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Disease-related malnutrition remains a health problem with a high prevalence that increases the risk of poor patient outcomes, in addition to an elevation of healthcare costs. The aim of this study was to evaluate the nutritional quality of the menus at Ribera Molina Hospital, including their adequacy regarding recommended daily nutrient intakes and the agreement with the theoretical nutrition information provided by catering. The mean levels of energy, macronutrients, vitamins, and minerals provided by the basal, diabetic, and soft diets were calculated through the weighing of plated food served throughout the first 14 days of February 2020. A nutritional overestimation was seen in the nutrition information provided by the catering compared to the values derived from weighing foods (p < 0.01). Despite this, the nutritional content calculated by weighing satisfied the energy and protein requirements of 203 hospitalized patients previously studied in the internal medicine area of the hospital. The mean age of these patients was 62 years, and the main causes of admission were lung, cardiovascular, renal, and digestive diseases. There seems to be an insufficient amount of vitamins E and D, as well as magnesium, on all the menus. A possible insufficient amount of calcium, potassium, zinc, and copper was observed in some of the menus studied. It is necessary to update the hospital prescription manual so the nutritional contents of the diets are accurate and based on the weighted and calculated values to improve the adequacy of diets prescribed to patients. [ABSTRACT FROM AUTHOR]

Background: The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. Objective: To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. Methods: A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. Results: The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS<9, ISS 9–15, ISS 16–24, ISS>24) showed 493 concordant pairs (87.4%). Regarding the criterion of “major trauma” patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. Conclusions: The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for “major trauma”. Further research is needed to improve the conversion process. [ABSTRACT FROM AUTHOR]

Within the framework of the Spanish monitoring program, this study reports on air concentration of DDTs, HCB, HCHs, NDL-PCBs, DL-PCBs, PCDD/Fs and PBDEs measured during the five-year sampling period 2008–2013. Spanish coastal remote and urban locations were studied using PUF disk passive air samplers which were deployed and collected every three months. Despite the wide range of concentrations measured for most contaminants, a common pattern of relative abundance (median values): NDL-PCBs (36.6 pg/m 3 ) > HCB (24.8 pg/m 3 ) ≈ HCHs (17.9 pg/m 3 ) ≈ DDTs (16.6 pg/m 3 ) > PBDEs (3.65 pg/m 3 ) > DL-PCBs (2.99 pg/m 3 ) >> PCDD/Fs (0.060 pg/m 3 ) was found fairly consistent across most seasons and locations. Nevertheless, important variations in yearly concentrations were measured for different POPs. In general, higher levels of DDTs, HCHs, NDL-PCBs, DL-PCBs and PCDD/Fs were found in urban sites highlighting important differences between remote and urban sampling locations for most target contaminants. Greater concentrations of the banned organochlorine pesticides in urban locations suggested the existence of unexpected pointed sources that need to be further investigated and characterized. The limited dataset collected thus far rendered no clear temporal trends for most study target compounds, which emphasizes the necessity of the Spanish monitoring program future maintenance in time. [ABSTRACT FROM AUTHOR]

Background: An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia (Spain). Potential differential impacts on local residents and socially vulnerable groups were evaluated to determine health inequalities. Methods: An in-depth, prospective and concurrent Health-Impact-Assessment (HIA) focused on equity was conducted by the regional Public Health Department, following the Merseyside guidelines. Data from different sources was triangulated and impacts were identified using qualitative and quantitative methods. Results: The intervention area is characterised by poor social, environmental, and health indicators. The distinctness of the two projects generates contrasting health and inequality impacts: generally positive for the new fish market and negative for the port area. The former creates recreational spaces and improves urban quality and social cohesion. By contrast, inaction and stagnation of the project in the port area perpetuates deterioration, a lack of safety, and poor health, as well as increased social frustration. Conclusions: In addition to assessing the health impacts of both projects this HIA promoted intersectoral partnerships, boosted a holistic and positive view of health and incorporated health and equity into the political discourse. Community-level participatory action enabled public health institutions to respond to new urban planning challenges and responsibilities in a more democratic manner. [ABSTRACT FROM AUTHOR]

The article discusses the meaning and importance of European identity and its relationship to regional and national identities in Spain. European, Spanish, and regional identities were studied as part of a wider research survey of youth beliefs and experiences regarding the European Union. The research was conducted in the capital city Madrid, Spain, and the Basque Country and Bilbao of Spain. At each location, representative and European-oriented youth samples of 18-24 years were gathered. The interviewees were asked about their perception of border countries as included in Europe, and to rate different feasible meanings of the EU, its impact at personal, regional, and country levels, and different cognitive, affective and evaluative aspects of European, Spanish and regional identities. Regarding European borders, Turkey was the only country most interviewees did not perceive as part of or belonging to Europe. Geography, membership in the EU and, above all, the Euro currency emerged as the most salient features of meaning for Europe, beyond shared values and traditions. The European Union was perceived as having a positive, but small impact for the person, moderate for the region, and greater impact for the country of Spain.

The article examines stereotypic trait disconfirmation and positive-negative asymmetry among Spanish high school students. Spanish high school students participated in two studies on stereotypical trait disconfirmation. The students were presented with information about typical members of a relevant social category who exhibited a counter-stereotypical trait. In the first study, the disconfirmation of a positive trait caused a decline in the participants' use of this trait to describe the social category as a whole, and the participants generalized counter-stereotypical information to the group as a whole more readily when this information was evaluatively consistent with their attitudes toward the group. In the second study, the disconfirmation of a negative trait had no effect on the participants' description of the target group. The results of the two studies are discussed in the context of positive-negative asymmetry. Research on stereotype disconfirmation that includes the ability dimension and considers participants' attitudes will allow researchers to better understand the effects of informational and affective factors in positive-negative asymmetry.

The Stockholm Convention (SC) on Persistent Organic Pollutants (POPs) calls for the Parties' effectiveness evaluation of those measures taken to meet the reduction and eventual elimination of POPs from the environment. With that goal, air concentrations of different POP families have been measured uninterruptedly since 2008 under the Spanish Monitoring Program (SMP) by means of passive air sampling. This work focuses on data for polybrominated diphenyl ethers (PBDEs) determined in a total of 321 samples collected seasonally each year in 5 urban and 7 background sites. Neither significant temporal trends nor significant seasonal variations for total PBDE air burdens were detected. In contrast, significant variations were found among PBDE congeners. Those related to the octa-PBDE formulation significantly decreased in the study period. However, PBDEs related to the penta-formulation showed steady concentrations while PBDE-209, the congener found at the greatest levels, showed increasing or steady levels in most sampling sites. Seasonal variations were also markedly different among congeners. Concentrations of the lightest PBDEs (tri- to penta-substituted) were highly influenced by ambient temperature (T), showing maximum values in summer probably due to higher volatilization rates compared to those of heavier PBDEs. Contrarily, no clear seasonal trends were found for hexa- to deca-PBDEs, which were negatively related to precipitation; thereby, indicating an efficient atmospheric wash out by wet deposition episodes. Regarding spatial patterns, overall significant greater PBDE levels were found in cities compared to background areas, pointing out the role of highly populated areas as sources for these pollutants in Spain. Yet and especially in the case of PBDE-209, our results suggested the presence of significant unknown sources of PBDEs in some background sites. Further monitoring efforts are needed to assess potential unknown sources in the sampling network as well as to ensure temporal trends of these pollutants in Spain. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the presence of perfluoroalkyl acids (PFAAs), namely perfluoroalkane sulfonates and perfluoroalkyl carboxylic acids, in Spanish river basins in order to: identify potential spatiotemporal variations; evaluate the effectiveness of the measures implemented for the reduction/elimination of these pollutants; verify the fulfillment of the Environmental Quality Standards (EQSs) in the European Union. PFOS and PFOA were determined in 116 water samples from four sites in the Duero basin, the largest in the Iberian Peninsula, collected seasonally from 2013 to 2020. In addition, 30 fish sample composites from the sample banks of Duero, Tagus, Ebro, Eastern Cantabrian and Catalonian basins were analyzed for 15 PFAAs. Median PFOS and PFOA concentrations were 0.72 and 0.42 ng/L, ranging from values below the limit of quantification (LOQ) to 81 and 22 ng/L, respectively. During the studied period, 51% of water samples were above the EQS of 0.65 ng/L for PFOS. In the case of fish, the PFOS range was

Background: Physical inactivity implies a significant individual and society health burden. Objectives: To assess the feasibility of implementing a preventive physical exercise (PE) programme for the general population and to analyse changes in fitness-related variables and quality of life. Methods: Pre-post comparison study in which general practitioners and nurses recommended PE to participants with sedentary behaviour and hypertension or dyslipidaemia attending in primary care for primary prevention of ischaemic cardiovascular disease. Eligible participants were referred to a PE programme (10 weeks, three days a week, a total of 30 sessions of one-hour duration). Data was collected for five years (2013-2017). Outcome measures were body weight, body mass index (BMI), physical condition (aerobic fitness, muscle strength, flexibility, balance), and quality of life (SF-36). Results: The PE programme was offered to 6,140 eligible subjects; 5,077 (82.7%) accepted to participate and received a recommendation; 3,656 (69.6% women) started the programme and 2,962 subjects (80.9% women) finished the programme. After 10 weeks, there were significant improvements (mean difference, 95% CI) in aerobic fitness (2.55 ml/min/kg, 2.32-2.79), muscle strength (0.62 m, 0.57 to 0.67), flexibility (2.34 cm, 2.06 to 2.63) and balance (-0.46 falls, -0.60 to -0.33) as well as significant decreases in body weight (-0.41 kg, -0.64 to -0.17) and BMI (-0.27 kg/m 2 , -0.34 to -0.20). Conclusion: Implementation of a government-supported PE programme for the general population recruited in the primary care setting and recommended by healthcare professionals is feasible, and was associated with health benefits, mainly improvements in physical fitness.

Purpose: The AIS scale is a measurement tool for single injuries. The ISS is considered the gold standard for determining the severity of injured patients, and the NISS was developed to improve the ISS with respect to loss of information, as well as to facilitate its calculation. The aim of this study was to analyse what injury severity measure, calculated according to the Abbreviated Injury Scale (AIS), 1998 and 2005 (update 2008) versions, performs better with mortality, cost and hospital length of stay healthcare indicators., Methods: This cross-sectional observational study was carried out between February 1st 2012 and February 1st 2013. Inclusion criteria were injured patients due to external causes admitted to trauma service through the emergency department. Manual coding of all injuries was performed and ISS and NISS scores were calculated for both versions of the AIS scale. Severity was then compared to mortality (in-hospital and at 30 days), healthcare cost, and length of hospital stay., Results: The index with the best predictive capability for in-hospital mortality was NISS 05 (AUC = 0.811). There was a significant increase in hospital stay and healthcare cost in the most severe patients in all indexes, except for ISS 05., Conclusions: NISS is found to be an index with higher predictive capability for in-hospital mortality and correlates better to length of hospital stay and healthcare cost.

Objectives: To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients., Material and Methods: Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005., Results: The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%)., Conclusion: The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.