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Objective: The aim of this study was to estimate the prevalence of ankylosing spondylitis (AS) in Spain.Method: This is a cross-sectional, population-based study of people aged 20 years or older in Spain. Randomly selected individuals were contacted by telephone and rheumatic disease screening was performed. If the first screening was positive, medical records were then reviewed and/or a telephone questionnaire was conducted by a rheumatologist, followed by an appointment if necessary. Cases had to fulfil the modified New York (mNY) criteria.Results: In total, 4916 individuals were included, of whom 355 had a positive screening result for AS. Of these, 11 were classified as AS. An additional individual who reported a prior diagnosis of rheumatoid arthritis had a diagnosis of AS confirmed on review of the medical records. Estimated prevalence was 0.26% (95% CI 0.14-0.49).Conclusion: EPISER2016 is the first population-based study to estimate the prevalence of AS in Spain, which has been estimated as being similar to that in other European countries. [ABSTRACT FROM AUTHOR]

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This qualitative study explores the difficulties in experiencing eating-derived pleasure within a group of functionally diverse people, based on personal interviews and Grounded Theory. Understanding the feelings and subjective experiences of functionally diverse people can help develop new approaches to address their loss of pleasure and motivation regarding food intake. The study included 27 participants, aged between 18 and 75 years, all of whom had a functional deficiency that affected the occupational aspects of the eating process. Interviews were conducted in clinical settings and several centres for differently abled people. Four main themes emerged from the analysis: eating through obligation; fear of eating; the social life of food; and the importance of the taste and visual aesthetics of food. These themes underscore the importance of taking into account the phenomenological experiences of pleasure in the eating process. [ABSTRACT FROM AUTHOR]

Background and Objectives: The Coronal Plane Alignment of the Knee (CPAK) classification is a pragmatic distribution of nine phenotypes for coronal knee alignment that can be used on healthy and arthritic knees. Our study aimed to describe the CPAK distributions in a Spanish southeast osteoarthritic population and compare them to other populations' published alignment distributions. Method and Materials: Full-leg standing X-rays of the lower limb from 528 cases originating from the so-called Vega Alta del Segura (southeast of the Iberian Peninsula) were retrospectively analysed. We measured the mechanical hip-knee-ankle, lateral distal femoral, and medial proximal tibial angles. We calculated the arithmetic hip-knee-ankle angle and the joint line obliquity to classify each case according to the criteria of the CPAK classification. Results: Based on the aHKA result, 59.1% of the cases were varus (less than -2°), 32.7% were neutral (0° ± 2°), and 8.2% were valgus (greater than +2°). Based on the JLO result, 56.7% of the cases had a distal apex (less than 177°), 39.9% had a neutral apex (180° ± 3°), and 3.4% had a proximal apex (greater than 183°). The most common CPAK distribution in our Spanish southeast osteoarthritic population was type I (30.7%), followed by type IV (25.9%), type II (21%), type V (11.2%), type III (5%), type VI (2.8%), type VII (2.4%), type VIII (0.6%), and type IX (0.4%). Conclusions: We described the distribution according to the CPAK classification in a sample of the osteoarthritic population from southeastern Spain. In our sample, more than 75% of the patients were classified as type I, II, and IV.

Despite college being a critical life stage for developing enduring healthy dietary behaviours, Spanish university students show poor adherence to a healthy diet. Since research has shown an association between home cooking and healthy eating, the aim of this study was to analyse the main barriers that influence home food preparation and healthy eating among students at three Catalan universities. Focus groups, the photovoice technique and a validated questionnaire were used. Six focus groups (10 female; 14 male; aged 18-22) were conducted. NVivo9, was used to analyse the transcripts using an inductive thematic analysis. In two focus groups, the photovoice technique was used to further explore their perceptions about a healthy diet and their barriers for home cooking and healthy eating. The validated questionnaire was sent out to obtain data on students' diet quality, food environment and cooking self-efficacy for the focus group's design. We found that lack of motivation was the main barrier to healthy eating and home cooking, which was further influenced by the lack of cooking self-efficacy. Young adults lacked the knowledge and skills to prepare quick, affordable, and nutritious meals. Hence, even lack of time was cited as a primary barrier, time constraints seemed to be related to personal priorities. Students did not feel motivated to eat healthy and adopt time-deepening behaviours that influence food-choices. Thus, further research is required to develop context-specific culinary interventions that enhance students' cooking self-efficacy and identify strategies for encouraging students to adopt healthier eating habits., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: In recent years, it has been seen that, despite the existence of emergency services in Primary Care, some users attend emergency services of their referral hospital on their own initiative. The objective of this study was to explore the causes of the increase in the Northern Health Management Area of Huelva (Spain) population's own initiative to attend hospital emergency services, to the detriment of the provision of emergency services by Primary Care., Methods: A qualitative study based on the Grounded Theory by Glasser and Strauss was carried out on a sample of nineteen patients and sixteen physicians from the Northern Health Management Area of Huelva (Spain), divided into four focus groups. This method has four phases: data collection, data organisation, data analysis, and theory development., Results: The qualitative analysis process of the four focus groups resulted in 104 codes or minimum units of information. The main causes of the increase in this own initiative were related to delays in medical appointments and complementary tests, mistrust in Primary Care physicians and greater trust in hospital specialists, ignorance regarding the offer of services, proximity to the hospital, and the closure of the Riotinto (Huelva) emergency point., Conclusions: Lack of accessibility to specialised care, geographic dispersion, mistrust due to deterioration of the physician-patient relationship, lack of health education among the population, and the culture of immediacy are the main causes of the increase in attending hospital emergency services on their own initiative identified in this population., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

This paper focuses on an unusual Pre-Hispanic burial, 11-12 th century cal AD, from Fuerteventura Island. The pattern of injuries of the skeletal remains, together with the grave's features suggest exceptional circumstances of death and funerary treatment differing from those commonly observed elsewhere among the indigenous population of the Canary Archipelago. The study first uses forensic anthropology techniques to characterise the individual's injuries before turning to archaeological and ethno-historical records of the indigenous populations to identify the potential scenarios explaining the fatal injuries. The nature of the peri-mortem lesions, especially those to the head, is consistent with an intention to kill. This case provides an opportunity to analyze the mechanisms of violence in a society with strong environmental limitations and conditions of isolation, as well as to deepen the concept of justice in ancient times.

To explore sagittal spinal alignment and pelvic disposition of schoolchildren in a slump sitting position is needed in order to establish preventive educational postural programs. The purposes of this study were to describe sagittal spinal alignment and pelvic tilt (LSA) in a slump sitting position and to explore the association of sagittal spine and pelvic tilt with back pain (BP) among 8-12-year-old children. It was a cross-sectional study. Sagittal spinal curvatures, BP and pelvic tilt were assessed in 582 students from 14 elementary schools. It was found that 53.44% of children had slight thoracic hyperkyphosis and that 48.80% presented moderate lumbar hyperkyphosis and 38.66% presented slight lumbar hyperkyphosis. Those who did not suffer from BP in any part of the back had a higher lumbar kyphosis (24.64 ± 7.84) or a greater LSA (107.27 ± 5.38) than children who had some type of BP in the previous year or week (lumbar kyphosis: 23.08 ± 8.06; LSA: 105.52 ± 6.00), although with no clinically relevant differences. In fact, neither sufferers nor those who did not have BP presented normal mean values for lumbar kyphosis or LSA according to normality references. This study demonstrates the need to assess sagittal morphotype in childhood since schoolchildren remain incorrectly seated for many hours and it greatly affects their spinal curvatures.

The sagittal spinal morphology presents 4 physiological curvatures that increase endurance to axial compression forces and allow adequate postural balance. These curves must remain within normal ranges to achieve a static and dynamic balance, a correct functioning of the muscles and an adequate distribution of the loads, and thus minimize the injury risk. The purpose of this study was to categorize the sagittal spinal alignment according to the different morphotypes obtained for each curve in standing, slump sitting, and trunk forward bending positions in schoolchildren. It was a cross-sectional study. Sagittal spinal curvatures were assessed in 731 students from 16 elementary schools. In the sagittal standing position assessment, 70.45% and 89.06% of schoolchildren presented a "normal" morphotype for both dorsal and lumbar curves, respectively. After the application of the "Sagittal Integral Morphotype" protocol according to the morphotypes obtained in the three positions assessment (standing, slump sitting, and trunk forward bending), it was observed how the frequency of normal morphotypes for the dorsal and lumbar curve decreased considerably (only 32% and 6.6% of children obtained a "normal sagittal integral morphotype" for the thoracic and lumbar curvatures, respectively). These results show how it is necessary to include the slump sitting and trunk forward bending assessment as part of the protocol to define the "integral" sagittal alignment of the spine and establish a correct diagnosis. The use of the diagnostic classification presented in this study will allow early detection of misalignment not identified with the assessment of standing position.

Background: The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP)., Objective: The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children., Methods: This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year., Results: The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028)., Conclusions: To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

Objective: An e-portfolio was used to determine the optimal number of times students need to repeat a procedure before they are fully capable of performing it without supervision. The results were compared with the actual number of repetitions performed during the internship period. We also asked these students and their teachers about the optimal number of times each skill should be repeated before it could be considered fully acquired. The questionnaire was answered by 98.6% of the students and 70.3% of their teachers., Results: Both students and teachers agreed on a similar optimal value for 16 out of the 21 clinical procedures selected; in the remaining 5, teachers thought that students needed to repeat the procedure more times than the number stated by students. When these optimal values were compared with the actual values recorded in the portfolio during the internships, it was found that about half of all clinical procedures were carried out fewer times than expected, thus providing important feedback about the rotation-based training process. Quantitative information collected in the portfolios revealed a moderate mismatch between students' and teachers' perceptions of training needs.

The purpose of the present study was to investigate percentage body fat (%BF) differences in three Spanish dance disciplines and to compare skinfold and bioelectrical impedance predictions of body fat percentage in the same sample. Seventy-six female dancers, divided into three groups, Classical (n=23), Spanish (n=29) and Flamenco (n=24), were measured using skinfold measurements at four sites: triceps, subscapular, biceps and iliac crest, and whole body multi-frequency bioelectrical impedance (BIA). The skinfold measures were used to predict body fat percentage via Durnin and Womersley's and Segal, Sun and Yannakoulia equations by BIA. Differences in percent fat mass between groups (Classical, Spanish and Flamenco) were tested by using repeated measures analysis (ANOVA). Also, Pearson's product-moment correlations were performed on the body fat percentage values obtained using both methods. In addition, Bland-Altman plots were used to assess agreement, between anthropometric and BIA methods. Repeated measures analysis of variance did not found differences in %BF between modalities (p<0.05). Fat percentage correlations ranged from r= 0.57 to r=0.97 (all, p<0.001). Bland-Altman analysis revealed differences between BIA Yannakoulia as a reference method with BIA Segal (-0.35 ± 2.32%, 95%CI: -0.89to 0.18, p=0.38), with BIA Sun (-0.73 ± 2.3%, 95%CI: -1.27 to -0.20, p=0.014) and Durnin-Womersley (-2.65 ± 2,48%, 95%CI: -3.22 to -2.07, p<0.0001). It was concluded that body fat percentage estimates by BIA compared with skinfold method were systematically different in young adult female ballet dancers, having a tendency to produce underestimations as %BF increased with Segal and Durnin-Womersley equations compared to Yannakoulia, concluding that these methods are not interchangeable., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background: Abdominal obesity is associated with coronary risk, although causality is not well established., Objective: In an obese Mediterranean population, we measured the fatty acid composition of adipose tissue, its relation with dietary fatty acids and central fat deposition, and its influence on plasma lipids and insulin., Design: Adipose tissue samples were obtained from 84 obese patients (29 men, 55 women) aged 30-70 y (body mass index, in kg/m(2): 27-35). We measured concentrations of insulin and lipids in plasma and fatty acids in subcutaneous, omental, and perivisceral fat. Dietary fatty acid intake was assessed with a 7-d diet record., Results: The population studied was normolipidemic and normoinsulinemic. There were important differences in fatty acid composition between tissue sites: saturated fatty acids were higher and monounsaturated fatty acids were lower in perivisceral than in subcutaneous fat (P < 0.05). Significant correlations were found for oleic, linoleic, alpha-linolenic, and total n-6 polyunsaturated fatty acids between the subject's habitual diet and adipose tissue composition. Oleic and n-3 fatty acids from adipose regions were negatively correlated with apolipoprotein B and triacylglycerols; adipose tissue 22:1n-9, 20:2n-6, stearic acid, and eicosapentaenoic acid were positively correlated with HDL and apolipoprotein A; and adipose tissue myristic acid was negatively correlated with apolipoprotein A (P < 0.05). Central obesity was positively associated with n-6 polyunsaturated fatty acids and inversely associated with monounsaturated fatty acids and n-3 polyunsaturated fatty acids in adipose tissue (P < 0.05)., Conclusion: The differences found in the composition and metabolism of perivisceral, omental, and subcutaneous fats may indicate that their atherogenic capacities also differ.

Objective: To analyse the consumption of antibiotics and the consumption trend for 1993 to 1996 in Primary Care in a health area with high rates of bacterial resistance., Design: Comparative retrospective analysis., Setting: Costa de Ponent Primary Care area, with a census of 1,158,098 inhabitants., Patients: Those belonging to the health area who took antibiotics during the study period., Interventions: Data were obtained from the records of the Catalan Health Service. As a measurement of consumption of various antibiotics, the daily defined dose (DDD)/1000 inhabitants/day (DID)., Results: The DID total was very high, 17,048, a light increase from 1993 to 1996 (+2.4%). The groups which increased were cephalosporins by 42.8% and macrolides by 12.2%., Conclusions: The total consumption of antibiotics was very high and consonant with the high rate of bacterial resistance detected in our area in recent years. The progressive consumption of the most recently introduced antibiotics was not accompanied by a proportionate decrease in the consumption of others. The rationalisation of antibiotic use and the formation of Antibiotic Policy Committees in the Primary Care field should be a priority public health objective.

In the present study we assessed the prevalence of sensitizations to Blomia in our environment. Perennial climatological conditions in the Canarian Islands facilitates the habitat to mites. The Blomia is found in tropical and subtropical homes of Europe, USA and Asia like the Dermatophagoides. We have designed a transversal and prospective study on 100 patients who consulted our Unit for the first time. A Prick-test for the common allergens, including Blomia Kulagini, and in vitro determination of total and specific IgE to Dermatophagoides Pteronyssinus and Farinae, was performed in those patients showing the same or higher levels than class 3 CAP System RAST-Fesa against Blomia Tropicalis. Results achieved in our environment and our patients are the following: 1. Prevalence of sensitizations to BK in patients who consult for the first time is 50%. 2. The specific IgE immunologic response to BK is 56% (45 patients). 3. Scarce correlation in the papule areas and specific IgE levels between BT and DTP (p = 0.22020); BT and DFA (p = 0.09063). Table VI. Fig. I and II. 4. These results and previous studies of allergenization suggest poor crossed reactivity between Blomia and Dermatophagoides. 5. We think that Blomia is a new etilogic agent of the allergic respiratory disorders in our environment and therefore it should be included in the standard set of allergens from a diagnostic and therapeutical point of view. We keep studying its identification and count in dust samples from our homes, as well as the crossed reactivity, by RAST inhibition, with other acari.