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The Guadiana River flows through the Southwest area of the Iberian Peninsula crossing from the Spanish provinces of Extremadura and Andalucia to the southern region of Portugal. Preliminary studies on the presence and distribution of toxic cyanobacteria led to the identification of several cyanobacterial species in the Guadiana River itself as well as in the freshwater reservoirs established along its course. The objectives of this paper were the identification and quantification of planktonic cyanobacteria in freshwater reservoirs from the Guadiana River, with different applications (human consumption, agriculture purposes and recreational uses), and determination of their toxicity. After the isolation of cyanobacterial strains, the characterisation of their toxicological profile was carried out using immunoadsorbent assays (ELISA) and chromatographic techniques (HPLC-UV). Monitorization studies revealed that predominant species were Microcystis aeruginosa , Anabaena spp. and Aphanizomenon flos-aquae . Some strains of M. aeruginosa were responsible for microcystins production. The toxicity observed in ISACYA 10B was low. The strain ISACYA 2C produces high amounts of microcystins, and probably these toxins were responsible for the toxicity of the cyanobacterial bloom detected in these waters. [ABSTRACT FROM AUTHOR]

Background: Multiple guidelines and systematic reviews recommend sealant use to reduce caries risk. Yet, multiple reports also indicate that sealants are significantly underutilized. This study examined the knowledge, opinions, values, and practice (KOVP) of dentists concerning sealant use in the southwest region of Andalusia, Spain. This is a prelude to the generation of a regional plan for improving children's oral health in Andalusia., Methods: The survey's target population was dentists working in western Andalusia, equally distributed in the provinces of Seville, Cadiz, and Huelva (N=2,047). A convenience sample of meeting participants and meeting participant email lists (N=400) were solicited from the annual course on Community and Pediatric Dentistry. This course is required for all public health sector dentists, and is open to all private sector dentists. Information on the dentist's KOVP of sealants was collected using four-part questionnaire with 31, 5-point Likert-scaled questions., Results: The survey population demographics included 190 men (48%) and 206 women (52%) with an average clinical experience of 10.6 (±8.4) years and 9.3 (±7.5) years, respectively. A significant sex difference was observed in the distribution of place of work (urban/suburb) (p=0.001), but no sex differences between working sector (public/private). The mean±SD values for each of the four KOVP sections for pit and fissure sealants were: knowledge=3.57±0.47; opinion=2.48±0.47; value=2.74±0.52; and practice=3.48±0.50. No sex differences were found in KOVP (all p>0.4). Independent of sex: knowledge statistically differed by years of experience and place of work; opinion statistically differed by years of experience and sector; and practice statistically differed by years of experience and sector. Less experienced dentists tended to have slightly higher scores (~0.25 on a Likert 1-5 scale). Statistically significant correlations were found between knowledge and practice (r=0.44, p=0.00) and between opinion and value (r=0.35, p=0.00)., Conclusions: The results suggest that, similar to other countries, Andalusian dentists know that sealants are effective, have neutral to positive attitudes toward sealants; though, based on epidemiological studies, underuse sealants. Therefore, methods other than classical behavior change (eg: financial or legal mechanisms) will be required to change practice patterns aimed at improving children's oral health.

Studies on the effectiveness and efficiency of palliative care (PC) services that use a methodology similar to that used by studies in other medical specialties face serious limitations, since the goals of PC are substantially different. Qualitative research methods can make an important contribution to our understanding of the features of palliative care (PC) that are most relevant to patients and their relatives. The goal of this study was to understand the reasons behind the gratitude shown in letters from bereaved relatives sent to two PC units, one in Spain and one in Portugal. A thematic analysis of the content of the letters was independently carried out by three researchers, who later collaborated to write up the results. Relatives appeared grateful primarily for the humane attitude, professional treatment, and emotional support that their loved ones received from the PC team; they thanked the team for creating a special atmosphere and offering holistic care, and they talked about the contrast between PC and other forms of care. The unsolicited gratitude expressed in their letters constitutes a valid and particularly rich source of information about the contribution that a PC team can make.

Objective: To investigate if handgrip strength (HGS) could be used as a single screening procedure in identifying patients who are classified as being undernourished or nutritionally-at-risk at hospital admission., Design: Cross-sectional study. In the second day of hospital admission, HGS was evaluated and results were compared with Nutritional Risk Screening (NRS-2002)., Setting: Two public hospitals in Porto, Portugal, a university and a district one., Subjects: A probabilistic sample of 50% in-patients from each hospital of 314 patients (age range of 18-96) was studied. Patients were considered eligible if they were >or=18 years old and able to give informed consent. Hand pain, upper limb deformities, incapacity to perform muscle strength measurements and pregnancy were considered further exclusion criteria., Results: Patients identified as undernourished by NRS-2002 (37.9%) were older, shorter and lighter, with a lower functional capacity, a longer length of stay and a lower HGS (P<0.001). When comparing patients with lower HGS (first quartile) with those with the highest HGS (fourth quartile), this parameter revealed good sensitivity (86.7%) and specificity (70.2%) and a k=0.56. Multivariate analysis showed that patients with higher HGS had an independent decreased risk of being at nutritional risk (P for trend <0.001) odds ratio=0.19 (95% confidence interval=0.08-0.48). Our entire sample of hospitalized patients was -1.96 Z-score below the HGS cutoff of distribution data for healthy individuals., Conclusions: HGS identifies a high proportion of nutritionally-at-risk patients and can be a reliable first screening tool for nutritional risk in hospitals.