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Background While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes. Methods We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes. Results During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality. Conclusion Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.

Abstract Background During the first wave of the COVID‐19 pandemic, the availability of mechanical ventilators was very limited and ad hoc recommendations establishing age to be used for patient triage for having access to intensive care beds (ICBs) were proposed. No reports have evaluated how this policy impacted ICB admission in Western countries. Aims We analyzed the age‐related probability of ICB admission during first COVID‐19 pandemic wave. Materials and Methods We included all patients ≥65 years attended in 42 Spanish emergency departments (EDs) covering around 22% of the Spanish population during 1‐week of the first wave of the COVID‐19 pandemic (9128 ED visits) and compared the probability of ICB admission respect to patients coming to these EDs 1‐week of 1‐year earlier (24,128 ED visits). Results We found that compared with patients aged 65, the probability of ICB admission was significantly reduced from 79 years and up during the pandemic period (odds ratio [OR] = 0.60 for patients aged 79, 95% confidence interval [CI] = 0.39–0.94), while a significant reduction of ICB admission probabilities was found from 88 years and up during the pre‐COVID‐19 period (OR = 0.66 for patients aged 88, 95% CI = 0.45–0.95) (p

This Data in Brief (DiB) article presents the differences in cycling behaviors related to violations, errors, and positive behaviors by region. The study data were collected by means of a structured questionnaire applied to a full sample of 7,001 participants from 19 countries, distributed over 5 continents. This paper proposes descriptive statistics, as well as common statistical tests. The aim is to enable authors to make their own analyses, not to provide precise interpretations. For further information about the macro project supporting the collection of these data, it is advised to refer to the paper titled “Cross-culturally approaching the cycling behavior questionnaire (CBQ): Evidence from 19 countries”, published in Transportation Research Part F: Traffic Psychology and Behavior.

Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs. Methods: A retrospective analysis of the Emergency Department Elderly in Needs (EDEN) project’s cohort was performed. This registry included all elderly patients who attended 52 Spanish EDs for any condition. Mild and severe polypharmacy was defined as the use of 5–9 drugs and ⩾10 drugs, respectively. The assessed outcomes were ED revisits, hospital readmissions, and mortality 30 days after discharge. Crude and adjusted logistic regression analyses, including the patient’s comorbidities, were performed. Results: A total of 25,557 patients were evaluated [mean age: 78 (IQR: 71–84) years]; 10,534 (41.2%) and 5678 (22.2%) patients presented with mild and severe polypharmacy, respectively. In the adjusted analysis, mild polypharmacy and severe polypharmacy were associated with an increase in ED revisits [odds ratio (OR) 1.13 (95% confidence interval (CI): 1.04–1.23) and 1.38 (95% CI: 1.24–1.51)] and hospital readmissions [OR 1.18 (95% CI: 1.04–1.35) and 1.36 (95% CI: 1.16–1.60)], respectively, compared to non-polypharmacy. Mild and severe polypharmacy were not associated with increased 30-day mortality [OR 1.05 (95% CI: 0.89–2.26) and OR 0.89 (95% CI: 0.72–1.12)], respectively. Conclusion: Polypharmacy was common among the elderly treated in EDs and associated with increased risks of ED revisits and hospital readmissions ⩽30 days but not with an increased risk of 30-day mortality. Patients with polypharmacy had a higher risk of ED revisits and hospital readmissions ⩽30 days after discharge.

IntroductionThe relationships between above-the-line (ATL) and below-the-line (BTL) communication and advertising strategies have been studied in many fields and procedures. Likewise, the interrelationships between both communicative typologies, when they exist, either strategically induced or spontaneously, are also known concerning their reinforcing effects. However, in the social communication field, specifically road safety communication, these interrelationships have been little studied, and few case studies have been done, particularly of those that have stood out as particularly significant.MethodsThus, this paper investigates the implementation process of an ATL awareness campaign of the Spanish Traffic Authority (DGT-General Directorate of Traffic) through the analysis of key digital reach indicators.ResultsDespite the foreseeable limitations of this research regarding the repercussions and positive impact on society of the DGT communication campaign, it is nevertheless a contribution of interest regarding the digital impact that has been generated in networks (BTL communication) from a DGT campaign broadcast on various media such as television, radio, posters, and social networks.DiscussionThus, from a methodology based on an exact delimitation (two DGT TV spots -from 2022- generating a quantitative activity on X (formally Twitter) that had never before produced DGT spots), significant conclusions and results have been reached related to issues of age groups, loyalty and distortion of messages, communication impact strategies, among others.

Among the most generalised preventive measures against traffic crashes, advertisements and broadcast campaigns in the media have stood out over the last six decades. The core aim of this paper is to describe the evolution of the subject matter and typology of road safety-related advertisements used in Spain during 62 years (1960–2021). Thus, this paper assesses their role in reducing road fatalities, while keeping in mind the potential effect of the many other road safety-related preventive measures carried out in the country during this period. The results of this study allow us to target five key time periods, all of them with clear particular communication strategies to be differentiated, using specific types of advertisements and informative, persuasive, emotional, and humorous techniques (among others) to reach the audience. Additionally, some key practical implications and guidelines are provided.

Resumen: Objetivo: Identificar factores predictores de hiperfrecuentación en Atención Primaria (AP) en una muestra de pacientes hiperfrecuentadores (HF) en servicios de urgencias hospitalarios (SUH). Diseño: Estudio observacional retrospectivo multicéntrico. Participantes: Se seleccionaron pacientes mayores de 14 años HF en el SUH entre el 1 de enero y el 31 de diciembre de 2013. Emplazamiento: se reclutaron pacientes atendidos en los SUH de 17 hospitales públicos de la Comunidad de Madrid. Método: Se recogieron variables relativas a la visita índice del SUH. Se analizó la muestra en función de ser o no HF en AP. Se considera HF al paciente que realizó al menos 10 visitas en cada nivel asistencial durante un año. Resultados: Se incluyeron 1.284 pacientes HF en SUH. Se analizaron 423 (32,9%) HF en AP con 16 visitas (RIC 12-25) frente a 861 (67,1%) pacientes no HF en AP con 4 visitas (RIC 2-6). Factores independientes predictores de HF en AP fueron la edad > 65 años (OR: 1,51; IC 95%: 1,07-2,13; p = 0,019), el deterioro cognitivo (OR: 1,63; IC 95%: 1,01-2,65; p = 0,049), el número de fármacos ≥3 (OR: 1,56; IC 95%: 1,06-2,30; p = 0,025) y vivir en la comunidad frente a vivir institucionalizado o en la calle (OR: 3,05; IC 95%: 1,14-8,16; p = 0,026). Conclusiones: En una muestra de pacientes HF en los SUH, el hecho de ser mayor de 65 años, tomar 3 o más fármacos, presentar deterioro cognitivo y vivir en la comunidad se consideran factores predictores de ser HF también en AP. Abstract: Objective: To identify predictors of frequent attenders (HF) in Primary Health Care (PHC) centres in a sample of frequent attenders (HF) in Emergency Departments (ED). Design: This was an observational, retrospective, multicentre cohort study. Participants: The HF patients were selected from patients seen in the ED between January 1 and December 31, 2013. Setting Patients were recruited from 17 public hospitals of the Community of Madrid, Spain. Method: Variables on the index visit to the ED were collected. The sample was analysed in terms of being or not being an HF user in PHC. An HF user is considered a patient who made at least 10 visits in each level of care for a year. Results: A total of 1284 HF patients were included. An analysis was performed on 423 (32.9%) HF users in ED with 16 (12-25) visits to PHC vs. 861 (67.1%) non-HF users in ED, with 4 (2-6) visits to PHC. Independent predictors of HF in PHC: over 65 years (OR: 1.51; 95% CI: 1.07-2.13; P=.019), cognitive impairment (OR: 1.63; 95% CI: 1.01-2.65; P=.049), taking >3 drugs (OR: 1.56; 95% CI: 1.06-2.30; P=.025), and living in the community vs. nursing home or homeless (OR: 3.05; 95% CI: 1.14-8.16; P=.026). Conclusions: Among HF patients in the ED, the fact that of being over 65 years, taking 3 or more drugs, suffering cognitive impairment, and living in the community, are also considered to be predictors of HF in PHC. Palabras clave: Factores predictores, Hiperfrecuentación, Urgencias hospitalarias, Atención primaria, Keywords: Predictors, Frequent attendance, Emergency Department, Primary Health Care

Communication campaigns are commonly used in the traffic and road safety sector to raise public awareness of the importance of avoiding risky road user attitudes and behaviors. Surprisingly few of these communication campaigns evaluate their effectiveness in a formal and comprehensive manner. The core aim of the present systematic review is to identify the type of studies that evaluate the effectiveness of campaigns in this sector, in order to identify and contrast their main findings. This systematic review followed the PRISMA methodology, by means of which the relevant articles based on the search term were identified. A total of 613 indexed articles were filtered, and a final set of 27 articles directly addressing the issue was analyzed. Search strategies were developed and conducted in WOS, Scopus, NCBI, Google Scholar and APA databases. The selected articles point out that, although advertisements alone have a certain positive effect, their effectiveness is substantially increased if they are accompanied by other preventive measures such as legislation or road safety education. In any case, more evaluations of traffic campaigns are needed to identify which techniques are effective and which are not, and which should therefore be replaced by new methods of behavior modification in future communication campaigns.

Although traffic crashes are the eighth leading cause of death in the world, and are linked to vehicle and infrastructure-related factors, crash-related fatality rates are much higher in low-income countries. Particularly, the Dominican Republic is the country with the highest accident rate in the whole American continent. Therefore, in the past few years, public agencies have been developing different measures aimed at reducing traffic fatalities, including road safety campaigns. The aim of the present study was to assess the recalling of such campaigns among the Dominican population, which may serve as an additional indicator to evaluate their effectiveness in this and other countries of the region presenting similar traffic safety issues. For this cross-sectional study, a nationwide sample composed of 1260 people (50% males and 50% females) with a mean age of 39.3 years was used. The data were collected through personal interviews. Overall, the recall of traffic safety campaigns was found to be very low (9%); male drivers who were employed, possessed a driver’s license and habitually drove were the ones who could commonly remember these campaigns. The results of this study suggest that further evaluation and follow-up could help to maximize the impact of future traffic campaigns and advertisements in the Dominican Republic, as well as in other emerging countries of the region with similar characteristics. Further, key segments of the population such as the female, young, less formally educated and non-driving populations should be also targeted for further actions in this regard.

Reseña: Códigos comunicativos y docencia Javier Rodríguez Torres (Coord.) Vision Libros, Madrid 2013

Al considerar la web en el ámbito de la enseñanza-aprendizaje, interesa más entenderla como una TCC (Tecnología de Comunicación y Conexión) que como una TIC. Muchas veces, la tecnología actual sólo se emplea desde sus posibilidades meramente conectivas (entre otras, de suministro y búsqueda de información), sin concebirla desde todas las potencialidades que posee de virtualización. En este texto se plantea el rol de la tecnología -y su imbricación funcional- en la formación, desde la necesidad de atender a lo virtual cuando nos enfrentamos al conocimiento y su transitivización.