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Although residues and resource shortages are major problems of modern living, these topics are not usually properly covered in university curricula. To tackle this situation, we have guided undergraduate students through the design of a group of active learning activities, to demonstrate the science behind separation and recycling: trash separation and recycling of paper, plastic, oil, and metals (lithium and cobalt available in mobile phone batteries). With a better understanding of the underlying scientific processes and fundamentals, undergraduate students were engaged to undertake and develop adequate physicochemical procedures for waste separation and recycling. A selection of the activities was presented at a science and technology fair at the University of the Balearic Islands as outreach activities that enrolled undergraduate students acting as teachers for fair visitors. The results showed a good engagement rate of the involved undergraduates as well as a stimulated visitors' interest.

Purpose: The purpose of this research is to analyse the relationship between entrepreneurial skills and innovation commitment and entrepreneurial skills and environmental commitment as drivers of awareness on sustainable development of higher education students. Design/methodology/approach: A sample of 1,318 business and management students out of the 3,535 students of Tecnocampus Pompeu Fabra University in Spain during the 2017-2018 academic year was selected to conduct a survey regarding their entrepreneurial skills and sustainability commitment, resulting in a total number of responses of 515. A structural equation model is proposed to contrast the hypothesis. Findings: The statistical analysis showed the existence of a positive relation between the entrepreneurial skill of self-consciousness, innovation and environmental commitment to foster sustainability and sustainable development. It is one of the few studies related to the self-consciousness competence of the entrepreneurial skills which found, as a novelty, that the entrepreneurial skill of self-consciousness is the skill with the greater impact on innovation and environmental commitment. Research limitations/implications: The limitations of the study are that it is based on a sample of students taking entrepreneurship courses at a specific Spanish University that is not representative of all entrepreneurs in all universities. Practical implications: The research proposes including entrepreneurial skills programmes in higher education and research programmes as a way to assure commitment to innovation and environmental sustainability. Originality/value: Promoting entrepreneurial skills among higher education students could act as drivers for sustainable development.

Introduction: Stringent regulations in pig farming, such as antibiotic control and the ban on certain additives and disinfectants, complicate disease control efforts. Despite the evolution of microbial communities inside the house environment, they maintain stability over the years, exhibiting characteristics specific to each type of production and, in some cases, unique to a particular company or farm production type. In addition, some infectious diseases are recurrent in specific farms, while other farms never present these diseases, suggesting a connection between the presence of these microorganisms in animals or their environment. Therefore, the aim of this study was to characterise environmental microbiomes of farms with high and low sanitary status, establishing the relationships between both, health status, environmental microbial ecology and its functionality. Methods: For this purpose, 6 pig farms were environmentally sampled. Farms were affiliated with a production company that handle the majority of the pigs slaughtered in Spain. This study investigated the relationship among high health and low health status farms using high throughput 16S rRNA gene sequencing. In addition, to identify ecologically relevant functions and potential pathogens based on the 16S rRNA gene sequences obtained, functional Annotation with PROkaryotic TAXa (FAPROTAX) was performed. Results and Discussion: This study reveals notable differences in microbial communities between farms with persistent health issues and those with good health outcomes, suggesting a need for protocols tailored to address specific challenges. The variation in microbial populations among farms underscores the need for specific and eco-friendly cleaning and disinfection protocols. These measures are key to enhancing the sustainability of livestock farming, ensuring safer products and boosting competitive edge in the market. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this study was to evaluate 18 different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastrectomy for gastric adenocarcinoma. This is a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of preoperative biomarkers for OS and DFS. The most relevant preoperative biomarkers of poorer OS and DFS were high neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII) (for stages I and III), and low prognostic nutritional index (PNI) (regardless tumour stage). Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23–2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36–3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58–0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24–2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49–4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent. [ABSTRACT FROM AUTHOR]

Simple Summary: In the present framework of constraints on healthcare budgets, an assessment of costs of antineoplastic drugs is a crucial step in contributing to the sustainability of public-payer systems. This study evaluated the characteristics of cancer clinical trials and potential drug cost avoidance in a large population of adult cancer patients with solid tumors enrolled in clinical trials over a 10-year period (2010–2019). These trials were conducted at the Medical Oncology Department of Vall d'Hebron University Hospital in Barcelona (Spain), one of the largest tertiary care centers in the country. Based on the data of 2930 clinical trials with 10,488 participants, it was found that the total cost of antineoplastic drugs supplied by sponsors in the clinical trials setting was EUR 107,306,084, with a potential cost savings of EUR 92,662,609. Participation in sponsored clinical trials in which drugs are provided free of charge yields considerable cost savings, with benefits in clinical strategies to reduce drug expenditures. The objective of this single-center retrospective study was to describe the clinical characteristics of adult patients with solid tumors enrolled in cancer clinical trials over a 10-year period (2010–2019) and to assess drug cost avoidance (DCA) associated with sponsors' contributions. The sponsors' contribution to pharmaceutical expenditure was calculated according to the actual price (for each year) of pharmaceutical specialties that the Vall d'Hebron University Hospital (HUVH) would have had to bear in the absence of sponsorship. A total of 2930 clinical trials were conducted with 10,488 participants. There were 140 trials in 2010 and 459 in 2019 (228% increase). Clinical trials of high complexity phase I and basket trials accounted for 34.3% of all trials. There has been a large variation in the pattern of clinical research over the study period, whereas, in 2010, targeted therapy accounted for 79.4% of expenditure and cytotoxic drugs for 20.6%; in 2019, immunotherapy accounted for 68.4%, targeted therapy for 24.4%, and cytotoxic drugs for only 7.1%. A total of four hundred twenty-one different antineoplastic agents were used, the variability of which increased from forty-seven agents in 2010, with only seven of them accounting for 92.8% of the overall pharmaceutical expenditure) to three hundred seventeen different antineoplastic agents in 2019, with thirty-three of them accounting for 90.6% of the overall expenditure. The overall expenditure on antineoplastic drugs in clinical care patients not included in clinical trials was EUR 120,396,096. The total cost of antineoplastic drugs supplied by sponsors in a clinical trial setting was EUR 107,306,084, with a potential DCA of EUR 92,662,609. Overall, clinical trials provide not only the best context for the progress of clinical research and healthcare but also create opportunities for reducing cancer care costs. [ABSTRACT FROM AUTHOR]

This article provides an overview of the offense of illicit enrichment in Spain and its recent implementation. Illicit enrichment is a crime related to corruption, but its definition and enforcement vary across countries. Spain has recently adopted a new offense of illicit enrichment, following Portugal's model, which differs from international standards. The article explores the debate surrounding this criminalization, the criticisms of the law, and the European Union's proposal to harmonize the offense across Member States. It also discusses the categorization of illicit enrichment as a form of disobedience rather than an increase in assets, the bodies responsible for verifying asset justifications, and the need for non-criminal regulations. The article also examines the principle of the right not to incriminate oneself and its relation to the offense of illicit enrichment. It concludes by suggesting that existing mechanisms for investigating public officials' assets should be strengthened before resorting to imprisonment for non-compliance. [Extracted from the article]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children. [ABSTRACT FROM AUTHOR]

This study evaluated the long-term changes in precipitation patterns and drought conditions in one of the key recharge areas of the hydrological system of southern and southeastern Spain, namely, the Sierra de Cazorla y Segura, which contains the headwater sectors of the catchment basins of two important rivers, namely, the Guadalquivir and the Segura. The research covered a period of 70 years (1952–2021) and undertook an exhaustive analysis of data from 348 pluviometric stations. The most relevant results are as follows: (1) most areas experienced a decrease in the precipitation volume and number of rainy days during the study period; (2) summer and winter showed the most significant decreases; (3) weak and moderate precipitation (<40 mm/d) showed significant decreases in both volume and frequency, while heavy precipitation (≥40 mm/d) showed the opposite behavior; (4) the durations of dry periods increased, while the durations of wet periods decreased in most areas; and (5) the SPEI showed an increase under drought conditions. This research underscores the need for water resource management and resilience strategies with interdisciplinary relevance in the face of changing hydrological patterns. [ABSTRACT FROM AUTHOR]

Background: The reasons for mental health consultations are becoming increasingly relevant in primary care. The Catalan health care system is undergoing a process of digital transformation, where eHealth is becoming increasingly relevant in routine clinical practice. Objective: This study aimed to analyze the approach to depressive episodes and the role of eHealth in the Catalan health care system from 2017 to 2022. Methods: A retrospective observational study was conducted on diagnostic codes related to depressive episodes and mood disorders between 2017 and 2022 using data from the Catalan Institute of Health. The sociodemographic evolution and prevalence of depression and mood disorders in Catalonia were analyzed between 2017 and 2022. Sociodemographic variables were analyzed using absolute frequency and percentage. The prevalence of depressive episodes was calculated, highlighting the year-to-year changes. The use of eHealth for related consultations was assessed by comparing the percentages of eHealth and face-to-face consultations. A comparison of sociodemographic variables based on attendance type was conducted. Additionally, a logistic regression model was used to explore factors influencing face-to-face attendance. The analysis used R software (version 4.2.1), with all differences examined using 95% CIs. Results: From 2017 to 2022, there was an 86.6% increase in the prevalence of depression and mood disorders, with women consistently more affected (20,950/31,197, 67.2% in 2017 and 22,078/33,169, 66.6% in 2022). In 2022, a significant rise in depression diagnoses was observed in rural areas (difference 0.71%, 95% CI 0.04%-1.43%), contrasting with a significant decrease in urban settings (difference --0.7%, 95% CI --1.35% to --0.05%). There was a significant increase in antidepressant use in 2022 compared to 2017 (difference 2.4%, 95% CI 1.87%-3.06%) and the proportion of eHealth visits rose from 4.34% (1240/28,561) in 2017 to 26.3% (8501/32,267) in 2022. Logistic regression analysis indicated that men (odds ratio [OR] 1.06, 95% CI 1.04-1.09) and younger individuals had a higher likelihood of eHealth consultations in 2022. Furthermore, individuals using eHealth consultations were more likely to use antidepressants (OR 1.54, 95% CI 1.50-1.57) and anxiolytics (OR 1.06, 95% CI 1.03-1.09). Conclusions: The prevalence of depression in Catalonia has significantly increased in the last 6 years, likely influenced by the COVID-19 pandemic. Despite ongoing digital transformation since 2011, eHealth usage remained limited as of 2017. During the lockdown period, eHealth accounted for nearly half of all health care consultations, representing a quarter of consultations by 2022. In the immediate aftermath of the COVID-19 pandemic, emerging evidence suggests a significant role of eHealth in managing depression-related consultations, along with an apparent likelihood of patients being prescribed antidepressants and anxiolytics. Further research is needed to understand the long-term impact of eHealth on diagnostic practices and medication use. [ABSTRACT FROM AUTHOR]

Background Evidence supporting combination treatment with a beta-lactam plus an aminoglycoside (C-BA) for endocarditis caused by viridans and gallolyticus group streptococci (VGS-GGS) with intermediate susceptibility to penicillin (PENI-I) is lacking. We assessed the clinical characteristics and outcomes of PEN-I VGS-GGS endocarditis and compared the effectiveness and safety of C-BA with third-generation cephalosporin monotherapy. Methods Retrospective analysis of prospectively collected data of a cohort of definite endocarditis caused by penicillin-susceptible and PENI-I VGS-GGS (penicillin minimum inhibitory concentration ranging from 0.25 to 2 mg/L) between 2008 and 2018 in 40 Spanish hospitals. We compared cases treated with monotherapy or with C-BA and performed multivariable analyses of risk factors for in-hospital and 1-year mortality. Results A total of 914 consecutive cases of definite endocarditis caused by VGS-GGS with complete or intermediate susceptibility to penicillin were included. A total of 688 (75.3%) were susceptible to penicillin and 226 (24.7%) were PENI-I. Monotherapy was used in 415 (45.4%) cases (cephalosporin in 331 cases) and 499 (54.6%) cases received C-BA. In-hospital mortality was 11.9%, and 190 (20.9%) patients developed acute kidney injury. Heart failure (odds ratio [OR]: 6.06; 95% confidence interval [CI]: 1.37–26.87; P =.018), central nervous system emboli (OR: 9.83; 95% CI: 2.17–44.49; P =.003) and intracardiac abscess (OR: 13.47; 95% CI: 2.24–81.08; P =.004) were independently associated with in-hospital mortality among PEN-I VGS-GGS cases, while monotherapy was not (OR: 1.01; 95% CI:.26–3.96; P =.982). Conclusions Our findings support the use of cephalosporin monotherapy in PEN-I VGS-GGS endocarditis in order to avoid nephrotoxicity without adversely affecting patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Canine leishmaniosis caused by Leishmania infantum is an endemic disease in Spain. The dog is considered the main reservoir, and the detection of specific serum antibodies against L. infantum antigen is the most used technique for diagnosing this infection. The LEISCAN LEISHMANIA ELISA test is a commercialized enzyme‐linked immunosorbent assay for the detection and measurement of canine anti‐Leishmania serum antibodies. Objectives: The aim of this study was to assess seroprevalence results of apparently healthy dogs in different areas of Spain using LEISCAN. Methods: Collection of sera from 5451 apparently healthy dogs was performed between 2020 and 2021 in different areas of Spain. Dogs were of adult age (≥12 months), were not previously diagnosed with clinical leishmaniosis or vaccinated against Leishmania and did not present clinical signs compatible with L. infantum infection. LEISCAN was performed following the manufacturer's protocol. Results: The overall seroprevalence was 5.5%. The highest seroprevalences were found in the Southeast of Spain: Comunidad Valenciana (14%) and Región de Murcia (14%), whereas the lowest seroprevalences were found in Northern Spain: Galicia (1%), Navarra (2%) and Castilla y León (2%) (p‐value <0.001). Conclusions: In conclusion, the seroprevalence for L. infantum in apparently healthy dogs in Spain varied from almost no infection to being over 10%. [ABSTRACT FROM AUTHOR]

Background Patients who acquire infective endocarditis (IE) following contact with the healthcare system, but outside the hospital, are classified as having non-nosocomial healthcare-associated IE (HCIE). Our aim was to characterize HCIE and establish whether its etiology, diagnosis, and therapeutic approach suggest it should be considered a distinct entity. Methods This study retrospectively analyzes data from a nationwide, multicenter, prospective cohort including consecutive cases of IE at 45 hospitals across Spain from 2008 to 2021. HCIE was defined as IE detected in patients in close contact with the healthcare system (eg, patients receiving intravenous treatment, hemodialysis, or institutionalized). The prevalence and main characteristics of HCIE were examined and compared with those of community-acquired IE (CIE) and nosocomial IE (NIE) and with literature data. Results IE was diagnosed in 4520 cases, of which 2854 (63%) were classified as CIE, 1209 (27%) as NIE, and 457 (10%) as HCIE. Patients with HCIE showed a high burden of comorbidities, a high presence of intravascular catheters, and a predominant staphylococcal etiology, Staphylococcus aureus being identified as the most frequent causative agent (35%). They also experienced more persistent bacteremia, underwent fewer surgeries, and showed a higher mortality rate than those with CIE (32.4% vs 22.6%). However, mortality in this group was similar to that recorded for NIE (32.4% vs 34.9%, respectively, P =.40). Conclusions Our data do not support considering HCIE as a distinct entity. HCIE affects a substantial number of patients, is associated with a high mortality, and shares many characteristics with NIE. [ABSTRACT FROM AUTHOR]

The 2022 annual meeting of the HTLV & HIV‐2 Spanish Network was held in Madrid on December 14. We summarize here the main information presented and discussed at the workshop and review time trends for human retroviral infections in Spain. As transmissible agents, infections by human retroviruses are of obligatory declaration. Until the end of 2022, the Spanish national registry had recorded 451 cases of HTLV‐1, 821 of HTLV‐2, and 416 of HIV‐2. For HIV‐1, estimates are of 150 000 people currently living with HIV‐1 and 60 000 cumulative deaths due to AIDS. During year 2022, new diagnoses in Spain were of 22 for HTLV‐1, 6 for HTLV‐2, and 7 for HIV‐2. The last updated figures for HIV‐1 are from 2021 and counted 2786 new diagnoses. The slowdown in yearly infections for HIV‐1 in Spain points out that new strategies are needed to achieve the United Nations 95‐95‐95 targets by 2025. For the remaining neglected human retroviral infections, their control might be pushed throughout four interventions: (1) expanding testing; (2) improving education and interventions aimed to reduce risk behaviors; (3) facilitating access to antiretrovirals as treatment and prevention, including further development of long‐acting formulations; and (4) increasing vaccine research efforts. Spain is a 47 million population country in South Europe with strong migration flows from HTLV‐1 endemic regions in Latin America and Sub‐Saharan Africa. At this time universal HTLV screening has been implemented only in the transplantation setting, following the report of 5 cases of HTLV‐associated myelopathy shortly after transplantation of organs from HTLV‐1 positive donors. There are four target populations for expanding testing and unveiling asymptomatic carriers responsible for silent HTLV‐1 transmissions: (1) migrants; (2) individuals with sexually transmitted infections; (3) pregnant women; and (4) blood donors. [ABSTRACT FROM AUTHOR]

Background: A protective hepatitis B virus (HBV) vaccine has been available for four decades. Universal HBV vaccination of infants is recommended by the WHO since the 1990s. Furthermore, HBV immunization is advised for all adults with high‐risk behaviours and no seroprotection. However, HBV vaccine coverage remains globally suboptimal. The advent of new more efficacious trivalent HBV vaccines has renewed the interest in HBV vaccination. At present, the extent of current HBV susceptibility in adults remains unknown in Spain. Methods: HBV serological markers were assessed on a large and representative sample of adults in Spain, including blood donors and individuals belonging to high‐risk groups. Serum HBsAg, anti‐HBc and anti‐HBs were tested in specimens collected during the last couple of years. Results: From 13 859 consecutive adults tested at seven cities across the Spanish geography, overall 166 (1.2%) had positive HBsAg. Past HBV infection was recognized in 14% and prior vaccine immunization in 24%. Unexpectedly, 37% of blood donors and 63% of persons belonging to high‐risk groups had no serum HBV markers and therefore were potentially HBV susceptible. Conclusion: Roughly 60% of adults living in Spain seem to be HBV susceptible. Waning immunity might be more common than expected. Hence, HBV serological testing should be performed at least once in all adults regardless of risk exposures. HBV vaccine full courses or boosters should be administered to all adults lacking serological evidence of HBV protection. [ABSTRACT FROM AUTHOR]

Following the COVID-19 pandemic, policies such as social distancing, hand washing, and the use of masks were implemented, which could play an important role in the reduction of infectious diseases. An observational, descriptive, cross-sectional study was conducted to observe the prevalence of respiratory infections in children under 15 years of age during the 2018–2020 period in Primary Care centres in Central Catalonia. In 2020, there was a 44.3% decrease in total consultations for respiratory infections compared to 2019. All respiratory infections exhibited a significant decrease except flu-like syndrome; children between the ages of 6 and 12 had the highest prevalence of flu-like syndrome (87.6%), and the SARS-CoV-2-19 infection was most frequent (4%) among those between the ages of 12 and 15. Compared to urban centres, rural centres presented a higher prevalence of all infections except flu-like syndrome and SARS-CoV-2. In conclusion, the COVID-19 pandemic caused a significant decrease in the number of consultations for respiratory infections in the paediatric population, except for flu-like syndrome, which increased in cases in January, February, and March 2020. No differences were found between sexes, although differences were found in the distribution of the different age groups. [ABSTRACT FROM AUTHOR]

The main objective of our study was to assess the associated risk between fibromyalgia (FM) and the incidence of the diagnosis of anxiety and depression in the general population during the years 2010–2017 in Catalonia. Method: A retrospective cohort study was designed using the Information System for Research Development in Primary Care database. All patients with FM were included (n = 56,098) and matched to the control group in a 1:2 pairing ratio (n = 112,196). The demographic variables studied were sex, age and socio-economic status. Results: Patients with FM have a lower survival rate if they are also diagnosed with anxiety and depression during the entire study period, with the rate being 26.6% lower in FM patients at an 8-year follow-up (0.58, 95%CI: 0.57–0.59 vs. 0.79, 95%CI: 0.78–0.79). There is a 58% reduction in the risk of developing anxiety and/or depression in the control group vs. the FM group (p-value < 0.05), and by 45% in male vs. female sex (p-value < 0.05). Conclusions: FM is a disease that is associated with anxiety and depression, and men are at lower risk of anxiety and depression after FM diagnosis. [ABSTRACT FROM AUTHOR]

Background: This longitudinal study addressed whether mindfulness practice prevents psychological and behavioral symptoms, especially mood disorders, in Alzheimer's disease (AD).Objective: To assess the incidence of depression in the course of AD and to determine which non-pharmacological treatment (NPT) is most effective in preventing psychopathological symptoms.Methods: We conducted a longitudinal, non-inferiority and equivalence randomized clinical trial, repeated-measures design, with a control group and three experimental treatments: mindfulness, cognitive stimulation, and relaxation. Each experimental group performed three weekly sessions for two years. The pharmacological treatment of all participants was donepezil (10 mg). Participants were patients with probable AD without diagnosed depression from the public neurology services of the Canary Health Service, Spain. Psychological evaluation was performed using the Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), and Neuropsychiatric Inventory (NPI-Q). The statistical analysis included only patients who attended at least 75% of the sessions. A nonparametric, repeated-measures analysis was performed with Kruskal-Wallis H test and between-group differences with Mann-Whitney U test with Bonferroni correction (p <  0.008). Effect size was calculated with partial eta-squared.Results: The results showed significant differences with large effect sizes (η2p>0.14) between mindfulness and the rest of the experimental groups as well as the control in the GDS, HDRS, and NPI-Q scales.Conclusion: Compared to the other experimental groups, only mindfulness prevented the onset of depression and other psychopathologies in early-stage AD. Based on its effectiveness in maintaining cognitive functions and preventing psychopathology, we recommend mindfulness as the first-choice NPT for mild to moderate AD. [ABSTRACT FROM AUTHOR]

Introduction: Social vulnerability is a known determinant of health in respiratory diseases. Our aim was to identify whether there are socio-demographic factors among COVID-19 patients hospitalized in Spain and their potential impact on health outcomes during the hospitalization.Methods: A multicentric retrospective case series study based on administrative databases that included all COVID-19 cases admitted in 19 Spanish hospitals from 1 March to 15 April 2020. Socio-demographic data were collected. Outcomes were critical care admission and in-hospital mortality.Results: We included 10,110 COVID-19 patients admitted to 18 Spanish hospitals (median age 68 (IQR 54-80) years old; 44.5% female; 14.8% were not born in Spain). Among these, 779 (7.7%) cases were admitted to critical care units and 1678 (16.6%) patients died during the hospitalization. Age, male gender, being immigrant, and low hospital saturation were independently associated with being admitted to an intensive care unit. Age, male gender, being immigrant, percentile of average per capita income, and hospital experience were independently associated with in-hospital mortality.Conclusions: Social determinants such as residence in low-income areas and being born in Latin American countries were associated with increased odds of being admitted to an intensive care unit and of in-hospital mortality. There was considerable variation in outcomes between different Spanish centers. [ABSTRACT FROM AUTHOR]

Simple Summary: The Iberian wolf (Canis lupus signatus) is a recognized reservoir of some zoonotic parasites that cause diseases transmissible to domestic animals and/or humans. The objective of this study was to determine the diversity of species of cardiopulmonary nematode parasites that affect wolves in northwestern Spain, and to estimate their prevalence and the relationship between these parasites and various epidemiological variables. The cardiopulmonary systems of 57 wolves from Galicia were examined using dissection and cup sedimentation techniques, and the collected worms were then morphologically identified. The overall prevalence of infection by cardiopulmonary nematodes was 24.5%, and the parasite species identified were Angiostrongylus vasorum (19.3%), Crenosoma vulpis (7%) and Eucoleus aerophilus (3.5%). The latter is of zoonotic interest. A significant relationship was found between age and C. vulpis infection, which was only found in animals under one year of age. Our findings indicate that the Iberian wolf could play an important role in maintaining cardiopulmonary parasites in the wild, and they highlight a need to identify potential risks for veterinary and public health. Cardiopulmonary nematodes are highly pathogenic parasites affecting domestic and wild canids. As the result of conservation programs, the Iberian wolf (Canis lupus signatus) population has recently expanded, and its distribution range covers lands from where it had long disappeared. However, the exact epidemiological role of the wolf in the life cycle of zoonotic parasites causing diseases transmissible to pets and/or humans is largely unknown. This study sought to determine the diversity of cardiopulmonary nematode parasite species that affect wolves inhabiting northwestern areas of the Iberian Peninsula, and to estimate their prevalence and the relationship between these parasites and several epidemiological variables. For this purpose, we examined the cardiopulmonary systems of 57 wolves from Galicia (from the provinces A Coruña n = 15, Lugo n = 21, Ourense n =15 and Pontevedra n = 6) using techniques of dissection and cup sedimentation. Collected worms were then identified under a light microscope according to their morphological features. Three species of nematodes were detected: Angiostrongylus vasorum (the "French-heartworm"), Crenosoma vulpis and Eucoleus aerophilus, the latter being of zoonotic interest. The prevalence was 24.5% (14/57; 95% CI 13.3–35.6%) overall, 19.3% for A. vasorum (11/57; 95% CI 8.8–29.2%), 7% for C. vulpis (4/57; 95% CI 0.4–13.6%) and 3.5% for E. aerophilus (2/57; CI −1.1–9.1%). A significant relationship (p = 0.002) was found between age and the presence of C. vulpis, which was only found in juvenile animals. Furthermore, a higher prevalence of A. vasorum and/or C. vulpis was observed in wolves with a lower body condition score (40% and 20%, respectively), though the difference was not significant (p = 0.221 and p = 0.444, respectively). Our findings indicate a high "French-heartworm" and lungworm burden in the wolf population of northern Spain, and they identify a need for studies designed to elucidate the epidemiological role played by the Iberian wolf and to identify possible risks for veterinary and public health. [ABSTRACT FROM AUTHOR]

Background: Motor phenotype (MP) can be associated with a different prognosis in Parkinson's disease (PD), but it is not fixed and can change over time. Objective: Our aim was to analyze how the MP changed over time and to identify factors associated with the changes in PD patients from a multicenter Spanish PD cohort. Methods: PD patients who were recruited from January-2016 to November-2017 (baseline visit; V0) and evaluated again at a 2-year±30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort, were included in this study.MP was calculated at both visits based on Jankovic classification in TD (tremor dominant), IND (indeterminate), or PIGD (postural instability and gait difficulty). Sociodemographic and clinical data were collected, including serum biomarkers. Results: Five hundred eleven patients (62.57±8.59 years old; 59.2%males) were included in the study. At V0, MP was: 47.4%(242/511) TD; 36.6%(187/511) PIGD; 16%(82/511) IND. Up to 38%(194/511) of the patients changed their phenotype from V0 to V2, being the most frequent from TD to IND (8.4%) and from TD to PIGD (6.7%). A worse cognitive status (OR = 0.966) and less autonomy for activities of daily living (OR = 0.937) at V0 and a greater increase in the globalNMS burden (OR = 1.011) from V0 to V2 were associated with changing from TD to another phenotype after 2-year follow-up. Conclusion: The MP in PD can change over time. With disease progression, the percentage of cases with non-tremoric MP increases. PD patients who changed from TD to postural instability and gait difficulty increased NMS burden significantly. [ABSTRACT FROM AUTHOR]

Background: Among the manifestations of COVID-19 are taste and smell disorders (TSDs). Aim: To evaluate the sensitivity and specificity of TSDs and other associated symptoms to estimate predictive values for determining SARS-CoV-2 infection. Design & setting: A retrospective observational study of healthcare professionals in Catalonia, Spain. Method: A study of the sensitivity and specificity of TSDs has been carried out using the polymerase chain reaction (PCR) test for the diagnosis of SARS-CoV-2 as the gold standard value. Logistic regressions adjusted for age and sex were performed to identify additional symptoms that might be associated with COVID-19. Results: The results are based on 226 healthcare workers with clinical symptoms suggestive of COVID-19, 116 with positive PCR and 110 with negative PCR. TSDs had an odds ratio (OR) of 12.4 (95% confidence interval [CI] = 6.3 to 26.2), sensitivity 60.3% and specificity 89.1%. In the logistic regression model, the association of TSD, fever or low-grade fever, shivering, dyspnoea, arthralgia, and myalgia obtained an area under the curve (AUC) of 85.7% (95% CI = 80.7 % to 90.7 %), sensitivity 82.8 %, specificity 80.0%, and positive predictive values 81.4% and negative 81.5%. Conclusion: TSDs are a strong predictor of COVID-19. The association of TSD, fever, low-grade fever or shivering, dyspnoea, arthralgia, and myalgia correctly predicts 85.7% of the results of the COVID-19 test. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to analyze the progression of non-motor symptoms (NMS) burden in Parkinson's disease (PD) patients regarding the development of motor fluctuations (MF). Methods: PD patients without MF at baseline, who were recruited from January 2016 to November 2017 (V0) and evaluated again at a 2-year follow-up (V2) from 35 centers of Spain from the COPPADIS cohort, were included in this analysis. MF development at V2 was defined as a score ≥ 1 in the item-39 of the UPDRS-Part IV, whereas NMS burden was defined according to the Non-motor Symptoms Scale (NMSS) total score. Results: Three hundred and thirty PD patients (62.67 ± 8.7 years old; 58.8% males) were included. From V0 to V2, 27.6% of the patients developed MF. The mean NMSS total score at baseline was higher in those patients who developed MF after the 2-year follow-up (46.34 ± 36.48 vs. 34.3 ± 29.07; p = 0.001). A greater increase in the NMSS total score from V0 to V2 was observed in patients who developed MF (+16.07 ± 37.37) compared to those who did not develop MF (+6.2 ± 25.8) (p = 0.021). Development of MF after a 2-year follow-up was associated with an increase in the NMSS total score (β = 0.128; p = 0.046) after adjustment to age, gender, years from symptoms onset, levodopa equivalent daily dose (LEDD) and the NMSS total score at baseline, and the change in LEDD from V0 to V2. Conclusions: In PD patients, the development of MF is associated with a greater increase in the NMS burden after a 2-year follow-up. [ABSTRACT FROM AUTHOR]

Objective: To measure the prevalence and cumulative incidence of individuals diagnosed with fibromyalgia (FM) in Catalonia between 2010 and 2017. Methods: A retrospective observational study of the population of Catalonia between 2010 and 2017, both included, was designed to describe the incidence, prevalence, and sociodemographic characteristics of individuals diagnosed with fibromyalgia. A total of 56 098 patients were included in the study. The scope of the study were the 283 Primary Care Teams (PCT), all managed by the Instituto Catalán de la Salud [Catalan Institute of Health] (ICS). Results: The diagnosis of FM is higher in females (95.4%) than males (4.55%), with a mean age of 53.0 [45.0-61.0] years. The prevalence of FM in the total population was 0.4% in 2010 and 1.4% in 2017. The highest prevalence was found in the 55 to 65 age group (1.05% in 2010, and 2.46% in 2017). A relationship was found between the prevalence of FM and the degree of socioeconomic deprivation in urban areas: the greater the deprivation, the greater the prevalence of FM. The cumulative incidence of FM in the population remained constant over time (0.11% in 2010 and 0.10% in 2017), being more prevalent in women than men (0.18% women, 0.01% men in 2017). Conclusions: Our study confirms that FM is a prevalent disease in Catalonia, with an upward trend in recent years and it is more prevalent in women. [ABSTRACT FROM AUTHOR]

• In this retrospective analysis of patients with PE diagnosed in the ED from two cohorts in Spain and France, patients with COVID exhibited PEs of less severity. • However, COVID was associated with an increased risk of in-hospital mortality. • This study suggests that the usual tools for risk stratification, specifically the sPESI and RVD, are still valid in COVID patients, while the size of a PE is not valid in this particular population infected by SARS-CoV-2. To compare the severity of pulmonary embolism (PE) between patients with and without COVID, and to assess the association between severity and in-hospital-mortality. We performed an analysis of 549 COVID (71.3% PCR-confirmed) and 439 non-COVID patients with PE consecutively included by 62 Spanish and 16 French emergency departments. PE-severity was assessed by size, the presence of right ventricular dysfunction (RVD), and the sPESI. The association of PE-severity and in-hospital-mortality was assessed both in COVID and non-COVID patients, and the interaction of COVID status and PE severity/outcome associations was also evaluated. COVID patients had PEs of smaller size (43% vs 56% lobar or larger, 42% vs. 35% segmental and 13% vs. 9% subsegmental, respectively; p = 0.01 for trend), less RVD (22% vs. 16%, p = 0.02) and lower sPESI (p = 0.03 for trend). Risk of in-hospital death was higher in COVID patients (12.8% vs. 5.3%, p < 0.001). PE-severity assessed by RVD and sPESI was independently associated with in-hospital-mortality in COVID patients, while PE size and sPESI were significantly associated with in-hospital-mortality in non-COVID. COVID status showed a significant interaction in the association of PE size and outcome (p = 0.01), with OR for in-hospital mortality in COVID and non-COVID patients with lobar or larger PE of 0.92 (95%CI=0.19–4.47) and 4.47 (95%CI=1.60–12.5), respectively. Sensitivity analyses using only PCR-confirmed COVID cases confirmed these results. COVID patients present a differential clinical picture, with PE of less severity than in non-COVID patients. An increased sPESI was associated with the risk of mortality in both groups but, PE size did not seem to be associated with in-hospital mortality in COVID patients. [ABSTRACT FROM AUTHOR]

Our purpose was to identify the reasons why members of the population, aged 18–60 years, are vaccinated against COVID-19 at the mass vaccination point in Bages, Spain. This is 1 of 42 provisional spaces outside of health centres which have been set up in Catalonia in the context of the COVID-19 pandemic, and where people from all over Catalonia could go to be vaccinated by appointment. Methodology: We performed a cross-sectional study of users attending mass vaccination points in Bages during the months of July, August, and September 2021. Results: A total of 1361 questionnaires were statistically analysed. The most common reasons for vaccination were fear of infecting family (49.52%) and fear of self-infection (39.45%), followed by socialising (31.00%) and travel (30.56%). However, by applying a logistic regression model to each reason for vaccination, it was possible to estimate the associations regarding age, sex, marital status, educational level, production sector, mass vaccination point, previous COVID-19 infection, and COVID-19 infection of a family member. Relevance: The data generated will inform decisions and formulations of appropriate campaigns that will promote vaccination in specific population groups. [ABSTRACT FROM AUTHOR]

Leishmania infantum, the etiological agent of canine lelshmaniosis (CanL) in Europe, was responsible of the largest outbreak of human leishmaniosis in Spain. The parasite infects and survives within myeloid lineage cells, causing a potentially fatal disease if left untreated. The only treatment option relies on chemotherapy, although immunotherapy strategies are being considered as novel approaches to prevent progression of the disease. To this aim, a deeper characterization of the molecular mechanisms behind the immunopathogenesis of leishmaniosis is necessary. Thus, we evaluated, for the first time, the host immune response during L. infantum infection through transcriptome sequencing of the popliteal lymph nodes aspirates of dogs with CanL. Differential expression and weighted gene co-expression network analyses were performed, resulting in the identification of 5,461 differentially expressed genes (DEGs) and four key modules in sick dogs, compared to controls. As expected, defense response was the highest enriched biological process in the DEGs, with six genes related to immune response against pathogens (CHI3L1, SLPI, ACOD1, CCL5, MPO, BPI) included among the ten most expressed genes; and two of the key co-expression modules were associated with regulation of immune response, which also positively correlated with clinical stage and blood monocyte concentration. In particular, sick dogs displayed significant changes in the expression of Th1, Th2, Th17 and Tr1 cytokines (e. g. TNF-α, IFN-γ, IL-21, IL-17, IL-15), markers of T cell and NKcell exhaustion (e. g. LAG3, CD244, Blimp-1, JUN), and B cell, monocyte and macrophage disrupted functionality (e. g. CD40LG, MAPK4, IL-1R, NLRP3, BCMA). In addition, we found an overexpression of XBP1 and some other genes involved in endoplasmic reticulum stress and the IRE1 branch of the unfolded protein response, as well as one co-expression module associated with these processes, which could be induced by L. infantum to prevent host cell apoptosis and modulate inflammation-induced lymphangiogenesis at lymph nodes. Moreover, 21 lncRNAs were differentially expressed in sick dogs, and one key co-expression module was associated with chromatin organization, suggesting that epigenetic mechanisms could also contribute to dampening host immune response during natural L. infantum infection in the lymph nodes of dogs suffering from clinical leishmaniosis. [ABSTRACT FROM AUTHOR]

Background: Constipation has been linked to cognitive impairment development in Parkinson's disease (PD). Objective: Our aim was to analyze cognitive changes observed in PD patients and controls from a Spanish cohort with regards to the presence or not of constipation. Methods: PD patients and controls recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were followed-up during 2 years. The change in cognitive status from baseline (V0) to 2-year follow-up was assessed with the PD-CRS (Parkinson's Disease Cognitive Rating Scale). Subjects with a score ≥1 on item 21 of the NMSS (Non-Motor Symptoms Scale) at baseline (V0) were considered as "with constipation". Regression analyses were applied for determining the contribution of constipation in cognitive changes. Results: At V0, 39.7% (198/499) of PD patients presented constipation compared to 11.4% of controls (14/123) (p < 0.0001). No change was observed in cognitive status (PD-CRS total score) neither in controls without constipation (from 100.24±13.72 to 100.27±13.68; p = 0.971) and with constipation (from 94.71±10.96 to 93.93±13.03; p = 0.615). The PD-CRS total score decreased significantly in PD patients with constipation (from 89.14±15.36 to 85.97±18.09; p < 0.0001; Coehn's effect = –0.35) compared to patients without constipation (from 93.92±15.58 to 93.14±17.52; p = 0.250) (p = 0.018). In PD patients, to suffer from constipation at V0 was associated with a decrease in the PD-CRS total score from V0 to V2 (β= –0.1; 95% CI, –4.36 – –0.27; p = 0.026) and having cognitive impairment at V2 (OR = 1.79; 95% CI, 1.01 – 3.17; p = 0.045). Conclusion: Constipation is associated with cognitive decline in PD patients but not in controls. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking. Methods Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality. Results Among 4856 endocarditis patients, 1652 (34%) had acute heart failure (AHF) and 244 (5%) CS. Compared with patients without AHF and AHF but no CS, patients with CS presented higher rates of surgery (40.5%, 52.5%, and 68%; P <.001) and in-hospital mortality (16.3%, 39.1%, and 52.5%). Compared with patients with septic shock, CS patients presented higher rates of surgery (42.5% vs 68%; P <.001) and lower rates of in-hospital and 1-year mortality (62.3% vs 52.5%, P =.008, and 65.3% vs 57.4%, P =.030). Severe aortic and mitral regurgitation (OR [95% CI], 2.47 [1.82-3.35] and 3.03 [2.26-4.07]; both P <.001), left-ventricle ejection fraction <60% (1.72; 1.22-2.40; P =.002), heart block (2.22; 1.41-3.47; P =.001), tachyarrhythmias (5.07; 3.13-8.19; P <.001), and acute kidney failure (2.29; 1.73-3.03; P <.001) were associated with higher likelihood of developing CS. Prosthetic endocarditis (2.03; 1.06 -3.88; P =.032), Staphylococcus aureus (3.10; 1.16 -8.30; P =.024), tachyarrhythmias (3.09; 1.50-10.13; P =.005), and not performing cardiac surgery (11.40; 4.83-26.90; P <.001) were associated with a higher risk of mortality. Conclusions AHF is common among patients with endocarditis. CS is associated with high mortality and should be promptly identified and assessed for cardiac surgery. [ABSTRACT FROM AUTHOR]

Background Although Streptococcus anginosus group (SAG) endocarditis is considered a severe disease associated with abscess formation and embolic events, there is limited evidence to support this assumption. Methods We performed a retrospective analysis of prospectively collected data from consecutive patients with definite SAG endocarditis in 28 centers in Spain and Italy. A comparison between cases due to SAG endocarditis and viridans group streptococci (VGS) or Streptococcus gallolyticus group (SGG) was performed in a 1:2 matched analysis. Results Of 5336 consecutive cases of definite endocarditis, 72 (1.4%) were due to SAG and matched with 144 cases due to VGS/SGG. SAG endocarditis was community acquired in 64 (88.9%) cases and affected aortic native valve in 29 (40.3%). When comparing SAG and VGS/SGG endocarditis, no significant differences were found in septic shock (8.3% vs 3.5%, P  = .116); valve disorder, including perforation (22.2% vs 18.1%, P  = .584), pseudoaneurysm (16.7% vs 8.3%, P  = .108), or prosthesis dehiscence (1.4% vs 6.3%, P  = .170); paravalvular complications, including abscess (25% vs 18.8%, P  = .264) and intracardiac fistula (5.6% vs 3.5%, P  = .485); heart failure (34.7% vs 38.9%, P  = .655); or embolic events (41.7% vs 32.6%, P  = .248). Indications for surgery (70.8% vs 70.8%; P  = 1) and mortality (13.9% vs 16.7%; P  = .741) were similar between groups. Conclusions SAG endocarditis is an infrequent but serious condition that presents a prognosis similar to that of VGS/SGG. [ABSTRACT FROM AUTHOR]

This article looks at how different electoral competition dynamics can result in differentiated party positioning on childcare and family policy. Italy and Spain are compared using a most similar case design. The presence of women in politics, the socioeconomic profiles of the voters of the two main left-wing and right-wing Italian and Spanish parties, and opinions on traditional norms of motherhood explain different policy trajectories and higher incentives for the conservative party in Spain to converge toward the social democratic party in more progressive views of family policy. [ABSTRACT FROM AUTHOR]

Background We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis. Methods A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy. Results Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval,.93–1.8]; P  = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P  = .003) and lower complicated bacteremia (16.2% vs 32.1%; P  = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P  = .018). Conclusions Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events. Clinical Trials Registration NCT01898338. [ABSTRACT FROM AUTHOR]

Climate change is modifying the arrival of tourists in the Mediterranean region of Spain, and also the occurrence of extreme torrential rainfall events in the same area, affecting the tourist potentiality of the area. These events show a good relationship with the Western Mediterranean Oscillation (WeMO) on the Mediterranean coast of Spain. From 1950 to 2016, 239 episodes of extreme torrential rainfall (≥200 mm/24 h) were recorded in the Júcar and Segura hydrographic basins. 92.1% of these events took place during a negative WeMO phase. We performed calendar and Fourier analyses to study the WeMO index (WeMOi) intraannual variability. The lowest WeMOi values tally with the highest frequency of extreme torrential rainfall events during the second 10-day period of October. A change in the calendar of the minimum values of the WeMOi was identified between 1950 and 1982 and 1983–2016. Negative WeMOi values persist until November during the second subperiod. This might be associated with a new temporal distribution of extreme torrential events of precipitation. This has given rise to greater exposure of people to torrential events in autumn. Tourism in this area faces new challenges related to the increase in tourist numbers, and also to the exposure risk to rainfall events. [ABSTRACT FROM AUTHOR]

To improve understanding of current practices in the treatment of children and adolescents with chronic pain in Spain. A web-based survey was conducted with a representative sample of healthcare professionals (i.e. general practitioners [GP] and pediatricians [P]) in Spain. The survey included 23 questions on the pain education and training they had been given, and on organizational issues and current practices in the assessment and management of children and adolescents with chronic pain in their current work. The survey was completed by 191 professionals (75 GP and 116 P) with wide experience (mean number of years = 21; SD = 8) in the management of children and adolescents with chronic pain. Half of the participants reported that they had not been given any specific education or training on pediatric chronic pain management during their studies, and 80% acknowledged important gaps in their training. Although the majority assessed pain when attending children with chronic pain (80%), and almost all (96%) believed that protocols to guide the management of chronic pain in young people were necessary, only a third reported that they usually use a specific protocol. Less than 25% were part of a multidisciplinary team addressing the needs of children and adolescents with chronic pain. This survey has identified considerable limitations in the management of children and adolescents with chronic pain in Spain. This information can now be used by policy makers to improve the care given to children and adolescents suffering from chronic pain and their families. [ABSTRACT FROM AUTHOR]

Background: Due to the change in screen time usage in the last decade, there is needed to add more evidence about the relationship of screen time and sleep duration. Objective: To assess the association between screen time and sleep duration among Spanish children between 1 and 14 years old. Methods: We used data from the 2017 Spanish National Health survey, conducted on a representative sample of the Spanish population. We categorised daily leisure screen time as 0‐59, 60‐119, 120‐179, and ≥180 minutes. We classified sleep duration, depending on the age, as proper sleep duration and short sleep duration. We calculated unadjusted, and adjusted prevalence ratio (PR) and 95% confidence interval (CI) of short sleep duration according to daily leisure screen time after adjusting for potential confounders. PR's were derived from fitting generalised linear models with Poisson distribution and robust variance. Results: Of the 5517 Spanish children aged 1‐14 years, 44.3% spent 120 minutes or more of daily leisure screen time and 23.6% had short sleep duration. 24.5% and 28.2% of children spending between 120 and 179 minutes and exceeding 180 minutes of daily leisure screen time suffered short sleep duration, respectively. In the adjusted model, higher patterns of daily leisure screen time were associated with short sleep duration: adjusted PR120‐179 = 1.34 (95% CI 1.18, 1.54) and adjusted PR≥180 = 1.48 (95% CI 1.27, 1.73). Conclusions: Around one out of four Spanish children between 1 and 14 years old, exceeding 120 minutes of daily leisure screen time, had short sleep duration. More scientific research is needed for institutions to work on providing novel healthcare programmes that consider these new determinants of child health. [ABSTRACT FROM AUTHOR]

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Little research has investigated how traumatic experiences relate to fibromyalgia (FM). We explored the presence of trauma exposure in a sample of Spanish participants with FM and examined the associations between (a) the number and type of traumatic experiences and posttraumatic stress disorder (PTSD) symptoms and (b) the severity of clinical manifestations in FM, testing for possible mediation models. Participants were 173 FM patients and 53 healthy controls aged 24 to 66 years. Traumatic event type (physical trauma, physical and sexual abuse, psychological trauma), PTSD symptoms, pain intensity, sleep disturbance, anxiety, depression, coping style, and daily functioning were evaluated via self-report. Fibromyalgia patients reported a higher percentage of trauma exposure than controls, more traumatic experiences (mainly emotional and physical trauma), and more PTSD symptoms, Hedges' gs/Cohen's ds = 0.42-0.76. Most FM patients reported having experienced their most distressing traumatic experience and PTSD symptoms before FM diagnosis. PTSD symptom severity was associated with more pain, sleep disturbances, anxiety, depression, coping style, and functional impairment, rs = .23-.33, ps = .025-.008. A multiple mediation analysis showed a significant indirect effect of anxiety in the association between PTSD symptoms and daily functioning. In a subset of FM patients, PTSD symptoms were associated with major clinical symptoms. The results suggest future research should explore the effectiveness of trauma-focused therapy compared to standard cognitive behavioral therapy for these patients. [ABSTRACT FROM AUTHOR]

Based on the theory of uneven geographical development and analysing Ibiza from the Lefebvrian point of view, the article presents a new narrative of the transformation of the Ibiza territory from the pre-tourist period to become a leading destination for hedonistic tourism. A process that has turned the city of Ibiza into the most expensive city in Spain and has subjected it to a profound housing crisis. In the text, housing is interpreted as one of the main axes that has facilitated this transformation: from the primitive accumulation that led to interest in the island's autarkic life and its vernacular architecture, to the emergence and expansion as a destination for clubbers and the offer of tourist rental, all as a trigger for the current processes of housing dispossession. The article aims to generate a discussion on the urbanization of poverty as a phenomenon that inherently integrates the processes of commodification, financialization and dispossession of housing in an urban logic that can be conceptualized as producing spatial inequity. [ABSTRACT FROM AUTHOR]

A reduction in property crime has been a central feature of criminological discussion in the last 25 years, and numerous studies have used police statistics to identify a drop throughout the Western world. However, fraud, which is included in a broad definition of property crime, has typically not been considered in the analysis. This study examines fraud in the Spanish and European context to further understanding of its nature, prevalence, evolution and role in the overall panorama of property crime. Furthermore, the present study explores the extent to which we are experiencing widespread fraud underreporting to police and the implications of this for crime control policy. To this end, the present paper analyses secondary data provided by the Spanish Ministry of Interior, Spanish and European central banking authorities as well as large-scale victimization surveys from a number of European countries. In contrast to other property crimes, the findings indicate that cyber fraud is rising and that reporting is considerably lower. Some of the main reasons for reporting or not reporting fraud victimization are also identified. The dark figure of fraud suggests the design and evaluation of policing and crime prevention policies based solely on police statistics may be inadequate. [ABSTRACT FROM AUTHOR]

Giardia duodenalis and Cryptosporidium spp. are ubiquitous intestinal protozoa that parasitize domestic and wild animals, as well as human beings. Due to their zoonotic potential, the objective of the present study was to determine the presence of these pathogens in the fox population (Vulpes vulpes) located in Northwest Spain. A total of 197 faecal samples from legally hunted foxes were collected in the autonomous region of Galicia. The presence of G. duodenalis and Cryptosporidium spp. was investigated by PCR‐based methods amplifying the small subunit ribosomal RNA (ssu rRNA) gene of the parasites. Attempts to genotype obtained positive samples were subsequently conducted at the glutamate dehydrogenase (gdh) and β‐giardin (bg) genes of G. duodenalis, and the 60 kDa glycoprotein (gp60) gene of Cryptosporidium. Giardia duodenalis and Cryptosporidium spp. were identified in 19 (9.6%) and 12 (6.1%) of the investigated samples, respectively. However, five Cryptosporidium species were detected at the ssu rRNA locus: C. hominis (33.4%, 4/12), C. canis (25.0%, 3/12), C. parvum (16.7%, 2/12), C. ubiquitum (8.3%, 1/12) and C. suis (8.3%, 1/12). An additional Cryptosporidium‐positive sample was identified at the genus level only. Typing and subtyping of Giardia‐ and Cryptosporidium‐positive samples were unsuccessful. The detection of C. hominis in wild foxes indicates the probable overlapping of sylvatic and domestic cycles of this parasite in rural settings. Besides, this finding raises the question of whether red foxes may act as natural reservoirs of C. hominis. The detection of C. parvum and C. suis is suggestive of active transmission events between farm and wild animals, opening up the possibility of transmission to human beings. [ABSTRACT FROM AUTHOR]

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The rapid internationalisation of the Spanish property market has triggered debates about the main characteristics of emerging post-crisis urban dynamics. Financial and urban policy reforms have shaped a model depicted by incessant rent increases and displacements. Echoing these concerns, this article addresses two interconnected objectives about the way policy restructuring encouraged transnational investments into Spanish real estate and the concomitant socio-spatial effects this wider asset reshuffling has produced. Both queries are discussed by pinpointing the multi-scalar investment strategies of the private equity firm, Blackstone, which emerged as the predominant institutional investor during the recovery phase of the Spanish property market. The article initially sketches out the trajectory of the political economy of housing in Spain, and then it focuses on the strategies pursued by Blackstone for the acquisition of real estate and housing stock. The following sections connect the nodes of the financial chain that link this investor to former social housing tenants whose homes are by now owned by Blackstone. The spatial and social effects of this change in property ownership demonstrate the importance of in-depth research about the financial nodes that interplay with and shape the post-crisis urban condition in and beyond Southern Europe. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to better understand the role that physical, cognitive and social factors play in pain interference with activities of daily living among individuals with cancer and chronic pain. Method: In this cross‐sectional study, interviews with 156 patients with chronic cancer pain were conducted across five tertiary level hospitals in the province of Tarragona (Spain). Participants were interviewed individually and provided information about the presence and characteristics of pain, fatigue, catastrophic thinking, social support and the impact of pain on their daily activities. Results: Pain intensity (β = 0.23, p =.003), fatigue (β = 0.26, p <.001) and pain catastrophising (β = 0.39, p <.001) were significantly and positively associated with pain interference in daily activities. Pain interference scores were not explained by social support (β = 0.12 p =.090) or socio‐demographic factors (R2 =.005; p =.94). Conclusion: This study provides important new findings regarding the association between physical, cognitive and social factors and function of individuals with cancer and chronic pain, thus supporting a biopsychosocial approach to the management of chronic pain in individuals with cancer. [ABSTRACT FROM AUTHOR]

Background: Pets may be carriers of infectious agents including parasites. As part of a larger-scale study covering the whole of Europe, this study examines deworming measures reported by Spanish pet owners and identifies risk factors. Methods: An online questionnaire was administered to cat and dog owners in Spain. The replies provided were used to obtain information about the pets' living conditions and to accordingly classify each pet into one of the four ESCCAP infection risk categories (A, B, C or D) for which different deworming frequencies are recommended. Questions were also asked about pet care and owners' attitude toward their pets. The Kruskal-Wallis test was used to correlate risk groups with deworming frequencies. Results: Completed questionnaires were returned by 500 cat owners and 501 dog owners. According to responses, 96.21% of dogs were assigned to risk category D (maximum risk), and only 1.2%, 2.2% and 0.4% to A, B and C, respectively. Almost all cats were assigned to the minimum risk category A (indoor cats, 62%) or maximum risk category D (outdoor cats, 32.8%); only 3.4% and 1.8% of cats were classified as risk B and C respectively. More dogs were allocated to the higher risk group compared to cats, which were more frequently kept indoors. Cats were reportedly dewormed less frequently than dogs (2.56 and 3.13 times per year respectively), consistent with their different infestation risk. Thus, pets in the lower risk group A were either adequately dewormed or treated more often than necessary. Only a small proportion of cats were not dewormed at all (n = 14). Alarmingly, almost all pets in risk groups B, C or D (representing 95% of dogs and 39% of cats) were dewormed less often than recommended. Conclusions: More effective health education is required for the management of zoonotic endoparasite diseases under the umbrella of One Health targeted at owners, veterinarians, general practitioners, and health authorities. To align deworming frequency with infection risk, pet owners should be provided with clear, compelling instructions. [ABSTRACT FROM AUTHOR]

This paper presents the technical, environmental, and economic evaluation of integrating various combinations of renewable energy sources-based systems in the expansion of a district heating and cooling network of a Technology Park near Barcelona in Spain. At present, a combined heat and power plant running on fossil fuels serves the heating, cooling, and electricity demand of the Park. However, this energy demand is expected to increase substantially in the coming years. EnergyPRO software was used to model the energy demand growth till 2030. Validation of the software application was done by making a base model using real plant data from the year 2014. The software was then used to project the energy supply based on three 15-year scenarios, having different combinations of renewable energy technologies, from 2016 until 2030. Primary energy consumption, CO2 emissions, and the net present value obtained in each scenario were used to decide the best combinations of renewable energy sources. The results of the study showed that presently, biomass boilers combined with absorption chillers and supported with solar thermal cooling are the most competitive technologies in comparison to ground source heat pumps for large DHC networks. This is mainly because of the lower primary energy consumption (624,380 MWh/year in 2030 vs. 665,367 MWh/year), higher net present value (NPV) (222 million € vs. 178 million €), and lower CO2 emissions (107,753 tons/year in 2030 vs. 111,166 tons/year) obtained as a result of the simulations. [ABSTRACT FROM AUTHOR]

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Objective Pain intensity is the most commonly assessed domain in pain research and clinical settings. To facilitate cross-cultural research, knowledge regarding the psychometric properties of pain intensity measures in individuals from different countries is needed. However, the majority of this research has been conducted in English-speaking countries. Design Survey study. Setting University. Subjects Four hundred nineteen college students. Methods Participants were asked to complete four measures assessing average pain intensity: 1) the 0–10 numerical rating scale (NRS-11), 2) the 100-mm visual analog scale (VAS), 3) the four-point verbal rating scale (VRS-4), and 4) the Faces Pain Scale–Revised (FPS-R). Results The rates of incorrect completion of the four scales were uniformly low (range = 1–2%). The NRS-11 had the highest preference rate (31%), although a substantial number of participants also preferred each of the other three scales (range = 22–24%). The findings support the utility and construct validity of all four pain intensity scales in this Spanish-speaking sample. Conclusions When considered in light of research from other non-English-speaking samples indicating significant psychometric weaknesses for the NRS-11 and VAS and relative strengths of the FPS-R in some groups, the findings suggest that the FPS-R might be the most appropriate pain intensity scale to use when comparisons across populations from different countries is a goal. More research is needed to determine the extent to which demographic (i.e. age, education levels, socioeconomic status) vs cultural factors (i.e. country of origin) influence the reliability, validity, and utility of different pain measures. [ABSTRACT FROM AUTHOR]

Background Outpatient parenteral antibiotic treatment (OPAT) has proven efficacious for treating infective endocarditis (IE). However, the 2001 Infectious Diseases Society of America (IDSA) criteria for OPAT in IE are very restrictive. We aimed to compare the outcomes of OPAT with those of hospital-based antibiotic treatment (HBAT). Methods Retrospective analysis of data from a multicenter, prospective cohort study of 2000 consecutive IE patients in 25 Spanish hospitals (2008–2012) was performed. Results A total of 429 patients (21.5%) received OPAT, and only 21.7% fulfilled IDSA criteria. Males accounted for 70.5%, median age was 68 years (interquartile range [IQR], 56–76), and 57% had native-valve IE. The most frequent causal microorganisms were viridans group streptococci (18.6%), Staphylococcus aureus (15.6%), and coagulase-negative staphylococci (14.5%). Median length of antibiotic treatment was 42 days (IQR, 32–54), and 44% of patients underwent cardiac surgery. One-year mortality was 8% (42% for HBAT; P <.001), 1.4% of patients relapsed, and 10.9% were readmitted during the first 3 months after discharge (no significant differences compared with HBAT). Charlson score (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04–1.42; P =.01) and cardiac surgery (OR, 0.24; 95% CI,.09–.63; P =.04) were associated with 1-year mortality, whereas aortic valve involvement (OR, 0.47; 95% CI,.22–.98; P =.007) was the only predictor of 1-year readmission. Failing to fulfill IDSA criteria was not a risk factor for mortality or readmission. Conclusions OPAT provided excellent results despite the use of broader criteria than those recommended by IDSA. OPAT criteria should therefore be expanded. [ABSTRACT FROM AUTHOR]

Objective: The pharmacokinetics of brivaracetam (BRV), added to its effectiveness observed in animal models of status epilepticus (SE), makes this drug attractive for use in emergency situations. Our objective was to evaluate the use of intravenous BRV in a multicenter study. Methods: A retrospective multicenter registry of SE cases treated with BRV was created. These patients were evaluated between January and December 2018 at seven hospitals in Spain. Demographic variables, SE characteristics, concomitant drugs, loading doses, and response to treatment were collected. Results: Forty‐three patients were registered. The mean age was 56 ± 23.1 years, 51.2% were male, 29 had previous epilepsy, 24 (55.8%) had prominent motor symptoms, and 19 had nonconvulsive symptoms. Regarding the etiology, 19 (44.2%) were considered acute symptomatic, 16 (17.2%) remote symptomatic, four (9.3%) progressive symptomatic, and four (9.3%) cryptogenic. Regarding concomitant antiepileptic drugs (AEDs), 17 had previously received levetiracetam (LEV). In 14 patients, BRV was used early (first or second AED). The median loading dose was 100 mg (range = 50‐400), and the weight‐adjusted dose was 1.8 mg/kg (range = 0.4‐7.3). BRV was effective in 54% (n = 23), and a response was observed in <6 hours in 13 patients. We observed a tendency for it to be more effective when administered earlier (P = 0.09), but there were no differences regarding SE type and the concomitant use of LEV. In those with the fastest responses, we observed that both the total administered dose (300 mg vs 100 mg, P = 0.008) and the weight‐adjusted dose (3.85 mg vs 1.43 mg, P = 0.006) were significantly higher. The receiver operating characteristic curve showed that the best cutoff point for a faster response was 1.82 mg/kg. Significance: BRV is useful for the treatment of SE, even when patients are already being treated with LEV. The response rate seems higher when it is administered earlier and at higher doses (>1.82 mg/kg). [ABSTRACT FROM AUTHOR]