T Shared DNA methylation signatures in childhood allergy: The MeDALL study
  %U https://www.sciencedirect.com/science/article/pii/S0091674920317668
  %V 147
  %X Background Differential DNA methylation associated with allergy might provide novel insights into the shared or unique etiology of asthma, rhinitis, and eczema. Objective We sought to identify DNA methylation profiles associated with childhood allergy. Methods Within the European Mechanisms of the Development of Allergy (MeDALL) consortium, we performed an epigenome-wide association study of whole blood DNA methylation by using a cross-sectional design. Allergy was defined as having symptoms from at least 1 allergic disease (asthma, rhinitis, or eczema) and positive serum-specific IgE to common aeroallergens. The discovery study included 219 case patients and 417 controls at age 4 years and 228 case patients and 593 controls at age 8 years from 3 birth cohorts, with replication analyses in 325 case patients and 1111 controls. We performed additional analyses on 21 replicated sites in 785 case patients and 2124 controls by allergic symptoms only from 8 cohorts, 3 of which were not previously included in analyses. Results We identified 80 differentially methylated CpG sites that showed a 1% to 3% methylation difference in the discovery phase, of which 21 (including 5 novel CpG sites) passed genome-wide significance after meta-analysis. All 21 CpG sites were also significantly differentially methylated with allergic symptoms and shared between asthma, rhinitis, and eczema. The 21 CpG sites mapped to relevant genes, including ACOT7, LMAN3, and CLDN23. All 21 CpG sties were differently methylated in asthma in isolated eosinophils, and 10 were replicated in respiratory epithelium. Conclusion Reduced whole blood DNA methylation at 21 CpG sites was significantly associated with childhood allergy. The findings provide novel insights into the shared molecular mechanisms underlying asthma, rhinitis, and eczema.
  

• 
  1.

  Torrens I, Esteva M, Vicens C, Pizá-Portell MR, Vidal-Thomàs MC, Vidal-Ribas C, Lorente-Montalvo P, Torres-Solera E. Assessing the feasibility and acceptability of a cluster-randomized study of cognitive behavioral therapy for chronic insomnia in a primary care setting. BMC Fam Pract. 2021;22(1):77.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Cognitive behavioral therapy for chronic insomnia (CBT-i) is the treatment of choice for this condition but is underutilized in patients who attend primary care. The purpose of the present feasibility-pilot study was to assess the feasibility and acceptability of a cluster-randomized study of CBT-i in a primary care setting. METHODS: This study, performed at two primary health care centers in Majorca, Spain, was a mixed methods feasibility-pilot study of a parallel cluster-randomized design comparing CBT-i and usual care (UC). Patients were included if they were 18 to 65 years-old; had diagnoses of chronic insomnia according to the Insomnia Severity Index (ISI ≥ 8); had insomnia for more than 3 months. Twenty-five GPs and nurses and 32 patients were randomly allocated to two groups. The main outcome of the intervention was improvement of dimensions of sleep quality, measured using the Spanish version of the Pittsburgh Sleep Quality Index, at baseline and at 3 months after the intervention. Other primary outcomes of the study were the feasibility and applicability of the intervention, collected through nominal groups. A thematic analysis was performed to classify primary care provider (PCP) proposals. Additionally, we assessed the recruitment process, compliance with the intervention sessions, and patient retention. RESULTS: We adapted the CBT-i approach of Morin to a primary care context. After intervention training, PCPs expressed the need for more extensive training in the different aspects of the therapy and the discussion of more cases. PCPs considered the intervention as adequate but wanted fewer but longer sessions as well as to discard the cognitive restructuring component. PCPs considered it crucial to prepare each session in advance and to establish a specific agenda for the CBT-i. Regular reminders given to PCPs and patients were suggested to improve study participation. Compared to the UC group, higher proportions of patients in the intervention group had short sleep latency, slept for longer than 5 h, and had fewer sleep disruptions. CONCLUSIONS: This feasibility-pilot study identified several key issues that must be addressed before performing a CBT-i intervention in future clinical trial in a primary care setting. TRIAL REGISTRATION: NCT04565223 . (Clinical trials.gov) Registered 1 September 2020-Retrospectively registered.

  @article{RN181,
  abstract = {BACKGROUND: Cognitive behavioral therapy for chronic insomnia (CBT-i) is the treatment of choice for this condition but is underutilized in patients who attend primary care. The purpose of the present feasibility-pilot study was to assess the feasibility and acceptability of a cluster-randomized study of CBT-i in a primary care setting. METHODS: This study, performed at two primary health care centers in Majorca, Spain, was a mixed methods feasibility-pilot study of a parallel cluster-randomized design comparing CBT-i and usual care (UC). Patients were included if they were 18 to 65 years-old; had diagnoses of chronic insomnia according to the Insomnia Severity Index (ISI ≥ 8); had insomnia for more than 3 months. Twenty-five GPs and nurses and 32 patients were randomly allocated to two groups. The main outcome of the intervention was improvement of dimensions of sleep quality, measured using the Spanish version of the Pittsburgh Sleep Quality Index, at baseline and at 3 months after the intervention. Other primary outcomes of the study were the feasibility and applicability of the intervention, collected through nominal groups. A thematic analysis was performed to classify primary care provider (PCP) proposals. Additionally, we assessed the recruitment process, compliance with the intervention sessions, and patient retention. RESULTS: We adapted the CBT-i approach of Morin to a primary care context. After intervention training, PCPs expressed the need for more extensive training in the different aspects of the therapy and the discussion of more cases. PCPs considered the intervention as adequate but wanted fewer but longer sessions as well as to discard the cognitive restructuring component. PCPs considered it crucial to prepare each session in advance and to establish a specific agenda for the CBT-i. Regular reminders given to PCPs and patients were suggested to improve study participation. Compared to the UC group, higher proportions of patients in the intervention group had short sleep latency, slept for longer than 5 h, and had fewer sleep disruptions. CONCLUSIONS: This feasibility-pilot study identified several key issues that must be addressed before performing a CBT-i intervention in future clinical trial in a primary care setting. TRIAL REGISTRATION: NCT04565223 . (Clinical trials.gov) Registered 1 September 2020-Retrospectively registered.},
  author = {Torrens, I. and Esteva, M. and Vicens, C. and Pizá-Portell, M. R. and Vidal-Thomàs, M. C. and Vidal-Ribas, C. and Lorente-Montalvo, P. and Torres-Solera, E.},
  journal = {BMC Fam Pract},
  keywords = {grapp-caib},
  number = 1,
  pages = 77,
  title = {Assessing the feasibility and acceptability of a cluster-randomized study of cognitive behavioral therapy for chronic insomnia in a primary care setting},
  type = {Journal Article},
  volume = 22,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN181
  %A Torrens, I.
  %A Esteva, M.
  %A Vicens, C.
  %A Pizá-Portell, M. R.
  %A Vidal-Thomàs, M. C.
  %A Vidal-Ribas, C.
  %A Lorente-Montalvo, P.
  %A Torres-Solera, E.
  %D 2021
  %J BMC Fam Pract
  %N 1
  %P 77
  %R 10.1186/s12875-021-01429-5
  %T Assessing the feasibility and acceptability of a cluster-randomized study of cognitive behavioral therapy for chronic insomnia in a primary care setting
  %V 22
  %X BACKGROUND: Cognitive behavioral therapy for chronic insomnia (CBT-i) is the treatment of choice for this condition but is underutilized in patients who attend primary care. The purpose of the present feasibility-pilot study was to assess the feasibility and acceptability of a cluster-randomized study of CBT-i in a primary care setting. METHODS: This study, performed at two primary health care centers in Majorca, Spain, was a mixed methods feasibility-pilot study of a parallel cluster-randomized design comparing CBT-i and usual care (UC). Patients were included if they were 18 to 65 years-old; had diagnoses of chronic insomnia according to the Insomnia Severity Index (ISI ≥ 8); had insomnia for more than 3 months. Twenty-five GPs and nurses and 32 patients were randomly allocated to two groups. The main outcome of the intervention was improvement of dimensions of sleep quality, measured using the Spanish version of the Pittsburgh Sleep Quality Index, at baseline and at 3 months after the intervention. Other primary outcomes of the study were the feasibility and applicability of the intervention, collected through nominal groups. A thematic analysis was performed to classify primary care provider (PCP) proposals. Additionally, we assessed the recruitment process, compliance with the intervention sessions, and patient retention. RESULTS: We adapted the CBT-i approach of Morin to a primary care context. After intervention training, PCPs expressed the need for more extensive training in the different aspects of the therapy and the discussion of more cases. PCPs considered the intervention as adequate but wanted fewer but longer sessions as well as to discard the cognitive restructuring component. PCPs considered it crucial to prepare each session in advance and to establish a specific agenda for the CBT-i. Regular reminders given to PCPs and patients were suggested to improve study participation. Compared to the UC group, higher proportions of patients in the intervention group had short sleep latency, slept for longer than 5 h, and had fewer sleep disruptions. CONCLUSIONS: This feasibility-pilot study identified several key issues that must be addressed before performing a CBT-i intervention in future clinical trial in a primary care setting. TRIAL REGISTRATION: NCT04565223 . (Clinical trials.gov) Registered 1 September 2020-Retrospectively registered.
  

• 
  1.

  Fiol deRoque MA, Serrano-Ripol MJ, Gens-Barberà M, Sánchez E, Mayer MA, Martín-Luján F, Valderas JM, Ricci-Cabello I. Impacto de la pandemia de COVID-19 en la seguridad del paciente percibida por los pacientes en Atención Primaria. Atención Primaria [Internet]. 2021;53:102222. https://www.sciencedirect.com/science/article/pii/S0212656721002560

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Resumen Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la seguridad del paciente (SP) percibida por los pacientes en Atención Primaria. Diseño Estudio observacional prospectivo de panel (centro de salud [CS]) basado en dos encuestas transversales. Emplazamiento 29 CS de tres regiones sanitarias de España (Mallorca, Cataluña Central y Camp de Tarragona). Participantes Muestreo aleatorio de pacientes que consultaron los CS antes (n=2.199) y durante (n=1.955) la pandemia. Mediciones principales Se administró el cuestionario validado PREOS-PC, que evalúa la SP experimentada por los pacientes atendidos en Atención Primaria. Se compararon las puntuaciones medias en las escalas «experiencias de errores» y «daño» en ambos períodos y se realizaron análisis de regresión multinivel para estudiar las variaciones en las características de los pacientes y de los CS asociadas a la percepción de peores niveles de seguridad. Se realizó un análisis cualitativo de contenido sobre las experiencias de los pacientes durante la pandemia. Resultados Las puntuaciones de «errores» y «daño» empeoraron significativamente durante el período de COVID-19 (92,65 a 88,81 [d de Cohen=0,27]; y 96,92 a 79,97 [d=0,70], respectivamente). Se observó un mayor empeoramiento en mujeres, personas con menor nivel educativo, peor estado de salud y con más años adscritos al centro. También se observaron diferencias en función de la región sanitaria. Conclusiones Durante la pandemia ha empeorado la SP percibida por los pacientes atendidos en Atención Primaria, siendo el impacto desigual según las características sociodemográficas de los pacientes y el perfil de los centros de salud. Objective To evaluate the impact of the changes introduced in response to the pandemic on patient-reported patient safety in Primary Care. Design Prospective observational panel study (health center) based on two cross-sectional surveys. Setting 29 Primary Health Care centers from three Spanish health regions (Mallorca, Catalunya Central and Camp de Tarragona). Participants Random sample of patients visiting their centers before (n=2199 patients) and during the pandemic (n=1955 patients) Main measurements We used the PREOS-PC questionnaire, a validated instrument which assesses patient-reported patient safety in Primary Care. We compared mean scores of the “experiences of errors” and “harm” scales in both periods, and built multilevel regression analyzes to study the variations in patient and center characteristics associated with worse levels of safety. A qualitative (content) analysis of patients’ experiences during the pandemic was also performed. Results The “experiences of errors” and “harm” scales scores significantly worsened during the COVID-19 period (92.65 to 88.81 (Cohen's d=0.27); and 96.92 to 79.97 (d=0.70), respectively). Patient and center characteristics associated to worsened scores were: women, people with a lower educational level, worse health status, more years assigned to the center, and health region. Conclusions During the pandemic, a perceptible worsening in patient safety perceived by patients treated in Primary Care has been observed, which has differentially affected patients according to their sociodemographic characteristics or health center profiles.

  @article{FIOLDEROQUE2021102222,
  abstract = {Resumen Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la seguridad del paciente (SP) percibida por los pacientes en Atención Primaria. Diseño Estudio observacional prospectivo de panel (centro de salud [CS]) basado en dos encuestas transversales. Emplazamiento 29 CS de tres regiones sanitarias de España (Mallorca, Cataluña Central y Camp de Tarragona). Participantes Muestreo aleatorio de pacientes que consultaron los CS antes (n=2.199) y durante (n=1.955) la pandemia. Mediciones principales Se administró el cuestionario validado PREOS-PC, que evalúa la SP experimentada por los pacientes atendidos en Atención Primaria. Se compararon las puntuaciones medias en las escalas «experiencias de errores» y «daño» en ambos períodos y se realizaron análisis de regresión multinivel para estudiar las variaciones en las características de los pacientes y de los CS asociadas a la percepción de peores niveles de seguridad. Se realizó un análisis cualitativo de contenido sobre las experiencias de los pacientes durante la pandemia. Resultados Las puntuaciones de «errores» y «daño» empeoraron significativamente durante el período de COVID-19 (92,65 a 88,81 [d de Cohen=0,27]; y 96,92 a 79,97 [d=0,70], respectivamente). Se observó un mayor empeoramiento en mujeres, personas con menor nivel educativo, peor estado de salud y con más años adscritos al centro. También se observaron diferencias en función de la región sanitaria. Conclusiones Durante la pandemia ha empeorado la SP percibida por los pacientes atendidos en Atención Primaria, siendo el impacto desigual según las características sociodemográficas de los pacientes y el perfil de los centros de salud. Objective To evaluate the impact of the changes introduced in response to the pandemic on patient-reported patient safety in Primary Care. Design Prospective observational panel study (health center) based on two cross-sectional surveys. Setting 29 Primary Health Care centers from three Spanish health regions (Mallorca, Catalunya Central and Camp de Tarragona). Participants Random sample of patients visiting their centers before (n=2199 patients) and during the pandemic (n=1955 patients) Main measurements We used the PREOS-PC questionnaire, a validated instrument which assesses patient-reported patient safety in Primary Care. We compared mean scores of the “experiences of errors” and “harm” scales in both periods, and built multilevel regression analyzes to study the variations in patient and center characteristics associated with worse levels of safety. A qualitative (content) analysis of patients’ experiences during the pandemic was also performed. Results The “experiences of errors” and “harm” scales scores significantly worsened during the COVID-19 period (92.65 to 88.81 (Cohen's d=0.27); and 96.92 to 79.97 (d=0.70), respectively). Patient and center characteristics associated to worsened scores were: women, people with a lower educational level, worse health status, more years assigned to the center, and health region. Conclusions During the pandemic, a perceptible worsening in patient safety perceived by patients treated in Primary Care has been observed, which has differentially affected patients according to their sociodemographic characteristics or health center profiles.},
  author = {Fiol deRoque, Maria A. and Serrano-Ripol, Maria J. and Gens-Barberà, Montserrat and Sánchez, Encarna and Mayer, Miguel A. and Martín-Luján, Francisco and Valderas, José M. and Ricci-Cabello, Ignacio},
  journal = {Atención Primaria},
  keywords = {grapp-caib myown},
  note = {Seguridad del Paciente en Atencion Primaria},
  pages = 102222,
  title = {Impacto de la pandemia de COVID-19 en la seguridad del paciente percibida por los pacientes en Atención Primaria},
  volume = 53,
  year = 2021
  }
  

  %0 Journal Article
  %1 FIOLDEROQUE2021102222
  %A Fiol deRoque, Maria A.
  %A Serrano-Ripol, Maria J.
  %A Gens-Barberà, Montserrat
  %A Sánchez, Encarna
  %A Mayer, Miguel A.
  %A Martín-Luján, Francisco
  %A Valderas, José M.
  %A Ricci-Cabello, Ignacio
  %D 2021
  %J Atención Primaria
  %P 102222
  %R https://doi.org/10.1016/j.aprim.2021.102222
  %T Impacto de la pandemia de COVID-19 en la seguridad del paciente percibida por los pacientes en Atención Primaria
  %U https://www.sciencedirect.com/science/article/pii/S0212656721002560
  %V 53
  %X Resumen Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la seguridad del paciente (SP) percibida por los pacientes en Atención Primaria. Diseño Estudio observacional prospectivo de panel (centro de salud [CS]) basado en dos encuestas transversales. Emplazamiento 29 CS de tres regiones sanitarias de España (Mallorca, Cataluña Central y Camp de Tarragona). Participantes Muestreo aleatorio de pacientes que consultaron los CS antes (n=2.199) y durante (n=1.955) la pandemia. Mediciones principales Se administró el cuestionario validado PREOS-PC, que evalúa la SP experimentada por los pacientes atendidos en Atención Primaria. Se compararon las puntuaciones medias en las escalas «experiencias de errores» y «daño» en ambos períodos y se realizaron análisis de regresión multinivel para estudiar las variaciones en las características de los pacientes y de los CS asociadas a la percepción de peores niveles de seguridad. Se realizó un análisis cualitativo de contenido sobre las experiencias de los pacientes durante la pandemia. Resultados Las puntuaciones de «errores» y «daño» empeoraron significativamente durante el período de COVID-19 (92,65 a 88,81 [d de Cohen=0,27]; y 96,92 a 79,97 [d=0,70], respectivamente). Se observó un mayor empeoramiento en mujeres, personas con menor nivel educativo, peor estado de salud y con más años adscritos al centro. También se observaron diferencias en función de la región sanitaria. Conclusiones Durante la pandemia ha empeorado la SP percibida por los pacientes atendidos en Atención Primaria, siendo el impacto desigual según las características sociodemográficas de los pacientes y el perfil de los centros de salud. Objective To evaluate the impact of the changes introduced in response to the pandemic on patient-reported patient safety in Primary Care. Design Prospective observational panel study (health center) based on two cross-sectional surveys. Setting 29 Primary Health Care centers from three Spanish health regions (Mallorca, Catalunya Central and Camp de Tarragona). Participants Random sample of patients visiting their centers before (n=2199 patients) and during the pandemic (n=1955 patients) Main measurements We used the PREOS-PC questionnaire, a validated instrument which assesses patient-reported patient safety in Primary Care. We compared mean scores of the “experiences of errors” and “harm” scales in both periods, and built multilevel regression analyzes to study the variations in patient and center characteristics associated with worse levels of safety. A qualitative (content) analysis of patients’ experiences during the pandemic was also performed. Results The “experiences of errors” and “harm” scales scores significantly worsened during the COVID-19 period (92.65 to 88.81 (Cohen's d=0.27); and 96.92 to 79.97 (d=0.70), respectively). Patient and center characteristics associated to worsened scores were: women, people with a lower educational level, worse health status, more years assigned to the center, and health region. Conclusions During the pandemic, a perceptible worsening in patient safety perceived by patients treated in Primary Care has been observed, which has differentially affected patients according to their sociodemographic characteristics or health center profiles.
  

• 
  1.

  Castro A, Roca M, Ricci-Cabello I, García-Toro M, Riera-Serra P, Coronado-Simsic V, Pérez-Ara M, Gili M. Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health [Internet]. MDPI AG; 2021 Dec.;18(24):13268. https://doi.org/10.3390%2Fijerph182413268

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.

  @article{Castro_2021,
  abstract = {The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.},
  author = {Castro, A. and Roca, M. and Ricci-Cabello, I. and García-Toro, M. and Riera-Serra, P. and Coronado-Simsic, V. and Pérez-Ara, MÁ and Gili, M.},
  journal = {International Journal of Environmental Research and Public Health},
  keywords = {grapp-caib myown},
  month = {dec},
  number = 24,
  pages = 13268,
  publisher = {MDPI AG},
  title = {Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis},
  volume = 18,
  year = 2021
  }
  

  %0 Journal Article
  %1 Castro_2021
  %A Castro, A.
  %A Roca, M.
  %A Ricci-Cabello, I.
  %A García-Toro, M.
  %A Riera-Serra, P.
  %A Coronado-Simsic, V.
  %A Pérez-Ara, MÁ
  %A Gili, M.
  %D 2021
  %I MDPI AG
  %J International Journal of Environmental Research and Public Health
  %N 24
  %P 13268
  %R 10.3390/ijerph182413268
  %T Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis
  %U https://doi.org/10.3390%2Fijerph182413268
  %V 18
  %X The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.
  

• 
  1.

  Zamanillo Campos R, Rovira Boixadera L, Rendo Urteaga T. [Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study]. Nutr Hosp. 2021;38(5):919-34.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.

  @article{RN184,
  abstract = {Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.},
  author = {Zamanillo Campos, R. and Rovira Boixadera, L. and Rendo Urteaga, T.},
  journal = {Nutr Hosp},
  keywords = {grapp-caib},
  number = 5,
  pages = {919-934},
  title = {[Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study]},
  type = {Journal Article},
  volume = 38,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN184
  %A Zamanillo Campos, R.
  %A Rovira Boixadera, L.
  %A Rendo Urteaga, T.
  %D 2021
  %J Nutr Hosp
  %N 5
  %P 919-934
  %R 10.20960/nh.03527
  %T [Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study]
  %V 38
  %X Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.
  

• 
  1.

  Serrano-Ripoll MJ, Zamanillo-Campos R, Castro A, Fiol-de Roque MA, Ricci-Cabello I. Insomnia and sleep quality in healthcare workers fighting against COVID-19: a systematic review of the literature and meta-analysis. Actas Esp Psiquiatr. 2021;49(4):155-79.

  AbstractBibTeXEndNoteBibSonomyDownload

  The COVID-19 pandemic has the potential to significant- ly affect the mental health of healthcare workers, who stand in the frontline of this crisis. Insomnia is often related to exposure to stressful situations, such as the current health crisis, as well as other mental disorders, physical conditions and work-related problems. The objectives of this systematic review were: 1) to examine the impact of the current health pandemic produced by COVID-19 on insomnia and sleep quality of health professionals, and 2) to identify risk factors associated with insomnia. After a literature search in MEDLINE, EMBASE, and PsycINFO, 18 relevant studies were identified. The prevalence of insomnia estimated by random effects meta-analysis was 38% (95%CI= 37 to 39%), being slightly higher in women (29%, 95%CI= 27% to 30%) than in men (24%, 95%CI= 21 to 27%). The main risk factor associated with insomnia was working in a high-risk environment, followed by female sex and having a lower educational level. The high figures of self-reported insomnia and poor sleep quality observed indicate the need to develop interventions aimed at mitigating and caring for the mental health of healthcare workers fighting against this pandemic.

  @article{RN179,
  abstract = {The COVID-19 pandemic has the potential to significant- ly affect the mental health of healthcare workers, who stand in the frontline of this crisis. Insomnia is often related to exposure to stressful situations, such as the current health crisis, as well as other mental disorders, physical conditions and work-related problems. The objectives of this systematic review were: 1) to examine the impact of the current health pandemic produced by COVID-19 on insomnia and sleep quality of health professionals, and 2) to identify risk factors associated with insomnia. After a literature search in MEDLINE, EMBASE, and PsycINFO, 18 relevant studies were identified. The prevalence of insomnia estimated by random effects meta-analysis was 38% (95%CI= 37 to 39%), being slightly higher in women (29%, 95%CI= 27% to 30%) than in men (24%, 95%CI= 21 to 27%). The main risk factor associated with insomnia was working in a high-risk environment, followed by female sex and having a lower educational level. The high figures of self-reported insomnia and poor sleep quality observed indicate the need to develop interventions aimed at mitigating and caring for the mental health of healthcare workers fighting against this pandemic.},
  author = {Serrano-Ripoll, M. J. and Zamanillo-Campos, R. and Castro, A. and Fiol-de Roque, M. A. and Ricci-Cabello, I.},
  journal = {Actas Esp Psiquiatr},
  keywords = {grapp-caib},
  number = 4,
  pages = {155-179},
  title = {Insomnia and sleep quality in healthcare workers fighting against COVID-19: a systematic review of the literature and meta-analysis},
  type = {Journal Article},
  volume = 49,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN179
  %A Serrano-Ripoll, M. J.
  %A Zamanillo-Campos, R.
  %A Castro, A.
  %A Fiol-de Roque, M. A.
  %A Ricci-Cabello, I.
  %D 2021
  %J Actas Esp Psiquiatr
  %N 4
  %P 155-179
  %T Insomnia and sleep quality in healthcare workers fighting against COVID-19: a systematic review of the literature and meta-analysis
  %V 49
  %X The COVID-19 pandemic has the potential to significant- ly affect the mental health of healthcare workers, who stand in the frontline of this crisis. Insomnia is often related to exposure to stressful situations, such as the current health crisis, as well as other mental disorders, physical conditions and work-related problems. The objectives of this systematic review were: 1) to examine the impact of the current health pandemic produced by COVID-19 on insomnia and sleep quality of health professionals, and 2) to identify risk factors associated with insomnia. After a literature search in MEDLINE, EMBASE, and PsycINFO, 18 relevant studies were identified. The prevalence of insomnia estimated by random effects meta-analysis was 38% (95%CI= 37 to 39%), being slightly higher in women (29%, 95%CI= 27% to 30%) than in men (24%, 95%CI= 21 to 27%). The main risk factor associated with insomnia was working in a high-risk environment, followed by female sex and having a lower educational level. The high figures of self-reported insomnia and poor sleep quality observed indicate the need to develop interventions aimed at mitigating and caring for the mental health of healthcare workers fighting against this pandemic.
  

• 
  1.

  Zamanillo Campos R, Colomar Ferrer MT, Ruiz López RM, Sanchís Cortés MP, Urgelés Planella JR. Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2021;45(3):490-8.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.

  @article{RN183,
  abstract = {BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.},
  author = {Zamanillo Campos, R. and Colomar Ferrer, M. T. and Ruiz López, R. M. and Sanchís Cortés, M. P. and Urgelés Planella, J. R.},
  journal = {JPEN J Parenter Enteral Nutr},
  keywords = {grapp-caib},
  number = 3,
  pages = {490-498},
  title = {Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition},
  type = {Journal Article},
  volume = 45,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN183
  %A Zamanillo Campos, R.
  %A Colomar Ferrer, M. T.
  %A Ruiz López, R. M.
  %A Sanchís Cortés, M. P.
  %A Urgelés Planella, J. R.
  %D 2021
  %J JPEN J Parenter Enteral Nutr
  %N 3
  %P 490-498
  %R 10.1002/jpen.1852
  %T Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition
  %V 45
  %X BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.
  

• 
  1.

  Ripoll J, Ramos M, Montaño J, Pons J, Ameijide A, Franch P. Cancer-specific survival by stage of bladder cancer and factors collected by Mallorca Cancer Registry associated to survival. BMC Cancer. 2021;21(1):676.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Information about survival by stage in bladder cancer is scarce, as well as about survival of non-invasive bladder cancer. The aims of this study are: 1) to find out the distribution of bladder cancer by stage; 2) to determine cancer-specific survival by stage of bladder cancer; 3) to identify factors that explain and predict the likelihood of survival and the risk of dying from these cancers. METHODS: Incident bladder cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. INCLUSION CRITERIA: cases with code C67 according to the ICD-O 3rd edition with any behaviour and any histology, except lymphomas and small cell carcinomas. Cases identified exclusively through the death certificate were excluded. We collected the following data: sex; age; date and method of diagnosis; histology according to the ICD-O 3rd edition; T, N, M and stage at the time of diagnosis; and date of follow-up or death. End point of follow-up was 31 December 2015. Multiple imputation (MI) was performed to estimate cases with unknown stage. Cases with benign or indeterminate behaviour were excluded for the survival analysis. Actuarial and Kaplan-Meier methods and Cox regression models were used for survival analysis. RESULTS: One thousand nine hundred fourteen cases were identified. 14% were women and 65.4% were 65 years or older. 3.9% had no stage (benign or undetermined behaviour) and 11.5% had unknown stage. After MI, 37.5% were in stage Ta (non-invasive papillary carcinoma), 3.2% in stage Tis (carcinoma in situ), 34.3% in stage I, 11.7% in Stage II, 4.3% in stage III, and 9.0% in stage IV. Survival was 76% at 5 years. Survival by stage: 98% at stage Ta, 90% at stage Tis, 85% at stage I, 45% at stage II, 35% at stage III, and 7% at stage IV. The Cox model showed that age, histology, and stage, but not sex, were associated with survival. CONCLUSION: Bladder cancer survival vary greatly with stage, among both non-invasive and invasive cases. The percentage of non-invasive cancers is high. Stage, age, and histology are associated to survival.

  @article{RN177,
  abstract = {BACKGROUND: Information about survival by stage in bladder cancer is scarce, as well as about survival of non-invasive bladder cancer. The aims of this study are: 1) to find out the distribution of bladder cancer by stage; 2) to determine cancer-specific survival by stage of bladder cancer; 3) to identify factors that explain and predict the likelihood of survival and the risk of dying from these cancers. METHODS: Incident bladder cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. INCLUSION CRITERIA: cases with code C67 according to the ICD-O 3rd edition with any behaviour and any histology, except lymphomas and small cell carcinomas. Cases identified exclusively through the death certificate were excluded. We collected the following data: sex; age; date and method of diagnosis; histology according to the ICD-O 3rd edition; T, N, M and stage at the time of diagnosis; and date of follow-up or death. End point of follow-up was 31 December 2015. Multiple imputation (MI) was performed to estimate cases with unknown stage. Cases with benign or indeterminate behaviour were excluded for the survival analysis. Actuarial and Kaplan-Meier methods and Cox regression models were used for survival analysis. RESULTS: One thousand nine hundred fourteen cases were identified. 14% were women and 65.4% were 65 years or older. 3.9% had no stage (benign or undetermined behaviour) and 11.5% had unknown stage. After MI, 37.5% were in stage Ta (non-invasive papillary carcinoma), 3.2% in stage Tis (carcinoma in situ), 34.3% in stage I, 11.7% in Stage II, 4.3% in stage III, and 9.0% in stage IV. Survival was 76% at 5 years. Survival by stage: 98% at stage Ta, 90% at stage Tis, 85% at stage I, 45% at stage II, 35% at stage III, and 7% at stage IV. The Cox model showed that age, histology, and stage, but not sex, were associated with survival. CONCLUSION: Bladder cancer survival vary greatly with stage, among both non-invasive and invasive cases. The percentage of non-invasive cancers is high. Stage, age, and histology are associated to survival.},
  author = {Ripoll, J. and Ramos, M. and Montaño, J. and Pons, J. and Ameijide, A. and Franch, P.},
  journal = {BMC Cancer},
  keywords = {grapp-caib},
  number = 1,
  pages = 676,
  title = {Cancer-specific survival by stage of bladder cancer and factors collected by Mallorca Cancer Registry associated to survival},
  type = {Journal Article},
  volume = 21,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN177
  %A Ripoll, J.
  %A Ramos, M.
  %A Montaño, J.
  %A Pons, J.
  %A Ameijide, A.
  %A Franch, P.
  %D 2021
  %J BMC Cancer
  %N 1
  %P 676
  %R 10.1186/s12885-021-08418-y
  %T Cancer-specific survival by stage of bladder cancer and factors collected by Mallorca Cancer Registry associated to survival
  %V 21
  %X BACKGROUND: Information about survival by stage in bladder cancer is scarce, as well as about survival of non-invasive bladder cancer. The aims of this study are: 1) to find out the distribution of bladder cancer by stage; 2) to determine cancer-specific survival by stage of bladder cancer; 3) to identify factors that explain and predict the likelihood of survival and the risk of dying from these cancers. METHODS: Incident bladder cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. INCLUSION CRITERIA: cases with code C67 according to the ICD-O 3rd edition with any behaviour and any histology, except lymphomas and small cell carcinomas. Cases identified exclusively through the death certificate were excluded. We collected the following data: sex; age; date and method of diagnosis; histology according to the ICD-O 3rd edition; T, N, M and stage at the time of diagnosis; and date of follow-up or death. End point of follow-up was 31 December 2015. Multiple imputation (MI) was performed to estimate cases with unknown stage. Cases with benign or indeterminate behaviour were excluded for the survival analysis. Actuarial and Kaplan-Meier methods and Cox regression models were used for survival analysis. RESULTS: One thousand nine hundred fourteen cases were identified. 14% were women and 65.4% were 65 years or older. 3.9% had no stage (benign or undetermined behaviour) and 11.5% had unknown stage. After MI, 37.5% were in stage Ta (non-invasive papillary carcinoma), 3.2% in stage Tis (carcinoma in situ), 34.3% in stage I, 11.7% in Stage II, 4.3% in stage III, and 9.0% in stage IV. Survival was 76% at 5 years. Survival by stage: 98% at stage Ta, 90% at stage Tis, 85% at stage I, 45% at stage II, 35% at stage III, and 7% at stage IV. The Cox model showed that age, histology, and stage, but not sex, were associated with survival. CONCLUSION: Bladder cancer survival vary greatly with stage, among both non-invasive and invasive cases. The percentage of non-invasive cancers is high. Stage, age, and histology are associated to survival.
  

• 
  1.

  Ricci-Cabello I, Ya~nez-Juan AM, Fiol deRoque MA, Leiva A, Canaves JL, 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. Journal of Clinical Medicine [Internet]. MDPI AG; 2021 Apr.;10(8):1782. https://doi.org/10.3390%2Fjcm10081782

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{Ricci_Cabello_2021,
  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.},
  author = {Ricci-Cabello, Ignacio and Ya~nez-Juan, Aina Mar'ia and Fiol deRoque, Maria A. and Leiva, Alfonso and Canaves, Joan Llobera and Parmentier, Fabrice B. R. and Valderas, Jose M.},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib myown},
  month = {apr},
  number = 8,
  pages = 1782,
  publisher = {MDPI AG},
  title = {Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data},
  volume = 10,
  year = 2021
  }
  

  %0 Journal Article
  %1 Ricci_Cabello_2021
  %A Ricci-Cabello, Ignacio
  %A Ya~nez-Juan, Aina Mar'ia
  %A Fiol deRoque, Maria A.
  %A Leiva, Alfonso
  %A Canaves, Joan Llobera
  %A Parmentier, Fabrice B. R.
  %A Valderas, Jose M.
  %D 2021
  %I MDPI AG
  %J Journal of Clinical Medicine
  %N 8
  %P 1782
  %R 10.3390/jcm10081782
  %T Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data
  %U https://doi.org/10.3390%2Fjcm10081782
  %V 10
  %X 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.
  

• 
  1.

  Martínez-Sotelo J, Pinteño-Blanco M, García-Ramos R, Llobera-Cànaves J, Cadavid-Torres MI. Pharmacist-led intervention on potentially inappropriate prescription in patients with polypharmacy: PHARM-PC clinical trial protocol. Farm Hosp. 2021;45(4):210-5.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: Polypharmacy and potentially inappropriate medications (that  is, those associated with an unfavorable risk-benefit ratio) are common concerns in the context of elderly patients treated in primary care as they may increase the risk of morbidity and mortality, as well as  healthcare costs. Several studies have assessed the impact of pharmacist- led systematic reviews with respect to prescription appropriateness, health outcomes and/or costs. However, no cluster-randomized controlled  trial has been identified that provides an overall assessment of these  variables. The objective is to determine the effectiveness of a pharmacist- led systematic medication review in reducing the mean number and proportion of patients on potentially inappropriate medications (primary  goal); as well as in decreasing morbidity and mortality and the cost of  medications and the use of healthcare resources (secondary goals). METHOD: An open-label, cluster-randomized controlled trial will be conducted; where primary care physicians will be randomized either to receive (intervention group) or not to receive pharmacist  recommendations to withdraw potentially inappropriate medications  detected through the combined use of explicit and implicit criteria (control  group). Primary end-points will be the proportion of patients on potentially inappropriate medications and the mean number of such medications per  patient. Secondary endpoints will be healthcare resources used, the  proportion of patients who die and the mean number of days survived, as  well as the cost of medications and cost of healthcare resources used. CONCLUSIONS: In line with similar reports and based on our study´s design, we hope to obtain statistically significant reductions in the use  of potentially inappropriate medications and in medication costs overall.  We do not however expect to obtain significant reductions in  morbimortality or the cost of health resources employed.

  @article{RN168,
  abstract = {OBJECTIVE: Polypharmacy and potentially inappropriate medications (that  is, those associated with an unfavorable risk-benefit ratio) are common concerns in the context of elderly patients treated in primary care as they may increase the risk of morbidity and mortality, as well as  healthcare costs. Several studies have assessed the impact of pharmacist- led systematic reviews with respect to prescription appropriateness, health outcomes and/or costs. However, no cluster-randomized controlled  trial has been identified that provides an overall assessment of these  variables. The objective is to determine the effectiveness of a pharmacist- led systematic medication review in reducing the mean number and proportion of patients on potentially inappropriate medications (primary  goal); as well as in decreasing morbidity and mortality and the cost of  medications and the use of healthcare resources (secondary goals). METHOD: An open-label, cluster-randomized controlled trial will be conducted; where primary care physicians will be randomized either to receive (intervention group) or not to receive pharmacist  recommendations to withdraw potentially inappropriate medications  detected through the combined use of explicit and implicit criteria (control  group). Primary end-points will be the proportion of patients on potentially inappropriate medications and the mean number of such medications per  patient. Secondary endpoints will be healthcare resources used, the  proportion of patients who die and the mean number of days survived, as  well as the cost of medications and cost of healthcare resources used. CONCLUSIONS: In line with similar reports and based on our study´s design, we hope to obtain statistically significant reductions in the use  of potentially inappropriate medications and in medication costs overall.  We do not however expect to obtain significant reductions in  morbimortality or the cost of health resources employed.},
  author = {Martínez-Sotelo, J. and Pinteño-Blanco, M. and García-Ramos, R. and Llobera-Cànaves, J. and Cadavid-Torres, M. I.},
  journal = {Farm Hosp},
  keywords = {grapp-caib},
  number = 4,
  pages = {210-215},
  title = {Pharmacist-led intervention on potentially inappropriate prescription in patients with polypharmacy: PHARM-PC clinical trial protocol},
  type = {Journal Article},
  volume = 45,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN168
  %A Martínez-Sotelo, J.
  %A Pinteño-Blanco, M.
  %A García-Ramos, R.
  %A Llobera-Cànaves, J.
  %A Cadavid-Torres, M. I.
  %D 2021
  %J Farm Hosp
  %N 4
  %P 210-215
  %R 10.7399/fh.11575
  %T Pharmacist-led intervention on potentially inappropriate prescription in patients with polypharmacy: PHARM-PC clinical trial protocol
  %V 45
  %X OBJECTIVE: Polypharmacy and potentially inappropriate medications (that  is, those associated with an unfavorable risk-benefit ratio) are common concerns in the context of elderly patients treated in primary care as they may increase the risk of morbidity and mortality, as well as  healthcare costs. Several studies have assessed the impact of pharmacist- led systematic reviews with respect to prescription appropriateness, health outcomes and/or costs. However, no cluster-randomized controlled  trial has been identified that provides an overall assessment of these  variables. The objective is to determine the effectiveness of a pharmacist- led systematic medication review in reducing the mean number and proportion of patients on potentially inappropriate medications (primary  goal); as well as in decreasing morbidity and mortality and the cost of  medications and the use of healthcare resources (secondary goals). METHOD: An open-label, cluster-randomized controlled trial will be conducted; where primary care physicians will be randomized either to receive (intervention group) or not to receive pharmacist  recommendations to withdraw potentially inappropriate medications  detected through the combined use of explicit and implicit criteria (control  group). Primary end-points will be the proportion of patients on potentially inappropriate medications and the mean number of such medications per  patient. Secondary endpoints will be healthcare resources used, the  proportion of patients who die and the mean number of days survived, as  well as the cost of medications and cost of healthcare resources used. CONCLUSIONS: In line with similar reports and based on our study´s design, we hope to obtain statistically significant reductions in the use  of potentially inappropriate medications and in medication costs overall.  We do not however expect to obtain significant reductions in  morbimortality or the cost of health resources employed.
  

• 
  1.

  Ripoll J, Contreras-Martos S, Esteva M, Soler A, Serrano-Ripoll MJ. Mental Health and Psychological Wellbeing during the COVID-19 Lockdown: A Longitudinal Study in the Balearic Islands (Spain). Journal of Clinical Medicine [Internet]. MDPI AG; 2021 Jul.;10(14):3191. https://doi.org/10.3390%2Fjcm10143191

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Confining the entire population to a lockdown after the outbreak of SARS-CoV-2 was an unprecedented measure designed to protect the health of those living in Spain. The objective of the present study is to assess the evolution of mental health and psychological wellbeing during lockdown. To do this, we carried out a longitudinal study, via an online survey over the eight weeks of lockdown (weekly assessments). Sociodemographic variables were recorded, along with data related to COVID-19, psychological wellbeing (anxiety, depression, psychotropic drugs, consultations made to improve mood or anxiety), life satisfaction, and self-perceived health. A total of 681 individuals participated in the study, 76.8% were women; the mean age was 43 years old (SD = 12.7). Initially, high scores were reported for anxiety, depression, and the number of consultations to improve mood, but these decreased significantly over the study period. The reverse seems to be true for life satisfaction, perceived good health, and intake of psychotropic drugs. We also identified groups whose psychological wellbeing was more susceptible to the effects of lockdown. Women, those worried about their jobs after the pandemic, and those afraid of being infected were the most affected individuals. More generally, after the initial negative effect on psychological wellbeing, various indicators improved over the lockdown period.

  @article{Ripoll_2021,
  abstract = {Confining the entire population to a lockdown after the outbreak of SARS-CoV-2 was an unprecedented measure designed to protect the health of those living in Spain. The objective of the present study is to assess the evolution of mental health and psychological wellbeing during lockdown. To do this, we carried out a longitudinal study, via an online survey over the eight weeks of lockdown (weekly assessments). Sociodemographic variables were recorded, along with data related to COVID-19, psychological wellbeing (anxiety, depression, psychotropic drugs, consultations made to improve mood or anxiety), life satisfaction, and self-perceived health. A total of 681 individuals participated in the study, 76.8% were women; the mean age was 43 years old (SD = 12.7). Initially, high scores were reported for anxiety, depression, and the number of consultations to improve mood, but these decreased significantly over the study period. The reverse seems to be true for life satisfaction, perceived good health, and intake of psychotropic drugs. We also identified groups whose psychological wellbeing was more susceptible to the effects of lockdown. Women, those worried about their jobs after the pandemic, and those afraid of being infected were the most affected individuals. More generally, after the initial negative effect on psychological wellbeing, various indicators improved over the lockdown period.},
  author = {Ripoll, Joana and Contreras-Martos, Sara and Esteva, Magdalena and Soler, Aina and Serrano-Ripoll, Maria Jesús},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {jul},
  number = 14,
  pages = 3191,
  publisher = {MDPI AG},
  title = {Mental Health and Psychological Wellbeing during the COVID-19 Lockdown: A Longitudinal Study in the Balearic Islands (Spain)},
  volume = 10,
  year = 2021
  }
  

  %0 Journal Article
  %1 Ripoll_2021
  %A Ripoll, Joana
  %A Contreras-Martos, Sara
  %A Esteva, Magdalena
  %A Soler, Aina
  %A Serrano-Ripoll, Maria Jesús
  %D 2021
  %I MDPI AG
  %J Journal of Clinical Medicine
  %N 14
  %P 3191
  %R 10.3390/jcm10143191
  %T Mental Health and Psychological Wellbeing during the COVID-19 Lockdown: A Longitudinal Study in the Balearic Islands (Spain)
  %U https://doi.org/10.3390%2Fjcm10143191
  %V 10
  %X Confining the entire population to a lockdown after the outbreak of SARS-CoV-2 was an unprecedented measure designed to protect the health of those living in Spain. The objective of the present study is to assess the evolution of mental health and psychological wellbeing during lockdown. To do this, we carried out a longitudinal study, via an online survey over the eight weeks of lockdown (weekly assessments). Sociodemographic variables were recorded, along with data related to COVID-19, psychological wellbeing (anxiety, depression, psychotropic drugs, consultations made to improve mood or anxiety), life satisfaction, and self-perceived health. A total of 681 individuals participated in the study, 76.8% were women; the mean age was 43 years old (SD = 12.7). Initially, high scores were reported for anxiety, depression, and the number of consultations to improve mood, but these decreased significantly over the study period. The reverse seems to be true for life satisfaction, perceived good health, and intake of psychotropic drugs. We also identified groups whose psychological wellbeing was more susceptible to the effects of lockdown. Women, those worried about their jobs after the pandemic, and those afraid of being infected were the most affected individuals. More generally, after the initial negative effect on psychological wellbeing, various indicators improved over the lockdown period.
  

• 
  1.

  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. Journal of Infection [Internet]. 2021;82(3):391-8. https://www.sciencedirect.com/science/article/pii/S0163445321000803

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Summary 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

  @article{BULILETE2021391,
  abstract = {Summary 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},
  author = {Bulilete, Oana and Lorente, Patricia and Leiva, Alfonso and Carandell, Eugenia and Oliver, Antonio and Rojo, Estrella and Pericas, Pau and Llobera, Joan},
  journal = {Journal of Infection},
  keywords = {grapp-caib},
  number = 3,
  pages = {391-398},
  title = {Panbio™ rapid antigen test for SARS-CoV-2 has acceptable accuracy in symptomatic patients in primary health care},
  volume = 82,
  year = 2021
  }
  

  %0 Journal Article
  %1 BULILETE2021391
  %A Bulilete, Oana
  %A Lorente, Patricia
  %A Leiva, Alfonso
  %A Carandell, Eugenia
  %A Oliver, Antonio
  %A Rojo, Estrella
  %A Pericas, Pau
  %A Llobera, Joan
  %D 2021
  %J Journal of Infection
  %N 3
  %P 391-398
  %R https://doi.org/10.1016/j.jinf.2021.02.014
  %T Panbio™ rapid antigen test for SARS-CoV-2 has acceptable accuracy in symptomatic patients in primary health care
  %U https://www.sciencedirect.com/science/article/pii/S0163445321000803
  %V 82
  %X Summary 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
  

• 
  1.

  Abbate M, Fresneda S, Yañez A, Ricci-Cabello I, Galmes-Panades AM, Aguilo A, Bennasar-Veny M. Nurse-led telephone intervention for lifestyle changes on glycaemic control in people with prediabetes: Study protocol for a randomized controlled trial. J Adv Nurs. 2021;77(7):3204-17.

  AbstractBibTeXEndNoteDOIBibSonomy

  AIM: To evaluate the effectiveness of a nurse-led personalized telephone lifestyle intervention versus automated SMSs in the reduction of fasting plasma glucose in adults with prediabetes. DESIGN: The PREDIPHONE is a randomized controlled, parallel, two arms, superiority trial with 15 months of follow-up. Participants will be randomized to either the intervention group (teleconsultations) or the active control group (SMSs). METHODS: A total of 428 participants will be randomized in a 1:1 ratio to one of the two arms and followed up during 9 months. The teleconsultations group will receive nurse-led personalized advice, while the SMSs group will receive 4-5 brief SMSs a week. Participants in both groups will receive evidence-based recommendations for diet and physical activity (PA). Outcome measures will be collected at baseline, months 4 and 9 and at month 15, to evaluate post-intervention effects. DISCUSSION: Prevention of diabetes through the implementation of lifestyle interventions remains an important priority. The current pandemic situation has magnified its urgency as it heavily affected the functionality of the healthcare system. Moreover, it created the need of remotely delivering preventative interventions. This study will provide insights on the effectiveness and feasibility of a telephone-based intervention led by nurses in the amelioration of risk factors associated with diabetes. IMPACT: Findings from this study will offer health services decision-makers sound evidence regarding an alternative method to face-to-face consultations that could be practical, acceptable and inexpensive, and that concretely answers the need for easily implementable prevention strategies. TRIAL REGISTRATION: NCT04735640 (ClinicalTrials.gov identifier). PROTOCOL VERSION: V1.0, 18/02/2021.

  @article{RN154,
  abstract = {AIM: To evaluate the effectiveness of a nurse-led personalized telephone lifestyle intervention versus automated SMSs in the reduction of fasting plasma glucose in adults with prediabetes. DESIGN: The PREDIPHONE is a randomized controlled, parallel, two arms, superiority trial with 15 months of follow-up. Participants will be randomized to either the intervention group (teleconsultations) or the active control group (SMSs). METHODS: A total of 428 participants will be randomized in a 1:1 ratio to one of the two arms and followed up during 9 months. The teleconsultations group will receive nurse-led personalized advice, while the SMSs group will receive 4-5 brief SMSs a week. Participants in both groups will receive evidence-based recommendations for diet and physical activity (PA). Outcome measures will be collected at baseline, months 4 and 9 and at month 15, to evaluate post-intervention effects. DISCUSSION: Prevention of diabetes through the implementation of lifestyle interventions remains an important priority. The current pandemic situation has magnified its urgency as it heavily affected the functionality of the healthcare system. Moreover, it created the need of remotely delivering preventative interventions. This study will provide insights on the effectiveness and feasibility of a telephone-based intervention led by nurses in the amelioration of risk factors associated with diabetes. IMPACT: Findings from this study will offer health services decision-makers sound evidence regarding an alternative method to face-to-face consultations that could be practical, acceptable and inexpensive, and that concretely answers the need for easily implementable prevention strategies. TRIAL REGISTRATION: NCT04735640 (ClinicalTrials.gov identifier). PROTOCOL VERSION: V1.0, 18/02/2021.},
  author = {Abbate, M. and Fresneda, S. and Yañez, A. and Ricci-Cabello, I. and Galmes-Panades, A. M. and Aguilo, A. and Bennasar-Veny, M.},
  journal = {J Adv Nurs},
  keywords = {grapp-caib myown},
  number = 7,
  pages = {3204-3217},
  title = {Nurse-led telephone intervention for lifestyle changes on glycaemic control in people with prediabetes: Study protocol for a randomized controlled trial},
  type = {Journal Article},
  volume = 77,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN154
  %A Abbate, M.
  %A Fresneda, S.
  %A Yañez, A.
  %A Ricci-Cabello, I.
  %A Galmes-Panades, A. M.
  %A Aguilo, A.
  %A Bennasar-Veny, M.
  %D 2021
  %J J Adv Nurs
  %N 7
  %P 3204-3217
  %R 10.1111/jan.14842
  %T Nurse-led telephone intervention for lifestyle changes on glycaemic control in people with prediabetes: Study protocol for a randomized controlled trial
  %V 77
  %X AIM: To evaluate the effectiveness of a nurse-led personalized telephone lifestyle intervention versus automated SMSs in the reduction of fasting plasma glucose in adults with prediabetes. DESIGN: The PREDIPHONE is a randomized controlled, parallel, two arms, superiority trial with 15 months of follow-up. Participants will be randomized to either the intervention group (teleconsultations) or the active control group (SMSs). METHODS: A total of 428 participants will be randomized in a 1:1 ratio to one of the two arms and followed up during 9 months. The teleconsultations group will receive nurse-led personalized advice, while the SMSs group will receive 4-5 brief SMSs a week. Participants in both groups will receive evidence-based recommendations for diet and physical activity (PA). Outcome measures will be collected at baseline, months 4 and 9 and at month 15, to evaluate post-intervention effects. DISCUSSION: Prevention of diabetes through the implementation of lifestyle interventions remains an important priority. The current pandemic situation has magnified its urgency as it heavily affected the functionality of the healthcare system. Moreover, it created the need of remotely delivering preventative interventions. This study will provide insights on the effectiveness and feasibility of a telephone-based intervention led by nurses in the amelioration of risk factors associated with diabetes. IMPACT: Findings from this study will offer health services decision-makers sound evidence regarding an alternative method to face-to-face consultations that could be practical, acceptable and inexpensive, and that concretely answers the need for easily implementable prevention strategies. TRIAL REGISTRATION: NCT04735640 (ClinicalTrials.gov identifier). PROTOCOL VERSION: V1.0, 18/02/2021.
  

• 
  1.

  Fraile Navarro D, López García-Franco A, Niño de Guzmán E, Rabassa M, Zamanillo Campos R, Pardo-Hernández H, Ricci-Cabello I, Canelo-Aybar C, Meneses-Echavez JF, Yepes-Nuñez JJ, Kuindersma J, Gich Saladich I, Alonso-Coello P. Vitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors. Int J Clin Pract. 2021;75(11):e14805.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. METHODS: We searched three databases and two guideline repositories from 2010 onwards. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, AGREE II domains' scores and pre-specified characteristics. RESULTS: We included 34 guidelines, 44.1% recommended, 26.5% suggested and 29.4% did not recommend vitamin D supplementation. Guidelines that scored higher for "editorial independence" and "overall quality score" were less likely to recommend or suggest vitamin D supplementation (median 68.8 vs 35.4; P = .001 and 58.3 vs 37.5; P = .02). Guidance produced by government organisations and those that reported source of funding were associated with higher AGREE II scores. Unclear role of source of funding was associated with recommending or suggesting vitamin D supplementation (P = .034). Editorial independence was an independent predictor for recommending or suggesting vitamin D supplementation (OR 1.09; CI95% 1.02 to 1.16; P = .006). CONCLUSIONS: Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.

  @article{RN160,
  abstract = {BACKGROUND: Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. METHODS: We searched three databases and two guideline repositories from 2010 onwards. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, AGREE II domains' scores and pre-specified characteristics. RESULTS: We included 34 guidelines, 44.1% recommended, 26.5% suggested and 29.4% did not recommend vitamin D supplementation. Guidelines that scored higher for "editorial independence" and "overall quality score" were less likely to recommend or suggest vitamin D supplementation (median 68.8 vs 35.4; P = .001 and 58.3 vs 37.5; P = .02). Guidance produced by government organisations and those that reported source of funding were associated with higher AGREE II scores. Unclear role of source of funding was associated with recommending or suggesting vitamin D supplementation (P = .034). Editorial independence was an independent predictor for recommending or suggesting vitamin D supplementation (OR 1.09; CI95% 1.02 to 1.16; P = .006). CONCLUSIONS: Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.},
  author = {Fraile Navarro, D. and López García-Franco, A. and Niño de Guzmán, E. and Rabassa, M. and Zamanillo Campos, R. and Pardo-Hernández, H. and Ricci-Cabello, I. and Canelo-Aybar, C. and Meneses-Echavez, J. F. and Yepes-Nuñez, J. J. and Kuindersma, J. and Gich Saladich, I. and Alonso-Coello, P.},
  journal = {Int J Clin Pract},
  keywords = {grapp-caib myown},
  number = 11,
  pages = {e14805},
  title = {Vitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors},
  type = {Journal Article},
  volume = 75,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN160
  %A Fraile Navarro, D.
  %A López García-Franco, A.
  %A Niño de Guzmán, E.
  %A Rabassa, M.
  %A Zamanillo Campos, R.
  %A Pardo-Hernández, H.
  %A Ricci-Cabello, I.
  %A Canelo-Aybar, C.
  %A Meneses-Echavez, J. F.
  %A Yepes-Nuñez, J. J.
  %A Kuindersma, J.
  %A Gich Saladich, I.
  %A Alonso-Coello, P.
  %D 2021
  %J Int J Clin Pract
  %N 11
  %P e14805
  %R 10.1111/ijcp.14805
  %T Vitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors
  %V 75
  %X BACKGROUND: Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. METHODS: We searched three databases and two guideline repositories from 2010 onwards. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, AGREE II domains' scores and pre-specified characteristics. RESULTS: We included 34 guidelines, 44.1% recommended, 26.5% suggested and 29.4% did not recommend vitamin D supplementation. Guidelines that scored higher for "editorial independence" and "overall quality score" were less likely to recommend or suggest vitamin D supplementation (median 68.8 vs 35.4; P = .001 and 58.3 vs 37.5; P = .02). Guidance produced by government organisations and those that reported source of funding were associated with higher AGREE II scores. Unclear role of source of funding was associated with recommending or suggesting vitamin D supplementation (P = .034). Editorial independence was an independent predictor for recommending or suggesting vitamin D supplementation (OR 1.09; CI95% 1.02 to 1.16; P = .006). CONCLUSIONS: Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
  

• 
  1.

  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 textellipsis. BMJ Open [Internet]. British Medical Journal Publishing Group; 2021;11(11). https://bmjopen.bmj.com/content/11/11/e055898

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{Garcia-Sangen'ise055898,
  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.},
  author = {Garcia-Sangenís, A. and Morros, R. and Aguilar-Sánchez, M. and Medina-Perucha, L. and Leiva, A. and Ripoll, J. and Martínez-Pecharromán, M. and Bartolomé-Moreno, C. B. and Magallon Botaya, R. and Marín-Cañada, J. and Molero, J. M. and Moragas, A. and Troncoso, A. and Monfà, R. and Llor, C.},
  journal = {BMJ Open},
  keywords = {grapp-caib myown},
  number = 11,
  publisher = {British Medical Journal Publishing Group},
  title = {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 textellipsis},
  volume = 11,
  year = 2021
  }
  

  %0 Journal Article
  %1 Garcia-Sangen'ise055898
  %A Garcia-Sangenís, A.
  %A Morros, R.
  %A Aguilar-Sánchez, M.
  %A Medina-Perucha, L.
  %A Leiva, A.
  %A Ripoll, J.
  %A Martínez-Pecharromán, M.
  %A Bartolomé-Moreno, C. B.
  %A Magallon Botaya, R.
  %A Marín-Cañada, J.
  %A Molero, J. M.
  %A Moragas, A.
  %A Troncoso, A.
  %A Monfà, R.
  %A Llor, C.
  %D 2021
  %I British Medical Journal Publishing Group
  %J BMJ Open
  %N 11
  %R 10.1136/bmjopen-2021-055898
  %T 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 textellipsis
  %U https://bmjopen.bmj.com/content/11/11/e055898
  %V 11
  %X 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.
  

• 
  1.

  del Carmen Carrascosa M, 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 [Internet]. 2021;103:103105. https://www.sciencedirect.com/science/article/pii/S0266613821001856

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{CARRASCOSA2021103105,
  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.},
  author = {del Carmen Carrascosa, María and Navas, Araceli and Artigues, Catalina and Ortas, Silvia and Portells, Elena and Soler, Aina and Bennasar-Veny, Miquel and Leiva, Alfonso},
  journal = {Midwifery},
  keywords = {grapp-caib},
  pages = 103105,
  title = {Effect of aerobic water exercise during pregnancy on epidural use and pain: A multi-centre, randomised, controlled trial},
  volume = 103,
  year = 2021
  }
  

  %0 Journal Article
  %1 CARRASCOSA2021103105
  %A del Carmen Carrascosa, María
  %A Navas, Araceli
  %A Artigues, Catalina
  %A Ortas, Silvia
  %A Portells, Elena
  %A Soler, Aina
  %A Bennasar-Veny, Miquel
  %A Leiva, Alfonso
  %D 2021
  %J Midwifery
  %P 103105
  %R https://doi.org/10.1016/j.midw.2021.103105
  %T Effect of aerobic water exercise during pregnancy on epidural use and pain: A multi-centre, randomised, controlled trial
  %U https://www.sciencedirect.com/science/article/pii/S0266613821001856
  %V 103
  %X 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.
  

• 
  1.

  Gibbons C, Porter I, Gonçalves-Bradley DC, Stoilov S, Ricci-Cabello I, Tsangaris E, Gangannagaripalli J, Davey A, Gibbons EJ, Kotzeva A, Evans J, van der Wees PJ, Kontopantelis E, Greenhalgh J, Bower P, Alonso J, Valderas JM. Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice. Cochrane Database Syst Rev. 2021;10(10):Cd011589.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback  on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback. OBJECTIVES: To assess the effects of PROMs feedback to patients, or healthcare workers, or both on patient-reported health outcomes and processes of care. SEARCH METHODS: We searched MEDLINE, Embase, CENTRAL, two other databases and two clinical trial registries on 5 October 2020. We searched grey literature and consulted experts in the field. SELECTION CRITERIA: Two review authors independently screened and selected studies for inclusion. We included randomised trials directly comparing the effects on outcomes and processes of care of PROMs feedback to healthcare professionals and patients, or both with the impact of not providing such information. DATA COLLECTION AND ANALYSIS: Two groups of two authors independently extracted data from the included studies and evaluated study quality. We followed standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the evidence. We conducted meta-analyses of the results where possible. MAIN RESULTS: We identified 116 randomised trials which assessed the effectiveness of PROMs feedback in improving processes or outcomes of care, or both in a broad range of disciplines including psychiatry, primary care, and oncology. Studies were conducted across diverse ambulatory primary and secondary care settings in North America, Europe and Australasia. A total of 49,785 patients were included across all the studies. The certainty of the evidence varied between very low and moderate. Many of the studies included in the review were at risk of performance and detection bias. The evidence suggests moderate certainty that PROMs feedback probably improves quality of life (standardised mean difference (SMD) 0.15, 95% confidence interval (CI) 0.05 to 0.26; 11 studies; 2687 participants), and leads to an increase in patient-physician communication (SMD 0.36, 95% CI 0.21 to 0.52; 5 studies; 658 participants), diagnosis and notation (risk ratio (RR) 1.73, 95% CI 1.44 to 2.08; 21 studies; 7223 participants), and disease control (RR 1.25, 95% CI 1.10 to 1.41; 14 studies; 2806 participants). The intervention probably makes little or no difference for general health perceptions (SMD 0.04, 95% CI -0.17 to 0.24; 2 studies, 552 participants; low-certainty evidence), social functioning (SMD 0.02, 95% CI -0.06 to 0.09; 15 studies; 2632 participants; moderate-certainty evidence), and pain (SMD 0.00, 95% CI -0.09 to 0.08; 9 studies; 2386 participants; moderate-certainty evidence). We are uncertain about the effect of PROMs feedback on physical functioning (14 studies; 2788 participants) and mental functioning (34 studies; 7782 participants), as well as fatigue (4 studies; 741 participants), as the certainty of the evidence was very low. We did not find studies reporting on adverse effects defined as distress following or related to PROM completion. AUTHORS' CONCLUSIONS: PROM feedback probably produces moderate improvements in communication between healthcare professionals and patients as well as in diagnosis and notation, and disease control, and small improvements to quality of life. Our confidence in the effects is limited by the risk of bias, heterogeneity and small number of trials conducted to assess outcomes of interest. It is unclear whether   many of these improvements are clinically meaningful or sustainable in the long term. There is a need for more high-quality studies in this area, particularly studies which employ cluster designs and utilise techniques to maintain allocation concealment.

  @article{RN163,
  abstract = {BACKGROUND: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback  on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback. OBJECTIVES: To assess the effects of PROMs feedback to patients, or healthcare workers, or both on patient-reported health outcomes and processes of care. SEARCH METHODS: We searched MEDLINE, Embase, CENTRAL, two other databases and two clinical trial registries on 5 October 2020. We searched grey literature and consulted experts in the field. SELECTION CRITERIA: Two review authors independently screened and selected studies for inclusion. We included randomised trials directly comparing the effects on outcomes and processes of care of PROMs feedback to healthcare professionals and patients, or both with the impact of not providing such information. DATA COLLECTION AND ANALYSIS: Two groups of two authors independently extracted data from the included studies and evaluated study quality. We followed standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the evidence. We conducted meta-analyses of the results where possible. MAIN RESULTS: We identified 116 randomised trials which assessed the effectiveness of PROMs feedback in improving processes or outcomes of care, or both in a broad range of disciplines including psychiatry, primary care, and oncology. Studies were conducted across diverse ambulatory primary and secondary care settings in North America, Europe and Australasia. A total of 49,785 patients were included across all the studies. The certainty of the evidence varied between very low and moderate. Many of the studies included in the review were at risk of performance and detection bias. The evidence suggests moderate certainty that PROMs feedback probably improves quality of life (standardised mean difference (SMD) 0.15, 95% confidence interval (CI) 0.05 to 0.26; 11 studies; 2687 participants), and leads to an increase in patient-physician communication (SMD 0.36, 95% CI 0.21 to 0.52; 5 studies; 658 participants), diagnosis and notation (risk ratio (RR) 1.73, 95% CI 1.44 to 2.08; 21 studies; 7223 participants), and disease control (RR 1.25, 95% CI 1.10 to 1.41; 14 studies; 2806 participants). The intervention probably makes little or no difference for general health perceptions (SMD 0.04, 95% CI -0.17 to 0.24; 2 studies, 552 participants; low-certainty evidence), social functioning (SMD 0.02, 95% CI -0.06 to 0.09; 15 studies; 2632 participants; moderate-certainty evidence), and pain (SMD 0.00, 95% CI -0.09 to 0.08; 9 studies; 2386 participants; moderate-certainty evidence). We are uncertain about the effect of PROMs feedback on physical functioning (14 studies; 2788 participants) and mental functioning (34 studies; 7782 participants), as well as fatigue (4 studies; 741 participants), as the certainty of the evidence was very low. We did not find studies reporting on adverse effects defined as distress following or related to PROM completion. AUTHORS' CONCLUSIONS: PROM feedback probably produces moderate improvements in communication between healthcare professionals and patients as well as in diagnosis and notation, and disease control, and small improvements to quality of life. Our confidence in the effects is limited by the risk of bias, heterogeneity and small number of trials conducted to assess outcomes of interest. It is unclear whether   many of these improvements are clinically meaningful or sustainable in the long term. There is a need for more high-quality studies in this area, particularly studies which employ cluster designs and utilise techniques to maintain allocation concealment.},
  author = {Gibbons, C. and Porter, I. and Gonçalves-Bradley, D. C. and Stoilov, S. and Ricci-Cabello, I. and Tsangaris, E. and Gangannagaripalli, J. and Davey, A. and Gibbons, E. J. and Kotzeva, A. and Evans, J. and van der Wees, P. J. and Kontopantelis, E. and Greenhalgh, J. and Bower, P. and Alonso, J. and Valderas, J. M.},
  journal = {Cochrane Database Syst Rev},
  keywords = {grapp-caib myown},
  number = 10,
  pages = {Cd011589},
  title = {Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice},
  type = {Journal Article},
  volume = 10,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN163
  %A Gibbons, C.
  %A Porter, I.
  %A Gonçalves-Bradley, D. C.
  %A Stoilov, S.
  %A Ricci-Cabello, I.
  %A Tsangaris, E.
  %A Gangannagaripalli, J.
  %A Davey, A.
  %A Gibbons, E. J.
  %A Kotzeva, A.
  %A Evans, J.
  %A van der Wees, P. J.
  %A Kontopantelis, E.
  %A Greenhalgh, J.
  %A Bower, P.
  %A Alonso, J.
  %A Valderas, J. M.
  %D 2021
  %J Cochrane Database Syst Rev
  %N 10
  %P Cd011589
  %R 10.1002/14651858.CD011589.pub2
  %T Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice
  %V 10
  %X BACKGROUND: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback  on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback. OBJECTIVES: To assess the effects of PROMs feedback to patients, or healthcare workers, or both on patient-reported health outcomes and processes of care. SEARCH METHODS: We searched MEDLINE, Embase, CENTRAL, two other databases and two clinical trial registries on 5 October 2020. We searched grey literature and consulted experts in the field. SELECTION CRITERIA: Two review authors independently screened and selected studies for inclusion. We included randomised trials directly comparing the effects on outcomes and processes of care of PROMs feedback to healthcare professionals and patients, or both with the impact of not providing such information. DATA COLLECTION AND ANALYSIS: Two groups of two authors independently extracted data from the included studies and evaluated study quality. We followed standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the evidence. We conducted meta-analyses of the results where possible. MAIN RESULTS: We identified 116 randomised trials which assessed the effectiveness of PROMs feedback in improving processes or outcomes of care, or both in a broad range of disciplines including psychiatry, primary care, and oncology. Studies were conducted across diverse ambulatory primary and secondary care settings in North America, Europe and Australasia. A total of 49,785 patients were included across all the studies. The certainty of the evidence varied between very low and moderate. Many of the studies included in the review were at risk of performance and detection bias. The evidence suggests moderate certainty that PROMs feedback probably improves quality of life (standardised mean difference (SMD) 0.15, 95% confidence interval (CI) 0.05 to 0.26; 11 studies; 2687 participants), and leads to an increase in patient-physician communication (SMD 0.36, 95% CI 0.21 to 0.52; 5 studies; 658 participants), diagnosis and notation (risk ratio (RR) 1.73, 95% CI 1.44 to 2.08; 21 studies; 7223 participants), and disease control (RR 1.25, 95% CI 1.10 to 1.41; 14 studies; 2806 participants). The intervention probably makes little or no difference for general health perceptions (SMD 0.04, 95% CI -0.17 to 0.24; 2 studies, 552 participants; low-certainty evidence), social functioning (SMD 0.02, 95% CI -0.06 to 0.09; 15 studies; 2632 participants; moderate-certainty evidence), and pain (SMD 0.00, 95% CI -0.09 to 0.08; 9 studies; 2386 participants; moderate-certainty evidence). We are uncertain about the effect of PROMs feedback on physical functioning (14 studies; 2788 participants) and mental functioning (34 studies; 7782 participants), as well as fatigue (4 studies; 741 participants), as the certainty of the evidence was very low. We did not find studies reporting on adverse effects defined as distress following or related to PROM completion. AUTHORS' CONCLUSIONS: PROM feedback probably produces moderate improvements in communication between healthcare professionals and patients as well as in diagnosis and notation, and disease control, and small improvements to quality of life. Our confidence in the effects is limited by the risk of bias, heterogeneity and small number of trials conducted to assess outcomes of interest. It is unclear whether   many of these improvements are clinically meaningful or sustainable in the long term. There is a need for more high-quality studies in this area, particularly studies which employ cluster designs and utilise techniques to maintain allocation concealment.
  

• 
  1.

  López-González Á A, Riutord Sbert P, Arroyo Bote S, González San Miguel H, Vidal Real C, Ramirez-Manent JI. Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers. Journal of Occupational \&amp\($\mathsemicolon$\) Environmental Medicine [Internet]. Ovid Technologies (Wolters Kluwer Health); 2021 Oct.;63(12):e911-e917. https://doi.org/10.1097%2Fjom.0000000000002402

  AbstractURLBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To evaluate different cardiovascular risk scales in construction workers. METHODS: A descriptive, cross-sectional study was carried out in 56,262 Spanish construction workers. Scales of obesity and fatty liver, metabolic syndrome, atherogenic indices, and cardiovascular risk scales, among others, were assessed. RESULTS: In women, 19.6% were obese, 18.2% hypertensive, 12.6% had metabolic syndrome, 12% were at high risk of non-alcoholic fatty liver disease, and 4.3% were at moderate or high risk on the SCORE scale. In men, 20.1% were obese, 30.1% hypertensive, 17.5% had metabolic syndrome, and 27.6% had high or moderate risk on the SCORE scale. CONCLUSIONS: Knowing the cardiovascular risk of a large number of construction workers by means of a large number of scales may be of great interest to occupational health professionals, as it may enable them to establish prevention strategies.

  @article{L_pez_Gonz_lez_2021,
  abstract = {OBJECTIVE: To evaluate different cardiovascular risk scales in construction workers. METHODS: A descriptive, cross-sectional study was carried out in 56,262 Spanish construction workers. Scales of obesity and fatty liver, metabolic syndrome, atherogenic indices, and cardiovascular risk scales, among others, were assessed. RESULTS: In women, 19.6% were obese, 18.2% hypertensive, 12.6% had metabolic syndrome, 12% were at high risk of non-alcoholic fatty liver disease, and 4.3% were at moderate or high risk on the SCORE scale. In men, 20.1% were obese, 30.1% hypertensive, 17.5% had metabolic syndrome, and 27.6% had high or moderate risk on the SCORE scale. CONCLUSIONS: Knowing the cardiovascular risk of a large number of construction workers by means of a large number of scales may be of great interest to occupational health professionals, as it may enable them to establish prevention strategies.},
  author = {López-González Á, A. and Riutord Sbert, P. and Arroyo Bote, S. and González San Miguel, H. and Vidal Real, C. and Ramirez-Manent, J. I.},
  journal = {Journal of Occupational \&\($\mathsemicolon$\) Environmental Medicine},
  keywords = {grapp-caib},
  month = {oct},
  number = 12,
  pages = {e911--e917},
  publisher = {Ovid Technologies (Wolters Kluwer Health)},
  title = {Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers},
  volume = 63,
  year = 2021
  }
  

  %0 Journal Article
  %1 L_pez_Gonz_lez_2021
  %A López-González Á, A.
  %A Riutord Sbert, P.
  %A Arroyo Bote, S.
  %A González San Miguel, H.
  %A Vidal Real, C.
  %A Ramirez-Manent, J. I.
  %D 2021
  %I Ovid Technologies (Wolters Kluwer Health)
  %J Journal of Occupational \&\($\mathsemicolon$\) Environmental Medicine
  %N 12
  %P e911--e917
  %R 10.1097/jom.0000000000002402
  %T Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers
  %U https://doi.org/10.1097%2Fjom.0000000000002402
  %V 63
  %X OBJECTIVE: To evaluate different cardiovascular risk scales in construction workers. METHODS: A descriptive, cross-sectional study was carried out in 56,262 Spanish construction workers. Scales of obesity and fatty liver, metabolic syndrome, atherogenic indices, and cardiovascular risk scales, among others, were assessed. RESULTS: In women, 19.6% were obese, 18.2% hypertensive, 12.6% had metabolic syndrome, 12% were at high risk of non-alcoholic fatty liver disease, and 4.3% were at moderate or high risk on the SCORE scale. In men, 20.1% were obese, 30.1% hypertensive, 17.5% had metabolic syndrome, and 27.6% had high or moderate risk on the SCORE scale. CONCLUSIONS: Knowing the cardiovascular risk of a large number of construction workers by means of a large number of scales may be of great interest to occupational health professionals, as it may enable them to establish prevention strategies.
  

• 
  1.

  Torrens Darder I, Argüelles-Vázquez R, Lorente-Montalvo P, Torrens-Darder MDM, Esteva M. Primary care is the frontline for help-seeking insomnia patients. Eur J Gen Pract. 2021;27(1):286-93.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Although insomnia is a very common disorder, few people seek medical help. OBJECTIVES: To determine the proportion of people who consult a healthcare professional about insomnia and examine reasons for help seeking. METHODS: Descriptive study of 99 patients diagnosed with insomnia following a telephone survey of 466 adults assigned to a primary healthcare unit in Majorca (Spain). Data were obtained from interviews and subsequent review of electronic medical records. RESULTS: Thirty-nine patients (39.8%) consulted at least once with one health care professional; 36(92.2%) consulted a general practitioner. Only 12.2% had an insomnia diagnosis registered in their medical record. Insomnia consultation was not associated with any sociodemographic variables analysed, anxiety, depression or comorbidities. Also, there was no association with sleep quality, duration, and sleep efficiency. Patients with clinical insomnia (OR, 2.48; 95% CI, 1.03-5.94), those who were more worried (OR, 2.93; 95% CI 1.08-7.95) or felt that others noticed the impact of insomnia on their quality of life (OR, 2.48; 95% CI, 1.02-19.08) are more likely to seek medical help. Patients taking sleep medication were 21.54 (95% CI, 7.34-63.20) times more likely to have asked for medical assistance. CONCLUSION: Insomnia is an under-reported problem for both patients and doctors. When patients decide to consult for insomnia problems, they first go to the GP, and the vast majority take medications for their sleep problem. Those who consult most are people with more severe insomnia and those who are more worried.

  @article{RN180,
  abstract = {BACKGROUND: Although insomnia is a very common disorder, few people seek medical help. OBJECTIVES: To determine the proportion of people who consult a healthcare professional about insomnia and examine reasons for help seeking. METHODS: Descriptive study of 99 patients diagnosed with insomnia following a telephone survey of 466 adults assigned to a primary healthcare unit in Majorca (Spain). Data were obtained from interviews and subsequent review of electronic medical records. RESULTS: Thirty-nine patients (39.8%) consulted at least once with one health care professional; 36(92.2%) consulted a general practitioner. Only 12.2% had an insomnia diagnosis registered in their medical record. Insomnia consultation was not associated with any sociodemographic variables analysed, anxiety, depression or comorbidities. Also, there was no association with sleep quality, duration, and sleep efficiency. Patients with clinical insomnia (OR, 2.48; 95% CI, 1.03-5.94), those who were more worried (OR, 2.93; 95% CI 1.08-7.95) or felt that others noticed the impact of insomnia on their quality of life (OR, 2.48; 95% CI, 1.02-19.08) are more likely to seek medical help. Patients taking sleep medication were 21.54 (95% CI, 7.34-63.20) times more likely to have asked for medical assistance. CONCLUSION: Insomnia is an under-reported problem for both patients and doctors. When patients decide to consult for insomnia problems, they first go to the GP, and the vast majority take medications for their sleep problem. Those who consult most are people with more severe insomnia and those who are more worried.},
  author = {Torrens Darder, I. and Argüelles-Vázquez, R. and Lorente-Montalvo, P. and Torrens-Darder, M. D. M. and Esteva, M.},
  journal = {Eur J Gen Pract},
  keywords = {grapp-caib},
  number = 1,
  pages = {286-293},
  title = {Primary care is the frontline for help-seeking insomnia patients},
  type = {Journal Article},
  volume = 27,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN180
  %A Torrens Darder, I.
  %A Argüelles-Vázquez, R.
  %A Lorente-Montalvo, P.
  %A Torrens-Darder, M. D. M.
  %A Esteva, M.
  %D 2021
  %J Eur J Gen Pract
  %N 1
  %P 286-293
  %R 10.1080/13814788.2021.1960308
  %T Primary care is the frontline for help-seeking insomnia patients
  %V 27
  %X BACKGROUND: Although insomnia is a very common disorder, few people seek medical help. OBJECTIVES: To determine the proportion of people who consult a healthcare professional about insomnia and examine reasons for help seeking. METHODS: Descriptive study of 99 patients diagnosed with insomnia following a telephone survey of 466 adults assigned to a primary healthcare unit in Majorca (Spain). Data were obtained from interviews and subsequent review of electronic medical records. RESULTS: Thirty-nine patients (39.8%) consulted at least once with one health care professional; 36(92.2%) consulted a general practitioner. Only 12.2% had an insomnia diagnosis registered in their medical record. Insomnia consultation was not associated with any sociodemographic variables analysed, anxiety, depression or comorbidities. Also, there was no association with sleep quality, duration, and sleep efficiency. Patients with clinical insomnia (OR, 2.48; 95% CI, 1.03-5.94), those who were more worried (OR, 2.93; 95% CI 1.08-7.95) or felt that others noticed the impact of insomnia on their quality of life (OR, 2.48; 95% CI, 1.02-19.08) are more likely to seek medical help. Patients taking sleep medication were 21.54 (95% CI, 7.34-63.20) times more likely to have asked for medical assistance. CONCLUSION: Insomnia is an under-reported problem for both patients and doctors. When patients decide to consult for insomnia problems, they first go to the GP, and the vast majority take medications for their sleep problem. Those who consult most are people with more severe insomnia and those who are more worried.
  

2020

• 
  1.

  Chela-Alvarez X, Bulilete O, Garc’ia-Buades ME, Ferrer-Perez VA, Llobera-Canaves J. Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective. International Journal of Environmental Research and Public Health [Internet]. MDPI AG; 2020 Dec.;18(1):52. https://doi.org/10.3390%2Fijerph18010052

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.

  @article{Chela_Alvarez_2020,
  abstract = {Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.},
  author = {Chela-Alvarez, Xenia and Bulilete, Oana and Garc'ia-Buades, M. Esther and Ferrer-Perez, Victoria A. and Llobera-Canaves, Joan},
  journal = {International Journal of Environmental Research and Public Health},
  keywords = {grapp-caib},
  month = {dec},
  number = 1,
  pages = 52,
  publisher = {MDPI AG},
  title = {Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective},
  volume = 18,
  year = 2020
  }
  

  %0 Journal Article
  %1 Chela_Alvarez_2020
  %A Chela-Alvarez, Xenia
  %A Bulilete, Oana
  %A Garc'ia-Buades, M. Esther
  %A Ferrer-Perez, Victoria A.
  %A Llobera-Canaves, Joan
  %D 2020
  %I MDPI AG
  %J International Journal of Environmental Research and Public Health
  %N 1
  %P 52
  %R 10.3390/ijerph18010052
  %T Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective
  %U https://doi.org/10.3390%2Fijerph18010052
  %V 18
  %X Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.
  

2019

• 
  1.

  Bulilete O, Leiva A, Rullán M, Roca A, Llobera J, Group on behalf of P. Efficacy of gabapentin for the prevention of postherpetic neuralgia in patients with acute herpes zoster: A double blind, randomized controlled trial. PLOS ONE [Internet]. Public Library of Science; 2019 Jun.;14(6):1-17. https://doi.org/10.1371/journal.pone.0217335

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). Previous trials have reported that gabapentin can relieve chronic neuropathic pain, but its effect on prevention of PHN is unclear. Objective To assess the efficacy of a 5-week course of gabapentin on acute herpetic pain and on the prevention of PHN at 12 weeks in patients with acute HZ. Methods This was a randomized, double blind, placebo-controlled trial conducted in 17 primary care health centers in Mallorca, Spain. All patients were older than 50 years, presented with HZ within 72 h of rash onset, and had moderate-severe pain (≥4 on a 10-point visual analogue scale [VAS]). Ninety-eight patients were randomized to receive gabapentin or placebo. All patients received valaciclovir for 7 days and analgesia if needed. The treatment period was 5 weeks, followed by 7 weeks of follow-up. Gabapentin was initiated at 300 mg/day and gradually titrated to a maximum of 1800 mg/day. The main outcome measure was pain at 12 weeks. Results Seventy-five patients completed the study, 33 in the gabapentin group and 42 in the control group. A total of 18.2% of patients in the gabapentin group and 9.5% in the control group reported pain at 12 weeks (p = 0.144). Four patients in the gabapentin group (12.1%), but no patients in the placebo group, reported pain of 4 or more on a 10-point VAS. Patients taking gabapentin reported worse health-related quality of life and poorer sleep quality. Three patients discontinued the trial due to adverse effects from gabapentin. Conclusion Addition of gabapentin to the usual treatment of HZ within 72 h of rash onset provided no significant relief from acute herpetic pain or prevention of PHN. Trial registration ISRCTN Registry identifier: ISRCTN79871784

  @article{10.1371/journal.pone.0217335,
  abstract = {Background Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). Previous trials have reported that gabapentin can relieve chronic neuropathic pain, but its effect on prevention of PHN is unclear. Objective To assess the efficacy of a 5-week course of gabapentin on acute herpetic pain and on the prevention of PHN at 12 weeks in patients with acute HZ. Methods This was a randomized, double blind, placebo-controlled trial conducted in 17 primary care health centers in Mallorca, Spain. All patients were older than 50 years, presented with HZ within 72 h of rash onset, and had moderate-severe pain (≥4 on a 10-point visual analogue scale [VAS]). Ninety-eight patients were randomized to receive gabapentin or placebo. All patients received valaciclovir for 7 days and analgesia if needed. The treatment period was 5 weeks, followed by 7 weeks of follow-up. Gabapentin was initiated at 300 mg/day and gradually titrated to a maximum of 1800 mg/day. The main outcome measure was pain at 12 weeks. Results Seventy-five patients completed the study, 33 in the gabapentin group and 42 in the control group. A total of 18.2% of patients in the gabapentin group and 9.5% in the control group reported pain at 12 weeks (p = 0.144). Four patients in the gabapentin group (12.1%), but no patients in the placebo group, reported pain of 4 or more on a 10-point VAS. Patients taking gabapentin reported worse health-related quality of life and poorer sleep quality. Three patients discontinued the trial due to adverse effects from gabapentin. Conclusion Addition of gabapentin to the usual treatment of HZ within 72 h of rash onset provided no significant relief from acute herpetic pain or prevention of PHN. Trial registration ISRCTN Registry identifier: ISRCTN79871784},
  author = {Bulilete, Oana and Leiva, Alfonso and Rullán, Manuel and Roca, Antonia and Llobera, Joan and on behalf of PHN Group},
  journal = {PLOS ONE},
  keywords = {grapp-caib},
  month = {06},
  number = 6,
  pages = {1-17},
  publisher = {Public Library of Science},
  title = {Efficacy of gabapentin for the prevention of postherpetic neuralgia in patients with acute herpes zoster: A double blind, randomized controlled trial},
  volume = 14,
  year = 2019
  }
  

  %0 Journal Article
  %1 10.1371/journal.pone.0217335
  %A Bulilete, Oana
  %A Leiva, Alfonso
  %A Rullán, Manuel
  %A Roca, Antonia
  %A Llobera, Joan
  %A Group, on behalf of PHN
  %D 2019
  %I Public Library of Science
  %J PLOS ONE
  %N 6
  %P 1-17
  %R 10.1371/journal.pone.0217335
  %T Efficacy of gabapentin for the prevention of postherpetic neuralgia in patients with acute herpes zoster: A double blind, randomized controlled trial
  %U https://doi.org/10.1371/journal.pone.0217335
  %V 14
  %X Background Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). Previous trials have reported that gabapentin can relieve chronic neuropathic pain, but its effect on prevention of PHN is unclear. Objective To assess the efficacy of a 5-week course of gabapentin on acute herpetic pain and on the prevention of PHN at 12 weeks in patients with acute HZ. Methods This was a randomized, double blind, placebo-controlled trial conducted in 17 primary care health centers in Mallorca, Spain. All patients were older than 50 years, presented with HZ within 72 h of rash onset, and had moderate-severe pain (≥4 on a 10-point visual analogue scale [VAS]). Ninety-eight patients were randomized to receive gabapentin or placebo. All patients received valaciclovir for 7 days and analgesia if needed. The treatment period was 5 weeks, followed by 7 weeks of follow-up. Gabapentin was initiated at 300 mg/day and gradually titrated to a maximum of 1800 mg/day. The main outcome measure was pain at 12 weeks. Results Seventy-five patients completed the study, 33 in the gabapentin group and 42 in the control group. A total of 18.2% of patients in the gabapentin group and 9.5% in the control group reported pain at 12 weeks (p = 0.144). Four patients in the gabapentin group (12.1%), but no patients in the placebo group, reported pain of 4 or more on a 10-point VAS. Patients taking gabapentin reported worse health-related quality of life and poorer sleep quality. Three patients discontinued the trial due to adverse effects from gabapentin. Conclusion Addition of gabapentin to the usual treatment of HZ within 72 h of rash onset provided no significant relief from acute herpetic pain or prevention of PHN. Trial registration ISRCTN Registry identifier: ISRCTN79871784
  

• 
  1.

  Torrens I, Argüelles-Vázquez R, Lorente-Montalvo P, Molero-Alfonso C, Esteva M. [Prevalence of insomnia and characteristic of patients with insomnia in a health area of Majorca (Spain)]. Aten Primaria. 2019;51(10):617-25.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVES: To estimate insomnia prevalence as well as habits comorbidity, sleep quality of insomnia patients. DESIGN: Cross sectional descriptive study. SETTING: Calvia health center (Majorca, Spain). PARTICIPANTS: We included subjects registered in a Health Center (> 2 years) of 18-80 years old. METHODS: Firstly, they were interviewed by telephone in order to identify persons with insomnia using the Insomnia Severity Index. Afterward, subjects with insomnia were interviewed in the health center in order to collect the data. RESULTS: From a simple of 1,563 persons, we contacted 591 and 467 participated. Insomnia prevalence was 21.1% (IC 95% 17.38-25.01) and 6.9% (IC 95% 4.45-9.25) clinical insomnia. It was significantly more frequent in women, widow, divorced, retired and unemployed. Two in three presented obesity or overweight, 37% chronic pain, 21.1% depression and 37.9% anxiety. Half of the patients with insomnia referred a negative impact on daily activities and difficulties to maintain enthusiasm. Moreover, 41.1% declared to take pharmacological treatment for sleep usually. The more common therapeutic measures for insomnia were sleep hygiene and benzodiazepines; while cognitive-behavioral therapies were rarely used. CONCLUSIONS: The prevalence of insomnia in our health area is similar to those described in population based studies. The presence of some prejudicial habits for sleep quality as well as comorbidities could facilitate insomnia to become a chronic illness. Then, management of insomnia should be considered in a patient more general context. Pharmacological treatment is still in the first line and effective non pharmacological treatment is still a rare option.

  @article{RN91,
  abstract = {OBJECTIVES: To estimate insomnia prevalence as well as habits comorbidity, sleep quality of insomnia patients. DESIGN: Cross sectional descriptive study. SETTING: Calvia health center (Majorca, Spain). PARTICIPANTS: We included subjects registered in a Health Center (> 2 years) of 18-80 years old. METHODS: Firstly, they were interviewed by telephone in order to identify persons with insomnia using the Insomnia Severity Index. Afterward, subjects with insomnia were interviewed in the health center in order to collect the data. RESULTS: From a simple of 1,563 persons, we contacted 591 and 467 participated. Insomnia prevalence was 21.1% (IC 95% 17.38-25.01) and 6.9% (IC 95% 4.45-9.25) clinical insomnia. It was significantly more frequent in women, widow, divorced, retired and unemployed. Two in three presented obesity or overweight, 37% chronic pain, 21.1% depression and 37.9% anxiety. Half of the patients with insomnia referred a negative impact on daily activities and difficulties to maintain enthusiasm. Moreover, 41.1% declared to take pharmacological treatment for sleep usually. The more common therapeutic measures for insomnia were sleep hygiene and benzodiazepines; while cognitive-behavioral therapies were rarely used. CONCLUSIONS: The prevalence of insomnia in our health area is similar to those described in population based studies. The presence of some prejudicial habits for sleep quality as well as comorbidities could facilitate insomnia to become a chronic illness. Then, management of insomnia should be considered in a patient more general context. Pharmacological treatment is still in the first line and effective non pharmacological treatment is still a rare option.},
  author = {Torrens, I. and Argüelles-Vázquez, R. and Lorente-Montalvo, P. and Molero-Alfonso, C. and Esteva, M.},
  journal = {Aten Primaria},
  keywords = {grapp-caib},
  number = 10,
  pages = {617-625},
  title = {[Prevalence of insomnia and characteristic of patients with insomnia in a health area of Majorca (Spain)]},
  type = {Journal Article},
  volume = 51,
  year = 2019
  }
  

  %0 Journal Article
  %1 RN91
  %A Torrens, I.
  %A Argüelles-Vázquez, R.
  %A Lorente-Montalvo, P.
  %A Molero-Alfonso, C.
  %A Esteva, M.
  %D 2019
  %J Aten Primaria
  %N 10
  %P 617-625
  %R 10.1016/j.aprim.2018.02.014
  %T [Prevalence of insomnia and characteristic of patients with insomnia in a health area of Majorca (Spain)]
  %V 51
  %X OBJECTIVES: To estimate insomnia prevalence as well as habits comorbidity, sleep quality of insomnia patients. DESIGN: Cross sectional descriptive study. SETTING: Calvia health center (Majorca, Spain). PARTICIPANTS: We included subjects registered in a Health Center (> 2 years) of 18-80 years old. METHODS: Firstly, they were interviewed by telephone in order to identify persons with insomnia using the Insomnia Severity Index. Afterward, subjects with insomnia were interviewed in the health center in order to collect the data. RESULTS: From a simple of 1,563 persons, we contacted 591 and 467 participated. Insomnia prevalence was 21.1% (IC 95% 17.38-25.01) and 6.9% (IC 95% 4.45-9.25) clinical insomnia. It was significantly more frequent in women, widow, divorced, retired and unemployed. Two in three presented obesity or overweight, 37% chronic pain, 21.1% depression and 37.9% anxiety. Half of the patients with insomnia referred a negative impact on daily activities and difficulties to maintain enthusiasm. Moreover, 41.1% declared to take pharmacological treatment for sleep usually. The more common therapeutic measures for insomnia were sleep hygiene and benzodiazepines; while cognitive-behavioral therapies were rarely used. CONCLUSIONS: The prevalence of insomnia in our health area is similar to those described in population based studies. The presence of some prejudicial habits for sleep quality as well as comorbidities could facilitate insomnia to become a chronic illness. Then, management of insomnia should be considered in a patient more general context. Pharmacological treatment is still in the first line and effective non pharmacological treatment is still a rare option.
  

• 
  1.

  Vicens C, Leiva A, Bejarano F, Sempere E, Rodr’iguez-Rincón RM, Fiol F, Mengual M, Ajenjo A, Do Pazo F, Mateu C, Folch S, Alegret S, Coll JM, Mart’in-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 [Internet]. British Medical Journal Publishing Group; 2019;9(1). https://bmjopen.bmj.com/content/9/1/e022046

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  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), ltextquoterightIDIAP 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.

  @article{Vicense022046,
  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), ltextquoterightIDIAP 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.},
  author = {Vicens, Caterina and Leiva, Alfonso and Bejarano, Ferran and Sempere, Ermengol and Rodr'iguez-Rincón, Raquel Mar'ia and Fiol, Francisca and Mengual, Marta and Ajenjo, Asunción and Do Pazo, Fernando and Mateu, Catalina and Folch, Silvia and Alegret, Santiago and Coll, Jose Maria and Mart'in-Rabadán, Mar'ia and Socias, Isabel},
  journal = {BMJ Open},
  keywords = {grapp-caib},
  number = 1,
  publisher = {British Medical Journal Publishing Group},
  title = {Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study},
  volume = 9,
  year = 2019
  }
  

  %0 Journal Article
  %1 Vicense022046
  %A Vicens, Caterina
  %A Leiva, Alfonso
  %A Bejarano, Ferran
  %A Sempere, Ermengol
  %A Rodr'iguez-Rincón, Raquel Mar'ia
  %A Fiol, Francisca
  %A Mengual, Marta
  %A Ajenjo, Asunción
  %A Do Pazo, Fernando
  %A Mateu, Catalina
  %A Folch, Silvia
  %A Alegret, Santiago
  %A Coll, Jose Maria
  %A Mart'in-Rabadán, Mar'ia
  %A Socias, Isabel
  %D 2019
  %I British Medical Journal Publishing Group
  %J BMJ Open
  %N 1
  %R 10.1136/bmjopen-2018-022046
  %T Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study
  %U https://bmjopen.bmj.com/content/9/1/e022046
  %V 9
  %X 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), ltextquoterightIDIAP 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.
  

• 
  1.

  Tapsfield J, Hall C, Lunan C, McCutcheon H, McLoughlin P, Rhee J, Leiva A, Spiller J, Finucane A, Murray SA. Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners. BMJ Support Palliat Care. 2019;9(4):e28.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care. AIMS: We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs' views on using KIS. METHODS: We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which aspects of care had been documented. We interviewed 10 GPs to understand barriers and facilitating factors. RESULTS: Overall, 60% of patients were identified for a KIS, a median of 18 weeks before death. The numbers identified were highest for patients with cancer, with 75% identified compared with 66% of those dying with dementia/frailty and only 41% dying from organ failure. Patients were more likely to die outside hospital if they had a KIS. GPs identified professional, patient and societal challenges in identifying patients for palliative care, especially those with non-cancer diagnoses. CONCLUSIONS: GPs are identifying patients for anticipatory and palliative care more equitably across the different disease trajectories and earlier in the disease process than they were previously identifying patients specifically for palliative care. However, many patients still lack care planning, particularly those dying with organ failure.

  @article{RN186,
  abstract = {BACKGROUND: Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care. AIMS: We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs' views on using KIS. METHODS: We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which aspects of care had been documented. We interviewed 10 GPs to understand barriers and facilitating factors. RESULTS: Overall, 60% of patients were identified for a KIS, a median of 18 weeks before death. The numbers identified were highest for patients with cancer, with 75% identified compared with 66% of those dying with dementia/frailty and only 41% dying from organ failure. Patients were more likely to die outside hospital if they had a KIS. GPs identified professional, patient and societal challenges in identifying patients for palliative care, especially those with non-cancer diagnoses. CONCLUSIONS: GPs are identifying patients for anticipatory and palliative care more equitably across the different disease trajectories and earlier in the disease process than they were previously identifying patients specifically for palliative care. However, many patients still lack care planning, particularly those dying with organ failure.},
  author = {Tapsfield, J. and Hall, C. and Lunan, C. and McCutcheon, H. and McLoughlin, P. and Rhee, J. and Leiva, A. and Spiller, J. and Finucane, A. and Murray, S. A.},
  journal = {BMJ Support Palliat Care},
  keywords = {grapp-caib},
  number = 4,
  pages = {e28},
  title = {Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners},
  type = {Journal Article},
  volume = 9,
  year = 2019
  }
  

  %0 Journal Article
  %1 RN186
  %A Tapsfield, J.
  %A Hall, C.
  %A Lunan, C.
  %A McCutcheon, H.
  %A McLoughlin, P.
  %A Rhee, J.
  %A Leiva, A.
  %A Spiller, J.
  %A Finucane, A.
  %A Murray, S. A.
  %D 2019
  %J BMJ Support Palliat Care
  %N 4
  %P e28
  %R 10.1136/bmjspcare-2015-001014
  %T Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners
  %V 9
  %X BACKGROUND: Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care. AIMS: We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs' views on using KIS. METHODS: We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which aspects of care had been documented. We interviewed 10 GPs to understand barriers and facilitating factors. RESULTS: Overall, 60% of patients were identified for a KIS, a median of 18 weeks before death. The numbers identified were highest for patients with cancer, with 75% identified compared with 66% of those dying with dementia/frailty and only 41% dying from organ failure. Patients were more likely to die outside hospital if they had a KIS. GPs identified professional, patient and societal challenges in identifying patients for palliative care, especially those with non-cancer diagnoses. CONCLUSIONS: GPs are identifying patients for anticipatory and palliative care more equitably across the different disease trajectories and earlier in the disease process than they were previously identifying patients specifically for palliative care. However, many patients still lack care planning, particularly those dying with organ failure.
  

• 
  1.

  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(1):1499.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN187,
  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.},
  author = {Rodríguez-Enríquez, M. and Bennasar-Veny, M. and Leiva, A. and Garaigordobil, M. and Yañez, A. M.},
  journal = {BMC Public Health},
  keywords = {grapp-caib},
  number = 1,
  pages = 1499,
  title = {Cybervictimization among secondary students: social networking time, personality traits and parental education},
  type = {Journal Article},
  volume = 19,
  year = 2019
  }
  

  %0 Journal Article
  %1 RN187
  %A Rodríguez-Enríquez, M.
  %A Bennasar-Veny, M.
  %A Leiva, A.
  %A Garaigordobil, M.
  %A Yañez, A. M.
  %D 2019
  %J BMC Public Health
  %N 1
  %P 1499
  %R 10.1186/s12889-019-7876-9
  %T Cybervictimization among secondary students: social networking time, personality traits and parental education
  %V 19
  %X 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.
  

• 
  1.

  Pons-Vigués M, Rando-Matos Y, Rodriguez-Blanco T, Ballvé-Moreno JL, Ripoll J, Llobera J, Morán J, López-Jiménez T, Violán-Fors C, Bolibar B. Effect of the comprehensive smoke-free law on time trends in smoking behaviour in primary healthcare patients in Spain: a longitudinal observational study. BMJ Open [Internet]. British Medical Journal Publishing Group; 2019;9(3). https://bmjopen.bmj.com/content/9/3/e020120

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective This study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall and stratified by sex.Design Longitudinal observational study conducted between 2008 and 2013.Setting 66 PHC teams in Catalonia, Navarre and the Balearic Islands (Spain).Participants Population over 15 years of age assigned to PHC teams.Primary and secondary outcomes measures Quarterly age-standardised prevalence of non-smoker, smoker and ex-smoker and incidence of new smoker, new ex-smoker and ex-smoker relapse rates were estimated with data retrieved from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardised prevalence and incidence rates. Trends were expressed as annual percentage change and average annual percent change.Results The overall standardised smoker prevalence rate showed a significant downward trend (higher in men than women) and the overall standardised ex-smoker prevalence rate showed a significant increased trend (higher in women than men) in the three regions. Standardised smoker and ex-smoker prevalence rates were higher for men than women in all regions. With regard to overall trends of incidence rates, new smokers decreased significantly in Catalonia and Navarre and similarly in men and women, new ex-smokers decreased significantly and more in men in Catalonia and the Balearic Islands, and ex-smoker relapse increased in Catalonia (particularly in women) and decreased in Navarre.Conclusions Trends in smoking behaviour in PHC patients remain unchanged after the implementation of comprehensive SFL. The impact of the comprehensive SFL might have been lessened by the effect of the preceding partial SFL.

  @article{Pons-Viguése020120,
  abstract = {Objective This study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall and stratified by sex.Design Longitudinal observational study conducted between 2008 and 2013.Setting 66 PHC teams in Catalonia, Navarre and the Balearic Islands (Spain).Participants Population over 15 years of age assigned to PHC teams.Primary and secondary outcomes measures Quarterly age-standardised prevalence of non-smoker, smoker and ex-smoker and incidence of new smoker, new ex-smoker and ex-smoker relapse rates were estimated with data retrieved from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardised prevalence and incidence rates. Trends were expressed as annual percentage change and average annual percent change.Results The overall standardised smoker prevalence rate showed a significant downward trend (higher in men than women) and the overall standardised ex-smoker prevalence rate showed a significant increased trend (higher in women than men) in the three regions. Standardised smoker and ex-smoker prevalence rates were higher for men than women in all regions. With regard to overall trends of incidence rates, new smokers decreased significantly in Catalonia and Navarre and similarly in men and women, new ex-smokers decreased significantly and more in men in Catalonia and the Balearic Islands, and ex-smoker relapse increased in Catalonia (particularly in women) and decreased in Navarre.Conclusions Trends in smoking behaviour in PHC patients remain unchanged after the implementation of comprehensive SFL. The impact of the comprehensive SFL might have been lessened by the effect of the preceding partial SFL.},
  author = {Pons-Vigués, M. and Rando-Matos, Y. and Rodriguez-Blanco, T. and Ballvé-Moreno, J. L. and Ripoll, J. and Llobera, J. and Morán, J. and López-Jiménez, T. and Violán-Fors, C. and Bolibar, B.},
  journal = {BMJ Open},
  keywords = {grapp-caib},
  number = 3,
  publisher = {British Medical Journal Publishing Group},
  title = {Effect of the comprehensive smoke-free law on time trends in smoking behaviour in primary healthcare patients in Spain: a longitudinal observational study},
  volume = 9,
  year = 2019
  }
  

  %0 Journal Article
  %1 Pons-Viguése020120
  %A Pons-Vigués, M.
  %A Rando-Matos, Y.
  %A Rodriguez-Blanco, T.
  %A Ballvé-Moreno, J. L.
  %A Ripoll, J.
  %A Llobera, J.
  %A Morán, J.
  %A López-Jiménez, T.
  %A Violán-Fors, C.
  %A Bolibar, B.
  %D 2019
  %I British Medical Journal Publishing Group
  %J BMJ Open
  %N 3
  %R 10.1136/bmjopen-2017-020120
  %T Effect of the comprehensive smoke-free law on time trends in smoking behaviour in primary healthcare patients in Spain: a longitudinal observational study
  %U https://bmjopen.bmj.com/content/9/3/e020120
  %V 9
  %X Objective This study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall and stratified by sex.Design Longitudinal observational study conducted between 2008 and 2013.Setting 66 PHC teams in Catalonia, Navarre and the Balearic Islands (Spain).Participants Population over 15 years of age assigned to PHC teams.Primary and secondary outcomes measures Quarterly age-standardised prevalence of non-smoker, smoker and ex-smoker and incidence of new smoker, new ex-smoker and ex-smoker relapse rates were estimated with data retrieved from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardised prevalence and incidence rates. Trends were expressed as annual percentage change and average annual percent change.Results The overall standardised smoker prevalence rate showed a significant downward trend (higher in men than women) and the overall standardised ex-smoker prevalence rate showed a significant increased trend (higher in women than men) in the three regions. Standardised smoker and ex-smoker prevalence rates were higher for men than women in all regions. With regard to overall trends of incidence rates, new smokers decreased significantly in Catalonia and Navarre and similarly in men and women, new ex-smokers decreased significantly and more in men in Catalonia and the Balearic Islands, and ex-smoker relapse increased in Catalonia (particularly in women) and decreased in Navarre.Conclusions Trends in smoking behaviour in PHC patients remain unchanged after the implementation of comprehensive SFL. The impact of the comprehensive SFL might have been lessened by the effect of the preceding partial SFL.
  

2018

• 
  1.

  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(1):94.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{RN116,
  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.},
  author = {Navas, A. and Artigues, C. and Leiva, A. and Portells, E. and Soler, A. and Cladera, A. and Ortas, S. and Alomar, M. and Gual, M. and Manzanares, C. and Brunet, M. and Julià, M. and López, L. and Granda, L. and Bennasar-Veny, M. and Carrascosa, M. C.},
  journal = {BMC Pregnancy Childbirth},
  keywords = {grapp-caib},
  number = 1,
  pages = 94,
  title = {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},
  type = {Journal Article},
  volume = 18,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN116
  %A Navas, A.
  %A Artigues, C.
  %A Leiva, A.
  %A Portells, E.
  %A Soler, A.
  %A Cladera, A.
  %A Ortas, S.
  %A Alomar, M.
  %A Gual, M.
  %A Manzanares, C.
  %A Brunet, M.
  %A Julià, M.
  %A López, L.
  %A Granda, L.
  %A Bennasar-Veny, M.
  %A Carrascosa, M. C.
  %D 2018
  %J BMC Pregnancy Childbirth
  %N 1
  %P 94
  %R 10.1186/s12884-018-1715-3
  %T 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
  %V 18
  %X 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.
  

• 
  1.

  Forns J, Stigum H, Høyer BB, Sioen I, Sovcikova E, Nowack N, Lopez-Espinosa MJ, Guxens M, Ibarluzea J, Torrent M, Wittsiepe J, Govarts E, Trnovec T, Chevrier C, Toft G, Vrijheid M, Iszatt N, Eggesbø M. Prenatal and postnatal exposure to persistent organic pollutants and attention-deficit and hyperactivity disorder: a pooled analysis of seven European birth cohort studies. Int J Epidemiol. 2018;47(4):1082-97.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Background: Attention-deficit/hyperactivity disorder (ADHD) is increasing worldwide for reasons largely unknown and environmental chemicals with neurotoxic properties, such as persistent organic pollutants (POPs), have been proposed to play a role. We investigated the association between prenatal and postnatal exposure to polychlorinated biphenyl-153 (PCB-153), p-p´-dichlorodiphenyldichloroethylene (p-p'-DDE) and hexachlorobenzene (HCB) and ADHD in childhood. Methods: We pooled seven European birth cohort studies encompassing 4437 mother-child pairs from the general population with concentrations of PCB-153, p-p´-DDE and HCB measured in cord blood, maternal blood or milk. We then calculated prenatal (birth) and postnatal (3, 6, 12 and 24 months) POP concentrations using a pharmacokinetic model. The operational definition of ADHD varied across cohorts and ranged from doctor diagnosis obtained from patient registries to maternal or teachers reports. We used multilevel (mixed) logistic regression models to estimate the associations between exposure to POPs at birth, 3, 6, 12 and 24 months and ADHD. Results: The global prevalence of ADHD in our study was 6%. The mean age at assessment of ADHD was 5.8 years (range: 3.8-9.5 years). We found no association between exposure to PCB-153, p-p´-DDE and HCB at any age point between birth and 24 months and ADHD, in the pooled analyses (pooled odds ratios ranging from 1.00 to 1.01). A number of sensitivity analyses gave basically the same results. Conclusions: In the largest study to date of 4437 children in seven European birth cohorts, we did not observe any association between either pre- or postnatal exposure (up to 24 months) to PCB-153, p-p´-DDE and HCB and the risk of ADHD before the age of 10 years.

  @article{RN121,
  abstract = {Background: Attention-deficit/hyperactivity disorder (ADHD) is increasing worldwide for reasons largely unknown and environmental chemicals with neurotoxic properties, such as persistent organic pollutants (POPs), have been proposed to play a role. We investigated the association between prenatal and postnatal exposure to polychlorinated biphenyl-153 (PCB-153), p-p´-dichlorodiphenyldichloroethylene (p-p'-DDE) and hexachlorobenzene (HCB) and ADHD in childhood. Methods: We pooled seven European birth cohort studies encompassing 4437 mother-child pairs from the general population with concentrations of PCB-153, p-p´-DDE and HCB measured in cord blood, maternal blood or milk. We then calculated prenatal (birth) and postnatal (3, 6, 12 and 24 months) POP concentrations using a pharmacokinetic model. The operational definition of ADHD varied across cohorts and ranged from doctor diagnosis obtained from patient registries to maternal or teachers reports. We used multilevel (mixed) logistic regression models to estimate the associations between exposure to POPs at birth, 3, 6, 12 and 24 months and ADHD. Results: The global prevalence of ADHD in our study was 6%. The mean age at assessment of ADHD was 5.8 years (range: 3.8-9.5 years). We found no association between exposure to PCB-153, p-p´-DDE and HCB at any age point between birth and 24 months and ADHD, in the pooled analyses (pooled odds ratios ranging from 1.00 to 1.01). A number of sensitivity analyses gave basically the same results. Conclusions: In the largest study to date of 4437 children in seven European birth cohorts, we did not observe any association between either pre- or postnatal exposure (up to 24 months) to PCB-153, p-p´-DDE and HCB and the risk of ADHD before the age of 10 years.},
  author = {Forns, J. and Stigum, H. and Høyer, B. B. and Sioen, I. and Sovcikova, E. and Nowack, N. and Lopez-Espinosa, M. J. and Guxens, M. and Ibarluzea, J. and Torrent, M. and Wittsiepe, J. and Govarts, E. and Trnovec, T. and Chevrier, C. and Toft, G. and Vrijheid, M. and Iszatt, N. and Eggesbø, M.},
  journal = {Int J Epidemiol},
  keywords = {grapp-caib},
  number = 4,
  pages = {1082-1097},
  title = {Prenatal and postnatal exposure to persistent organic pollutants and attention-deficit and hyperactivity disorder: a pooled analysis of seven European birth cohort studies},
  type = {Journal Article},
  volume = 47,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN121
  %A Forns, J.
  %A Stigum, H.
  %A Høyer, B. B.
  %A Sioen, I.
  %A Sovcikova, E.
  %A Nowack, N.
  %A Lopez-Espinosa, M. J.
  %A Guxens, M.
  %A Ibarluzea, J.
  %A Torrent, M.
  %A Wittsiepe, J.
  %A Govarts, E.
  %A Trnovec, T.
  %A Chevrier, C.
  %A Toft, G.
  %A Vrijheid, M.
  %A Iszatt, N.
  %A Eggesbø, M.
  %D 2018
  %J Int J Epidemiol
  %N 4
  %P 1082-1097
  %R 10.1093/ije/dyy052
  %T Prenatal and postnatal exposure to persistent organic pollutants and attention-deficit and hyperactivity disorder: a pooled analysis of seven European birth cohort studies
  %V 47
  %X Background: Attention-deficit/hyperactivity disorder (ADHD) is increasing worldwide for reasons largely unknown and environmental chemicals with neurotoxic properties, such as persistent organic pollutants (POPs), have been proposed to play a role. We investigated the association between prenatal and postnatal exposure to polychlorinated biphenyl-153 (PCB-153), p-p´-dichlorodiphenyldichloroethylene (p-p'-DDE) and hexachlorobenzene (HCB) and ADHD in childhood. Methods: We pooled seven European birth cohort studies encompassing 4437 mother-child pairs from the general population with concentrations of PCB-153, p-p´-DDE and HCB measured in cord blood, maternal blood or milk. We then calculated prenatal (birth) and postnatal (3, 6, 12 and 24 months) POP concentrations using a pharmacokinetic model. The operational definition of ADHD varied across cohorts and ranged from doctor diagnosis obtained from patient registries to maternal or teachers reports. We used multilevel (mixed) logistic regression models to estimate the associations between exposure to POPs at birth, 3, 6, 12 and 24 months and ADHD. Results: The global prevalence of ADHD in our study was 6%. The mean age at assessment of ADHD was 5.8 years (range: 3.8-9.5 years). We found no association between exposure to PCB-153, p-p´-DDE and HCB at any age point between birth and 24 months and ADHD, in the pooled analyses (pooled odds ratios ranging from 1.00 to 1.01). A number of sensitivity analyses gave basically the same results. Conclusions: In the largest study to date of 4437 children in seven European birth cohorts, we did not observe any association between either pre- or postnatal exposure (up to 24 months) to PCB-153, p-p´-DDE and HCB and the risk of ADHD before the age of 10 years.
  

• 
  1.

  Saletti-Cuesta L, Aizenberg L, Ricci-Cabello I. Opinions and Experiences of Primary Healthcare Providers Regarding Violence against Women: a Systematic Review of Qualitative Studies. Journal of Family Violence [Internet]. 2018 Aug. 1;33(6):405-20. https://doi.org/10.1007/s10896-018-9971-6

  AbstractURLBibTeXEndNoteDOIBibSonomy

  The aim of this systematic review of qualitative studies is to explore the opinions and experiences of primary care providers regarding violence against women. Structured searches were conducted in nine bibliographic databases (March 2016). Study identification, critical appraisal (using the CASP tool), and analyses (thematic synthesis) were conducted. 46 qualitative studies were selected. Three main themes were identified: 1) Defining violence against women and its causes; 2) Awareness of violence against women and disclosure, with subthemes: 2.1.) Barriers experienced by primary care providers; 2.2) Facilitators for providing appropriate help; 3) Actions taken by providers to help women. Violence against women was generally considered as an unacceptable act with important health consequences. Barriers to address violence against women included organizational factors, providers' subjective feelings and perceived role, and providers' perceptions about women facing violence against women. Facilitators included a trusting relationship with women, attentive non-judgmental listening, participate in the community, team-work and continuing education. Providing emotional support and offering information about resources were the main actions taken by primary care providers. Women-centred care, respecting women's decision making processes and a biopsychosocial approach may provide direction to more compassionate and supportive care while strengthening primary healthcare response.

  @article{Saletti-Cuesta2018,
  abstract = {The aim of this systematic review of qualitative studies is to explore the opinions and experiences of primary care providers regarding violence against women. Structured searches were conducted in nine bibliographic databases (March 2016). Study identification, critical appraisal (using the CASP tool), and analyses (thematic synthesis) were conducted. 46 qualitative studies were selected. Three main themes were identified: 1) Defining violence against women and its causes; 2) Awareness of violence against women and disclosure, with subthemes: 2.1.) Barriers experienced by primary care providers; 2.2) Facilitators for providing appropriate help; 3) Actions taken by providers to help women. Violence against women was generally considered as an unacceptable act with important health consequences. Barriers to address violence against women included organizational factors, providers' subjective feelings and perceived role, and providers' perceptions about women facing violence against women. Facilitators included a trusting relationship with women, attentive non-judgmental listening, participate in the community, team-work and continuing education. Providing emotional support and offering information about resources were the main actions taken by primary care providers. Women-centred care, respecting women's decision making processes and a biopsychosocial approach may provide direction to more compassionate and supportive care while strengthening primary healthcare response.},
  author = {Saletti-Cuesta, Lorena and Aizenberg, Lila and Ricci-Cabello, Ignacio},
  journal = {Journal of Family Violence},
  keywords = {grapp-caib myown},
  month = {aug},
  number = 6,
  pages = {405--420},
  title = {Opinions and Experiences of Primary Healthcare Providers Regarding Violence against Women: a Systematic Review of Qualitative Studies},
  volume = 33,
  year = 2018
  }
  

  %0 Journal Article
  %1 Saletti-Cuesta2018
  %A Saletti-Cuesta, Lorena
  %A Aizenberg, Lila
  %A Ricci-Cabello, Ignacio
  %D 2018
  %J Journal of Family Violence
  %N 6
  %P 405--420
  %R 10.1007/s10896-018-9971-6
  %T Opinions and Experiences of Primary Healthcare Providers Regarding Violence against Women: a Systematic Review of Qualitative Studies
  %U https://doi.org/10.1007/s10896-018-9971-6
  %V 33
  %X The aim of this systematic review of qualitative studies is to explore the opinions and experiences of primary care providers regarding violence against women. Structured searches were conducted in nine bibliographic databases (March 2016). Study identification, critical appraisal (using the CASP tool), and analyses (thematic synthesis) were conducted. 46 qualitative studies were selected. Three main themes were identified: 1) Defining violence against women and its causes; 2) Awareness of violence against women and disclosure, with subthemes: 2.1.) Barriers experienced by primary care providers; 2.2) Facilitators for providing appropriate help; 3) Actions taken by providers to help women. Violence against women was generally considered as an unacceptable act with important health consequences. Barriers to address violence against women included organizational factors, providers' subjective feelings and perceived role, and providers' perceptions about women facing violence against women. Facilitators included a trusting relationship with women, attentive non-judgmental listening, participate in the community, team-work and continuing education. Providing emotional support and offering information about resources were the main actions taken by primary care providers. Women-centred care, respecting women's decision making processes and a biopsychosocial approach may provide direction to more compassionate and supportive care while strengthening primary healthcare response.
  

• 
  1.

  Ruiz-Pérez I, Rodríguez-Barranco M, Cervilla JA, Ricci-Cabello I. Intimate partner violence and mental disorders: Co-occurrence and gender differences in a large cross-sectional population based study in Spain. Journal of Affective Disorders [Internet]. 2018;229:69-78. https://www.sciencedirect.com/science/article/pii/S0165032717319390

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Background Intimate partner violence (IPV) and mental disorders (MD) are important public health problems disproportionally affecting women. We aimed to study the epidemiology of IPV victimization, MD, and co-occurring IPV-MD in Spanish men and women in terms of i) prevalence, ii) association between IPV and MD, and iii) sociodemographic and clinical characteristics associated with IPV, MD, and co-occurring IPV-MD. Methods Community-based cross-sectional study with 4507 randomly selected participants. Measurement instruments (Mini International Neuropsychiatric Interview and set of validated questions about IPV during the last 12 months) were administered by trained interviewers in participants’ households. Statistical analyses included multivariate logistic regression models. Results The prevalence of IPV was 9.4%, of MD 22.3%, and of co-occurring MD-IPV 4.4%. MD was associated with higher odds of experiencing IPV (OR = 3.6; p < 0.05). Lack of social support, neuroticism, impulsivity, and family history of MD were associated with higher odds of IPV, MD, and co-occurring IPV-MD in men and women. Poor health status was associated with MD and with co-occurring IPV-MD in men and women. In women, not being married was associated with MD and with co-occurring IPV-MD; having a non-Spanish nationality was associated with IPV and co-occurring IPV-MD; and older age with IPV. In men, younger age was associated with MD. Limitations The cross-sectional nature of this study limited our ability to examine causal inferences. Conclusions MD and IPV are strongly associated. Although less frequently than in women, IPV in men is also associated with depression, post-traumatic and mood disorders, which has relevant implications for healthcare delivery.

  @article{RUIZPEREZ201869,
  abstract = {Background Intimate partner violence (IPV) and mental disorders (MD) are important public health problems disproportionally affecting women. We aimed to study the epidemiology of IPV victimization, MD, and co-occurring IPV-MD in Spanish men and women in terms of i) prevalence, ii) association between IPV and MD, and iii) sociodemographic and clinical characteristics associated with IPV, MD, and co-occurring IPV-MD. Methods Community-based cross-sectional study with 4507 randomly selected participants. Measurement instruments (Mini International Neuropsychiatric Interview and set of validated questions about IPV during the last 12 months) were administered by trained interviewers in participants’ households. Statistical analyses included multivariate logistic regression models. Results The prevalence of IPV was 9.4%, of MD 22.3%, and of co-occurring MD-IPV 4.4%. MD was associated with higher odds of experiencing IPV (OR = 3.6; p < 0.05). Lack of social support, neuroticism, impulsivity, and family history of MD were associated with higher odds of IPV, MD, and co-occurring IPV-MD in men and women. Poor health status was associated with MD and with co-occurring IPV-MD in men and women. In women, not being married was associated with MD and with co-occurring IPV-MD; having a non-Spanish nationality was associated with IPV and co-occurring IPV-MD; and older age with IPV. In men, younger age was associated with MD. Limitations The cross-sectional nature of this study limited our ability to examine causal inferences. Conclusions MD and IPV are strongly associated. Although less frequently than in women, IPV in men is also associated with depression, post-traumatic and mood disorders, which has relevant implications for healthcare delivery.},
  author = {Ruiz-Pérez, Isabel and Rodríguez-Barranco, Miguel and Cervilla, Jorge A. and Ricci-Cabello, Ignacio},
  journal = {Journal of Affective Disorders},
  keywords = {grapp-caib myown},
  pages = {69-78},
  title = {Intimate partner violence and mental disorders: Co-occurrence and gender differences in a large cross-sectional population based study in Spain},
  volume = 229,
  year = 2018
  }
  

  %0 Journal Article
  %1 RUIZPEREZ201869
  %A Ruiz-Pérez, Isabel
  %A Rodríguez-Barranco, Miguel
  %A Cervilla, Jorge A.
  %A Ricci-Cabello, Ignacio
  %D 2018
  %J Journal of Affective Disorders
  %P 69-78
  %R https://doi.org/10.1016/j.jad.2017.12.032
  %T Intimate partner violence and mental disorders: Co-occurrence and gender differences in a large cross-sectional population based study in Spain
  %U https://www.sciencedirect.com/science/article/pii/S0165032717319390
  %V 229
  %X Background Intimate partner violence (IPV) and mental disorders (MD) are important public health problems disproportionally affecting women. We aimed to study the epidemiology of IPV victimization, MD, and co-occurring IPV-MD in Spanish men and women in terms of i) prevalence, ii) association between IPV and MD, and iii) sociodemographic and clinical characteristics associated with IPV, MD, and co-occurring IPV-MD. Methods Community-based cross-sectional study with 4507 randomly selected participants. Measurement instruments (Mini International Neuropsychiatric Interview and set of validated questions about IPV during the last 12 months) were administered by trained interviewers in participants’ households. Statistical analyses included multivariate logistic regression models. Results The prevalence of IPV was 9.4%, of MD 22.3%, and of co-occurring MD-IPV 4.4%. MD was associated with higher odds of experiencing IPV (OR = 3.6; p < 0.05). Lack of social support, neuroticism, impulsivity, and family history of MD were associated with higher odds of IPV, MD, and co-occurring IPV-MD in men and women. Poor health status was associated with MD and with co-occurring IPV-MD in men and women. In women, not being married was associated with MD and with co-occurring IPV-MD; having a non-Spanish nationality was associated with IPV and co-occurring IPV-MD; and older age with IPV. In men, younger age was associated with MD. Limitations The cross-sectional nature of this study limited our ability to examine causal inferences. Conclusions MD and IPV are strongly associated. Although less frequently than in women, IPV in men is also associated with depression, post-traumatic and mood disorders, which has relevant implications for healthcare delivery.
  

• 
  1.

  Ricci-Cabello I, Stevens S, Dalton ARH, Griffiths RI, Campbell JL, Valderas JM. Identifying Primary Care Pathways from Quality of Care to Outcomes and Satisfaction Using Structural Equation Modeling. Health Serv Res. 2018;53(1):430-49.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction. The relationships between the subdomains were hypothesized in a conceptual model and subsequently tested using structural equation modeling. PRINCIPAL FINDINGS: The model supported two independent paths. In the first path, "access" was associated with "patient-centered care" (β = 0.63), which in turn was strongly associated with "patient satisfaction" (β = 0.88). In the second path, "education and training" was associated with "clinical management" (β = 0.32), which in turn was associated with "intermediate outcomes" (β = 0.69). "Patient-reported health status" was weakly associated with "patient-centered care" (β = -0.05) and "patient satisfaction" (β = 0.09), and not associated with "clinical management" or "intermediate outcomes." CONCLUSIONS: This is the first empirical model to simultaneously provide evidence on the independence of intermediate health care outcomes, patient satisfaction, and health status. The explanatory paths via technical quality clinical management and patient centeredness offer specific opportunities for the development of quality improvement initiatives.

  @article{RN104,
  abstract = {OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction. The relationships between the subdomains were hypothesized in a conceptual model and subsequently tested using structural equation modeling. PRINCIPAL FINDINGS: The model supported two independent paths. In the first path, "access" was associated with "patient-centered care" (β = 0.63), which in turn was strongly associated with "patient satisfaction" (β = 0.88). In the second path, "education and training" was associated with "clinical management" (β = 0.32), which in turn was associated with "intermediate outcomes" (β = 0.69). "Patient-reported health status" was weakly associated with "patient-centered care" (β = -0.05) and "patient satisfaction" (β = 0.09), and not associated with "clinical management" or "intermediate outcomes." CONCLUSIONS: This is the first empirical model to simultaneously provide evidence on the independence of intermediate health care outcomes, patient satisfaction, and health status. The explanatory paths via technical quality clinical management and patient centeredness offer specific opportunities for the development of quality improvement initiatives.},
  author = {Ricci-Cabello, I. and Stevens, S. and Dalton, A. R. H. and Griffiths, R. I. and Campbell, J. L. and Valderas, J. M.},
  journal = {Health Serv Res},
  keywords = {grapp-caib myown},
  number = 1,
  pages = {430-449},
  title = {Identifying Primary Care Pathways from Quality of Care to Outcomes and Satisfaction Using Structural Equation Modeling},
  type = {Journal Article},
  volume = 53,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN104
  %A Ricci-Cabello, I.
  %A Stevens, S.
  %A Dalton, A. R. H.
  %A Griffiths, R. I.
  %A Campbell, J. L.
  %A Valderas, J. M.
  %D 2018
  %J Health Serv Res
  %N 1
  %P 430-449
  %R 10.1111/1475-6773.12666
  %T Identifying Primary Care Pathways from Quality of Care to Outcomes and Satisfaction Using Structural Equation Modeling
  %V 53
  %X OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction. The relationships between the subdomains were hypothesized in a conceptual model and subsequently tested using structural equation modeling. PRINCIPAL FINDINGS: The model supported two independent paths. In the first path, "access" was associated with "patient-centered care" (β = 0.63), which in turn was strongly associated with "patient satisfaction" (β = 0.88). In the second path, "education and training" was associated with "clinical management" (β = 0.32), which in turn was associated with "intermediate outcomes" (β = 0.69). "Patient-reported health status" was weakly associated with "patient-centered care" (β = -0.05) and "patient satisfaction" (β = 0.09), and not associated with "clinical management" or "intermediate outcomes." CONCLUSIONS: This is the first empirical model to simultaneously provide evidence on the independence of intermediate health care outcomes, patient satisfaction, and health status. The explanatory paths via technical quality clinical management and patient centeredness offer specific opportunities for the development of quality improvement initiatives.
  

• 
  1.

  Recio-Rodriguez JI, Gómez-Marcos MA, Agudo-Conde C, Ramirez I, Gonzalez-Viejo N, Gomez-Arranz A, Salcedo-Aguilar F, Rodriguez-Sanchez E, Alonso-Domínguez R, Sánchez-Aguadero N, Gonzalez-Sanchez J, Garcia-Ortiz L. EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol. Medicine (Baltimore). 2018;97(2):e9633.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40 kg/m), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. ETHICS AND DISSEMINATION: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614.

  @article{RN125,
  abstract = {INTRODUCTION: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40 kg/m), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. ETHICS AND DISSEMINATION: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614.},
  author = {Recio-Rodriguez, J. I. and Gómez-Marcos, M. A. and Agudo-Conde, C. and Ramirez, I. and Gonzalez-Viejo, N. and Gomez-Arranz, A. and Salcedo-Aguilar, F. and Rodriguez-Sanchez, E. and Alonso-Domínguez, R. and Sánchez-Aguadero, N. and Gonzalez-Sanchez, J. and Garcia-Ortiz, L.},
  journal = {Medicine (Baltimore)},
  keywords = {grapp-caib},
  number = 2,
  pages = {e9633},
  title = {EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol},
  type = {Journal Article},
  volume = 97,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN125
  %A Recio-Rodriguez, J. I.
  %A Gómez-Marcos, M. A.
  %A Agudo-Conde, C.
  %A Ramirez, I.
  %A Gonzalez-Viejo, N.
  %A Gomez-Arranz, A.
  %A Salcedo-Aguilar, F.
  %A Rodriguez-Sanchez, E.
  %A Alonso-Domínguez, R.
  %A Sánchez-Aguadero, N.
  %A Gonzalez-Sanchez, J.
  %A Garcia-Ortiz, L.
  %D 2018
  %J Medicine (Baltimore)
  %N 2
  %P e9633
  %R 10.1097/md.0000000000009633
  %T EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol
  %V 97
  %X INTRODUCTION: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40 kg/m), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. ETHICS AND DISSEMINATION: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614.
  

• 
  1.

  Pastor-Moreno G, Ruiz-Pérez I, Ricci-Cabello I. Historia de Violencia y Violencia de Compañero íntimo en mujeres embarazadas. Resultados en salud. Index de Enfermería [Internet]. 2018;27(4):191-5. https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1132-12962018000300003

  AbstractURLBibTeXEndNoteBibSonomyDownload

  Objetivos: examinar la frecuencia de Historia de Violencia (HV) en mujeres embarazadas; estudiar las características sociodemográficas asociadas e identificar los resultados en salud. Metodología: estudio transversal (Andalucía, España) con 754 mujeres embarazadas con cuestionario autoadministrado, incluyendo variables sociodemográficas, estado de salud y violencia. Se calculó la prevalencia de HV y modelos de regresión logística multivariable. Resultados: el 9% refirió HV, el 4,8% Violencia de Compañero íntimo actual y el 1,9% durante su embarazo. La HV se asoció significativamente con mala percepción del estado de salud (ORa 2,54; IC95%: 1,46-4,43), morbilidad psíquica (ORa 2,82; IC95%:1,56-5,07) y uso de medicación en el embarazo (ORa 2,36 IC95%: 1,14-4,87). Conclusión principal: la HV tiene un impacto en los resultados de salud de las gestantes. Dada la alta tasa de cobertura sanitaria durante el embarazo, este se convierte en un momento idóneo para poner en marcha las recomendaciones de los protocolos.

  @article{pastormoreno2018historia,
  abstract = {Objetivos: examinar la frecuencia de Historia de Violencia (HV) en mujeres embarazadas; estudiar las características sociodemográficas asociadas e identificar los resultados en salud. Metodología: estudio transversal (Andalucía, España) con 754 mujeres embarazadas con cuestionario autoadministrado, incluyendo variables sociodemográficas, estado de salud y violencia. Se calculó la prevalencia de HV y modelos de regresión logística multivariable. Resultados: el 9% refirió HV, el 4,8% Violencia de Compañero íntimo actual y el 1,9% durante su embarazo. La HV se asoció significativamente con mala percepción del estado de salud (ORa 2,54; IC95%: 1,46-4,43), morbilidad psíquica (ORa 2,82; IC95%:1,56-5,07) y uso de medicación en el embarazo (ORa 2,36 IC95%: 1,14-4,87). Conclusión principal: la HV tiene un impacto en los resultados de salud de las gestantes. Dada la alta tasa de cobertura sanitaria durante el embarazo, este se convierte en un momento idóneo para poner en marcha las recomendaciones de los protocolos.},
  author = {Pastor-Moreno, Guadalupe and Ruiz-Pérez, Isabel and Ricci-Cabello, Ignacio},
  journal = {Index de Enfermería},
  keywords = {grapp-caib myown},
  number = 4,
  pages = {191-195},
  title = {Historia de Violencia y Violencia de Compañero íntimo en mujeres embarazadas. Resultados en salud},
  type = {misc},
  volume = 27,
  year = 2018
  }
  

  %0 Journal Article
  %1 pastormoreno2018historia
  %A Pastor-Moreno, Guadalupe
  %A Ruiz-Pérez, Isabel
  %A Ricci-Cabello, Ignacio
  %D 2018
  %J Index de Enfermería
  %N 4
  %P 191-195
  %T Historia de Violencia y Violencia de Compañero íntimo en mujeres embarazadas. Resultados en salud
  %U https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1132-12962018000300003
  %V 27
  %X Objetivos: examinar la frecuencia de Historia de Violencia (HV) en mujeres embarazadas; estudiar las características sociodemográficas asociadas e identificar los resultados en salud. Metodología: estudio transversal (Andalucía, España) con 754 mujeres embarazadas con cuestionario autoadministrado, incluyendo variables sociodemográficas, estado de salud y violencia. Se calculó la prevalencia de HV y modelos de regresión logística multivariable. Resultados: el 9% refirió HV, el 4,8% Violencia de Compañero íntimo actual y el 1,9% durante su embarazo. La HV se asoció significativamente con mala percepción del estado de salud (ORa 2,54; IC95%: 1,46-4,43), morbilidad psíquica (ORa 2,82; IC95%:1,56-5,07) y uso de medicación en el embarazo (ORa 2,36 IC95%: 1,14-4,87). Conclusión principal: la HV tiene un impacto en los resultados de salud de las gestantes. Dada la alta tasa de cobertura sanitaria durante el embarazo, este se convierte en un momento idóneo para poner en marcha las recomendaciones de los protocolos.
  

• 
  1.

  Mart’in-Rioboó E, de Torres LAP, Banegas JR, Lobos-Bejarano JM, Cuixart CB, Criado EIG, Martin-Carrillo P, Muro MM-R, Cabello MIE, Galán AM. Knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain. Journal of Hypertension [Internet]. Ovid Technologies (Wolters Kluwer Health); 2018 May;36(5):1051-8. https://doi.org/10.1097%2Fhjh.0000000000001673

  AbstractURLBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS: Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.

  @article{Mart_n_Riobo__2018,
  abstract = {OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS: Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.},
  author = {Mart'in-Rioboó, Enrique and de Torres, Luis A. Pérula and Banegas, José R. and Lobos-Bejarano, José M. and Cuixart, Carlos Brotons and Criado, Emilio I. Garc'ia and Martin-Carrillo, Pilar and Muro, Mar'ia Mart'in-Rabadán and Cabello, M. Isabel Egocheaga and Galán, Antoni Maiques},
  journal = {Journal of Hypertension},
  keywords = {grapp-caib},
  month = {may},
  number = 5,
  pages = {1051--1058},
  publisher = {Ovid Technologies (Wolters Kluwer Health)},
  title = {Knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain},
  volume = 36,
  year = 2018
  }
  

  %0 Journal Article
  %1 Mart_n_Riobo__2018
  %A Mart'in-Rioboó, Enrique
  %A de Torres, Luis A. Pérula
  %A Banegas, José R.
  %A Lobos-Bejarano, José M.
  %A Cuixart, Carlos Brotons
  %A Criado, Emilio I. Garc'ia
  %A Martin-Carrillo, Pilar
  %A Muro, Mar'ia Mart'in-Rabadán
  %A Cabello, M. Isabel Egocheaga
  %A Galán, Antoni Maiques
  %D 2018
  %I Ovid Technologies (Wolters Kluwer Health)
  %J Journal of Hypertension
  %N 5
  %P 1051--1058
  %R 10.1097/hjh.0000000000001673
  %T Knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain
  %U https://doi.org/10.1097%2Fhjh.0000000000001673
  %V 36
  %X OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS: Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.
  

• 
  1.

  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. Preventive Medicine [Internet]. 2018;114:88-94. https://www.sciencedirect.com/science/article/pii/S0091743518301993

  AbstractURLBibTeXEndNoteDOIBibSonomy

  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.

  @article{LEIVA201888,
  abstract = {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.},
  author = {Leiva, Alfonso and Estela, Andreu and Bennasar-Veny, Miquel and Aguiló, Antoni and Llobera, Joan and Yáñez, Aina M.},
  journal = {Preventive Medicine},
  keywords = {grapp-caib},
  pages = {88-94},
  title = {Effectiveness of a complex intervention on smoking in adolescents: A cluster-randomized controlled trial},
  volume = 114,
  year = 2018
  }
  

  %0 Journal Article
  %1 LEIVA201888
  %A Leiva, Alfonso
  %A Estela, Andreu
  %A Bennasar-Veny, Miquel
  %A Aguiló, Antoni
  %A Llobera, Joan
  %A Yáñez, Aina M.
  %D 2018
  %J Preventive Medicine
  %P 88-94
  %R https://doi.org/10.1016/j.ypmed.2018.06.009
  %T Effectiveness of a complex intervention on smoking in adolescents: A cluster-randomized controlled trial
  %U https://www.sciencedirect.com/science/article/pii/S0091743518301993
  %V 114
  %X 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.
  

• 
  1.

  Harris M, Vedsted P, Esteva M, Murchie P, Aubin-Auger I, Azuri J, Brekke M, Buczkowski K, Buono N, Costiug E, Dinant G-J, Foreva G, Gav sparovi’c Babi’c S, Hoffman R, Jakob E, Koskela TH, Marzo-Castillejo M, Neves AL, Petek D, Petek Ster M, Sawicka-Powierza J, Schneider A, Smyrnakis E, Streit S, Thulesius H, Weltermann B, Taylor G. Identifying important health system factors that influence primary care practitionerstextquoteright referrals for cancer suspicion: a European cross-sectional survey. BMJ Open [Internet]. British Medical Journal Publishing Group; 2018;8(9). https://bmjopen.bmj.com/content/8/9/e022904

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objectives Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitionerstextquoteright (PCPs\textquoteright) referral decisions is lacking.This study analyses health system factors potentially influencing PCPstextquoteright referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.Design Based on a content-validity consensus, a list of 45 items relating to a PCPtextquoterights decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPstextquoteright referral decision-making.Setting A primary care study; 25 participating centres in 20 European countries.Participants 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measures The factors derived from items related to PCPstextquoteright referral decision-making. Mean factor scores were produced for each country, allowing comparisons.Results Factor analysis identified five underlying factors: PCPstextquoteright ability to refer; degree of direct patient access to secondary care; PCPstextquoteright perceptions of being under pressure; expectations of PCPstextquoteright role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.Conclusions Five healthcare system factors influencing PCPstextquoteright referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

  @article{Harrise022904,
  abstract = {Objectives Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitionerstextquoteright (PCPs\textquoteright) referral decisions is lacking.This study analyses health system factors potentially influencing PCPstextquoteright referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.Design Based on a content-validity consensus, a list of 45 items relating to a PCPtextquoterights decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPstextquoteright referral decision-making.Setting A primary care study; 25 participating centres in 20 European countries.Participants 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measures The factors derived from items related to PCPstextquoteright referral decision-making. Mean factor scores were produced for each country, allowing comparisons.Results Factor analysis identified five underlying factors: PCPstextquoteright ability to refer; degree of direct patient access to secondary care; PCPstextquoteright perceptions of being under pressure; expectations of PCPstextquoteright role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.Conclusions Five healthcare system factors influencing PCPstextquoteright referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.},
  author = {Harris, Michael and Vedsted, Peter and Esteva, Magdalena and Murchie, Peter and Aubin-Auger, Isabelle and Azuri, Joseph and Brekke, Mette and Buczkowski, Krzysztof and Buono, Nicola and Costiug, Emiliana and Dinant, Geert-Jan and Foreva, Gergana and Gav sparovi'c Babi'c, Svjetlana and Hoffman, Robert and Jakob, Eva and Koskela, Tuomas H and Marzo-Castillejo, Mercè and Neves, Ana Lu'isa and Petek, Davorina and Petek Ster, Marija and Sawicka-Powierza, Jolanta and Schneider, Antonius and Smyrnakis, Emmanouil and Streit, Sven and Thulesius, Hans and Weltermann, Birgitta and Taylor, Gordon},
  journal = {BMJ Open},
  keywords = {grapp-caib},
  number = 9,
  publisher = {British Medical Journal Publishing Group},
  title = {Identifying important health system factors that influence primary care practitionerstextquoteright referrals for cancer suspicion: a European cross-sectional survey},
  volume = 8,
  year = 2018
  }
  

  %0 Journal Article
  %1 Harrise022904
  %A Harris, Michael
  %A Vedsted, Peter
  %A Esteva, Magdalena
  %A Murchie, Peter
  %A Aubin-Auger, Isabelle
  %A Azuri, Joseph
  %A Brekke, Mette
  %A Buczkowski, Krzysztof
  %A Buono, Nicola
  %A Costiug, Emiliana
  %A Dinant, Geert-Jan
  %A Foreva, Gergana
  %A Gav sparovi'c Babi'c, Svjetlana
  %A Hoffman, Robert
  %A Jakob, Eva
  %A Koskela, Tuomas H
  %A Marzo-Castillejo, Mercè
  %A Neves, Ana Lu'isa
  %A Petek, Davorina
  %A Petek Ster, Marija
  %A Sawicka-Powierza, Jolanta
  %A Schneider, Antonius
  %A Smyrnakis, Emmanouil
  %A Streit, Sven
  %A Thulesius, Hans
  %A Weltermann, Birgitta
  %A Taylor, Gordon
  %D 2018
  %I British Medical Journal Publishing Group
  %J BMJ Open
  %N 9
  %R 10.1136/bmjopen-2018-022904
  %T Identifying important health system factors that influence primary care practitionerstextquoteright referrals for cancer suspicion: a European cross-sectional survey
  %U https://bmjopen.bmj.com/content/8/9/e022904
  %V 8
  %X Objectives Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitionerstextquoteright (PCPs\textquoteright) referral decisions is lacking.This study analyses health system factors potentially influencing PCPstextquoteright referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.Design Based on a content-validity consensus, a list of 45 items relating to a PCPtextquoterights decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPstextquoteright referral decision-making.Setting A primary care study; 25 participating centres in 20 European countries.Participants 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measures The factors derived from items related to PCPstextquoteright referral decision-making. Mean factor scores were produced for each country, allowing comparisons.Results Factor analysis identified five underlying factors: PCPstextquoteright ability to refer; degree of direct patient access to secondary care; PCPstextquoteright perceptions of being under pressure; expectations of PCPstextquoteright role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.Conclusions Five healthcare system factors influencing PCPstextquoteright referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.
  

• 
  1.

  Santos S, Eekhout I, Voerman E, Gaillard R, Barros H, Charles MA, Chatzi L, Chevrier C, Chrousos GP, Corpeleijn E, Costet N, Crozier S, Doyon M, Eggesbø M, Fantini MP, Farchi S, Forastiere F, Gagliardi L, Georgiu V, Godfrey KM, Gori D, Grote V, Hanke W, Hertz-Picciotto I, Heude B, Hivert MF, Hryhorczuk D, Huang RC, Inskip H, Jusko TA, Karvonen AM, Koletzko B, Küpers LK, Lagström H, Lawlor DA, Lehmann I, Lopez-Espinosa MJ, Magnus P, Majewska R, Mäkelä J, Manios Y, McDonald SW, Mommers M, Morgen CS, Moschonis G, Murínová Ľ, Newnham J, Nohr EA, Andersen AN, Oken E, Oostvogels A, Pac A, Papadopoulou E, Pekkanen J, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas-Shiman SL, Roeleveld N, Santa-Marina L, Santos AC, Smit HA, Sørensen TIA, Standl M, Stanislawski M, Stoltenberg C, Thiering E, Thijs C, Torrent M, Tough SC, Trnovec T, van Gelder M, van Rossem L, von Berg A, Vrijheid M, Vrijkotte TGM, Zvinchuk O, van Buuren S, Jaddoe VWV. Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania. BMC Med. 2018;16(1):201.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

  @article{RN102,
  abstract = {BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.},
  author = {Santos, S. and Eekhout, I. and Voerman, E. and Gaillard, R. and Barros, H. and Charles, M. A. and Chatzi, L. and Chevrier, C. and Chrousos, G. P. and Corpeleijn, E. and Costet, N. and Crozier, S. and Doyon, M. and Eggesbø, M. and Fantini, M. P. and Farchi, S. and Forastiere, F. and Gagliardi, L. and Georgiu, V. and Godfrey, K. M. and Gori, D. and Grote, V. and Hanke, W. and Hertz-Picciotto, I. and Heude, B. and Hivert, M. F. and Hryhorczuk, D. and Huang, R. C. and Inskip, H. and Jusko, T. A. and Karvonen, A. M. and Koletzko, B. and Küpers, L. K. and Lagström, H. and Lawlor, D. A. and Lehmann, I. and Lopez-Espinosa, M. J. and Magnus, P. and Majewska, R. and Mäkelä, J. and Manios, Y. and McDonald, S. W. and Mommers, M. and Morgen, C. S. and Moschonis, G. and Murínová, Ľ and Newnham, J. and Nohr, E. A. and Andersen, A. N. and Oken, E. and Oostvogels, Ajjm and Pac, A. and Papadopoulou, E. and Pekkanen, J. and Pizzi, C. and Polanska, K. and Porta, D. and Richiardi, L. and Rifas-Shiman, S. L. and Roeleveld, N. and Santa-Marina, L. and Santos, A. C. and Smit, H. A. and Sørensen, T. I. A. and Standl, M. and Stanislawski, M. and Stoltenberg, C. and Thiering, E. and Thijs, C. and Torrent, M. and Tough, S. C. and Trnovec, T. and van Gelder, Mmhj and van Rossem, L. and von Berg, A. and Vrijheid, M. and Vrijkotte, T. G. M. and Zvinchuk, O. and van Buuren, S. and Jaddoe, V. W. V.},
  journal = {BMC Med},
  keywords = {grapp-caib},
  number = 1,
  pages = 201,
  title = {Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania},
  type = {Journal Article},
  volume = 16,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN102
  %A Santos, S.
  %A Eekhout, I.
  %A Voerman, E.
  %A Gaillard, R.
  %A Barros, H.
  %A Charles, M. A.
  %A Chatzi, L.
  %A Chevrier, C.
  %A Chrousos, G. P.
  %A Corpeleijn, E.
  %A Costet, N.
  %A Crozier, S.
  %A Doyon, M.
  %A Eggesbø, M.
  %A Fantini, M. P.
  %A Farchi, S.
  %A Forastiere, F.
  %A Gagliardi, L.
  %A Georgiu, V.
  %A Godfrey, K. M.
  %A Gori, D.
  %A Grote, V.
  %A Hanke, W.
  %A Hertz-Picciotto, I.
  %A Heude, B.
  %A Hivert, M. F.
  %A Hryhorczuk, D.
  %A Huang, R. C.
  %A Inskip, H.
  %A Jusko, T. A.
  %A Karvonen, A. M.
  %A Koletzko, B.
  %A Küpers, L. K.
  %A Lagström, H.
  %A Lawlor, D. A.
  %A Lehmann, I.
  %A Lopez-Espinosa, M. J.
  %A Magnus, P.
  %A Majewska, R.
  %A Mäkelä, J.
  %A Manios, Y.
  %A McDonald, S. W.
  %A Mommers, M.
  %A Morgen, C. S.
  %A Moschonis, G.
  %A Murínová, Ľ
  %A Newnham, J.
  %A Nohr, E. A.
  %A Andersen, A. N.
  %A Oken, E.
  %A Oostvogels, Ajjm
  %A Pac, A.
  %A Papadopoulou, E.
  %A Pekkanen, J.
  %A Pizzi, C.
  %A Polanska, K.
  %A Porta, D.
  %A Richiardi, L.
  %A Rifas-Shiman, S. L.
  %A Roeleveld, N.
  %A Santa-Marina, L.
  %A Santos, A. C.
  %A Smit, H. A.
  %A Sørensen, T. I. A.
  %A Standl, M.
  %A Stanislawski, M.
  %A Stoltenberg, C.
  %A Thiering, E.
  %A Thijs, C.
  %A Torrent, M.
  %A Tough, S. C.
  %A Trnovec, T.
  %A van Gelder, Mmhj
  %A van Rossem, L.
  %A von Berg, A.
  %A Vrijheid, M.
  %A Vrijkotte, T. G. M.
  %A Zvinchuk, O.
  %A van Buuren, S.
  %A Jaddoe, V. W. V.
  %D 2018
  %J BMC Med
  %N 1
  %P 201
  %R 10.1186/s12916-018-1189-1
  %T Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania
  %V 16
  %X BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.
  

• 
  1.

  Crocker JC, Ricci-Cabello I, Parker A, Hirst JA, Chant A, Petit-Zeman S, Evans D, Rees S. Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis. BMJ [Internet]. BMJ Publishing Group Ltd; 2018;363. https://www.bmj.com/content/363/bmj.k4738

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective To investigate the impact of patient and public involvement (PPI) on rates of enrolment and retention in clinical trials and explore how this varies with the context and nature of PPI.Design Systematic review and meta-analysis.Data sources Ten electronic databases, including Medline, INVOLVE Evidence Library, and clinical trial registries.Eligibility criteria Experimental and observational studies quantitatively evaluating the impact of a PPI intervention, compared with no intervention or non-PPI intervention(s), on participant enrolment and/or retention rates in a clinical trial or trials. PPI interventions could include additional non-PPI components inseparable from the PPI (for example, other stakeholder involvement).Data extraction and analysis Two independent reviewers extracted data on enrolment and retention rates, as well as on the context and characteristics of PPI intervention, and assessed risk of bias. Random effects meta-analyses were used to determine the average effect of PPI interventions on enrolment and retention in clinical trials: main analysis including randomised studies only, secondary analysis adding non-randomised studies, and several exploratory subgroup and sensitivity analyses.Results 26 studies were included in the review; 19 were eligible for enrolment meta-analysis and five for retention meta-analysis. Various PPI interventions were identified with different degrees of involvement, different numbers and types of people involved, and input at different stages of the trial process. On average, PPI interventions modestly but significantly increased the odds of participant enrolment in the main analysis (odds ratio 1.16, 95\% confidence interval and prediction interval 1.01 to 1.34). Non-PPI components of interventions may have contributed to this effect. In exploratory subgroup analyses, the involvement of people with lived experience of the condition under study was significantly associated with improved enrolment (odds ratio 3.14 v 1.07; P=0.02). The findings for retention were inconclusive owing to the paucity of eligible studies (odds ratio 1.16, 95\% confidence interval 0.33 to 4.14), for main analysis).Conclusions These findings add weight to the case for PPI in clinical trials by indicating that it is likely to improve enrolment of participants, especially if it includes people with lived experience of the health condition under study. Further research is needed to assess which types of PPI work best in particular contexts, the cost effectiveness of PPI, the impact of PPI at earlier stages of trial design, and the impact of PPI interventions specifically targeting retention.Systematic review registration PROSPERO CRD42016043808.

  @article{Crockerk4738,
  abstract = {Objective To investigate the impact of patient and public involvement (PPI) on rates of enrolment and retention in clinical trials and explore how this varies with the context and nature of PPI.Design Systematic review and meta-analysis.Data sources Ten electronic databases, including Medline, INVOLVE Evidence Library, and clinical trial registries.Eligibility criteria Experimental and observational studies quantitatively evaluating the impact of a PPI intervention, compared with no intervention or non-PPI intervention(s), on participant enrolment and/or retention rates in a clinical trial or trials. PPI interventions could include additional non-PPI components inseparable from the PPI (for example, other stakeholder involvement).Data extraction and analysis Two independent reviewers extracted data on enrolment and retention rates, as well as on the context and characteristics of PPI intervention, and assessed risk of bias. Random effects meta-analyses were used to determine the average effect of PPI interventions on enrolment and retention in clinical trials: main analysis including randomised studies only, secondary analysis adding non-randomised studies, and several exploratory subgroup and sensitivity analyses.Results 26 studies were included in the review; 19 were eligible for enrolment meta-analysis and five for retention meta-analysis. Various PPI interventions were identified with different degrees of involvement, different numbers and types of people involved, and input at different stages of the trial process. On average, PPI interventions modestly but significantly increased the odds of participant enrolment in the main analysis (odds ratio 1.16, 95\% confidence interval and prediction interval 1.01 to 1.34). Non-PPI components of interventions may have contributed to this effect. In exploratory subgroup analyses, the involvement of people with lived experience of the condition under study was significantly associated with improved enrolment (odds ratio 3.14 v 1.07; P=0.02). The findings for retention were inconclusive owing to the paucity of eligible studies (odds ratio 1.16, 95\% confidence interval 0.33 to 4.14), for main analysis).Conclusions These findings add weight to the case for PPI in clinical trials by indicating that it is likely to improve enrolment of participants, especially if it includes people with lived experience of the health condition under study. Further research is needed to assess which types of PPI work best in particular contexts, the cost effectiveness of PPI, the impact of PPI at earlier stages of trial design, and the impact of PPI interventions specifically targeting retention.Systematic review registration PROSPERO CRD42016043808.},
  author = {Crocker, Joanna C and Ricci-Cabello, Ignacio and Parker, Adwoa and Hirst, Jennifer A and Chant, Alan and Petit-Zeman, Sophie and Evans, David and Rees, Sian},
  journal = {BMJ},
  keywords = {grapp-caib myown},
  publisher = {BMJ Publishing Group Ltd},
  title = {Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis},
  volume = 363,
  year = 2018
  }
  

  %0 Journal Article
  %1 Crockerk4738
  %A Crocker, Joanna C
  %A Ricci-Cabello, Ignacio
  %A Parker, Adwoa
  %A Hirst, Jennifer A
  %A Chant, Alan
  %A Petit-Zeman, Sophie
  %A Evans, David
  %A Rees, Sian
  %D 2018
  %I BMJ Publishing Group Ltd
  %J BMJ
  %R 10.1136/bmj.k4738
  %T Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis
  %U https://www.bmj.com/content/363/bmj.k4738
  %V 363
  %X Objective To investigate the impact of patient and public involvement (PPI) on rates of enrolment and retention in clinical trials and explore how this varies with the context and nature of PPI.Design Systematic review and meta-analysis.Data sources Ten electronic databases, including Medline, INVOLVE Evidence Library, and clinical trial registries.Eligibility criteria Experimental and observational studies quantitatively evaluating the impact of a PPI intervention, compared with no intervention or non-PPI intervention(s), on participant enrolment and/or retention rates in a clinical trial or trials. PPI interventions could include additional non-PPI components inseparable from the PPI (for example, other stakeholder involvement).Data extraction and analysis Two independent reviewers extracted data on enrolment and retention rates, as well as on the context and characteristics of PPI intervention, and assessed risk of bias. Random effects meta-analyses were used to determine the average effect of PPI interventions on enrolment and retention in clinical trials: main analysis including randomised studies only, secondary analysis adding non-randomised studies, and several exploratory subgroup and sensitivity analyses.Results 26 studies were included in the review; 19 were eligible for enrolment meta-analysis and five for retention meta-analysis. Various PPI interventions were identified with different degrees of involvement, different numbers and types of people involved, and input at different stages of the trial process. On average, PPI interventions modestly but significantly increased the odds of participant enrolment in the main analysis (odds ratio 1.16, 95\% confidence interval and prediction interval 1.01 to 1.34). Non-PPI components of interventions may have contributed to this effect. In exploratory subgroup analyses, the involvement of people with lived experience of the condition under study was significantly associated with improved enrolment (odds ratio 3.14 v 1.07; P=0.02). The findings for retention were inconclusive owing to the paucity of eligible studies (odds ratio 1.16, 95\% confidence interval 0.33 to 4.14), for main analysis).Conclusions These findings add weight to the case for PPI in clinical trials by indicating that it is likely to improve enrolment of participants, especially if it includes people with lived experience of the health condition under study. Further research is needed to assess which types of PPI work best in particular contexts, the cost effectiveness of PPI, the impact of PPI at earlier stages of trial design, and the impact of PPI interventions specifically targeting retention.Systematic review registration PROSPERO CRD42016043808.
  

• 
  1.

  Rando-Matos Y, Pons-Vigués M, Rodriguez-Blanco T, Ripoll J, Llobera J, Morán J, Ballvé-Moreno JL, Violán C, Bolíbar B. Effect of comprehensive smoke-free legislation on asthma and coronary disease trends in Spanish primary care patients. Eur J Public Health. 2018;28(3):553-9.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: To examine the impact of comprehensive smoke-free legislation (SFL) (Law 42/2010) on the incidence and prevalence of adult asthma and coronary disease in primary health care (PHC) patients from three Spanish regions, overall and stratified by sex. METHODS: Longitudinal observational study conducted between 2007 and 2013 in the population over 15 years of age assigned to 66 PHC teams in Catalonia, Navarre and the Balearic Islands. Crude rates and age-standardized (truncated: asthma ≥ 16 years and coronary disease ≥ 35 years) incidence and prevalence rates using the direct method based on the European Standard Population were estimated based on data from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardized incidence and prevalence rates. Trends were expressed as annual percentage change and average annual percent change (AAPC). RESULTS: The standardized asthma incidence rate showed a non-significant downward trend and the standardized prevalence rates rose significantly in the three regions. Standardized coronary disease incidence and prevalence rates were considerably higher for men than for women in all regions. The standardized coronary disease incidence rates in Catalonia (AAPC: -8.00%, 95% CI: -10.46; -5.47) and Navarre (AAPC: -3.66%, 95% CI: -4.95;-2.35) showed a significant downward trend from 2007 to 2013, overall and by sex. The standardized coronary disease prevalence trend rate increased significantly in the whole period in Catalonia and the Balearic Islands, although a non-significant downward trend was observed from 2010 in Catalonia. CONCLUSION: No changes in the trends of adult asthma and coronary disease in PHC Spanish patients were detected after the introduction of comprehensive SFL.

  @article{RN114,
  abstract = {BACKGROUND: To examine the impact of comprehensive smoke-free legislation (SFL) (Law 42/2010) on the incidence and prevalence of adult asthma and coronary disease in primary health care (PHC) patients from three Spanish regions, overall and stratified by sex. METHODS: Longitudinal observational study conducted between 2007 and 2013 in the population over 15 years of age assigned to 66 PHC teams in Catalonia, Navarre and the Balearic Islands. Crude rates and age-standardized (truncated: asthma ≥ 16 years and coronary disease ≥ 35 years) incidence and prevalence rates using the direct method based on the European Standard Population were estimated based on data from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardized incidence and prevalence rates. Trends were expressed as annual percentage change and average annual percent change (AAPC). RESULTS: The standardized asthma incidence rate showed a non-significant downward trend and the standardized prevalence rates rose significantly in the three regions. Standardized coronary disease incidence and prevalence rates were considerably higher for men than for women in all regions. The standardized coronary disease incidence rates in Catalonia (AAPC: -8.00%, 95% CI: -10.46; -5.47) and Navarre (AAPC: -3.66%, 95% CI: -4.95;-2.35) showed a significant downward trend from 2007 to 2013, overall and by sex. The standardized coronary disease prevalence trend rate increased significantly in the whole period in Catalonia and the Balearic Islands, although a non-significant downward trend was observed from 2010 in Catalonia. CONCLUSION: No changes in the trends of adult asthma and coronary disease in PHC Spanish patients were detected after the introduction of comprehensive SFL.},
  author = {Rando-Matos, Y. and Pons-Vigués, M. and Rodriguez-Blanco, T. and Ripoll, J. and Llobera, J. and Morán, J. and Ballvé-Moreno, J. L. and Violán, C. and Bolíbar, B.},
  journal = {Eur J Public Health},
  keywords = {grapp-caib},
  number = 3,
  pages = {553-559},
  title = {Effect of comprehensive smoke-free legislation on asthma and coronary disease trends in Spanish primary care patients},
  type = {Journal Article},
  volume = 28,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN114
  %A Rando-Matos, Y.
  %A Pons-Vigués, M.
  %A Rodriguez-Blanco, T.
  %A Ripoll, J.
  %A Llobera, J.
  %A Morán, J.
  %A Ballvé-Moreno, J. L.
  %A Violán, C.
  %A Bolíbar, B.
  %D 2018
  %J Eur J Public Health
  %N 3
  %P 553-559
  %R 10.1093/eurpub/cky010
  %T Effect of comprehensive smoke-free legislation on asthma and coronary disease trends in Spanish primary care patients
  %V 28
  %X BACKGROUND: To examine the impact of comprehensive smoke-free legislation (SFL) (Law 42/2010) on the incidence and prevalence of adult asthma and coronary disease in primary health care (PHC) patients from three Spanish regions, overall and stratified by sex. METHODS: Longitudinal observational study conducted between 2007 and 2013 in the population over 15 years of age assigned to 66 PHC teams in Catalonia, Navarre and the Balearic Islands. Crude rates and age-standardized (truncated: asthma ≥ 16 years and coronary disease ≥ 35 years) incidence and prevalence rates using the direct method based on the European Standard Population were estimated based on data from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardized incidence and prevalence rates. Trends were expressed as annual percentage change and average annual percent change (AAPC). RESULTS: The standardized asthma incidence rate showed a non-significant downward trend and the standardized prevalence rates rose significantly in the three regions. Standardized coronary disease incidence and prevalence rates were considerably higher for men than for women in all regions. The standardized coronary disease incidence rates in Catalonia (AAPC: -8.00%, 95% CI: -10.46; -5.47) and Navarre (AAPC: -3.66%, 95% CI: -4.95;-2.35) showed a significant downward trend from 2007 to 2013, overall and by sex. The standardized coronary disease prevalence trend rate increased significantly in the whole period in Catalonia and the Balearic Islands, although a non-significant downward trend was observed from 2010 in Catalonia. CONCLUSION: No changes in the trends of adult asthma and coronary disease in PHC Spanish patients were detected after the introduction of comprehensive SFL.
  

• 
  1.

  Córdoba García R, Camarelles Guillem F, Muñoz Seco E, Gómez Puente JM, José Arango JS, Ramírez Manent JI, Martín Cantera C, Campo Giménez M del, Revenga Frauca J. Recomendaciones sobre el estilo de vida. Actualizacón PAPPS 2018. Atención Primaria [Internet]. 2018;50:29-40. /brokenurl#/02126567/00000050000000S1/v1_201806020516/S0212656718303615/v1_201806020516/es/main.assetsER

  URLBibTeXEndNoteDOIBibSonomyDownload

  @article{RN90,
  author = {Córdoba García, Rodrigo and Camarelles Guillem, Francisco and Muñoz Seco, Elena and Gómez Puente, Juana M. and José Arango, Joaquín San and Ramírez Manent, José Ignacio and Martín Cantera, Carlos and Campo Giménez, M. del and Revenga Frauca, Juan},
  journal = {Atención Primaria},
  keywords = {grapp-caib},
  pages = {29-40},
  title = {Recomendaciones sobre el estilo de vida. Actualizacón PAPPS 2018},
  type = {Journal Article},
  volume = 50,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN90
  %A Córdoba García, Rodrigo
  %A Camarelles Guillem, Francisco
  %A Muñoz Seco, Elena
  %A Gómez Puente, Juana M.
  %A José Arango, Joaquín San
  %A Ramírez Manent, José Ignacio
  %A Martín Cantera, Carlos
  %A Campo Giménez, M. del
  %A Revenga Frauca, Juan
  %D 2018
  %J Atención Primaria
  %P 29-40
  %R 10.1016/S0212-6567(18)30361-5
  %T Recomendaciones sobre el estilo de vida. Actualizacón PAPPS 2018
  %U /brokenurl#/02126567/00000050000000S1/v1_201806020516/S0212656718303615/v1_201806020516/es/main.assetsER
  %V 50
  

• 
  1.

  Coll-Benejam T, Bravo-Toledo R, Marcos-Calvo MP, Astier-Peña MP. Impacto del sobrediagnóstico y sobretratamiento en el paciente, el sistema sanitario y la sociedad. Atención Primaria [Internet]. 2018;50:86-95. https://www.sciencedirect.com/science/article/pii/S0212656718305158

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Resumen La actividad médica despliega un conjunto de competencias encaminadas a mejorar el estado de salud de las personas. En este camino se realizan diagnósticos, se hacen elecciones de pruebas y tratamientos y se toman decisiones sobre hacer y no hacer que afectan a la vida de los pacientes. En este artículo, proponemos una reflexión ante el sobrediagnóstico y sobretratamiento en relación con los factores que lo promueven y el impacto que tienen en la sociedad, en el funcionamiento del sistema sanitario y también directamente en los pacientes. Finalmente, realizamos unas propuestas de cómo redirigir este exceso considerando que la atención primaria es un lugar privilegiado para actuar en adecuar y minimizar el impacto de las actuaciones del sistema sanitario en la salud de los ciudadanos y reducir los incidentes de seguridad del paciente ligados al sobrediagnóstico y al uso inadecuado de pruebas y tratamientos que no aportan valor a la salud de los pacientes. The medical activity displays a set of skills aimed at improving the health status of people. In this way, diagnoses are made, choices of tests and treatments are made, and decisions are made about what to do and what not to do that affect the lives of patients. In this article, we propose a reflection on overdiagnosis and overtreatment in relation to the factors that promote it and the impact they have on society, on the functioning of the health system and also directly on patients. Finally, we make some proposals on how to address this overuse considering that primary care is a privileged place to adapt and minimize the impact of the actions of the health system on the health of citizens and reduce the incidents of patient safety linked to the overdiagnosis and inappropriate use of tests and treatments that do not add value to the health of patients.

  @article{COLLBENEJAM201886,
  abstract = {Resumen La actividad médica despliega un conjunto de competencias encaminadas a mejorar el estado de salud de las personas. En este camino se realizan diagnósticos, se hacen elecciones de pruebas y tratamientos y se toman decisiones sobre hacer y no hacer que afectan a la vida de los pacientes. En este artículo, proponemos una reflexión ante el sobrediagnóstico y sobretratamiento en relación con los factores que lo promueven y el impacto que tienen en la sociedad, en el funcionamiento del sistema sanitario y también directamente en los pacientes. Finalmente, realizamos unas propuestas de cómo redirigir este exceso considerando que la atención primaria es un lugar privilegiado para actuar en adecuar y minimizar el impacto de las actuaciones del sistema sanitario en la salud de los ciudadanos y reducir los incidentes de seguridad del paciente ligados al sobrediagnóstico y al uso inadecuado de pruebas y tratamientos que no aportan valor a la salud de los pacientes. The medical activity displays a set of skills aimed at improving the health status of people. In this way, diagnoses are made, choices of tests and treatments are made, and decisions are made about what to do and what not to do that affect the lives of patients. In this article, we propose a reflection on overdiagnosis and overtreatment in relation to the factors that promote it and the impact they have on society, on the functioning of the health system and also directly on patients. Finally, we make some proposals on how to address this overuse considering that primary care is a privileged place to adapt and minimize the impact of the actions of the health system on the health of citizens and reduce the incidents of patient safety linked to the overdiagnosis and inappropriate use of tests and treatments that do not add value to the health of patients.},
  author = {Coll-Benejam, Txema and Bravo-Toledo, Rafael and Marcos-Calvo, María Pilar and Astier-Peña, María Pilar},
  journal = {Atención Primaria},
  keywords = {grapp-caib},
  note = {Sobrediagnóstico y sobretratamiento: la visión de la Atención Primaria},
  pages = {86-95},
  title = {Impacto del sobrediagnóstico y sobretratamiento en el paciente, el sistema sanitario y la sociedad},
  volume = 50,
  year = 2018
  }
  

  %0 Journal Article
  %1 COLLBENEJAM201886
  %A Coll-Benejam, Txema
  %A Bravo-Toledo, Rafael
  %A Marcos-Calvo, María Pilar
  %A Astier-Peña, María Pilar
  %D 2018
  %J Atención Primaria
  %P 86-95
  %R https://doi.org/10.1016/j.aprim.2018.08.004
  %T Impacto del sobrediagnóstico y sobretratamiento en el paciente, el sistema sanitario y la sociedad
  %U https://www.sciencedirect.com/science/article/pii/S0212656718305158
  %V 50
  %X Resumen La actividad médica despliega un conjunto de competencias encaminadas a mejorar el estado de salud de las personas. En este camino se realizan diagnósticos, se hacen elecciones de pruebas y tratamientos y se toman decisiones sobre hacer y no hacer que afectan a la vida de los pacientes. En este artículo, proponemos una reflexión ante el sobrediagnóstico y sobretratamiento en relación con los factores que lo promueven y el impacto que tienen en la sociedad, en el funcionamiento del sistema sanitario y también directamente en los pacientes. Finalmente, realizamos unas propuestas de cómo redirigir este exceso considerando que la atención primaria es un lugar privilegiado para actuar en adecuar y minimizar el impacto de las actuaciones del sistema sanitario en la salud de los ciudadanos y reducir los incidentes de seguridad del paciente ligados al sobrediagnóstico y al uso inadecuado de pruebas y tratamientos que no aportan valor a la salud de los pacientes. The medical activity displays a set of skills aimed at improving the health status of people. In this way, diagnoses are made, choices of tests and treatments are made, and decisions are made about what to do and what not to do that affect the lives of patients. In this article, we propose a reflection on overdiagnosis and overtreatment in relation to the factors that promote it and the impact they have on society, on the functioning of the health system and also directly on patients. Finally, we make some proposals on how to address this overuse considering that primary care is a privileged place to adapt and minimize the impact of the actions of the health system on the health of citizens and reduce the incidents of patient safety linked to the overdiagnosis and inappropriate use of tests and treatments that do not add value to the health of patients.
  

• 
  1.

  Birks LE, Struchen B, Eeftens M, van Wel L, Huss A, Gajšek P, Kheifets L, Gallastegi M, Dalmau-Bueno A, Estarlich M, Fernandez MF, Meder IK, Ferrero A, Jiménez-Zabala A, Torrent M, Vrijkotte TG, Cardis E, Olsen J, Valič B, Vermeulen R, Vrijheid M, Röösli M, Guxens M. Spatial and temporal variability of personal environmental exposure to radio frequency electromagnetic fields in children in Europe. Environment International [Internet]. 2018;117:204-1. https://www.sciencedirect.com/science/article/pii/S0160412017320597

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Background Exposure to radiofrequency electromagnetic fields (RF-EMF) has rapidly increased and little is known about exposure levels in children. This study describes personal RF-EMF environmental exposure levels from handheld devices and fixed site transmitters in European children, the determinants of this, and the day-to-day and year-to-year repeatability of these exposure levels. Methods Personal environmental RF-EMF exposure (μW/m2, power flux density) was measured in 529 children (ages 8–18 years) in Denmark, the Netherlands, Slovenia, Switzerland, and Spain using personal portable exposure meters for a period of up to three days between 2014 and 2016, and repeated in a subsample of 28 children one year later. The meters captured 16 frequency bands every 4 s and incorporated a GPS. Activity diaries and questionnaires were used to collect children's location, use of handheld devices, and presence of indoor RF-EMF sources. Six general frequency bands were defined: total, digital enhanced cordless telecommunications (DECT), television and radio antennas (broadcast), mobile phones (uplink), mobile phone base stations (downlink), and Wireless Fidelity (WiFi). We used adjusted mixed effects models with region random effects to estimate associations of handheld device use habits and indoor RF-EMF sources with personal RF-EMF exposure. Day-to-day and year-to-year repeatability of personal RF-EMF exposure were calculated through intraclass correlations (ICC). Results Median total personal RF-EMF exposure was 75.5 μW/m2. Downlink was the largest contributor to total exposure (median: 27.2 μW/m2) followed by broadcast (9.9 μW/m2). Exposure from uplink (4.7 μW/m2) was lower. WiFi and DECT contributed very little to exposure levels. Exposure was higher during day (94.2 μW/m2) than night (23.0 μW/m2), and slightly higher during weekends than weekdays, although varying across regions. Median exposures were highest while children were outside (157.0 μW/m2) or traveling (171.3 μW/m2), and much lower at home (33.0 μW/m2) or in school (35.1 μW/m2). Children living in urban environments had higher exposure than children in rural environments. Older children and users of mobile phones had higher uplink exposure but not total exposure, compared to younger children and those that did not use mobile phones. Day-to-day repeatability was moderate to high for most of the general frequency bands (ICCs between 0.43 and 0.85), as well as for total, broadcast, and downlink for the year-to-year repeatability (ICCs between 0.49 and 0.80) in a small subsample. Conclusion The largest contributors to total personal environmental RF-EMF exposure were downlink and broadcast, and these exposures showed high repeatability. Urbanicity was the most important determinant of total exposure and mobile phone use was the most important determinant of uplink exposure. It is important to continue evaluating RF-EMF exposure in children as device use habits, exposure levels, and main contributing sources may change.

  @article{BIRKS2018204,
  abstract = {Background Exposure to radiofrequency electromagnetic fields (RF-EMF) has rapidly increased and little is known about exposure levels in children. This study describes personal RF-EMF environmental exposure levels from handheld devices and fixed site transmitters in European children, the determinants of this, and the day-to-day and year-to-year repeatability of these exposure levels. Methods Personal environmental RF-EMF exposure (μW/m2, power flux density) was measured in 529 children (ages 8–18 years) in Denmark, the Netherlands, Slovenia, Switzerland, and Spain using personal portable exposure meters for a period of up to three days between 2014 and 2016, and repeated in a subsample of 28 children one year later. The meters captured 16 frequency bands every 4 s and incorporated a GPS. Activity diaries and questionnaires were used to collect children's location, use of handheld devices, and presence of indoor RF-EMF sources. Six general frequency bands were defined: total, digital enhanced cordless telecommunications (DECT), television and radio antennas (broadcast), mobile phones (uplink), mobile phone base stations (downlink), and Wireless Fidelity (WiFi). We used adjusted mixed effects models with region random effects to estimate associations of handheld device use habits and indoor RF-EMF sources with personal RF-EMF exposure. Day-to-day and year-to-year repeatability of personal RF-EMF exposure were calculated through intraclass correlations (ICC). Results Median total personal RF-EMF exposure was 75.5 μW/m2. Downlink was the largest contributor to total exposure (median: 27.2 μW/m2) followed by broadcast (9.9 μW/m2). Exposure from uplink (4.7 μW/m2) was lower. WiFi and DECT contributed very little to exposure levels. Exposure was higher during day (94.2 μW/m2) than night (23.0 μW/m2), and slightly higher during weekends than weekdays, although varying across regions. Median exposures were highest while children were outside (157.0 μW/m2) or traveling (171.3 μW/m2), and much lower at home (33.0 μW/m2) or in school (35.1 μW/m2). Children living in urban environments had higher exposure than children in rural environments. Older children and users of mobile phones had higher uplink exposure but not total exposure, compared to younger children and those that did not use mobile phones. Day-to-day repeatability was moderate to high for most of the general frequency bands (ICCs between 0.43 and 0.85), as well as for total, broadcast, and downlink for the year-to-year repeatability (ICCs between 0.49 and 0.80) in a small subsample. Conclusion The largest contributors to total personal environmental RF-EMF exposure were downlink and broadcast, and these exposures showed high repeatability. Urbanicity was the most important determinant of total exposure and mobile phone use was the most important determinant of uplink exposure. It is important to continue evaluating RF-EMF exposure in children as device use habits, exposure levels, and main contributing sources may change.},
  author = {Birks, Laura Ellen and Struchen, Benjamin and Eeftens, Marloes and van Wel, Luuk and Huss, Anke and Gajšek, Peter and Kheifets, Leeka and Gallastegi, Mara and Dalmau-Bueno, Albert and Estarlich, Marisa and Fernandez, Mariana F. and Meder, Inger Kristine and Ferrero, Amparo and Jiménez-Zabala, Ana and Torrent, Maties and Vrijkotte, Tanja G.M. and Cardis, Elisabeth and Olsen, Jørn and Valič, Blaž and Vermeulen, Roel and Vrijheid, Martine and Röösli, Martin and Guxens, Mònica},
  journal = {Environment International},
  keywords = {grapp-caib},
  pages = {204-214},
  title = {Spatial and temporal variability of personal environmental exposure to radio frequency electromagnetic fields in children in Europe},
  volume = 117,
  year = 2018
  }
  

  %0 Journal Article
  %1 BIRKS2018204
  %A Birks, Laura Ellen
  %A Struchen, Benjamin
  %A Eeftens, Marloes
  %A van Wel, Luuk
  %A Huss, Anke
  %A Gajšek, Peter
  %A Kheifets, Leeka
  %A Gallastegi, Mara
  %A Dalmau-Bueno, Albert
  %A Estarlich, Marisa
  %A Fernandez, Mariana F.
  %A Meder, Inger Kristine
  %A Ferrero, Amparo
  %A Jiménez-Zabala, Ana
  %A Torrent, Maties
  %A Vrijkotte, Tanja G.M.
  %A Cardis, Elisabeth
  %A Olsen, Jørn
  %A Valič, Blaž
  %A Vermeulen, Roel
  %A Vrijheid, Martine
  %A Röösli, Martin
  %A Guxens, Mònica
  %D 2018
  %J Environment International
  %P 204-214
  %R https://doi.org/10.1016/j.envint.2018.04.026
  %T Spatial and temporal variability of personal environmental exposure to radio frequency electromagnetic fields in children in Europe
  %U https://www.sciencedirect.com/science/article/pii/S0160412017320597
  %V 117
  %X Background Exposure to radiofrequency electromagnetic fields (RF-EMF) has rapidly increased and little is known about exposure levels in children. This study describes personal RF-EMF environmental exposure levels from handheld devices and fixed site transmitters in European children, the determinants of this, and the day-to-day and year-to-year repeatability of these exposure levels. Methods Personal environmental RF-EMF exposure (μW/m2, power flux density) was measured in 529 children (ages 8–18 years) in Denmark, the Netherlands, Slovenia, Switzerland, and Spain using personal portable exposure meters for a period of up to three days between 2014 and 2016, and repeated in a subsample of 28 children one year later. The meters captured 16 frequency bands every 4 s and incorporated a GPS. Activity diaries and questionnaires were used to collect children's location, use of handheld devices, and presence of indoor RF-EMF sources. Six general frequency bands were defined: total, digital enhanced cordless telecommunications (DECT), television and radio antennas (broadcast), mobile phones (uplink), mobile phone base stations (downlink), and Wireless Fidelity (WiFi). We used adjusted mixed effects models with region random effects to estimate associations of handheld device use habits and indoor RF-EMF sources with personal RF-EMF exposure. Day-to-day and year-to-year repeatability of personal RF-EMF exposure were calculated through intraclass correlations (ICC). Results Median total personal RF-EMF exposure was 75.5 μW/m2. Downlink was the largest contributor to total exposure (median: 27.2 μW/m2) followed by broadcast (9.9 μW/m2). Exposure from uplink (4.7 μW/m2) was lower. WiFi and DECT contributed very little to exposure levels. Exposure was higher during day (94.2 μW/m2) than night (23.0 μW/m2), and slightly higher during weekends than weekdays, although varying across regions. Median exposures were highest while children were outside (157.0 μW/m2) or traveling (171.3 μW/m2), and much lower at home (33.0 μW/m2) or in school (35.1 μW/m2). Children living in urban environments had higher exposure than children in rural environments. Older children and users of mobile phones had higher uplink exposure but not total exposure, compared to younger children and those that did not use mobile phones. Day-to-day repeatability was moderate to high for most of the general frequency bands (ICCs between 0.43 and 0.85), as well as for total, broadcast, and downlink for the year-to-year repeatability (ICCs between 0.49 and 0.80) in a small subsample. Conclusion The largest contributors to total personal environmental RF-EMF exposure were downlink and broadcast, and these exposures showed high repeatability. Urbanicity was the most important determinant of total exposure and mobile phone use was the most important determinant of uplink exposure. It is important to continue evaluating RF-EMF exposure in children as device use habits, exposure levels, and main contributing sources may change.
  

• 
  1.

  Bauzà ML, Esteva M, Molina J, Pereiró I, Ingla M, March S. Emergency contraception and risk habits in a university population. Eur J Contracept Reprod Health Care. 2018;23(6):427-33.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: The aim of our study was to determine the self-reported prevalence of use of emergency contraception (EC), identify factors associated with EC use, and measure the prevalence in university students of pregnancy and abortion among users and non-users of EC. METHODS: A cross-sectional descriptive study of university students using a self-administered questionnaire was carried out in 2016. The main dependent variable was EC use at any time. Independent variables included sociodemographic factors and factors related to harmful habits and sexual behaviour. RESULTS: The study sample consisted of 1309 students (median age 20 years). Forty per cent of participants reported using EC; condom failure was given as the main reason. Variables associated with EC use in both men and women were illegal drug consumption and having had more than 10 sexual partners. In women, other factors associated with EC use were age at first coitus and non-centrist political views. The prevalence of pregnancy was 6.5% and the prevalence of voluntary abortion was 2.9%. This prevalence was similar for men and women and for EC users and non-users. CONCLUSION: EC use in university students was more likely in those who experienced contraceptive failure or used no contraception. There were differences between men and women. Those at higher risk of unplanned pregnancy were more likely to report EC use, which may explain why there was no difference in the rates of unwanted pregnancies between EC users and non-users.

  @article{RN105,
  abstract = {OBJECTIVE: The aim of our study was to determine the self-reported prevalence of use of emergency contraception (EC), identify factors associated with EC use, and measure the prevalence in university students of pregnancy and abortion among users and non-users of EC. METHODS: A cross-sectional descriptive study of university students using a self-administered questionnaire was carried out in 2016. The main dependent variable was EC use at any time. Independent variables included sociodemographic factors and factors related to harmful habits and sexual behaviour. RESULTS: The study sample consisted of 1309 students (median age 20 years). Forty per cent of participants reported using EC; condom failure was given as the main reason. Variables associated with EC use in both men and women were illegal drug consumption and having had more than 10 sexual partners. In women, other factors associated with EC use were age at first coitus and non-centrist political views. The prevalence of pregnancy was 6.5% and the prevalence of voluntary abortion was 2.9%. This prevalence was similar for men and women and for EC users and non-users. CONCLUSION: EC use in university students was more likely in those who experienced contraceptive failure or used no contraception. There were differences between men and women. Those at higher risk of unplanned pregnancy were more likely to report EC use, which may explain why there was no difference in the rates of unwanted pregnancies between EC users and non-users.},
  author = {Bauzà, M. L. and Esteva, M. and Molina, J. and Pereiró, I. and Ingla, M. and March, S.},
  journal = {Eur J Contracept Reprod Health Care},
  keywords = {grapp-caib},
  number = 6,
  pages = {427-433},
  title = {Emergency contraception and risk habits in a university population},
  type = {Journal Article},
  volume = 23,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN105
  %A Bauzà, M. L.
  %A Esteva, M.
  %A Molina, J.
  %A Pereiró, I.
  %A Ingla, M.
  %A March, S.
  %D 2018
  %J Eur J Contracept Reprod Health Care
  %N 6
  %P 427-433
  %R 10.1080/13625187.2018.1533547
  %T Emergency contraception and risk habits in a university population
  %V 23
  %X OBJECTIVE: The aim of our study was to determine the self-reported prevalence of use of emergency contraception (EC), identify factors associated with EC use, and measure the prevalence in university students of pregnancy and abortion among users and non-users of EC. METHODS: A cross-sectional descriptive study of university students using a self-administered questionnaire was carried out in 2016. The main dependent variable was EC use at any time. Independent variables included sociodemographic factors and factors related to harmful habits and sexual behaviour. RESULTS: The study sample consisted of 1309 students (median age 20 years). Forty per cent of participants reported using EC; condom failure was given as the main reason. Variables associated with EC use in both men and women were illegal drug consumption and having had more than 10 sexual partners. In women, other factors associated with EC use were age at first coitus and non-centrist political views. The prevalence of pregnancy was 6.5% and the prevalence of voluntary abortion was 2.9%. This prevalence was similar for men and women and for EC users and non-users. CONCLUSION: EC use in university students was more likely in those who experienced contraceptive failure or used no contraception. There were differences between men and women. Those at higher risk of unplanned pregnancy were more likely to report EC use, which may explain why there was no difference in the rates of unwanted pregnancies between EC users and non-users.
  

• 
  1.

  Baena-Díez JM, Subirana I, Ramos R, Gómez de la Cámara A, Elosua R, Vila J, Marín-Ibáñez A, Guembe MJ, Rigo F, Tormo-Díaz MJ, Moreno-Iribas C, Cabré JJ, Segura A, Lapetra J, Quesada M, Medrano MJ, González-Diego P, Frontera G, Gavrila D, Ardanaz E, Basora J, García JM, García-Lareo M, Gutiérrez-Fuentes JA, Mayoral E, Sala J, Dégano IR, Francès A, Castell C, Grau M, Marrugat J. Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts. Rev Esp Cardiol (Engl Ed). 2018;71(4):274-82.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION AND OBJECTIVES: To assess the validity of the original low-risk SCORE function without and with high-density lipoprotein cholesterol and SCORE calibrated to the Spanish population. METHODS: Pooled analysis with individual data from 12 Spanish population-based cohort studies. We included 30 919 individuals aged 40 to 64 years with no history of cardiovascular disease at baseline, who were followed up for 10 years for the causes of death included in the SCORE project. The validity of the risk functions was analyzed with the area under the ROC curve (discrimination) and the Hosmer-Lemeshow test (calibration), respectively. RESULTS: Follow-up comprised 286 105 persons/y. Ten-year cardiovascular mortality was 0.6%. The ratio between estimated/observed cases ranged from 9.1, 6.5, and 9.1 in men and 3.3, 1.3, and 1.9 in women with original low-risk SCORE risk function without and with high-density lipoprotein cholesterol and calibrated SCORE, respectively; differences were statistically significant with the Hosmer-Lemeshow test between predicted and observed mortality with SCORE (P < .001 in both sexes and with all functions). The area under the ROC curve with the original SCORE was 0.68 in men and 0.69 in women. CONCLUSIONS: All versions of the SCORE functions available in Spain significantly overestimate the cardiovascular mortality observed in the Spanish population. Despite the acceptable discrimination capacity, prediction of the number of fatal cardiovascular events (calibration) was significantly inaccurate.

  @article{RN123,
  abstract = {INTRODUCTION AND OBJECTIVES: To assess the validity of the original low-risk SCORE function without and with high-density lipoprotein cholesterol and SCORE calibrated to the Spanish population. METHODS: Pooled analysis with individual data from 12 Spanish population-based cohort studies. We included 30 919 individuals aged 40 to 64 years with no history of cardiovascular disease at baseline, who were followed up for 10 years for the causes of death included in the SCORE project. The validity of the risk functions was analyzed with the area under the ROC curve (discrimination) and the Hosmer-Lemeshow test (calibration), respectively. RESULTS: Follow-up comprised 286 105 persons/y. Ten-year cardiovascular mortality was 0.6%. The ratio between estimated/observed cases ranged from 9.1, 6.5, and 9.1 in men and 3.3, 1.3, and 1.9 in women with original low-risk SCORE risk function without and with high-density lipoprotein cholesterol and calibrated SCORE, respectively; differences were statistically significant with the Hosmer-Lemeshow test between predicted and observed mortality with SCORE (P < .001 in both sexes and with all functions). The area under the ROC curve with the original SCORE was 0.68 in men and 0.69 in women. CONCLUSIONS: All versions of the SCORE functions available in Spain significantly overestimate the cardiovascular mortality observed in the Spanish population. Despite the acceptable discrimination capacity, prediction of the number of fatal cardiovascular events (calibration) was significantly inaccurate.},
  author = {Baena-Díez, J. M. and Subirana, I. and Ramos, R. and Gómez de la Cámara, A. and Elosua, R. and Vila, J. and Marín-Ibáñez, A. and Guembe, M. J. and Rigo, F. and Tormo-Díaz, M. J. and Moreno-Iribas, C. and Cabré, J. J. and Segura, A. and Lapetra, J. and Quesada, M. and Medrano, M. J. and González-Diego, P. and Frontera, G. and Gavrila, D. and Ardanaz, E. and Basora, J. and García, J. M. and García-Lareo, M. and Gutiérrez-Fuentes, J. A. and Mayoral, E. and Sala, J. and Dégano, I. R. and Francès, A. and Castell, C. and Grau, M. and Marrugat, J.},
  journal = {Rev Esp Cardiol (Engl Ed)},
  keywords = {grapp-caib},
  number = 4,
  pages = {274-282},
  title = {Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts},
  type = {Journal Article},
  volume = 71,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN123
  %A Baena-Díez, J. M.
  %A Subirana, I.
  %A Ramos, R.
  %A Gómez de la Cámara, A.
  %A Elosua, R.
  %A Vila, J.
  %A Marín-Ibáñez, A.
  %A Guembe, M. J.
  %A Rigo, F.
  %A Tormo-Díaz, M. J.
  %A Moreno-Iribas, C.
  %A Cabré, J. J.
  %A Segura, A.
  %A Lapetra, J.
  %A Quesada, M.
  %A Medrano, M. J.
  %A González-Diego, P.
  %A Frontera, G.
  %A Gavrila, D.
  %A Ardanaz, E.
  %A Basora, J.
  %A García, J. M.
  %A García-Lareo, M.
  %A Gutiérrez-Fuentes, J. A.
  %A Mayoral, E.
  %A Sala, J.
  %A Dégano, I. R.
  %A Francès, A.
  %A Castell, C.
  %A Grau, M.
  %A Marrugat, J.
  %D 2018
  %J Rev Esp Cardiol (Engl Ed)
  %N 4
  %P 274-282
  %R 10.1016/j.rec.2017.03.030
  %T Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts
  %V 71
  %X INTRODUCTION AND OBJECTIVES: To assess the validity of the original low-risk SCORE function without and with high-density lipoprotein cholesterol and SCORE calibrated to the Spanish population. METHODS: Pooled analysis with individual data from 12 Spanish population-based cohort studies. We included 30 919 individuals aged 40 to 64 years with no history of cardiovascular disease at baseline, who were followed up for 10 years for the causes of death included in the SCORE project. The validity of the risk functions was analyzed with the area under the ROC curve (discrimination) and the Hosmer-Lemeshow test (calibration), respectively. RESULTS: Follow-up comprised 286 105 persons/y. Ten-year cardiovascular mortality was 0.6%. The ratio between estimated/observed cases ranged from 9.1, 6.5, and 9.1 in men and 3.3, 1.3, and 1.9 in women with original low-risk SCORE risk function without and with high-density lipoprotein cholesterol and calibrated SCORE, respectively; differences were statistically significant with the Hosmer-Lemeshow test between predicted and observed mortality with SCORE (P < .001 in both sexes and with all functions). The area under the ROC curve with the original SCORE was 0.68 in men and 0.69 in women. CONCLUSIONS: All versions of the SCORE functions available in Spain significantly overestimate the cardiovascular mortality observed in the Spanish population. Despite the acceptable discrimination capacity, prediction of the number of fatal cardiovascular events (calibration) was significantly inaccurate.
  

• 
  1.

  Barroso M, Goday A, Ramos R, Marín-Ibañez A, Guembe MJ, Rigo F, Tormo-Díaz MJ, Moreno-Iribas C, Cabré JJ, Segura A, Baena-Díez JM, de la Cámara AG, Lapetra J, Quesada M, Medrano MJ, Berjón J, Frontera G, Gavrila D, Barricarte A, Basora J, García JM, García-Lareo M, Lora-Pablos D, Mayoral E, Grau M, Marrugat J. Interaction between cardiovascular risk factors and body mass index and 10-year incidence of cardiovascular disease, cancer death, and overall mortality. Preventive Medicine [Internet]. 2018;107:81-9. https://www.sciencedirect.com/science/article/pii/S0091743517304541

  AbstractURLBibTeXEndNoteDOIBibSonomy

  The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35–79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19–4.61) and 5.65 (1.54–20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53–10.37) and 11.61 (1.93–69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03–2.54) and 1.34 (1.01–1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.

  @article{BARROSO201881,
  abstract = {The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35–79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19–4.61) and 5.65 (1.54–20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53–10.37) and 11.61 (1.93–69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03–2.54) and 1.34 (1.01–1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.},
  author = {Barroso, Maria and Goday, Albert and Ramos, Rafel and Marín-Ibañez, Alejandro and Guembe, Maria Jesús and Rigo, Fernando and Tormo-Díaz, Maria José and Moreno-Iribas, Conchi and Cabré, Joan Josep and Segura, Antonio and Baena-Díez, Jose Miguel and de la Cámara, Agustín Gómez and Lapetra, José and Quesada, Miquel and Medrano, María José and Berjón, Jesús and Frontera, Guillem and Gavrila, Diana and Barricarte, Aurelio and Basora, Josep and García, José María and García-Lareo, Manel and Lora-Pablos, David and Mayoral, Eduardo and Grau, María and Marrugat, Jaume},
  journal = {Preventive Medicine},
  keywords = {grapp-caib},
  pages = {81-89},
  title = {Interaction between cardiovascular risk factors and body mass index and 10-year incidence of cardiovascular disease, cancer death, and overall mortality},
  volume = 107,
  year = 2018
  }
  

  %0 Journal Article
  %1 BARROSO201881
  %A Barroso, Maria
  %A Goday, Albert
  %A Ramos, Rafel
  %A Marín-Ibañez, Alejandro
  %A Guembe, Maria Jesús
  %A Rigo, Fernando
  %A Tormo-Díaz, Maria José
  %A Moreno-Iribas, Conchi
  %A Cabré, Joan Josep
  %A Segura, Antonio
  %A Baena-Díez, Jose Miguel
  %A de la Cámara, Agustín Gómez
  %A Lapetra, José
  %A Quesada, Miquel
  %A Medrano, María José
  %A Berjón, Jesús
  %A Frontera, Guillem
  %A Gavrila, Diana
  %A Barricarte, Aurelio
  %A Basora, Josep
  %A García, José María
  %A García-Lareo, Manel
  %A Lora-Pablos, David
  %A Mayoral, Eduardo
  %A Grau, María
  %A Marrugat, Jaume
  %D 2018
  %J Preventive Medicine
  %P 81-89
  %R https://doi.org/10.1016/j.ypmed.2017.11.013
  %T Interaction between cardiovascular risk factors and body mass index and 10-year incidence of cardiovascular disease, cancer death, and overall mortality
  %U https://www.sciencedirect.com/science/article/pii/S0091743517304541
  %V 107
  %X The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35–79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19–4.61) and 5.65 (1.54–20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53–10.37) and 11.61 (1.93–69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03–2.54) and 1.34 (1.01–1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.
  

• 
  1.

  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, behalf of the DECCIRE GROUP O. Emergency presentation of colorectal patients in Spain. PLOS ONE [Internet]. Public Library of Science; 2018 Oct.;13(10):1-14. https://doi.org/10.1371/journal.pone.0203556

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  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.

  @article{10.1371/journal.pone.0203556,
  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.},
  author = {Esteva, Magdalena and Ruiz-Díaz, Mercedes and Sánchez, M. Antonia and Pértega, Sonia and Pita-Fernández, Salvador and Macià, Francesc and Posso, Margarita and González-Luján, Luis and Boscá-Wats, Marta M. and Leiva, Alfonso and Ripoll, Joana and behalf of the DECCIRE GROUP, On},
  journal = {PLOS ONE},
  keywords = {grapp-caib},
  month = 10,
  number = 10,
  pages = {1-14},
  publisher = {Public Library of Science},
  title = {Emergency presentation of colorectal patients in Spain},
  volume = 13,
  year = 2018
  }
  

  %0 Journal Article
  %1 10.1371/journal.pone.0203556
  %A Esteva, Magdalena
  %A Ruiz-Díaz, Mercedes
  %A Sánchez, M. Antonia
  %A Pértega, Sonia
  %A Pita-Fernández, Salvador
  %A Macià, Francesc
  %A Posso, Margarita
  %A González-Luján, Luis
  %A Boscá-Wats, Marta M.
  %A Leiva, Alfonso
  %A Ripoll, Joana
  %A behalf of the DECCIRE GROUP, On
  %D 2018
  %I Public Library of Science
  %J PLOS ONE
  %N 10
  %P 1-14
  %R 10.1371/journal.pone.0203556
  %T Emergency presentation of colorectal patients in Spain
  %U https://doi.org/10.1371/journal.pone.0203556
  %V 13
  %X 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.
  

• 
  1.

  Waage J, Standl M, Curtin JA, Jessen LE, Thorsen J, Tian C, Schoettler N, Flores C, Abdellaoui A, Ahluwalia TS, Alves AC, Amaral AFS, Antó JM, Arnold A, Barreto-Luis A, Baurecht H, van Beijsterveldt CEM, Bleecker ER, Bonàs-Guarch S, Boomsma DI, Brix S, Bunyavanich S, Burchard EG, Chen Z, Curjuric I, Custovic A, den Dekker HT, Dharmage SC, Dmitrieva J, Duijts L, Ege MJ, Gauderman WJ, Georges M, Gieger C, Gilliland F, Granell R, Gui H, Hansen T, Heinrich J, Henderson J, Hernandez-Pacheco N, Holt P, Imboden M, Jaddoe VWV, Jarvelin MR, Jarvis DL, Jensen KK, Jónsdóttir I, Kabesch M, Kaprio J, Kumar A, Lee YA, Levin AM, Li X, Lorenzo-Diaz F, Melén E, Mercader JM, Meyers DA, Myers R, Nicolae DL, Nohr EA, Palviainen T, Paternoster L, Pennell CE, Pershagen G, Pino-Yanes M, Probst-Hensch NM, Rüschendorf F, Simpson A, Stefansson K, Sunyer J, Sveinbjornsson G, Thiering E, Thompson PJ, Torrent M, Torrents D, Tung JY, Wang CA, Weidinger S, Weiss S, Willemsen G, Williams LK, Ober C, Hinds DA, Ferreira MA, Bisgaard H, Strachan DP, Bønnelykke K. Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis. Nat Genet. 2018;50(8):1072-80.

  AbstractBibTeXEndNoteDOIBibSonomy

  Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries(1,2). To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis.

  @article{RN120,
  abstract = {Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries(1,2). To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis.},
  author = {Waage, J. and Standl, M. and Curtin, J. A. and Jessen, L. E. and Thorsen, J. and Tian, C. and Schoettler, N. and Flores, C. and Abdellaoui, A. and Ahluwalia, T. S. and Alves, A. C. and Amaral, A. F. S. and Antó, J. M. and Arnold, A. and Barreto-Luis, A. and Baurecht, H. and van Beijsterveldt, C. E. M. and Bleecker, E. R. and Bonàs-Guarch, S. and Boomsma, D. I. and Brix, S. and Bunyavanich, S. and Burchard, E. G. and Chen, Z. and Curjuric, I. and Custovic, A. and den Dekker, H. T. and Dharmage, S. C. and Dmitrieva, J. and Duijts, L. and Ege, M. J. and Gauderman, W. J. and Georges, M. and Gieger, C. and Gilliland, F. and Granell, R. and Gui, H. and Hansen, T. and Heinrich, J. and Henderson, J. and Hernandez-Pacheco, N. and Holt, P. and Imboden, M. and Jaddoe, V. W. V. and Jarvelin, M. R. and Jarvis, D. L. and Jensen, K. K. and Jónsdóttir, I. and Kabesch, M. and Kaprio, J. and Kumar, A. and Lee, Y. A. and Levin, A. M. and Li, X. and Lorenzo-Diaz, F. and Melén, E. and Mercader, J. M. and Meyers, D. A. and Myers, R. and Nicolae, D. L. and Nohr, E. A. and Palviainen, T. and Paternoster, L. and Pennell, C. E. and Pershagen, G. and Pino-Yanes, M. and Probst-Hensch, N. M. and Rüschendorf, F. and Simpson, A. and Stefansson, K. and Sunyer, J. and Sveinbjornsson, G. and Thiering, E. and Thompson, P. J. and Torrent, M. and Torrents, D. and Tung, J. Y. and Wang, C. A. and Weidinger, S. and Weiss, S. and Willemsen, G. and Williams, L. K. and Ober, C. and Hinds, D. A. and Ferreira, M. A. and Bisgaard, H. and Strachan, D. P. and Bønnelykke, K.},
  journal = {Nat Genet},
  keywords = {grapp-caib},
  number = 8,
  pages = {1072-1080},
  title = {Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis},
  type = {Journal Article},
  volume = 50,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN120
  %A Waage, J.
  %A Standl, M.
  %A Curtin, J. A.
  %A Jessen, L. E.
  %A Thorsen, J.
  %A Tian, C.
  %A Schoettler, N.
  %A Flores, C.
  %A Abdellaoui, A.
  %A Ahluwalia, T. S.
  %A Alves, A. C.
  %A Amaral, A. F. S.
  %A Antó, J. M.
  %A Arnold, A.
  %A Barreto-Luis, A.
  %A Baurecht, H.
  %A van Beijsterveldt, C. E. M.
  %A Bleecker, E. R.
  %A Bonàs-Guarch, S.
  %A Boomsma, D. I.
  %A Brix, S.
  %A Bunyavanich, S.
  %A Burchard, E. G.
  %A Chen, Z.
  %A Curjuric, I.
  %A Custovic, A.
  %A den Dekker, H. T.
  %A Dharmage, S. C.
  %A Dmitrieva, J.
  %A Duijts, L.
  %A Ege, M. J.
  %A Gauderman, W. J.
  %A Georges, M.
  %A Gieger, C.
  %A Gilliland, F.
  %A Granell, R.
  %A Gui, H.
  %A Hansen, T.
  %A Heinrich, J.
  %A Henderson, J.
  %A Hernandez-Pacheco, N.
  %A Holt, P.
  %A Imboden, M.
  %A Jaddoe, V. W. V.
  %A Jarvelin, M. R.
  %A Jarvis, D. L.
  %A Jensen, K. K.
  %A Jónsdóttir, I.
  %A Kabesch, M.
  %A Kaprio, J.
  %A Kumar, A.
  %A Lee, Y. A.
  %A Levin, A. M.
  %A Li, X.
  %A Lorenzo-Diaz, F.
  %A Melén, E.
  %A Mercader, J. M.
  %A Meyers, D. A.
  %A Myers, R.
  %A Nicolae, D. L.
  %A Nohr, E. A.
  %A Palviainen, T.
  %A Paternoster, L.
  %A Pennell, C. E.
  %A Pershagen, G.
  %A Pino-Yanes, M.
  %A Probst-Hensch, N. M.
  %A Rüschendorf, F.
  %A Simpson, A.
  %A Stefansson, K.
  %A Sunyer, J.
  %A Sveinbjornsson, G.
  %A Thiering, E.
  %A Thompson, P. J.
  %A Torrent, M.
  %A Torrents, D.
  %A Tung, J. Y.
  %A Wang, C. A.
  %A Weidinger, S.
  %A Weiss, S.
  %A Willemsen, G.
  %A Williams, L. K.
  %A Ober, C.
  %A Hinds, D. A.
  %A Ferreira, M. A.
  %A Bisgaard, H.
  %A Strachan, D. P.
  %A Bønnelykke, K.
  %D 2018
  %J Nat Genet
  %N 8
  %P 1072-1080
  %R 10.1038/s41588-018-0157-1
  %T Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis
  %V 50
  %X Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries(1,2). To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis.
  

• 
  1.

  Olivan-Blázquez B, Montero-Marin J, García-Toro M, Vicens-Pons E, Serrano-Ripoll MJ, Castro-Gracia A, Sarasa-Bosque MC, Mendive-Arbeloa JM, López-Del-Hoyo Y, Garcia-Campayo J. Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study. BMC Psychiatry. 2018;18(1):205.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS: A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS: Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION: The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.

  @article{RN188,
  abstract = {BACKGROUND: Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS: A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS: Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION: The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.},
  author = {Olivan-Blázquez, B. and Montero-Marin, J. and García-Toro, M. and Vicens-Pons, E. and Serrano-Ripoll, M. J. and Castro-Gracia, A. and Sarasa-Bosque, M. C. and Mendive-Arbeloa, J. M. and López-Del-Hoyo, Y. and Garcia-Campayo, J.},
  journal = {BMC Psychiatry},
  keywords = {grapp-caib},
  number = 1,
  pages = 205,
  title = {Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study},
  type = {Journal Article},
  volume = 18,
  year = 2018
  }
  

  %0 Journal Article
  %1 RN188
  %A Olivan-Blázquez, B.
  %A Montero-Marin, J.
  %A García-Toro, M.
  %A Vicens-Pons, E.
  %A Serrano-Ripoll, M. J.
  %A Castro-Gracia, A.
  %A Sarasa-Bosque, M. C.
  %A Mendive-Arbeloa, J. M.
  %A López-Del-Hoyo, Y.
  %A Garcia-Campayo, J.
  %D 2018
  %J BMC Psychiatry
  %N 1
  %P 205
  %R 10.1186/s12888-018-1779-7
  %T Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study
  %V 18
  %X BACKGROUND: Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS: A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS: Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION: The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.
  

• 
  1.

  Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, Basora J, Fitó M, Corella D, Serra-Majem L, Wärnberg J, Romaguera D, Estruch R, Vidal J, Martínez JA, Arós F, Vázquez C, Ros E, Vioque J, López-Miranda J, Bueno-Cavanillas A, Tur JA, Tinahones FJ, Martín V, Lapetra J, Pintó X, Daimiel L, Delgado-Rodríguez M, Matía P, Gómez-Gracia E, Díez-Espino J, Babio N, Castañer O, Sorlí JV, Fiol M, Zulet M, Bulló M, Goday A, Martínez-González M. Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial. Diabetes Care [Internet]. American Diabetes Association; 2018 Nov.;42(5):777-88. https://doi.org/10.2337%2Fdc18-0836

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVE: The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS: Overweight/obese adults with metabolic syndrome aged 55-75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS: Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA(1c), and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS: PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.

  @article{Salas_Salvad__2018,
  abstract = {OBJECTIVE: The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS: Overweight/obese adults with metabolic syndrome aged 55-75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS: Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA(1c), and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS: PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.},
  author = {Salas-Salvadó, J. and Díaz-López, A. and Ruiz-Canela, M. and Basora, J. and Fitó, M. and Corella, D. and Serra-Majem, L. and Wärnberg, J. and Romaguera, D. and Estruch, R. and Vidal, J. and Martínez, J. A. and Arós, F. and Vázquez, C. and Ros, E. and Vioque, J. and López-Miranda, J. and Bueno-Cavanillas, A. and Tur, J. A. and Tinahones, F. J. and Martín, V. and Lapetra, J. and Pintó, X. and Daimiel, L. and Delgado-Rodríguez, M. and Matía, P. and Gómez-Gracia, E. and Díez-Espino, J. and Babio, N. and Castañer, O. and Sorlí, J. V. and Fiol, M. and Zulet, MÁ and Bulló, M. and Goday, A. and Martínez-González, MÁ},
  journal = {Diabetes Care},
  keywords = {grapp-caib},
  month = {nov},
  number = 5,
  pages = {777--788},
  publisher = {American Diabetes Association},
  title = {Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial},
  volume = 42,
  year = 2018
  }
  

  %0 Journal Article
  %1 Salas_Salvad__2018
  %A Salas-Salvadó, J.
  %A Díaz-López, A.
  %A Ruiz-Canela, M.
  %A Basora, J.
  %A Fitó, M.
  %A Corella, D.
  %A Serra-Majem, L.
  %A Wärnberg, J.
  %A Romaguera, D.
  %A Estruch, R.
  %A Vidal, J.
  %A Martínez, J. A.
  %A Arós, F.
  %A Vázquez, C.
  %A Ros, E.
  %A Vioque, J.
  %A López-Miranda, J.
  %A Bueno-Cavanillas, A.
  %A Tur, J. A.
  %A Tinahones, F. J.
  %A Martín, V.
  %A Lapetra, J.
  %A Pintó, X.
  %A Daimiel, L.
  %A Delgado-Rodríguez, M.
  %A Matía, P.
  %A Gómez-Gracia, E.
  %A Díez-Espino, J.
  %A Babio, N.
  %A Castañer, O.
  %A Sorlí, J. V.
  %A Fiol, M.
  %A Zulet, MÁ
  %A Bulló, M.
  %A Goday, A.
  %A Martínez-González, MÁ
  %D 2018
  %I American Diabetes Association
  %J Diabetes Care
  %N 5
  %P 777--788
  %R 10.2337/dc18-0836
  %T Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial
  %U https://doi.org/10.2337%2Fdc18-0836
  %V 42
  %X OBJECTIVE: The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS: Overweight/obese adults with metabolic syndrome aged 55-75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS: Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA(1c), and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS: PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.