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Rationale: Obstructive sleep apnea (OSA) is associated with impaired glycemic control and a higher risk of vascular complications, such as diabetic retinopathy. However, the effect of apnea-hypopnea suppression on retinal disease progression is unclear. Objectives: To evaluate the efficacy and safety of continuous positive airway pressure (CPAP) for the reduction of retinal lesions in patients with non-proliferative diabetic retinopathy (NPDR) and OSA. Methods: This open-label, parallel-group, randomized controlled trial was conducted between October 2016 and February 2020 at a university hospital in Spain. The date of final follow-up was March 2, 2021. Eighty-three patients with OSA and mild to moderate NPDR receiving stable treatment were randomized to receive CPAP and usual care (43 patients with 79 available eyes) or usual care alone (40 patients with 67 available eyes) for 52 weeks. The primary outcomes were the change in the percentage of eyes with retinal exudates and the number of retinal microhemorrhages from baseline to week 52. We also assessed the effects of both interventions on retinal thickness by means of optical coherence tomography, serum concentrations of glycated hemoglobin, blood pressure, lipid concentrations, sleepiness, and quality of life. Results: Fifty-two weeks of CPAP treatment was associated with reductions from baseline in the percentage of eyes with hard exudates (overall difference, 221.7%; P = 0.035) and in optical coherence tomography indices of retinal edema, including central subfield thickness and cube volume. However, in patients who met prespecified criteria for CPAP adherence, treatment was also associated with a higher number of retinal microhemorrhages at 52weeks (intergroup adjusted difference, 6.0 [95% confidence interval, 0.6-11.5]; P = 0.029), which was directly related to prescribed pressure levels. CPAP treatment also improved glycemic control, sleepiness, and general health-related quality of life. Conclusions: In patients with OSA and NPDR, long-term CPAP treatment in addition to usual care may result in slower progression of retinal disease, although it could also induce an increase in retinal microhemorrhages. [ABSTRACT FROM AUTHOR]

This study aims to analyse the effectiveness of a psychosocial intervention programme in preventing loneliness and increasing self‐efficacy and social participation among older women living alone in Spain. A sequential, nested experimental design was used, with a primary quantitative quasi‐experimental pre‐post study with a control group (CG) and a secondary qualitative study. A total of 48 women participated, and 34 of them (the experimental group, EG) received a 25‐hour psychosocial support intervention delivered by volunteers who focused on three aspects: conversation, attribution retraining and behavioural activation. The other women remained on the waiting list (CG = 14). The women (EG and CG) were all interviewed before and after the intervention and a follow‐up of the EG was performed at 6 months (N = 25). Semi‐structured interviews were used to collect sociodemographic and health‐related data, as well as data on satisfaction with the programme and its benefits. Validated instruments were used to collect data on the dependent variables (self‐efficacy in ageing, subjective social participation and loneliness). Quantitative and qualitative methods were used for data analysis. Compared to the pre‐test results, women in the EG improved their self‐efficacy in ageing (t‐test: −2.246; p: 0.031; d: 0.30), and, more specifically, their self‐efficacy in managing socio‐emotional problems such as loneliness (t‐test: −1.995; p: 0.054; d: 0.25) and in managing their health (t‐test: −2.450; p: 0.020; d: 0.47). No significant differences were observed between the follow‐up and the post‐test results, meaning that the changes identified after the intervention remained stable. Four additional categories of benefits were identified in the participants' discourses. In conclusion, the intervention appears to be beneficial and effective in improving self‐efficacy, which is a well‐established predictor of loneliness in old age, in a group of vulnerable individuals. Further studies on this type of community intervention are necessary to prevent loneliness among older people. [ABSTRACT FROM AUTHOR]

Within the lifestyle migration studies, a relation between mobile patterns of retired migrants and the propensity to get some socio-political integration is not a common theme. This paper aims at deepening into this relationship by questioning to what extent some multilocal behaviours may, or not, drive to an integration at destination. To this objective, a combination of a survey questionnaire and in-depth interviews directed to North-European retirement migrants, over 50 years old, in Spain has been deployed. Variables related to multilocality are the time of annual residence in Spain, the maintenance of property in their country of origin and the number of times they travelled to their country of origin in the year before. Social integration has been measured through variables such as daily social relations, voting in municipal elections, membership in clubs and associations, registration with the local register, trust in Spanish institutions and interest in Spanish political issues. Results from the multivariate statistical analysis and qualitative research indicate that multilocality is associated with migrants' specific social and political integration in Spain since migrants enter the receiving society unevenly. While they show a certain degree of integration, their social relations tend to stand aside from the whole Spanish population. Collected data suggest that, on the one hand, research on lifestyle migration should develop explanatory models open to the different dimensions of the integration processes, and on the other, that theory on social integration can be improved by considering contemporary mobilities as a field of research. [ABSTRACT FROM AUTHOR]

Analysing multilocality as a specific integration pattern among retirement migrants is the aim of the paper. The study shows how the search for quality of life leads retirees to make use of different properties, placed either in origin and/or destination countries. The results of quantitative and qualitative research point out that the property in the origin country is a key factor to explain migrant's lifestyle and their social integration in Spain. Furthermore, the multilocal behaviour is not equally distributed among the retirees, as it is conditioned by some migrant's socio-demographic features such as nationality or household income. [ABSTRACT FROM AUTHOR]

Intensive groundwater development is a common circumstance in semiarid and arid areas. Often abstraction exceeds recharge, thus continuously depleting reserves. There is groundwater mining when the recovery of aquifer reserves needs more than 50 years. The MASE project has been carried out to compile what is known about Spain and specifically about the south-eastern Iberian Peninsula and the Canary Islands. The objective was the synthetic analysis of available data on the hydrological, economic, managerial, social, and ethical aspects of groundwater mining. Since the mid-20th century, intensive use of groundwater in south-eastern Spain allowed extending and securing the areas with traditional surface water irrigation of cash crops and their extension to former dry lands, taking advantage of good soils and climate. This fostered a huge economic and social development. Intensive agriculture is a main activity, although tourism plays currently an increasing economic role in the coasts. Many aquifers are relatively high yielding small carbonate units where the total groundwater level drawdown may currently exceed 300 m. Groundwater storage depletion is estimated about 15 km 3 . This volume is close to the total contribution of the Tagus-Segura water transfer, but without large investments paid for with public funds. Seawater desalination complements urban supply and part of cash crop cultivation. Reclaimed urban waste water is used for irrigation. Groundwater mining produces benefits but associated to sometimes serious economic, administrative, legal and environmental problems. The use of an exhaustible vital resource raises ethical concerns. It cannot continue under the current legal conditions. A progressive change of water use paradigm is the way out, but this is not in the mind of most water managers and politicians. The positive and negative results observed in south-eastern Spain may help to analyse other areas under similar hydrogeological conditions in a less advanced stage of water use evolution. [ABSTRACT FROM AUTHOR]

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Examines the relationship between self-reported HIV testing history and socio-behavioral variables of interest, by comparing men previously tested HIV positive, HIV negative and untested men in Barcelona, Spain. Potentially protective behaviors exhibited by untested men; Greater likelihood of having the highest interpersonal barriers to safer sex among HIV positive men.

Assesses the causes of ascites present in patients with primary liver cell carcinoma (PLCC) in Barcelona, Spain. Effect of ascites on renal function; Complication of liver diseases; Consideration of ascites in patients with cirrhosis and PLCC to be refractory to diuretics.

Presents letters to the editor on antiretroviral therapy for HIV-infected patients. Benefit of adding hydroxyurea to highly active antiretroviral therapy (HAART); Effect of HAART on the incidence and outcome of visceral leishmaniasis in HIV-positive patients; Clinical impact of human T-cell lymphotropic virus-1 infection in Spain.

The basic epidemiological characteristics of HIV infection and AIDS among children are described with a particular reference to HIV vertical transmission. The HIV transmission pattern identified in our community is described according to the WHO classification scheme. To describe the epidemic, as well as its temporal evolution, 1.933 cases reported to the population based registry of Catalonia and 287 seropositive children and their mothers are used. We have quantified the importance of intravenous drug usage by the parents in relationship to HIV transmission; 54.7% of the mothers of HIV positive children were intravenous drug users. We predict that during the coming years there will be a continuous increase in AIDS cases as a result of vertical transmission.

Background: Most programs for the control of the acquired immunodeficiency syndrome (AIDS) contemplate the registry of cases as the principal source of information. Despite the fact that these data have permitted important epidemiologic and clinical aspects of the disease to become known epidemiologic surveillance systems should be developed based on the detection of infection by the human immunodeficiency virus (HIV)., Methods: The prevalence and the epidemiologic profile of patients who underwent an anti-HIV test were studied in 17 hospitals in Catalonia in 1989. In addition, a questionnaire concerning demographic and epidemiologic variables was completed by all the patients in whom an ELISA test had been carried out during 4 periods of 15 days., Results: During this period 33,012 serologic tests were performed in 17 centers with a global prevalence of positive results of 20.7% (IC 95% = 20.2%-21.1%). The greatest number of positive serologies corresponded to the collective of intravenous drug users (IVDU), consisting of 68% of all the positive tests with a prevalence of infection of 76.4%. Prevalence was considered as constant throughout the year despite the differences between the prevalence observed in some periods., Conclusions: The fact that the collective of intravenous drug users is most prevalent among the patient with positive results in the serologic detection of the human immunodeficiency virus (HIV) confirms that this is the principal group of transmission in Catalonia. This type of study may provide information on the rate of infection by HIV complementing other surveillance methods of the epidemic. However, the basic function of these tests stems from the study of the demand and use of detection tests.

The early response rate in the first MONICA-Catalonia population survey was 52.7% and the final response rate was 73.8%. The intensity of recruitment effort in this survey led to a considerable increase in response rate (20%), with the extra cost per late respondent being relatively low ($13.9). Added recruitment effort was most effective in the youngest age group, 25-34 years. It was also more effective among women living in urban areas than among those from rural areas. In men, early respondents had a higher proportion of smokers than late respondents, and in women, early respondents had higher systolic and diastolic blood pressure levels and were more aware of their history of high blood pressure than late respondents. Non-respondents were less educated than respondents in both sexes, and this was more marked in women. No differences were found in the proportion of smokers between respondents and non-respondents. Respondents were more aware of their high blood pressure history than non-respondents. The recruitment costs and distribution of non-response components are given.