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Despite the advantages of surgical handrub in terms of the ease of application and effectiveness, chlorhexidine (CHG)-based hand scrubbing remains the preferred method for surgical hand preparation. However, it does not systematically meet the non-inferiority requirement of the European norm (EN) 12791 with respect to n-propanol (the reference product) and does not provide the sustained efficacy expected for these long-lasting agents. Commercially available alcohol-based products have also failed to demonstrate sustained efficacy according to EN 12791. Multi-step protocols enhance the efficacy of hand scrubbing, yet their extended disinfection duration might diminish their allure for healthcare professionals. In this study, we show that hand scrubbing with CHG 4% followed by a 1 min rubbing with the novel formulation of ethanol (Et) 70%/CHG 3% plus 0.3% potassium sorbate food additive (PS) meets the non-inferiority requirement and demonstrates sustained efficacy when tested according to EN 12791. The immediate and 3 h effect of this protocol was significantly higher than that of n-propanol and the homologous disinfection protocol without PS (CHG 4% hand scrub plus Et 70%/CHG 3% rub), demonstrating that the inclusion of PS confers a notable residual effect. We speculate that this non-volatile ingredient acts synergistically with CHG. This promising combination represents an alternative method for the development of new disinfection strategies., Depto. de Medicina, Fac. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Toxoplasma gondii is a paradigmatic zoonotic parasite from the One Health perspective, since it is broadly distributed and virtually infects all warm-blooded species. A wide variety of serological techniques have been developed to detect T. gondii infection in humans and animals. Our aim was to describe and compare the main characteristics of these serological tests and validation processes and to critically analyze whether these tests meet the standards required to ensure an accurate serological diagnosis. The current systematic review and meta-analysis included 134 studies that were published from 2013 to 2023. QUADAS 2 tool was used to evaluate the quality of the included studies. A total of 52 variables related to the characteristics of the techniques and analytical and diagnostic validation parameters were studied. A wider panel of tests was developed for humans, including techniques exclusively developed for humans that involve costly equipment and the measurement of different Ig isotypes that are considered biomarkers of congenital toxoplasmosis. Studies conducted in humans frequently employed commercial techniques as reference tests, measured different immunoglobulin isotypes with a predominance for IgG (>50%) and discriminated between acute and chronic infections. In animals, the most commonly used reference techniques were in-house tests, which almost exclusively detected IgG. Common limitations identified in a large number of studies were some misunderstandings of the terms “gold standard” and “reference test” and the absence of information about the negative and positive control sera used or the exact cutoff employed, which were independent of the quality of the study. There is a lack of analytical validation, with few evaluations of cross-reactivity with other pathogens. Diagnostic odds ratio values showed that indirect ELISA based on native or chimeric antigens performed better than other tests. The reproducibility of serological test results in both h, Universidad de Murcia, European Commission, Fundación Séneca-Agencia de Ciencia y Tecnología de la Región de Murcia, Depto. de Sanidad Animal, Fac. de Veterinaria, TRUE, pub

This was a prospective observational study based on clinical simulation courses taught in 2017 at the IDEhA Simulation Center of Alcorcón Foundation University Hospital. Two courses in metabolic emergencies (MEs) and respiratory emergencies (REs) were offered to primary care physicians all over Spain. The main objective was to teach nontechnical skills (crisis resource management). Using a modified five-level Kirkpatrick–Phillips education evaluation model, level I (reaction, K1), level II (learning, K2) and level III (behavioral change, K3) changes were evaluated through surveys at the end of the courses and one year later. Thirty courses were held (15 ME courses and 15 RE courses) with 283 primary care physicians. The overall satisfaction (K1) was high: ME courses, 9.5/10; RE courses, 9.6/10. More than 80% of the participants rated the organization, resources, content, debriefing and scenarios as excellent, with no significant differences between the two courses. After one year (156 responses), the respondents for both courses reported that they would repeat the training annually (K2), encourage debriefing with colleagues (K3) and have modified some aspects of their workplace (K3), citing improvements in procedures and in the organization of the health team as the most important. After the ME course, few participants, i.e., 5 (6%), reported providing improved care to patients; after the RE course, 15 (19%) participants reported providing improved care; the difference between groups was significant (p < 0.05). Compared with the ME course, the RE course imparted greater knowledge about patient safety (K2) (38 (49%) vs. 24 (31%) (p < 0.05)) and more useful tools for daily clinical practice (K3) (67% vs. 56.4%) and resulted in participants paying more attention to personal performance and to colleagues when working as a team (K2) (64% vs. 50%). Clinical simulation courses are highly valued and potentially effective for training primary care physicians in patient safet, European Commission, Ministerio de Ciencia e Innovación (España), Instituto de Salud Carlos III (España), Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub, Descuento UCM

Referencias bibliográficas: • Arte, Salud y Cuidados (2022), Dossier Art, Health and Care, Madrid: Complutense University of Madrid and Madrid Salud, https://hdl.handle. net/20.500.14352/4332. Accessed 1 September 2023. • Ávila, Noemí (2020), ‘Arte, Salud y Cuidados: Una apuesta por la educación artística desde Madrid Salud’, ESAMEC: Education Journal: Health, Environment and Citizenship, 1, pp. 29–37. • Ávila, Noemí, Orellana, Ana, García, Marta, Antúnez, Noelia and Claver, Dolores (2014), ‘Arte, salud y prevención: Primeras colaboraciones’, Gaceta Sanitaria, 28:6, pp. 501–04. • Ávila, Noemí, Claver, Dolores, Larraín, Adelaida, Azcona, Claudia, Segura, Javier and Martínez, Mercedes (2019), ‘Art, health promotion and community health: Constructing the “Madrid Salud” model’, Journal Applied Arts and Health, 10:2, pp. 203–17. • Boydell, Katherine, Gladstone, Brenda, Volpe, Tiziana, Allemang, Brooke and Stasiulis, Elaine (2012), ‘The production and dissemination of knowledge: A scoping review of arts-based health research’, Forum: Qualitative Social Research Sozialfdorschung, 13:1, pp. 1–30. • Castillejo, Mar (2019), ‘Replanteando el Bulevar: Un jardín vertical como intervención artística y comunitaria’, Educación artística: revista de investigación, 10, pp. 82–94. • Castillejo, Mar (2022), ‘Experiencias en Puente de Vallecas, Madrid: Redes Comunitarias: Prácticas artísticas colaborativas, movimientos sociales y salud: Experiencias en Puente de Vallecas’, Ph.D. thesis, Madrid: Complutense University of Madrid, https://hdl.handle. net/20.500.14352/4110. Accessed 1 September 2023. • Castillejo, Mar, Fernández-Cedena, Jorge, Siles, Silvia, Claver, Dolores and Ávila, Noemí (2018), ‘Batas Nómadas en Madrid Salud: El arte y los artistas en equipos profesionales de salud comunitaria’, Gaceta Sanitaria, 32:5, pp. 466–72. • Larraín, Adelaida, Azcona, Claudia, Ávila, Noemí and Claver, Dolores (2018), ‘Arte como recurso de salud y bienestar: Una experiencia con mujeres a partir, Madrid Salud, a public body of Madrid City Council responsible for prevention, promotion and community healthcare, initiated an early career researcher (ECR) in arts and health programme in 2017. This ongoing programme, in collaboration with Complutense University of Madrid, funded fellowships for Ph.D. students, supporting their training and research in the application of artistic methodologies within Madrid Salud’s teams and centres. This article outlines the programme’s implementation, emphasizing the significance of intersectoral actions for its success. Furthermore, it describes the experiences of ECRs within Madrid Salud, exploring how the arts contribute to contexts of prevention and health promotion., Depto. de Didáctica de las Lenguas, Artes y Educación Física, Fac. de Educación, TRUE, pub

Producción Científica, (1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing’s role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences., Enfermería - España

Producción Científica, The increase in responsibilities, together with the multiple challenges that students face in the university period, has a direct impact on their healthy lifestyles. This literature review describes the benefits of promoting healthy habits in college, highlighting the fundamental role of prevention and promotion. A systematic review was carried out following the PRISMA recommendations, searching for information in the WOS and Scopus databases. On the other hand, a search was carried out within the existing and available grey literature. The review focused on finding information about physical activity, nutrition, and stress (with an emphasis on resilience and academic burnout) in university students. This bibliographic review includes 32 articles and six web pages, containing information on the benefits of physical activity, healthy habits, and health prevention. The information collected in this study shows that university students are exposed to multiple changes during this period, increasing as the academic years progress. At that time, their habits worsen, with low adherence to the Mediterranean diet, low physical activity, and high levels of stress, specifically increasing cases of academic burnout. The establishment of healthy habits during the university period is necessary, observing an improvement in all the variables studied. Prevention has played a fundamental role.

La creciente incidencia de enfermedades crónicas en la sociedad contemporánea representa un desafío importante para la salud pública, representando un alto costo. La educación desde la infancia sobre estas y su actuación, emerge como una herramienta clave para fomentar prácticas de vida saludables ya que la falta de conocimientos en situaciones de riesgo vital contribuye al aumento de impacto patológico (morbilidad) y a muertes evitables asociadas. Un enfoque holístico y preventivo desde la infancia es fundamental para abordar estos desafíos, promoviendo la autonomía en salud y la educación sanitaria en las etapas escolares para mejorar el autocuidado y la respuesta ante emergencias. El objetivo es educar a los niños frente a situaciones de salud cotidianas, aprendiendo a gestionar sus acciones frente a estas e identificar situaciones de riesgo reales mediante un Programa de Educación para la Salud (EpS). Se realiza un diseño de un programa de intervención escolar de EpS acerca de las enfermedades comunes a nivel social causante de posibles situaciones que requieran una respuesta rápida por parte del entorno; con evaluación de los conocimientos adquiridos mediante un cuestionario post-intervención. Además, se realiza una encuesta de satisfacción del alumnado acerca de la realización de este tipo de programas de EpS en las clases. La participación de 53 alumnos en las intervenciones escolares, su posterior evaluación de conocimientos y la encuesta de satisfacción, muestran en conjunto resultados positivos de este programa. El test realizado post-intervención data de una media de aciertos del 92,43% en global a todas las preguntas realizadas, incrementando los conocimientos y promoviendo hábitos de vida saludables. La intervención escolar de este programa de EpS resultó ser efectiva por la consecución de sus objetivos de aprendizaje y razonamiento de conocimientos acerca de las patologías comunes y su actuación, Grado en Enfermería

Producción Científica, Lower back pain (LBP) describes pain of indeterminate duration between the lower edge of the ribs and the buttocks. LBP hinders movement, quality of life, and mental well-being, and limits work activities and engagement with family and friends. LBP represents a public health problem, and most workers are expected to experience LBP symptoms throughout their working lives. The study’s main objective was to characterize LBP in the hospitality population of the province of León, Spain, determining the risk factors. A pilot study with a cross-sectional observational design was developed following the guidelines of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for 150 Spanish hotel workers. Sociodemographic and lifestyle, occupational, and clinical data related to LBP were obtained through surveys. The annual prevalence of LBP in this study was 87.1% which was higher in women. A significant relationship (p < 0.05) was obtained between sex, income, smoking, sleep quality, and all labor variables with LBP. In addition, the Fear Avoidance Beliefs Questionnaire (FABQ) results revealed that 49% of the participants had a score > 14. Also, 83.3% of patients with >6 annual LBP crises suffered from sciatica. Once the results were known, preventive intervention would be needed to reduce these main risk factors for LBP for hospitality workers.

El siglo XIX fue para España un año de gran inestabilidad política con cambios desde el absolutismo hasta el liberalismo, y grandes reformas como la Constitución de 1812 y las desamortizaciones que transformaron la estructura social. En el marco sanitario se transita a un sistema público por las reformas legales de la Ley de Beneficencia de 1849 y la Ley General de Sanidad de 1855. Sin embargo, persistieron la falta de higiene, las epidemias y la escasez de recursos. El Hospital prestó a todo tipo de pobres y enfermos cuidados básicos, médicos, quirúrgicos y espirituales. La carga de trabajo de los cuidados básicos recaía sobre las Hijas de la Caridad., Grado en Enfermería

La salud planetaria muestra cómo el estado del planeta está interconectado a la salud de la humanidad. La situación climática actual pone en peligro la salud a nivel mundial. Enfermería es una de las profesiones clave para evitar el avance de este problema. Identificar las implicaciones del rol de enfermería en la salud planetaria. Revisión sistemática de la literatura en las bases de datos de Pubmed, Cochraine, Scielo y Dialnet. Todos los artículos obtenidos fueron cribados mediante un proceso de selección y los resultados finales fueron evaluados mediante los niveles y grados de recomendación del JBI. Numerosos artículos coinciden en la importancia de la labor de la enfermería para afrontar la situación de la crisis climática. El uso de conocimientos indígenas tradicionales, creación de dietas sostenibles, implementar el concepto de “One Health” y asegurar la justicia climática son puntos clave en la lucha contra el cambio climático. Las enfermeras se encuentran en una posición esencial para el manejo de las comunidades en la educación ambiental y la asistencia, además de la investigación y la propuesta de políticas en el contexto de salud planetaria., Grado en Enfermería

Producción Científica, Introduction: Interest in 3D printing for orthopedic surgery has been increasing since its progressive adoption in most of the hospitals around the world. The aim of the study is to describe all the current applications of 3D printing in patients undergoing hip surgery of any type at the present time. Materials and Methods: We conducted a systematic narrative review of publications indexed in MedLine through the search engine PubMed, with the following parameters: 3D printing AND (orthopedics OR traumatology) NOT tissue engineering NOT scaffold NOT in vitro and deadline 31 July 2023. After reading the abstracts of the articles, papers were selected according to the following criteria: full text in English or Spanish and content related to hip surgery. Those publications involving experimental studies (in vitro or with anatomical specimens) or 3D printing outside of hospital facilities as well as 3D-printed commercial implants were excluded. Results are presented as a reference guide classified by disease, including the used software and the steps required for the development of the idea. Results: We found a total of 27 indications for in-house 3D printing for hip surgery, which are described in the article. Conclusions: There are many surgical applications of 3D printing in hip surgery, most of them based on CT images. Most of the publications lack evidence, and further randomized studies should be encouraged to assess the advantages of these indications.

Este trabajo de Fin de Grado se centra en reflexionar acerca de la importancia de fomentar la actividad física en los niños y las niñas, destacando la preocupación generada por su falta de ejercicio y el tiempo que pasan delante de las pantallas y la necesidad de promover hábitos de vida saludable desde edades tempranas. Se incide en el papel fundamental y crucial que tiene el profesorado en motivar a los y las estudiantes para realizar actividad física más allá del entorno escolar. En dicha propuesta se incluye un análisis teórico sobre la importancia de la salud, la importancia del área de Educación Física en los centros educativos, el impacto del sedentarismo en edades tempranas y estrategias para fomentar la actividad física fuera del colegio. Para ello se platea una propuesta en un centro educativo de la Comunidad de Madrid donde se evalúan los resultados seguido de unas conclusiones con el fin de mejorar las futuras intervenciones. Esta propuesta ha fomentado el aumento de la actividad física en el alumnado de 6º de primaria del CEIP Virgen de la Paz a través de la colaboración del alumnado y sus familias en la promoción de los hábitos de vida saludable. Mejoró no solo el rendimiento físico, sino las relaciones sociales con los iguales y los adultos, el trabajo cooperativo, la comunicación y la resolución de conflictos. Esta propuesta subraya la importancia del centro como promoción de la actividad física y el estilo de vida saludable en los niños y las niñas., Grado en Educación Primaria

Producción Científica, Teleworking has become an increasingly adopted modality in organizations. However, changes in working conditions have led to several challenges regarding its impacts on professionals’ health. The aim of this study is to provide a systematic review of the literature about the impact of teleworking on workers’ mental health. The PRISMA protocol and VOSviewer were used to identify the main trends from the set of 64 articles. The co-occurrence analyzes showed combined relationships between this new type of work and its effects on workers’ health, which resulted in four different clusters and a robust knowledge structure. Furthermore, the findings indicate that working from home has a dualistic nature. This study offers a prominent and promising framework regarding the teleworking impact on workers’ health research agenda.

Producción Científica, Stroke is the third leading cause of disability in the world, and effective rehabilitation is needed to improve lost functionality post-stroke. In this regard, robot-assisted therapy (RAT) and transcranial direct current stimulation (tDCS) are promising rehabilitative approaches that have been shown to be effective in motor recovery. In the past decade, they have been combined to study whether their combination produces adjuvant and greater effects on stroke recovery. The aim of this study was to estimate the effectiveness of the combined use of RATs and tDCS in the motor recovery of the upper extremities after stroke. After reviewing 227 studies, we included nine randomised clinical trials (RCTs) in this study. We analysed the methodological quality of all nine RCTs in the meta-analysis. The analysed outcomes were deficit severity, hand dexterity, spasticity, and activity. The addition of tDCS to RAT produced a negligible additional benefit on the effects of upper limb function (SMD −0.09, 95% CI −0.31 to 0.12), hand dexterity (SMD 0.12, 95% CI −0.22 to 0.46), spasticity (SMD 0.04, 95% CI −0.24 to 0.32), and activity (SMD 0.66, 95% CI −1.82 to 3.14). There is no evidence of an additional effect when adding tDCS to RAT for upper limb recovery after stroke. Combining tDCS with RAT does not improve upper limb motor function, spasticity, and/or hand dexterity. Future research should focus on the use of RAT protocols in which the patient is given an active role, focusing on the intensity and dosage, and determining how certain variables influence the success of RAT., Universidad de Castilla-La Mancha - (grant # 2021-GRIN-31053)

Producción Científica, Systemic Lupus Erythematosus (SLE) is a multifaceted autoimmune ailment that impacts multiple bodily systems and manifests with varied clinical manifestations. Early detection is considered the most effective way to save patients’ lives, but detecting severe SLE activity in its early stages is proving to be a formidable challenge. Consequently, this work advocates the use of Machine Learning (ML) algorithms for the diagnosis of SLE flares in the context of infections. In the pursuit of this research, the Random Forest (RF) method has been employed due to its performance attributes. With RF, our objective is to uncover patterns within the patient data. Multiple ML techniques have been scrutinized within this investigation. The proposed system exhibited around a 7.49% enhancement in accuracy when compared to k-Nearest Neighbors (KNN) algorithm. In contrast, the Support Vector Machine (SVM), Binary Linear Discriminant Analysis (BLDA), Decision Trees (DT) and Linear Regression (LR) methods demonstrated inferior performance, with respective values around 81%, 78%, 84% and 69%. It is noteworthy that the proposed method displayed a superior area under the curve (AUC) and balanced accuracy (both around 94%) in comparison to other ML approaches. These outcomes underscore the feasibility of crafting an automated diagnostic support method for SLE patients grounded in ML systems., Ministerio de Asuntos Económicos y Transformación Digital (MINECO) y Cátedra UCLM-Telefónica - (grant PID2021-125122OB-I00)

La profilaxis pre-exposición (PrEP) consiste en el empleo de una combinación de 2 fármacos antirretrovirales como estrategia de prevención frente a la infección por el VIH en aquellas personas que presentan un elevado riesgo de contraerla. Por otro lado, las infecciones de transmisión sexual (ITS) son entidades cada vez más prevalentes en nuestro medio, suponiendo un problema de Salud Pública no controlado, ya que tienen una amplia y rápida cadena de transmisión. El tipo de población candidata a recibir PrEP también suele tener un elevado número de ITS. Una vez que se consideran candidatos a entrar dentro del programa PrEP, se someten a controles analíticos y revisiones trimestrales con determinación de las principales ITS. Con esto, se busca evitar que el individuo contraiga la infección por VIH. En estas revisiones, se realizan asesorías sobre prevención de todo tipo de enfermedades infecciosas trasmisibles por vía sexual y tratamiento de las infecciones que se diagnostican. El objetivo de este estudio es constatar los beneficios que pueda aportar el programa de asesoría en las consultas de PrEP y todo lo que ofrece, en la disminución de la incidencia de las ITS bacterianas de las personas en PrEP de la Unidad de Enfermedades Infecciosas del Hospital Clínico de Valladolid., Grado en Medicina

Producción Científica, Background: Patellar tendinopathy is a degenerative clinical disorder that causes load-related pain in the lower pole of the patella or patellar tendon. It predominantly affects young male athletes engaged in sports involving repetitive tendon loading, particularly explosive jumping. The combination of manual techniques with therapeutic exercise is hypothesized to provide greater benefits than exercise alone. Objective: The aim of this study is to analyze the scientific evidence regarding the effects of soft-tissue techniques combined with therapeutic exercise versus therapeutic exercise alone on pain intensity and function in individuals with patellar tendinopathy. Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. PubMed, Lilacs, IBECS, CENTRAL, WOS, SciELO, Academic Search, CINAHL, SportDiscus, PEDro, and Google Scholar databases were consulted. Randomized controlled trials and quasi-randomized trials focusing on the effects of soft-tissue techniques combined with therapeutic exercise (experimental group) versus therapeutic exercise alone (control group) on pain and function in individuals aged 16 years and older with patellar tendinopathy were selected. The Cochrane tool for risk-of-bias assessment and the PEDro scale for methodological quality were used. Results and Discussion: A total of six studies (n = 309; age range = 16–40 years), considered to have a low risk of bias and moderate-to-high methodological quality, were included. The results showed improvements in function in the experimental group (mean of 60% on the Visa-P scale) and pain in the experimental group (mean decrease of 2 points in the VAS scale). There were improvements in 50% of the studies when comparing variables between the experimental and control groups. Conclusions: The combination of manual techniques, such as dry needling, percutaneous electrolysis, transverse friction massage, and stretching, along with a squat on a 25° inclined plane, appea

Producción Científica, Circadian rhythms integrate a finely tuned network of biological processes recurring every 24 h, intricately coordinating the machinery of all cells. This self-regulating system plays a pivotal role in synchronizing physiological and behavioral responses, ensuring an adaptive metabolism within the environmental milieu, including dietary and physical activity habits. The systemic integration of circadian homeostasis involves a balance of biological rhythms, each synchronically linked to the central circadian clock. Central to this orchestration is the temporal dimension of nutrient and food intake, an aspect closely interwoven with the neuroendocrine circuit, gut physiology, and resident microbiota. Indeed, the timing of meals exerts a profound influence on cell cycle regulation through genomic and epigenetic processes, particularly those involving gene expression, DNA methylation and repair, and non-coding RNA activity. These (epi)genomic interactions involve a dynamic interface between circadian rhythms, nutrition, and the gut microbiota, shaping the metabolic and immune landscape of the host. This research endeavors to illustrate the intricate (epi)genetic interplay that modulates the synchronization of circadian rhythms, nutritional signaling, and the gut microbiota, unravelling the repercussions on metabolic health while suggesting the potential benefits of feed circadian realignment as a non-invasive therapeutic strategy for systemic metabolic modulation via gut microbiota. This exploration delves into the interconnections that underscore the significance of temporal eating patterns, offering insights regarding circadian rhythms, gut microbiota, and chrono-nutrition interactions with (epi)genomic phenomena, thereby influencing diverse aspects of metabolic, well-being, and quality of life outcomes., Instituto Carlos III, Contratos Sara Borrell - (grant CD22/00011), Comunidad Autónoma de Madrid, Consejería de Educación, CIBERobn, Instituto IMDEA Alimentación - (project METAINFLAMACION: Y2020/BIO-6600)

Producción Científica, (1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45–50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed “Up & Go” at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods.

Los niños y niñas desde que nacen quieren observar y experimentar todo lo que hay a su alrededor y sienten interés por fenómenos de su entorno cercano. Cuando alcanzan la edad de 5 años, sienten la curiosidad y aumenta su deseo de saber más acerca de los dientes y, por lo que los podemos animar a investigar para alcanzar así respuestas. De ahí que la escuela tenga un papel fundamental en la primera etapa de vida de las criaturas ya que desde ésta se puede potenciar este tipo de enseñanza donde el niño y la niña puede llevar a cabo aprendizajes significativos gracias a la experimentación, manipulación, juego, etc. y abordar así la globalidad de las tres áreas del currículo de Educación Infantil. Con este Trabajo de Fin de Grado, se pone de manifiesto la importancia de enseñar y promover hábitos de vida saludable y crear rutinas para combatir las enfermedades bucodentales que cada vez son más frecuentes en la actualidad por la mala alimentación o higiene de ella. También, en este proyecto, trabajaré la lengua inglesa para adquirir nuevo vocabulario, aprendizaje y un conocimiento más amplio de ésta. Incluir la lengua inglesa en el aula en edades tempranas es importante puesto que a estas edades es mucho más fácil para ellos adquirir nuevos conocimientos y vocabulario. La escuela es el lugar idóneo para comenzar a prevenir futuros problemas de salud con una buena alimentación y una adecuada higiene bucodental. A través de este proyecto, se proponen una serie de actividades relacionadas con la buena alimentación, materiales, salud e higiene bucodental que se han puesto en práctica en el prácticum II realizado en una clase de 3º de Educación Infantil con 18 alumnos y alumnas de entre 4 y 5 años, con el objetivo de lograr una mejora y promover una correcta higiene bucodental, buenos hábitos alimenticios y conocer algunas de sus enfermedades y herramientas para prevenirlas, todo ello a través del trabajo en la lengua materna, español, y la lengua extranjera, inglés., Grado en Educación Infantil

Producción Científica, Background and Objectives: Modern classification and categorization of individuals’ health requires personalized variables such as nutrition, physical activity, lifestyle, and medical data through advanced analysis and clustering methods involving machine learning tools. The objective of this project was to categorize Mediterranean dwellers’ health factors and design metabotypes to provide personalized well-being in order to develop professional implementation tools in addition to characterizing nutritional and lifestyle features in such populations. Materials and Methods: A two-phase observational study was conducted by the Pharmacists Council to identify Spanish nutritional and lifestyle characteristics. Adults over 18 years of age completed questionnaires on general lifestyle habits, dietary patterns (FFQ, MEDAS-17 p), physical activity (IPAQ), quality of life (SF-12), and validated well-being indices (LS7, MEDLIFE, HHS, MHL). Subsequently, exploratory factor, clustering, and random forest analysis methods were conducted to objectively define the metabotypes considering population determinants. Results: A total of 46.4% of the sample (n = 5496) had moderate-to-high adherence to the Mediterranean diet (>8 points), while 71% of the participants declared that they had moderate physical activity. Almost half of the volunteers had a good self-perception of health (49.9%). Regarding lifestyle index, population LS7 showed a fair cardiovascular health status (7.9 ± 1.7), as well as moderate quality of life by MEDLIFE (9.3 ± 2.6) and MHL scores (2.4 ± 0.8). In addition, five metabotype models were developed based on 26 variables: Westernized Millennial (28.6%), healthy (25.1%), active Mediterranean (16.5%), dysmetabolic/pre-morbid (11.5%), and metabolically vulnerable/pro-morbid (18.3%). Conclusions: The support of tools related to precision nutrition and lifestyle integrates well-being characteristics and contributes to reducing the impact of unhealthy lifestyle habits w, Instituto de Salud Carlos III, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN) y Fondo Europeo de Desarrollo Regional (FEDER) - (grants CB12/03/30038; CB22/03/00068; CB12/03/30002)

Producción Científica, Sex workers are particularly vulnerable to violence, isolation, and stigmatization. This study uses the theory of loneliness to explore the relations among violence, self-esteem, loneliness, health, and drug use. Specifically, this study tested a model in which loneliness mediates the relationship between situational (violence) and characterological (self-esteem) loneliness factors and physical and psychological health and drug abuse. The study sample consisted of 146 sex workers from one region of Spain, recruited through the purposive sampling method. Partial least squares (PLS) path modeling has been employed to test the hypothesis. The findings of this study suggest that two kinds of violence (physical and psychological) have a direct and positive influence on loneliness, so that higher levels of violence increase loneliness, while self-esteem has a protector role on loneliness. Loneliness has a direct and negative impact on psychological and physical health, and determines an increase in drug use, which, in turn, decreases both physical and psychological health. The results support, among other points, that policy makers and sex worker service programs need to be aware of how loneliness plays a role in the health and risk behavior of sex workers. Society has an important role to improve sex workers’ health and minimize their risk behavior.

Producción Científica, The aim of the researchers is to explore the causes and consequences of the psychological health of sex workers as well as provide an intervention model for the prevention of mental disorders in accordance with World Health Organization (WHO) levels. The study sample consisted of 146 sex workers from Spain. Loneliness and maltreatment have a negative influence on psychological health, while self-esteem has a protector role over psychological health. Psychological health has a positive impact on perceived quality of life and other health domains. On the contrary, psychological health has a negative impact on drug use and symptoms of anxiety. Data are discussed.

This article examines the prevention and treatment of depression as part of the fundamental right to health that all human beings have, including the right to accurate health information, in this case, about the nature and treatment of depression. After presenting data on the frequency and severity of depression that support its consideration as a major global health problem and after reviewing the definition of depression and its distinction from sadness and related normal problems, the global problems of the low coverage of the treatment of depression and the excessive prescription of antidepressant drugs for its treatment to the detriment of psychotherapy are addressed. This excessive prescription of antidepressant drugs does not respond to the fact that they are the best therapeutic alternative compared to psychotherapy or to an informed choice by patients, but, in part, to the existence of erroneous or imprecise information about the treatment of depression. In the context of the right to adequate information about therapeutic alternatives for depression, the article uses current scientific knowledge to dismantle some misconceptions about depression and its treatment that proliferate on the Internet and even in some clinical guides and manuals for the training of health professionals. The article also addresses the problems of the medicalization of depression, the pathologization and medicalization of everyday problems, the unreliability of the health information found on the Internet, and the increasingly widespread use of pseudotherapies and diagnostic and therapeutic procedures or lifestyles based on pseudosciences., En este artículo se analiza la prevención y el tratamiento de la depresión como parte del derecho fundamental a la salud que tienen todos los seres humanos, incluido el derecho a una información veraz sobre la salud, en este caso, sobre la naturaleza y el tratamiento de la depresión. Tras presentar los datos sobre la frecuencia y gravedad de la depresión que apoyan su consideración de problema sanitario mundial de primera magnitud y tras revisar la definición de depresión y su distinción de la tristeza y los problemas normales relacionados, se aborda el problema mundial de la baja cobertura del tratamiento de la depresión y de la prescripción excesiva de fármacos antidepresivos para su tratamiento en detrimento de la psicoterapia. Esta prescripción excesiva de fármacos antidepresivos no responde al hecho de que sean la mejor alternativa terapéutica en comparación a la psicoterapia o a una elección informada por parte de los pacientes, sino, en parte, a la existencia de información errónea o imprecisa sobre el tratamiento de la depresión. En el contexto del derecho a una información adecuada sobre las alternativas terapéuticas para la depresión, en el artículo se desmontan con los conocimientos científicos actualmente vigentes algunas ideas equivocadas sobre la depresión y su tratamiento que proliferan en Internet e, incluso, en algunas guías clínicas y manuales para la formación de los profesionales de la salud. El artículo también aborda el problema de la medicalización de la depresión, de la patologización y medicalización de los problemas cotidianos, de la baja fiabilidad de la información sobre la salud que se encuentra en Internet y de la utilización cada vez más amplia de pseudoterapias y de procedimientos diagnósticos y terapéuticos o estilos de vida basados en pseudociencias., Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, FALSE, pub

This study analyzed the individual differences in hemodynamic time patterns and reactivity to cognitive and emotional tasks, and explored the diversity of psycho-physiological profiles that could be used for the personalized prediction of different diseases. An analysis of heart rate (HR)—blood pressure (BP) relationship patterns across time using cross-correlations (CCs) during a logical-mathematical task and a task recalling negative emotions (rumination) was carried out in a laboratory setting on 45 participants. The results showed maximum HR–BP CCs during the mathematical task significantly more positive than the maximum HR–BP CCs during the rumination task. Furthermore, our results showed a large variety of hemodynamic reactivity profiles across the participants, even when carrying out the same tasks. The most frequent type showed positive HR–BP CCs under cognitive activity, and several positive–negative HR–BP CCs cycles under negative emotional activity. In general terms, our results supported the main hypothesis. We observed some distinct time-based “coordination strategies” in the reactivity of the autonomic nervous system under emotional vs. cognitive loading. Overall, large individual, as well as situational, specificities in hemodynamic reactivity time patterns were seen. The possible relationships between this variety of profiles and different psychosocial characteristics, and the potential for integrative predictive health within the provision of highly personalized medicine, are discussed., Este estudio analizó las diferencias individuales en los patrones de tiempo hemodinámicos y la reactividad a las tareas cognitivas y emocionales, y exploró la diversidad de perfiles psicofisiológicos que podrían utilizarse para la predicción personalizada de diferentes enfermedades. Se llevó a cabo un análisis de los patrones de relación entre la frecuencia cardíaca (FC) y la presión arterial (PA) a lo largo del tiempo mediante correlaciones cruzadas (CC) durante una tarea matemática lógica y una tarea que recordaba emociones negativas (rumiación) en un entorno de laboratorio con 45 participantes. Los resultados mostraron CC máximos de HR-BP durante la tarea matemática significativamente más positivos que los CC máximos de HR-BP durante la tarea de rumiación. Además, nuestros resultados mostraron una gran variedad de perfiles de reactividad hemodinámica entre los participantes, incluso cuando realizaban las mismas tareas. El tipo más frecuente mostró CC de FC-PA positivas bajo actividad cognitiva, y varios ciclos de CC de FC-PA positivos-negativos bajo actividad emocional negativa. En términos generales, nuestros resultados apoyaron la hipótesis principal. Observamos algunas "estrategias de coordinación" distintas basadas en el tiempo en la reactividad del sistema nervioso autónomo bajo carga emocional versus cognitiva. En general, se observaron grandes especificidades individuales, así como situacionales, en los patrones de tiempo de reactividad hemodinámica. Se discuten las posibles relaciones entre esta variedad de perfiles y diferentes características psicosociales, y el potencial para la salud predictiva integradora dentro de la provisión de una medicina altamente personalizada., Depto. de Psicología Social, del Trabajo y Diferencial, Fac. de Psicología, TRUE, pub

Entre marzo y mayo de 2020, el Ministerio de Sanidad y el Consejo General de la Psicología de España, pusieron en marcha el Servicio de Primera Ayuda Psicológica (SPAP), un servicio telefónico para toda España, diseñado para proveer atención psicológica temprana a las personas afectadas por la COVID-19. En el tiempo en que el servicio estuvo disponible, se gestionaron 15.170 llamadas, que condujeron a realizar 11.417 intervenciones psicológicas con personal sanitario y otros intervinientes, con enfermos y familiares de enfermos o fallecidos, y población general. Los resultados muestran que la mayoría de llamadas (45,7%) provenían de la Comunidad Autónoma de Madrid, que hubo significativamente más mujeres que utilizaron el servicio (73,5%) y que el rango de edad más común entre los usuarios era el de 40-59 años. El 75,9% de las consultas tuvo que ver con problemas psicológicos relacionados con sintomatología ansiosa y depresiva, aunque también destacaba la sintomatología de duelo entre los enfermos o familiares de enfermos y fallecidos y, en menor medida, la sintomatología de estrés en el grupo de intervinientes. Estos datos muestran la necesidad de este servicio de atención psicológica temprana y sugieren que recursos como este deberían implementarse de manera integrada en el Sistema Nacional de Salud., Between March and May 2020, the Spanish Ministry of Health and the Spanish Psychological Association created the Psychological First Care Service (Servicio de Primera Ayuda Psicológica-SPAP), a national helpline designed to provide early psychological intervention to those people affected by COVID-19. This service attended more than 15,000 calls and carried out more than 11,000 interventions and 9,500 follow-ups with the general population, healthcare and other essential professionals and the patients and relatives of the sick or deceased. Results show that the majority of calls (45.7%) came from the Autonomous Community of Madrid, that women significantly used this service in a higher proportion than men (73.5%) and that the commonest age range among users was 40-59. 75.9% of consultations were related to psychological problems linked to anxiety and depressive symptoms. However, grief symptoms also stood out among the patients or relatives of the sick and deceased and, to a lesser extent, stress symptoms were prevalent in the group of professionals. These data show the usefulness of this early psychological care service and the need for similar resources to be implemented in coordination with or within the National Health System., Ministerio de Sanidad, Consejo General de la Psicología de España, Ministerio de Ciencia, Innovación y Universidades, Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

El SARS-CoV-2 (en adelante, COVID-19) ha generado un impacto sin precedentes en la sociedad española a nivel sanitario y social. El objetivo de este estudio es analizar en qué medida factores sanitarios,sociales y psicológicos se relacionan con resiliencia durante la pandemia en la población española. Se realizó un estudio cuantitativo y cross sectional y se aplicó un cuestionario creado ad hoc de 43 preguntas cerradas en formato online, a una muestra de 3.436 personas residentes en España durante la segunda prórroga del Estado de Alarma. Se ajustó un modelo lineal mixto con intersección aleatoria, estimado bajo un enfoque bayesiano. Los resultados muestran asociaciones positivas entre resiliencia y presentar sintomatología de COVID-19 (principalmente en hombres), así como haber sufrido fallecimientos en sus entornos. Asimismo, se obtienen relaciones negativas entre resiliencia y enfermedad previa diagnosticada, experimentar malestar emocional y estar desempleado a consecuencia de la actual pandemia, siendo este último efecto relevante principalmente entre los hombres. El factor género no influyó en la resiliencia, excepto en los casos señalados. El estudio permite concluir que identificar factores de riesgo sanitarios, sociales y psicológicos que inciden en la vulnerabilidad poblacional deben ser considerados en la planificación de políticas para afrontar la crisis actual., Depto. de Trabajo Social y Servicios Sociales, Fac. de Trabajo Social, TRUE, pub

Background: Worldwide, asthma, back pain, and migraine are major public health problems due to their high prevalence, effect on the quality of life, and huge economic costs. The association of asthma with an increased risk of these types of pain has been suggested; however, no conclusive results have been obtained to date. The aims of our study were (1) to describe and compare the prevalence of three types of pain localization, namely migraine or frequent headaches (MFH), chronic neck pain (CNP), and chronic low back pain (CLBP), in adults with and without asthma in Spain during the years 2014 and 2020 and (2) to identify which variables were associated with the presence of these types of pain in adults with asthma. (2) Methods: A cross-sectional study and a case-control study were conducted. The 2014 and 2020 European Health Interview Surveys for Spain were used as the data source. (3) Results: A total of 2463 individuals were interviewed and had self-reported asthma. In this group, the prevalence of pain was high, with CLBP (30.9%) being the most common, followed by CNP (26.7%) and MFH (13.3%). All types of pain remained stable from 2014 to 2020. In both surveys, the women with asthma reported a remarkably higher prevalence of all the types of pain analyzed than the men with asthma. After matching by age and sex, the prevalence of all pain types was significantly higher in the patients with asthma than in the matched individuals without asthma. Multivariable adjustment showed that asthma increased the likelihood of CNP by 1.45 times (OR 1.45; 95% CI 1.19-1.76), that of CLBP by 1.37 times (OR 1.37; 95% CI 1.11-1.64), and that of MFH by 1.19 times (OR 1.19; 95% CI 1.02-1.51). The three types of pain analyzed were associated with the female sex and worse self-rated health. (4) Conclusions: Among the men and women with asthma, the prevalence of all the pain types was high and remained stable over time. The prevalence was higher and the severity was greater among the w, Comunidad Autónoma de Madrid, Universidad Complutense de Madrid, Depto. de Inmunología, Oftalmología y ORL, Fac. de Medicina, TRUE, pub

La prevalencia de desórdenes emocionales (DE) ha aumentado considerablemente en los últimos años. Los servicios de Atención Primaria (AP) son los primeros receptores de la mayoría de pacientes con estas patologías, especialmente las relacionadas con la depresión, la ansiedad y las somatizaciones. En España, la proporción de estos pacientes que recibe un tratamiento mínimamente adecuado es baja, por lo que resulta necesario establecer de protocolos de tratamiento eficientes, basados en la evidencia científica, para el abordaje de los DE. El proyecto PsicAP es un protocolo de intervención grupal fundamentado en el enfoque transdiagnóstico y basado en técnicas cognitivo-conductuales. El objetivo es acercar los tratamientos psicológicos a la AP, facilitando el acceso a un porcentaje elevado de la población. A continuación, se describe el caso clínico de un paciente con un DE que participa en el proyecto PsicAP. El programa, basado en el modelo de tratamiento transdiagnóstico, se desarrolla en 7 sesiones grupales, de hora y media de duración y repartidas en 24 semanas. El programa resulta eficaz en la reducción de la sintomatología clínica, lo que confirma que se trata de un tratamiento breve, de bajo coste y útil para el abordaje de los DE en el contexto de AP., In recent years the emotional disorders’ (ED) prevalence has increased considerably. Primary Care (PC) services are the first receivers of the majority of patients with these pathologies, especially those related to depression, anxiety and somatization. In Spain, the proportion of these patients that receives a minimally adequate treatment is low. It is necessary to establish efficient treatment protocols based on scientific evidence to approach the ED. Psychology project in PC PsicAP is a groupal intervention protocol based on the transdiagnostic approach and cognitive-behavioral techniques. The objective is bringing psychological treatments closer to PC, making easier access to a high percentage of the population. Next, we describe the case of an ED patient who participates in PsicAP project. The program, based on the transdiagnostic treatment approach, is developed in 7 group sessions, with a duration of an hour and a half over 24 weeks. The program is effective in reducing clinical symptoms, which confirms that is a short, low-cost and useful treatment for ED patients in the PC context., Depto. de Psicología Experimental, Procesos Cognitivos y Logopedia, Fac. de Trabajo Social, TRUE, pub

Background: We analyzed the association between atrial fibrillation or atrial flutter (AF) and in-hospital mortality (IHM) among patients who underwent solid organ transplants in Spain from 2004 to 2021. (2) Methods: We gathered information from all hospital admissions for lung, liver, kidney, and heart transplants. (3) Results: A total of 71,827 transplants were analyzed (4598 lung transplants; 18,127 liver transplants; 45,262 kidney transplants; and 4734 heart transplants). One third of these were for women. Overall, the prevalence of AF was 6.8% and increased from 5.3% in 2004-2009 to 8.6% in 2016-2021. The highest prevalence of AF was found for heart transplants (24.0%), followed by lung transplants (14.7%). The rates for kidney and liver transplants were 5.3% and 4.1%, respectively. The AF code increased over time for all of the transplants analyzed (p < 0.001). The patients' IHM decreased significantly from 2004-2009 to 2016-2021 for all types of transplants. AF was associated with a higher IHM for all of the types of transplants analyzed, except for heart transplants. (4) Conclusions: The prevalence of AF among patients admitted for solid organ transplants was highest for those who underwent heart transplants. The mortality rate during the patients' admission for lung, liver, kidney, or heart transplants decreased over time. AF was independently associated with a higher risk of dying in the hospital for those who underwent lung, liver, or kidney transplants., Comunidad Autónoma de Madrid, Universidad Complutense de Madrid, Depto. de Inmunología, Oftalmología y ORL, Fac. de Medicina, TRUE, pub

Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods: This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated., The Innocent Foundation, European Civil Protection and Humanitarian Aid Operations Commission, Post Code Lottery Foundation, Depto. de Biodiversidad, Ecología y Evolución, Fac. de Ciencias Biológicas, TRUE, pub

El SARS-CoV-2 (en adelante, COVID-19) ha generado un impacto sin precedentes en la sociedad española a nivel sanitario y social. El objetivo de este estudio es analizar en qué medida factores sanitarios, sociales y psicológicos se relacionan con resiliencia durante la pandemia en la población española. Se realizó un estudio cuantitativo y cross sectional y se aplicó un cuestionario creado ad hoc de 43 preguntas cerradas en formato online, a una muestra de 3.436 personas residentes en España durante la segunda prórroga del Estado de Alarma. Se ajustó un modelo lineal mixto con intersección aleatoria, estimado bajo un enfoque bayesiano. Los resultados muestran asociaciones positivas entre resiliencia y presentar sintomatología de COVID-19 (principalmente en hombres), así como haber sufrido fallecimientos en sus entornos. Asimismo, se obtienen relaciones negativas entre resiliencia y enfermedad previa diagnosticada, experimentar malestar emocional y estar desempleado a consecuencia de la actual pandemia, siendo este último efecto relevante principalmente entre los hombres. El factor género no influyó en la resiliencia, excepto en los casos señalados. El estudio permite concluir que identificar factores de riesgo sanitarios, sociales y psicológicos que inciden en la vulnerabilidad poblacional deben ser considerados en la planificación de políticas para afrontar la crisis actual., SARS-CoV-2 (hereinafter, COVID-19) has generated an unprecedented impact on Spanish society at a health and social level. The objective of this study is to analyze to what extent health, social and psychological factors are related to resilience during the pandemic in the Spanish population. A quantitative and cross-sectional study was carried out and an ad hoc questionnaire of 43 closed questions was applied in online format, to a sample of 3,436 people residing in Spain during the second extension of the State of Alarm. A mixed linear model with random intersection was fitted, estimated under a Bayesian approach. The results show positive associations between resilience and presenting symptoms of COVID-19 (mainly in men), as well as having suffered deaths in their surroundings. Likewise, negative relationships are obtained between resilience and a previously diagnosed disease, experiencing emotional distress and being unemployed as a result of the current pandemic, the latter effect being relevant mainly among men. The gender factor did not influence resilience, except in the cases indicated. The study allows us to conclude that identifying health, social and psychological risk factors that affect population vulnerability should be considered in planning policies to face the current crisis., Depto. de Trabajo Social y Servicios Sociales, Fac. de Trabajo Social, TRUE, pub

El procedimiento estándar de selección de pacientes con hipertensión arterial (HTA) esencial en los ensayos clínicos de los tratamientos antihipertensivos puede incluir pacientes con HTA clínica aislada (HTA-CA) o de bata blanca, lo cual amenaza su validez. Utilizando mediciones clínicas (procedimiento estándar) y automediciones de la presión arterial (PA), se estimó la prevalencia de HTA-CA entre 43 varones con HTA esencial participantes en un ensayo controlado sobre entrenamiento en control de estrés. El error diagnóstico debido a la presencia de HTACA osciló entre 28% y 55%. Tras reanalizar los datos de eficacia del ensayo en función del tipo de HTA se encontró que la presencia de HTA-CA sobreestima la reducción observada en la PA sistólica clínica, pero no en la automedida ni en la PA diastólica clínica o automedida. Se concluye que el procedimiento estándar de selección de pacientes con HTA esencial debe complementarse con medidas no clínicas de PA (automediciones o medidas ambulatorias)., In clinical trials on antihypertensive treatments, the standard procedure to select patients with essential hypertension (EH) may involve the admission of patients with white-coat or isolated clinical hypertension (ICH) that threats trial validity. Employing clinic blood pressure (BP) measurements (standard procedure) and BP self-measurements, the present study estimated the prevalence of ICH among 43 males with EH who had participated in a controlled trial on stress-management training. Diagnostic errors due to the inclusion of ICH ranged from 28% to 55%. After re-analyzing data on efficacy taking into account the type of hypertension, the results suggested that the inclusion of ICH leads one to overestimate the reductions of clinic systolic BP found at postreatment but not those of clinic diastolic BP or self-measured BP. It was concluded that the standard procedure of selection of EH patients should be supplemented by other BP measures taken outside clinic (e.g., self-measurements or ambulatory recordings)., Comunidad de Madrid, Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Knowing the attitudes and behaviors of nursing students in relation to vaccination is important because they will soon be determinant for the health literacy of the population. Vaccination remains the most effective response in the fight against communicable diseases, including COVID-19 and influenza. The objective of this study is to analyze the attitudes and behaviors of Portuguese nursing students with regard to vaccination. A cross-sectional study was carried out, with data collection from nursing students at a university in Lisbon, Portugal. A sample of 216 nursing students was obtained, representing 67.1% of the students enrolled in this university. What stands out from the results of the questionnaire “Attitudes and Behaviors in Relation to Vaccination among Students of Health Sciences” is that for the majority of students the answers were positive; in addition, 84.7% had a completed vaccination schedule for COVID-19. Being a nursing student, being in the final years of the course and being a woman are the factors that most influence the positive attitude of the students. The results obtained are motivating, because these students will be the future health professionals most likely to integrate health promotion programs through vaccination., Foundation for Science and Technology (FCT), Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Este trabajo fue publicado en línea el 29 de abril de 2020, y posteriormente publicado en el año 2021 en el volumen 37(2):86-94, Cognitive emotion regulation strategies have been proposed as an explanation for transdiagnostic vulnerability to emotional disorders, which are highly prevalent in the primary care setting. The use of brief psychological instruments to detect cognitive-emotional factors—such as worry, rumination, interpretative and attentional distortions, and metacognitions—could provide valuable clinical data to better guide treatment in primary care. The aim of the present study was to evaluate the psychometric properties of four brief scales derived from the full versions of four assessment instruments (PSWQ, RRS, IACTA, and MCQ-30). The brief scales were completed by 1,250 primary care patients with an emotional disorder diagnosed by a general practitioner. The following characteristics of the scales were assessed: (a) internal structure (assessed by confirmatory factor analysis), (b) internal consistency, (c) convergent validity, (d) metric invariance across gender and age, and (e) predictive validity. The results showed a unifactorial structure for all of the tested scales, with an acceptable internal consistency and convergent validity, and invariance across gender and age. The brief scales presented predictive validity using the PHQ-4, a 4-item scale used to detect depression and generalized anxiety disorders, suggesting that these brief scales are optimal for use in the primary care setting., Depto. de Psicología Experimental, Procesos Cognitivos y Logopedia, Fac. de Trabajo Social, TRUE, pub

ANTECEDENTES Y OBJETIVO: La automedicación (AM) es una parte del autocuidado que se sabe que contribuye a la atención primaria de salud. Si se practica adecuadamente, tiene importantes beneficios para los consumidores, como la autosuficiencia y la disminución del gasto. Sin embargo, una práctica inadecuada puede conllevar peligros potenciales como un autodiagnóstico incorrecto, interacciones medicamentosas peligrosas, forma incorrecta de administración, dosificación incorrecta, elección incorrecta del tratamiento, enmascaramiento de una enfermedad grave y/o riesgo de dependencia y abuso. El objetivo principal de este estudio era evaluar la prevalencia y los factores determinantes de la práctica de la automedicación en Addis Abeba. METODOLOGÍA: Se llevó a cabo un estudio transversal basado en la comunidad entre los hogares seleccionados en Addis Abeba de abril a mayo de 2016, con un período de recuerdo de dos meses antes de su realización. Se emplearon recopiladores de datos capacitados para recopilar los datos de los 604 participantes de la muestra utilizando cuestionarios previamente probados y validados. RESULTADO: De los 604 participantes en este estudio, 422 (69,9%) eran mujeres y 182 (30,1%) hombres, con una edad media de 41,04 (± 13,45) años. La prevalencia de AM en este estudio fue del 75,5%. Las tres dolencias más frecuentemente referidas fueron cefalea 117 (25,7%), dolor abdominal 59 (12,9%) y tos 54 (11,8%). Los dos motivos principales de la AM fueron la levedad de la enfermedad 216 (47,4%) y el conocimiento previo del medicamento 106 (23,2%). Los dos medicamentos consumidos con más frecuencia fueron el paracetamol 92 (20,2%) y los remedios tradicionales 73 (16,0%), mientras que los puntos de venta de medicamentos 319 (83,3%) fueron la principal fuente de medicamentos. Las dos fuentes de información sobre medicamentos más frecuentes fueron los profesionales sanitarios 174 (45,4%) y la experiencia de tratamientos anteriores 82 (21,4%). Además, hubo diferenc, Background and aim: Self-medication (SM) is one part of self-care which is known to contribute to primary health care. If practiced appropriately, it has major benefits for the consumers such as self-reliance and decreased expense. However, inappropriate practice can have potential dangers such as incorrect self-diagnosis, dangerous drug-drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease, and/or risk of dependence and abuse. The main objective of this study was to assess the prevalence and determinants of the self-medication practice (SMP) in Addis Ababa. Methodology: A community based cross-sectional study was conducted among selected households in Addis Ababa from April 2016 to May 2016, with a recall period of two months before its conduction. Trained data collectors were employed to collect the data from the 604 sampled participants using pre-tested and validated questionnaires. Result: Among the 604 participants involved in this study, 422 (69.9%) were female and 182 (30.1%) were male and there was a mean age of 41.04 (± 13.45) years. The prevalence of SM in this study was 75.5%. The three most frequently reported ailments were headache 117 (25.7%), abdominal pain 59 (12.9%) and cough 54 (11.8%). The two main reasons for SM were mildness of illness 216 (47.4%) and previous knowledge about the drug 106 (23.2%). The two most frequently consumed medications were paracetamol 92 (20.2%) and traditional remedies 73 (16.0%), while drug retail outlets 319 (83.3%) were the main source of drugs. The two most frequently reported source of drug information were health professionals 174 (45.4%) and experience from previous treatment 82 (21.4%). Moreover, there were statistically significant differences among respondents who reported practicing SM based on income and knowledge about appropriate SMP. Conclusion and recommendation: Self-medication was practiced with a range of drugs from the convent, Saint Paul’s Hospital Millennium Medical College, Research Directorate Director, Democratic Republic of Ethiopia, Depto. de Farmacología, Farmacognosia y Botánica, Fac. de Farmacia, TRUE, pub

Background: Guatemala is the Latin American country with the highest prevalence of childhood stunting. Short height can bias the diagnosis of wasting when using the weight-for-height indicator. The aim of this study was to evaluate the diagnostic concordance of the anthropometric indicators of wasting and the relationship between wasting and stunting in children from highly vulnerable communities in Guatemala. Methods: The sample consisted of 13,031 anthropometric records of children under five years of age (49.5% girls, average age of 27.9 months), including weight, height, and mid-upper arm circumference (MUAC), collected in March–August 2019. The proportions of stunting, underweight, and wasting, assessed by three different indicators, as well as their concurrence through the Composite Index of Anthropometric Failure were calculated. Results: Stunting affected 73% of the sample, and 74.2% showed anthropometric failure. Wasting varied by indicator (weight-for-height: 2.8%; MUAC: 4.4%; MUAC-for-age: 10.6%). Concordance between MUAC and weight-for-height was very low (Kappa: 0.310; sensitivity: 40.9%). MUAC identified more wasted children in the stunted group (53.6% vs. 26.5%), while the opposite occurred in the non-stunted group (34.8% vs. 46.7%). Conclusion: The presence of stunting affected the diagnosis of wasting, and both indicators should be included as diagnostic criteria for screening campaigns and in the treatment of moderate to acute wasting in vulnerable populations affected by multiple forms of undernutrition., European Civil Protection and Humanitarian Aid Operations Commission, Depto. de Biodiversidad, Ecología y Evolución, Fac. de Ciencias Biológicas, TRUE, pub

A hipertensão arterial tem sido estudada sob vários enfoques. As pesquisas demonstram a conexão entre os determinantes sociais e as manifestações a doença. Este estudo trata dos estressores sociais de hipertensão na Vila Nossa Senhora de Fátima, Porto Alegre, Brasil. Relata e discute os resultados do trabalho realizado junto a esta população, no qual se examinam variáveis constitucionais, sociais e fisiológicas. O exame da literatura sobre o tema e a comparação com um grupo controle, advindo de estudo semelhante com população de outro contexto social, mostrou a influência dos estressores sociais no processo de desenvolvimento da hipertensão. As conclusões alcançadas permitem algumas recomendações de ação no sentido da construção da cidadania como instrumento de participação e promoção de saúde., The origins of systemic high blood pressure has been studied from a wide array of different approaches. Researches suggests a very close connection between social environment stressors and all the manifestations of the disease itself. The present study deals with relevant social stressors that might be related to the high rates of high blood pressure found among the inhabitants of Vila Nossa Senhora de Fátima, a poor neighborhood in Porto Alegre, Brasil. Results, when compared to those comming from samples from different contexts of the same city, suggest an important relationship between certain social circunstances and the evolution of the hypertension desease. The discussion points to the importance of building up ciitzenship as a tool for health participation and promotion., Depto. de Psicología Social, del Trabajo y Diferencial, Fac. de Psicología, TRUE, pub

Inter-regional patient mobility represents both a resource and a challenge for the organization and financing of health systems, particularly in decentralised countries. We use cross-sectional time series regression analysis to test the determinants of imbalances in regional funds to finance inter-regional patient mobility for the 17 Spanish regions for the period 2014–2020. The findings indicate that highly specialised health centres and bilateral agreements partly explain the budget imbalance from inter-regional patient referrals, while local tourism partly explains the budget imbalance from non-referred patient mobility. Developing effective national schemes to compensate net patient recipient regions would be fundamental to addressing territorial imbalances., INAP, Ministerio de Ciencia e Innovación, Depto. de Ciencia Política y de la Administración, Fac. de Ciencias Políticas y Sociología, TRUE, pub

Introducción: la emergencia sanitaria por el COVID-19 ha generado una conmoción mundial que conlleva una serie de problemáticas relacionadas con la salud, los factores psicosociales y la situación económica. Objetivo: evaluar el efecto del confinamiento en el ánimo depresivo en población residente en España mayor de 18 años durante el estado de alarma provocada por la pandemia de la COVID-19, analizando, además, la posible incidencia de las variables sexo, edad, tamaño de la vivienda e ingresos económicos. Material y Métodos: diseño transversal, descriptivo y correlacional con metodología de carácter cuantitativo. El acceso a la muestra fue no probabilístico a través de la técnica bola de nieve. Para evaluar la condición de ánimo depresivo se utilizó la escala CES-D. Para recopilar los datos relacionados con el sexo, la edad, el tamaño de vivienda y la situación económica, se crearon preguntas ad hoc en la propia encuesta. Resultados: las mujeres presentan valores de ánimo depresivo superiores a los hombres. Además, los valores de ánimo depresivo son mayores cuanto menor es la edad. Las personas que residen en viviendas con un tamaño menor, presentan valores de ánimo depresivo superiores respecto a las personas que viven en residencias con superficies mayores. A su vez, las personas con peores condiciones económicas perciben mayores niveles de ánimo depresivo. Conclusiones: los resultados indican que los síntomas de ánimo depresivo y las consecuencias psicosociales en la población española durante el confinamiento, se encuentran condicionadas por el sexo, la edad, el tamaño de la vivienda y la situación económica., Depto. de Trabajo Social y Servicios Sociales, Fac. de Trabajo Social, TRUE, pub

Background: In 2015, the Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated Community Case Management (iCCM). This paper aims to analyze the impact of including community health workers (CHWs) as treatment providers outside the Health Facilities (HFs) on the coverage of SAM treatment when scaling up the intervention in the three largest districts of the Kayes Region in Mali. Methods: A baseline coverage assessment was conducted in August 2017 in the three districts before the CHWs started treating SAM. The end-line assessment was conducted one year later, in August 2018. Coverage was assessed by the standardized methodology called Semi-Quantitative Evaluation of Access and Coverage (SQUEAC). The primary outcome was treatment coverage and other variables evaluated were the geographical distribution of the HFs, CHW’s sites and overlapping between both health providers, the estimation of children with geographical access to health care and the estimation of children screened for acute malnutrition in their communities. Results: Treatment coverage increased in Kayes (28.7–57.1%) and Bafoulabé (20.4–61.1%) but did not in Kita (28.4–28.5%). The decentralization of treatment has not had the same impact on coverage in all districts, with significant differences. The geospatial analyses showed that Kita had a high proportion of overlap between HFs and/or CHWs 48.7% (39.2–58.2), a high proportion of children without geographical access to health care 70.4% (70.1–70.6), and a high proportion of children not screened for SAM in their communities 52.2% (51.9–52.5). Conclusions: Working with CHWs in SAM increases treatment coverage, but other critical aspects need to be considered by policymakers if this intervention model is intended to be scaled up at the country level. To improve families’ access to nutritional health care, before establishing decentralized treatment in a whole region it must be, The Innocent Foundation, The European Civil Protection and Humanitarian Aid Operation (ECHO), Post Code Lottery Foundation, Depto. de Biodiversidad, Ecología y Evolución, Fac. de Ciencias Biológicas, TRUE, pub

(1) Background: Our aim was to determine changes in the prevalence of physical activity (PA) in adults with asthma between 2014 and 2020 in Spain, investigate sex differences and the effect of other variables on adherence to PA, and compare the prevalence of PA between individuals with and without asthma. (2) Methods: This study was a cross-sectional, population-based, matched, case–control study using European Health Interview Surveys for Spain (EHISS) for 2014 and 2020. (3) Results: We identified 1262 and 1103 patients with asthma in the 2014 and 2020 EHISS, respectively. The prevalence of PA remained stable (57.2% vs. 55.7%, respectively), while the percentage of persons who reported walking continuously for at least 2 days a week increased from 73.9% to 82.2% (p < 0.001). Male sex, younger age, better self-rated health, and lower body mass index (BMI) were significantly associated with greater PA. From 2014 to 2020, the number of walking days ≥2 increased by 64% (OR1.64 95%CI 1.34–2.00). Asthma was associated with less PA (OR0.87 95%CI 0.47–0.72) and a lower number of walking days ≥2 (OR0.84 95%0.72–0.97). (4) Conclusions: Walking frequency improved over time among people with asthma. Differences in PA were detected by age, sex, self-rated health status, and BMI. Asthma was associated with less LTPA and a lower number of walking days ≥2. © 2024 by the authors., Comunidad de Madrid (ESpaña), Universidad Complutense de Madrid (España), Depto. de Inmunología, Oftalmología y ORL, Depto. de Salud Pública y Materno - Infantil, Unidad Docente de Inmunología, Oftalmología y ORL, Depto. de Medicina, Fac. de Óptica y Optometría, Fac. de Medicina, TRUE, pub

We study a stochastic epidemic model of Susceptible-Exposed-Infective-Removed (SEIR) type and we quantify its behavior during an outbreak. More specifically, we model the epidemic by a continuous-time Markov chain and we develop efficient computational procedures for the distribution of the duration of an outbreak. We also study the evolution of the epidemic before its extinction using the ratio-of-expectations (RE) distribution for the number of individuals in the various classes of the model. The obtained results are illustrated by numerical examples including an application to an outbreak of Marburg hemorrhagic fever, Ministerio de Ciencia e Innovación de España, Comisión Europea, Universidad Complutense de Madrid, Banco Santander, Depto. de Estadística y Ciencia de los Datos, Fac. de Estudios Estadísticos, TRUE, pub

Objective: To analyse acute ChObjective: To analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control. Methods: Review of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs. Results: Thirty-two outbreaks (1965-2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids). Conclusion: Under a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed., Depto. de Farmacología y Toxicología, Fac. de Veterinaria, TRUE, pub

Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain, Background: To assess changes in the prevalence of dementia among patients hospitalized with type 2 diabetes (T2DM), to analyze the effects of dementia on in-hospital mortality (IHM) in this population, to evaluate sex differences, and to determine the impact of the COVID-19 pandemic on these parameters. (2) Methods: We used a nationwide discharge database to select all patients with T2DM aged 60 years or over admitted to Spanish hospitals from 2011 to 2020. We identified those with all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VaD). The effect of sex, age, comorbidity, and COVID-19 on the prevalence of dementia subtypes and on IHM was assessed using multivariable logistic regression. (3) Results: We identified 5,250,810 hospitalizations with T2DM. Allcause dementia was detected in 8.31%, AD in 3.00%, and VaD in 1.55%. The prevalence of all subtypes of dementia increased significantly over time. After multivariable adjustment, higher values were observed in women for all-cause dementia (OR 1.34; 95% CI 1.33–1.35), AD (OR 1.6; 95% CI 1.58–1.62), and VaD (OR 1.12; 95% CI 1.11–1.14). However, female sex was a protective factor for IHM in patients with all-cause dementia (OR 0.90; 95% CI 0.89–0.91), AD (OR 0.89; 95% CI 0.86–0.91), and VaD (OR 0.95; 95% CI 0.91–0.99). IHM among patients with dementia remained stable over time, until 2020, when it increased significantly. Higher age, greater comorbidity, and COVID-19 were associated with IHM in all dementia subtypes. (4) Conclusions: The prevalence of dementia (all-cause, AD, and VaD) in men and women with T2DM increased over time; however, the IHM remained stable until 2020, when it increased significantly, probably because of the COVID-19 pandemic. The prevalence of dementia is higher in women than in men, although female sex is a protective factor for IHM., Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Introducción El exceso de peso es un problema de salud pública, asociado a una mayor carga de enfermedades crónicas y a un mayor uso de recursos sanitarios. Material y métodos Submuestra de adultos españoles de 18 a 45 años de la Encuesta Nacional de Salud 2017 (N = 7.081). Las odds ratios de utilización de servicios del grupo con IMC ≥ 30 kg/m2 en comparación con el grupo de peso normal, utilizando un modelo ajustado por sexo, edad, educación, clase socioeconómica, estado de salud percibido y presencia de comorbilidades. Resultados El 12,4% de la muestra tenía obesidad, del cual el 24,8% acudió al médico de cabecera, el 37,1% acudió a los servicios de urgencias, el 6,1% fue hospitalizado durante los últimos 12 meses, siendo significativamente mayor que en la población de peso normal (el 20,3, el 29,2, el 3,8%, respectivamente). Sin embargo, el 16,1% visitó a un fisioterapeuta y el 3,1% utilizó terapias alternativas, en comparación con el 20,8 y el 6,4% del grupo de peso normal. Tras ajustar por factores de confusión, las personas con obesidad tenían una mayor probabilidad de acudir a los servicios de urgencias (OR: 1,225 [1,037-1,446]) y menos de acudir al fisioterapeuta (OR: 0,720 [0,583-0,889]) o a las terapias alternativas (OR: 0,481 [0,316-0,732]). Conclusiones Los adultos jóvenes españoles que presentan obesidad muestran mayor probabilidad de utilizar algunos recursos sanitarios que los de peso normal, incluso después de ajustar por variables socioeconómicas y comorbilidades, pero son menos propensos a acudir a fisioterapia. La literatura muestra que estas diferencias son menos marcadas que en edades más avanzadas, por lo que esta etapa de la vida podría ser una ventana de oportunidad para la prevención para lograr una mejor gestión de los recursos., Introduction Excess weight is a public health problem associated with a greater burden of chronic diseases and increased use of health resources. Material and methods A subsample of Spanish adults aged 18–45 from the 2017 Spanish National Health Survey (N = 7081) was used. The odds ratios of service utilisation of the group with BMI ≥ 30 kg/m2 were compared to the normal-weight group, using a model adjusted for sex, age, education, socioeconomic level, perceived health status and the presence of comorbidities. Results In all, 12.4% of the sample had obesity. Of these, 24.8% visited their general physician, 37.1% attended emergency services and 6.1% were hospitalised during the last 12 months, which were significantly higher rates than in the normal-weight population (20.3%, 29.2%, 3.8%, respectively). However, 16.1% visited a physiotherapist and 3.1% used alternative therapies, compared to 20.8% and 6.4% in the healthy weight group. After adjusting for confounding factors, people with obesity were more likely to visit emergency services (OR: 1.225 [1.037–1.446]) and less likely to visit a physiotherapist (OR: 0.720 [0.583–0.889]) or use alternative therapies (OR: 0.481 [0.316–0.732]). Conclusions Spanish young adults suffering from obesity are more likely to use some health resources than those of normal weight, even after adjusting for socioeconomic variables and comorbidities, but they are less likely to attend physical therapy. The literature shows that these differences are less marked than in older ages, so this stage of life could be a window of opportunity for prevention to achieve better resource management., Depto. de Biodiversidad, Ecología y Evolución, Fac. de Ciencias Biológicas, TRUE, pub

Background. After the COVID-19 pandemic, society has become more aware of the importance of some basic hygienic habits to avoid exposure to pathogens transmitted via hands. Given that a high frequency of touching mucous membranes can lead to a high risk of infection, it is essential to establish strategies to reduce this behavior as a preventive measure against contagion. This risk can be extrapolated to a multitude of health scenarios and transmission of many infectious diseases. #RedPingüiNO was designed as an intervention to prevent the transmission of SARS-CoV-2 and other pathogens through the reduction of facial self-touches by thoughtfully engaging participants in a serious game. Objective. Facial self-touches should be understood as behaviors of limited control and awareness, used to regulate situations of cognitive and emotional demands, or as part of nonverbal communication. The objective of this study was to ensure that participants become aware of and reduce these behaviors through a game of self-perception. Methods. The quasi-experimental intervention was applied to 103 healthy university students selected by convenience sampling and put into practice for 2 weeks, with 1 control group (n=24, 23.3%) and 2 experimental groups (experimental group with no additional social reinforcement interventions: n=36, 35%; experimental group with additional social reinforcement interventions: n=43, 41.7%). The objective was to improve knowledge and perception and reduce facial self-touches to prevent exposure to pathogens transmitted via hands not only in health multihazard scenarios but also in ordinary circumstances. The ad hoc instrument used to analyze the experience consisted of 43 items and was valid and reliable for the purpose of this study. The items were divided into 5 blocks extracted from the theoretical framework: sociological issues (1-5); hygiene habits (6-13); risk awareness (14-19); strategies for not touching the face (20-26); and questions after the, Depto. de Biodiversidad, Ecología y Evolución, Fac. de Ciencias Biológicas, TRUE, pub

We aim to assess the time trend from 2014 to 2020 in the prevalence of physical activity (PA), identify gender differences and sociodemographic and health-related factors associated with PA among people with diabetes, and compare PA between people with and without diabetes. (2) Methods: We conducted a cross-sectional and a case–control study using as data source the European Health Interview Surveys for Spain (EHISS) conducted in years 2014 and 2020. The presence of diabetes and PA were self-reported. Covariates included socio-demographic characteristics, health-related variables, and lifestyles. To compare people with and without diabetes, we matched individuals by age and sex. (3) Results: The number of participants aged ≥18 years with self-reported diabetes were 1852 and 1889 in the EHISS2014 and EHISS2020, respectively. The proportion of people with diabetes that had a medium or high frequency of PA improved from 48.3% in 2014 to 52.6% in 2020 (p = 0.009), with 68.5% in 2014 and 77.7% in 2020 being engaged in two or more days of PA (p < 0.001). Males with diabetes reported more PA than females with diabetes in both surveys. After matching by age and gender, participants with diabetes showed significantly lower engagement in PA than those without diabetes. Among adults with diabetes, multivariable logistic regression showed confirmation that PA improved significantly from 2014 to 2020 and that male sex, higher educational level, and better self-rated health were variables associated to more PA. However, self-reported comorbidities, smoking, or BMI > 30 were associated to less PA. (4) Conclusions: The time trend of PA among Spanish adults with diabetes is favorable but insufficient. The prevalence of PA in this diabetes population is low and does not reach the levels of the general population. Gender differences were found with significantly more PA among males with diabetes. Our result could help to improve the design and implementation of public health strategie, Comunidad de Madrid-España, FIS (Fondo de Investigaciones Sanitarias—Health Research Fund, Instituto de Salud Carlos III), Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”), Universidad Complutense de Madrid. Grupo de Investigación en Epidemiología de las Enfermedades Crónicas de Alta Prevalencia en España, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Introduction: During the SARS-CoV-2 pandemic, there has been a decrease in the supervision of the medication of subjects with chronic diseases. Customized automated dosing systems (SPDA) are devices that allow medication to be dispensed and administered, which have proven to be safe and effective for the patient and cost-effective for the healthcare system. Methods: an intervention study was carried out on patients from January to December 2019 in a residential centre for the elderly with more than 100 beds. The economic costs derived from manual dosing were compared with those of an automated preparation (Robotik Technology®). Results: Of the 198 patients included, 195 (97.47%) of them were polymedicated. Of the total of 276 active substances of registered medicinal products, it was possible to include them in the process of automating the preparation of the SPDA 105 active pharmaceutical ingredients. A cost reduction of EUR 5062.39 per year was found using SPDA. Taking into account the active ingredients of emblistable and non-emblistable medicines, the use of SPDA resulted in savings of EUR 6120.40 per year. The system contributed to the detection of cases of therapeutic duplication and reduced the time to prepare the medication. Conclusions: the use of SPDA is a useful and economically profitable strategy for its use in residential centres for the elderly., Depto. de Farmacología, Farmacognosia y Botánica, Fac. de Farmacia, TRUE, pub

The authors would like to thank Universidad San Pablo CEU and the Cátedra de Educación Médica y humanización “Nemesio Diez” for funding the open access., Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency “to know”); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency “to know how to do”). They are also evaluated on the transversal competencies that we call “communication with the patient” (transversal competency “to know how to be there”) and “dealing with the patient” (transversal competency “to know how to be”). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students’ awareness in the development of a more, Depto. de Genética, Fisiología y Microbiología, Fac. de Ciencias Biológicas, TRUE, pub