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Abstract Background Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Abstract Background Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. Methods A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). Results 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. Conclusions Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.

Abstract Background Previous studies have shown that immigrant workers face relatively worse working and employment conditions, as well as lower rates of sickness absence than native-born workers. This study aims to assess rates of sickness presenteeism in a sample of Spanish-born and foreign-born workers according to different characteristics. Methods A cross-sectional survey was conducted amongst a convenience sample of workers (Spanish-born and foreign-born), living in four Spanish cities: Barcelona, Huelva, Madrid and Valencia (2008-2009). Sickness presenteeism information was collected through two items in the questionnaire ("Have you had health problems in the last year?" and "Have you ever had to miss work for any health problem?") and was defined as worker who had a health problem (answered yes, first item) and had not missed work (answered no, second item). For the analysis, the sample of 2,059 workers (1,617 foreign-born) who answered yes to health problems was included. After descriptives, logistic regressions were used to establish the association between origin country and sickness presenteeism (adjusted odds ratios aOR; 95% confidence interval 95%CI). Analyses were stratified per time spent in Spain among foreign-born workers. Results All of the results refer to the comparison between foreign-born and Spanish-born workers as a whole, and in some categories relating to personal and occupational conditions. Foreign-born workers were more likely to report sickness presenteeism compared with their Spanish-born counterparts, especially those living in Spain for under 2 years [Prevalence: 42% in Spanish-born and 56.3% in Foreign-born; aOR 1.77 95%CI 1.24-2.53]. In case of foreign-born workers (with time in Spain < 2 years), men [aOR 2.31 95%CI 1.40-3.80], those with university studies [aOR 3.01 95%CI 1.04-8.69], temporary contracts [aOR 2.26 95%CI 1.29-3.98] and salaries between 751-1,200€ per month [aOR 1.74 95% CI 1.04-2.92] were more likely to report sickness presenteeism. Also, recent immigrants with good self-perceived health and good mental health were more likely to report presenteeism than Spanish-born workers with the same good health indicators. Conclusions Immigrant workers report more sickness presenteeism than their Spanish-born counterparts. These results could be related to precarious work and employment conditions of immigrants. Immigrant workers should benefit from the same standards of social security, and of health and safety in the workplace that are enjoyed by Spanish workers.

One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual and social factors that affect the health of the immigrant populations. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to analyse the perspectives of screening candidates and healthcare professionals on shared decision-making (SDM) in prostate cancer (PCa) screening using the prostate-specific antigen (PSA) test., Design: Descriptive qualitative study (May-December 2022): six face-to-face focus groups and four semistructured interviews were conducted, transcribed verbatim and thematically analysed using ATLAS.ti software., Setting: Data were obtained as part of the project PROSHADE (Decision Aid for Promoting Shared Decision Making in Opportunistic Screening for Prostate Cancer) to develop a tool for SDM in PCa screening with PSA testing in Spain., Participants: A total of 27 screening candidates (three groups of men: 40-50 years old; 51-60 years old and 61-80 years old), 25 primary care professionals (one group of eight nurses and two groups of physicians: one with more and one with less than 10 years of experience), and four urologists. Focus groups for patients and healthcare professionals were conducted separately., Main Outcome Measures: Participants' perceptions of shared decision-making related to PSA opportunistic screening, including their understanding, preferences, and attitudes., Results: Three themes were generated: (1) perceptions of SDM, (2) perceptions of PSA testing and (3) perceptions of SDM regarding PCa screening. Theme 1: screening candidates valued SDM when it included clear information and empowered them. There was consensus with primary care health professionals on this point, although their knowledge and implementation of SDM varied. Theme 2: candidates were divided on PSA testing; some trusted it for early detection, while others expressed scepticism due to concerns about false positives and invasive procedures, reflecting gaps in accessible information. Theme 3: professionals across primary and specialised care stressed the need for standardised SDM protocols. Primary care physicians were particularly concerned that PSA decisions align with scientific evidence and urologists recognised SDM as valuable in PSA testing only if it was adequately explained to each patient. Barriers to implementing SDM included insufficient coordination across care levels, lack of consensus-driven protocols and limited clinical time., Conclusions: While patients expect comprehensive information, primarily based on practice to achieve empowerment, healthcare professionals face obstacles such as limited time and insufficient coordination between primary care and urology. All stakeholders agree on the importance of evidence-based tools to reinforce effective SDM and enhance collaboration across urologists and primary care in the context of PSA testing., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Interventions through telerehabilitation have shown positive effects in various clinical conditions, facilitating the return to work of the working population. This study aimed to compare conventional, center-based physiotherapy versus an intervention combining home- and center-based treatment for whiplash syndrome in workers enrolled in a mutual insurance company, evaluating differences in the number of face-to-face sessions and the duration of sickness absence. The secondary aim was to assess the acceptability and usability of the telerehabilitation intervention. Methods: The study population ( n = 387) comprised workers aged 16 to 65 years who required physiotherapy due to whiplash (ICD-9 847.0). The main outcome variable was the number of face-to-face sessions. The duration of sickness absence was also calculated. A survey was also conducted to determine patient acceptance and usability of the platform. The analyses were adjusted for sex, age, occupation, and the center where the physiotherapy treatment was administered. Results: The number of face-to-face physiotherapy sessions dropped significantly, from 9 to 7, due to the implementation of telerehabilitation. This decrease was not associated with a longer duration of sickness absence. The difference in the median duration of sickness absence between patients who had not undergone telerehabilitation and those who had undergone telerehabilitation was -1 [95% CI= (-6 to 2)]. Conclusion: Telerehabilitation reduces the number of face-to-face physiotherapy sessions needed, which can reduce the care burden in physiotherapy centers and avoid the need for patients to travel (with a corresponding reduction in transportation costs), without increasing the duration of sickness absence.

Adolescents' extensive use of digital devices raises significant concerns about their visual health. This study aimed to adapt and validate the computer vision syndrome questionnaire (CVS-Q © ) for adolescents aged 12-17 years. A mixed-method sequential design was used. First, a qualitative study was involved two nominal groups to assess the instrument's acceptability. A subsequent cross-sectional quantitative study with 277 randomly selected adolescents assessed reliability and validity. Participants completed the adapted CVS-Q © , an ad hoc questionnaire, and the ocular surface disease index (OSDI) questionnaire. Repeatability was tested in 54 adolescents after 7-14 days. The Rasch-Andrich rating scale model was used. Instructions and symptoms were modified to obtain the 14-item CVS-Q teen © . It showed unidimensionality, no local dependence between items, and respected monotonicity. Adequate internal consistency (person reliability = 0.69, item reliability = 0.98) and intraobserver reliability (intraclass correlation coefficient = 0.77, Cohen's Kappa = 0.49) were observed. A significant correlation (0.782, p < 0.001) between CVS-Q teen © and OSDI supported construct validity. A score of ≥ 6 points indicated computer vision syndrome (CVS) (sensitivity = 85.2%, specificity = 76.5%, and area under the curve = 0.879). In conclusion, CVS-Q teen © is a valid and reliable instrument for assessing CVS in adolescents using digital devices, applicable in research and clinical practice for early identification and recommendations for visual health., (© 2024. The Author(s).)

Objective: This study aimed to evaluate the effectiveness of SARS-CoV-2 mRNA vaccines in preventing infection and hospitalization among healthcare workers (HCWs) in the Valencian Community (Spain), considering vaccination timing, dose number, and predominant variant., Methods: A test-negative case-control design estimated vaccine effectiveness against symptomatic disease and hospitalization due to SARS-CoV-2. HCWs who underwent PCR or antigen testing for SARS-CoV-2 from January 2021 to March 2022 were included. Cases had a positive diagnostic test, while controls had negative tests. Adjusted vaccine effectiveness (aVE) was calculated using the formula: aVE = (1 - Odds ratio) × 100., Results: During the Delta variant's predominance, aVE against infection within 12-120 days post-second dose was 64.8 % (BNT162b2) and 59.4 % (mRNA-1273), declining to 21.2 % and 42.2 %, respectively, after 120 days. For the Omicron variant, aVE within 12-120 days post-second dose was 61.1 % (BNT162b2) and 85.1 % (mRNA-1273), decreasing to 36.7 % and 24.9 %, respectively, after 120 days. After a booster dose of mRNA-1273, aVE was 64.0 % (BNT162b2 recipients) and 65.9 % (initial mRNA-1273 recipients). Regardless of variant, aVE for hospitalization prevention after 2 doses was 87.0 % (BNT162b2) and 89.0 % (mRNA-1273)., Conclusion: The administration of two doses of Moderna-mRNA-1273 against SARS-CoV-2 in HCWs proved to be highly effective in preventing infections and hospitalizations in the first 120 days after the second dose during the predominance of the Omicron variant. The decline in VE after 120 days since the administration of the second dose was significantly restored by the booster dose administration. This increase in VE was greater for the Pfizer vaccine. COVID-19 hospitalization prevention remained stable with both mRNA vaccines throughout the study period., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Healthcare-associated infections (HAIs) present a global public health challenge, contributing to high morbidity and mortality and substantial economic burdens. Ventilator-associated pneumonia (VAP) ranks as the second most prevalent HAI in intensive care units (ICUs), emphasizing the need for economic analyses in this context. This retrospective cohort study, conducted at the General Hospital of Alicante from 2012 to 2019, aimed to assess additional costs related to VAP by comparing the extended length of stay for infected and non-infected ICU patients undergoing mechanical ventilation (MV) for more than 48 h. Employing propensity score association, 434 VAP patients were compared to an equal number without VAP. The findings indicate a significantly longer mechanical ventilation period for VAP patients (17.40 vs. 8.93 days, p < 0.001), resulting in an extra 13.56 days of stay and an additional cost of EUR 20,965.28 per VAP episode. The study estimated a total cost of EUR 12,348,965.28 for VAP during the study period, underscoring the economic impact of VAP. These findings underscore the urgent need for rigorous infection surveillance, prevention, and control measures to enhance healthcare quality and reduce overall expenditures.

Purpose: As digital devices are increasingly used at work, valid and reliable tools are needed to assess their effect on visual health. This study aimed to translate, cross-culturally adapt, and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Portuguese., Methods: A 5-phase process was followed: direct translation, synthesis of translation, back-translation, consolidation by an expert committee, and pretest. To run the pretest, a cross-sectional pilot study was conducted with 26 participants who completed the prefinal Portuguese version of the CVS-Q© and were asked about difficulties, comprehensibility, and suggestions to improve the questionnaire. To evaluate the reliability and validity of the Portuguese version of the CVS-Q©, a cross-sectional validation study was performed in a different sample (280 workers)., Results: In the pretest, 96.2% had no difficulty in completing it, and 84.0% valued it as clear and understandable. CVS-Q© in Portuguese (Questionário da Síndrome Visual do Computador, CVS-Q PT©) was then obtained. Validation revealed the scale's good internal consistency (Cronbach's alpha=0.793), good temporal stability (intraclass correlation coefficient=0.847; 95% CI 0.764-0.902, kappa=0.839), adequate sensitivity and specificity (78.5% and 70.7%, respectively), good discriminant capacity (area under the curve=0.832; 95% CI 0.784-0.879), and adequate convergent validity with the ocular surface disease index (Spearman correlation coefficient=0.728, p<0.001). The factor analysis provided a single factor accounting for 37.7% of the explained common variance. A worker who scored ≥7 points would have computer vision syndrome., Conclusions: CVS-Q PT© can be considered an intuitive and easy-to-understand tool with good psychometric properties to measure computer vision syndrome in Portuguese workers exposed to digital devices. This questionnaire will assist in making decisions on preventive measures, interventions, and treatment and comparing exposed populations in different Portuguese-speaking countries.

Background: The Spanish version of the Computer Vision Syndrome Questionnaire (CVS-Q © ) is a validated instrument, with good psychometric properties, to measure Computer Vision Syndrome (CVS) in workers using Video Display Terminals (VDTs). To date, there are no known valid instruments in Chinese for the assessment of CVS despite the high exposure to VDTs at work that this population presents. For this, the purpose of this study is to translate and cross-culturally adapt the CVS-Q © into Chinese., Methods: A study with five consecutive stages: direct translation, synthesis of translations, back translation, consolidation by a committee of experts, and pre-test. During the pre-test, a cross-sectional pilot study was conducted on VDT users (n = 44) who completed the Chinese version of the questionnaire plus an ad hoc post-test to assess the comprehensibility of the scale and to verify aspects of its applicability and feasibility. Data concerning sociodemographic information, general and ocular health, use of optical correction and varying exposure to VDTs was also collected., Results: The entire sample considered the Chinese version of the CVS-Q © simple, clear, and easy to understand and 95.5% also found it easy to complete. 88.7% considered that the scale did not need any improvement. The final version of the Chinese scale to measure CVS was obtained (the CVS-Q CN © ). The mean age of participants was 31.3 ± 9.8 years, 47.6% were women, and 57.1% used VDTs to work for more than 8 h/day., Conclusions: The CVS-Q CN © can be considered an easy tool to assess CVS in workers exposed to digital devices in China. This version would facilitate research, its use in clinical practice, and the prevention of occupational hazards in the workplace., (© 2023. The Author(s).)

The COVID-19 pandemic disrupted work-family balance due to lockdown measures. The aim of this study was to explore the experiences of working mothers in Spain and the consequences of trying to balance work and family for their health and wellbeing. We conducted a qualitative study based on 18 semi-structured interviews with mothers of children under 10. Five themes were identified: (1) Telework-characteristics and challenges of a new labor scenario; (2) Survival and chaos-inability to work, look after children, and manage a household at the same time; (3) Is co-responsibility a matter of luck?-challenges when sharing housework during lockdown; (4) Breakdown of the care and social support system; and (5) decline in health of women trying to balance work and family life. Mothers who had to balance telework against family life suffered physical, mental, and social effects, such as anxiety, stress, sleep deprivation, and relationship problems. This study suggests that, in situations of crisis, gender inequality increases in the household, and women tend to shift back to traditional gendered roles. Governments and employers should be made aware of this, and public policies should be implemented to facilitate work-family reconciliation and co-responsibility within couples.

Background: Rheumatoid arthritis (RA) and periodontitis (PD) are chronic diseases that are associated with connective tissue and bone destruction, which affects the quality of life of the people suffering from these conditions. The identification of social conditions and the determinants of RA and PD would permit the elaboration of policies and strategies based on social reality., Objectives: The aim of the present study was to identify the relationship between oral health-related quality of life (OHRQoL) and the indicators of general health and oral health in patients with RA., Material and Methods: A cross-sectional study involving 59 patients with RA was conducted between 2019 and 2020. Demographic, general health, periodontal, and oral health parameters were collected. In addition, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was administered to each patient. A description of the OHIP-14 dimensions according to different variables was performed. The relationship between OHRQoL and general/oral health indicators was analyzed with logistic and linear regression analyses., Results: The highest OHIP-14 scores were found in people that were 60 years of age and over, single, had low educational achievements, a low socioeconomic status, were unemployed, and had no health affiliation. In the adjusted model, the prevalence of the impact on OHRQoL was 1.34 (1.10-5.29) times greater in those with erosive RA than in those without, and 2.22 (1.16-29.50) times greater in those who self-reported morning stiffness. Regarding the stage of PD, those with stage IV had a prevalence of the impact on the OHRQoL of 70%, an average extent of 3.4 ±4.5 and a severity score of 11.5 ±22.0, with statistically significant differences., Conclusions: The dimensions with the greatest impact on the OHRQoL of patients were physical pain, discomfort and psychological disability. The type of RA and the severity of PD are indicators of worse scores on the OHRQoL scale.

Objective: To analyse the prevalence and progression of computer vision syndrome in secondary and high school students with the CVS-Q© adapted and validated for adolescents, depending on whether they use textbooks or digital books., Method: The CVS-Q© will be adapted by a pilot study in adolescents and a nominal group of visual health specialists, teachers and parents. The resulting version (CVS-Q teen©) will be tested to confirm its quality and applicability and a validation study will be done with visual tests, retest and psychometric analysis. Subsequently, a prospective longitudinal study with four repeated measures will be carried out in adolescents from two secondary schools of San Juan de Alicante (one has replaced textbooks by tablets). Computer vision syndrome will be measured by the CVS-Q teen© with three follow-ups. The prevalence of computer vision syndrome will be analysed according to sociodemographic, visual and digital device use variables. Logistic regression models will be performed, with random effect by student and time of use., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Purpose: To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q © ) into Persian., Methods: This study was carried out in 2 phases: (1) the CVS-Q © was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA © were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA © were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test-retest reliability., Results: The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA © showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test-retest reliability (ICC = 0.81 and κ = 0.65)., Conclusion: The CVS-Q FA © was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population., (© 2022. The Author(s).)

The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine effectiveness against SARS-CoV-2 infection in health care workers (HCWs) at a tertiary hospital depending on time elapsed since the completion of a two-dose vaccination regimen. We conducted a case-control with negative test study between 25 January and 12 December 2021 that included 1404 HCWs who underwent an active infection diagnostic test (AIDT) to rule out SARS-CoV-2 infection due to COVID-19 suspicion or prior close contact with patients diagnosed with COVID-19. The adjusted vaccine effectiveness (aVE) for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccination regimen was 91.9%. Then, aVE decreased to 63.7% between 121 to 240 days after completing the full two-dose regimen and to 37.2% after 241 days since the second dose. Vaccination against SARS-CoV-2 infection in HCWs remains highly effective after 12 to 120 days have elapsed since the administration of two doses of the BNT162b2 vaccine; however, effectiveness decreases as time elapses since its administration.

This study aims to explore the perceptions of the Venezuelan immigrant population in Medellín, Colombia, regarding their employment, working and health conditions (physical, mental and psychosocial). A qualitative study was conducted (focused ethnography perspective). Semi-structured interviews were carried out with 31 Venezuelans and 12 key informants from different social organisations that work with the immigrant population. A narrative content analysis was carried out (Atlas.Ti 8.0 software). The migratory process for Venezuelans is caused for political, economical and social aspects in Venezuela and Colombia is offered as the first destination for labour establishing. Access to the labour market is limited to certain occupations, in many cases in the informal economy. Participants referring low salaries, working long hours and reduced social benefits. Occupational risks are evidenced by low experience in the labour market. Some health problems are perceived, and a good part of the interviewed population referred to signs and symptoms related to mental health problems. Barriers to access health and social protection services were found. Finally, future expectations depend on their adaptation to Colombia, the improvement of social conditions in Venezuela or having chances of improving their social and living conditions in another country. A high labour and social vulnerability were found in Venezuelan participants that impact on physical and mental health. Political and strategies from a public health perspective are required and the implementation of systems for monitoring and evaluating the labour and health situation in the working immigrant population., (© 2022 John Wiley & Sons Ltd.)

Objective: To assess the effectiveness of the vaccine against SARS-CoV-2 (BNT162b2) in healthcare personnel of a health department., Method: Test-negative case̶control study. Healthcare personnel with suspected COVID-19 and healthcare personnel close contacts of COVID-19 cases were included between January 27th and June 6th, 2021. They were PCR tested for SARS-CoV-2; those with positive PCR were considered cases and those with negative PCR were considered controls. The adjusted vaccine effectiveness (aVE) to prevent COVID-19 cases and their 95% confidence interval (95%CI) were calculated using the formula VE=(1-odds ratio)×100., Results: 624 healthcare personnel were included, of which 43 (6.9%) were considered cases and 581 (93.8%) controls. The aVE of the complete regimen was 96.3% (95%CI: 82.5̶99.2). The aVE of the incomplete pattern was 68.0% (95%CI: 30.0̶85.4)., Conclusions: The administration of the complete pattern of BNT162b2 vaccine against SARS-CoV-2 is effective for the prevention of cases of COVID-19 in healthcare personnel., (Copyright © 2021 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain., Method: Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR)., Results: The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75)., Conclusions: The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations., (Copyright © 2021 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

To analyze compliance with dietary recommendations (DR) based on the Mediterranean Diet among natives and immigrants in Spain. A cross-sectional study was carried out using the Platform of Longitudinal Studies of Immigrant Families comparing immigrant workers from Colombia, Ecuador and Morocco with Spanish workers. Adjusted odds ratios (ORa) of sufficient compliance with DR were obtained by sociodemographic variables. We also obtained the adjusted difference in means (DMa) for foods for which there was compliance with DR. Moroccans had greater compliance for meat (ORa = 7.22), eggs (ORa = 5.03) and cured-meats (ORa = 89.78). Ecuadorians for sweets (ORa = 4.03) and Spaniards for natural-juices and dairy-products. Moroccans had the greatest compliance in terms of the number of foods (DMa = 1.53), while Colombians had the least (DMa = - 0.95). Men (DMa = - 0.98), those with primary or incomplete primary education (DMa = - 0.83) and single-parent families (DMa = - 0.58) showed lower compliance. Compliance with DR was low among both Spaniards and immigrants, despite differences in levels of compliance, especially between Moroccans and Colombians., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Accommodative support (AS) lenses are a low add progressive addition spectacle lens designed to ease symptoms in computer vision syndrome (CVS). The study aims to investigate if (1) AS lenses improve CVS symptoms; (2) binocular/accommodative functions predict a benefit from AS lenses and (3) wearing AS lenses for six months impacts on binocular/accommodative functions., Methods: Pre-presbyopic adults with symptoms of CVS (Computer Vision Syndrome Questionnaire, CVS-Q © , score ≥ 6) were randomly allocated to wear AS lenses or control single vision (SV) lenses. The CVS-Q © and a battery of optometric tests were applied at baseline and after three and six months. Participants and researchers were masked to participant group. After six months, the SV group were unmasked and changed to AS lenses and one week later asked to choose which they preferred., Results: The change in CVS-Q © scores from baseline to six months did not differ significantly in the two groups. At the end of the one week period, when the control group wore the AS lenses, control group participants were significantly more likely to prefer AS lenses to SV lenses. No optometric functions correlated with the benefit from AS lenses. AS lenses did not have any adverse effects on binocular or accommodative function., Conclusions: In pre-presbyopic adults, there was no greater improvement in CVS-Q © scores in the group wearing AS lenses than in the control group. No adverse effects on optometric function (including accommodation) are associated with wearing AS lenses., (© 2021 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

The COVID-19 pandemic is clearly showing the importance for the surveillance and protection of human health of acting in all settings of life: family, community, education, leisure or work, among others, as well as addressing the multiple determinants that influence the health and well-being of the population: demographic, healthcare, environmental, social, eco-nomic, cultural or occupational, among others. With respect to occupational health and the work-related determinants of health, the potential of occupational health services acting at the company level is clear, and could be generalized to almost any public health action setting. This article reflects on the opportunities for coordination between the occupational health system in Spain (including resources from mutual insurance companies, companies themselves and administrations) and the public health system, including both health care (primary care, hospital) and public health services. We examine this in the context of health crises, like the present one, but also with a broader vision, commensurate with the necessary comprehensive care for human health, guaranteeing health as a fundamental and universal right in all life circumstances. To advance along these lines, we propose the incorporation of the "occupational health perspective" in all actions and services of the public healthcare system, especially with respect to public health services under the purview of the health administration.

Background: The analysis of mortality offers an important indicator for assessing the state of workers' occupational health. Workers involved in the extraction, refining, alloying and manufacturing of metals are frequently exposed to occupational risks that can lead to their death. The objective of this work was to synthesize the scientific evidence about factors associated with mortality among workers in the metallurgical industry., Methods: A bibliographic review was conducted using the PubMed database. Seventeen studies were included, where topics addressed specific problems that influence the mortality of workers in the metallurgical industry sector. Complete texts of the articles were reviewed., Results: Findings show the highest probabilities of death due to malignant neoplasms (48%), diseases of the circulatory system (28%), work accidents (15%), suicide and violence (9%)., Conclusions: Despite the research carried out, there are gaps and limitations in the study of mortality in workers in the metallurgical industry, mainly related to the relationship of the cause of death with occupational risk factors.

This study explored the general and oral health perceptions in the Venezuelan immigrant population in Medellín (Colombia) and its conditioning factors. A qualitative study involving Venezuelan immigrants ≥18 years with a minimum stay of six months in Colombia was conducted. Dentists, dental students, and other health professionals also participated. Semi-structured interviews ( n = 17), focus groups ( n = 2), and key informants' interviews ( n = 4) were utilized. The interviews and focus groups were recorded and transcribed for later narrative content analysis. A high degree of vulnerability of participants was found due to the precarious living conditions from the premigratory moment and the lack of job placement possibilities at the time of settling in Colombia, where the migratory status played a fundamental role. Among the perceived needs, the mitigation of noncommunicable diseases stood out. Poor mental health symptoms (depression and anxiety) were perceived, and oral health was not a priority. Barriers to accessing health and dental care were found. The migrant condition was found to be a determinant that affected physical, mental, and oral health and the provision of health care. This situation is of interest to the construction of public health policies that guarantee access to fundamental rights.

Objective: To characterize the diet and eating habits of adult immigrants of Chinese origin residing in Santa Coloma de Gramenet (Barcelona, Spain), and to identify the factors that influence the changes in diet and eating habits., Method: Qualitative study conducted in 2017 through a discussion group with eight adults of Chinese origin (one man and seven women). The information was complemented by five interviews with key informants (three men and two women) and non-participant observation in health promotion workshops aimed at Chinese patients of a health center in Santa Coloma de Gramenet., Results: Chinese adults made three meals a day and tended to snack between meals. Their diet was based on rice, soy and proteins of vegetable origin. Participants rarely consumed milk and milk derivatives but highlighted their consumption of snacks, sugary drinks and pastries, as well as the incorporation of foods, new dishes and cooking techniques from the host country. The Chinese immigrants tried to maintain their diet of origin, however there were various barriers to this, such as the preference of the local diet by the children, work schedules and lack of time., Conclusions: A tendency towards dietary acculturation is observed among the participants. Health promotion activities aimed at Chinese families are needed to improve aspects of their diet and eating habits, aiming to reduce the consumption of snacks and sugary products., (Copyright © 2019 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

The present study aims to examine the differences in daily fruit and vegetable consumption in the working population in Spain. A cross-sectional study was conducted, using data from the 2017 National Health Survey ( n = 10,700 workers aged between 18 and 65 years). The daily consumption of fruit and vegetables was evaluated using two items included in a food frequency questionnaire. Occupations were classified into the 17 main groups of the National Classification of Occupations of 2011 (CNO-11). The prevalence (P) of daily fruit and vegetable consumption was calculated in relation to sociodemographic characteristics, health behaviors, work-related characteristics and occupations. Logistic regression analysis was performed to examine the association, with simple and adjusted Odds Ratio (aOR). The P of daily consumption of fruit and vegetables in workers was 60% for fruit and 40% for vegetables. After adjusting for sociodemographic characteristics and health behaviors, workers working night or rotating shifts had a lower consumption of fruits (aOR:0.9; p < 0.05), and those working on temporary contracts had a lower consumption of vegetables (aOR:0.8; p < 0.05). Engineers, scientists, health care workers and teachers had the highest fruit consumption (74.5%) and the highest vegetable consumption (55.1%). The lowest consumption of fruits was presented by the military (42.3%) and unskilled workers in the service sector (45.8%), and the lowest consumption of vegetables was presented by skilled construction workers (25.5%). These findings could aid in workplace health promotion and could be used in future studies to evaluate the impact of the activities adopted.

Background: Employment and working conditions are considered as an element that impacts on health inequalities, especially among vulnerable groups such as the immigrant population. This study aims to describe the characteristics of precarious employment in the Venezuelan immigrant population in Medellín (Colombia) according to its theoretical model and its relationship with the perception of their physical, mental, and psychosocial health., Methods: A qualitative study was conducted with a focused ethnography perspective. 31 people with Venezuelan origin and work experience were interviewed in the city of Medellin and its metropolitan area and 12 key informants from different formal and informal social organizations that work with the immigrant population. A narrative content analysis was carried manually and by using the Atlas.Ti 8.0 software. The principles of analytical induction were applied to carry out a thematic analysis of the main categories defined in the precarious employment framework., Results: The following characteristics of precarious employment were found: instability in employment conditions, work in the informal or submerged economy, limited empowerment, absence of social benefits, high vulnerability, low income, and a limited capacity for exercising labor rights. This situation affects mental health conditions, access to health services, and the presence of risks due to the work they perform., Conclusions: The Venezuelan working population in Medellín is found in a precarious employment situation. Inclusive social strategies and policies that take into account the reality of this population are required., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Author(s).)

Objective: The objective of this study is to examine the relationship between bullying in migrants and Australians and types of workplace Iso-strain, by gender., Design and Setting: Two descriptive cross-sectional surveys of the Australian working population., Participants: Australian-born workers of Caucasian ancestry (n=1051, participant response rate=87.3%) and workers born in New Zealand (n=566), India (n=633) and the Philippines (n=431) (participant response rate=79.5%)., Primary and Secondary Outcomes Measures: Using logistic regression, we examined whether self-reported assessment of various forms of bullying in the workplace was associated with Iso-strain (job with high demands and low control and without social support), gender and migrant status., Results: The prevalence of workplace bullying within the previous year was 14.5%. Sexual harassment, though rare (n=47, 1.8%), was reported by more women than men (83% vs 17%, χ 2 =19.3, p<0.0001) and more Australia or New Zealand born workers compared to India or the Philippines workers (75.5% vs 25.5%, χ 2 =4.6, p=0.032). Indian-born women had lower adjusted OR for being bullied and for being intimidated compared to other women. Independent of migrant status, Iso-strain (1), (low support from boss) and Iso-strain (2), (low support from colleagues) predicted being bullied. Women were more likely to be in an Iso-strain (1) job than men (18.7% vs 13.6%, p=0.013) and had twice the risk of being both verbally abused and intimidated compared to men (OR 9 vs OR 5.5, p<0.0001)., Conclusion: Workplace bullying was more likely for women than men. There were few differences between workers from different migrant groups. Iso-strain was the strongest predictor of workplace bullying. Workplaces should encourage supportive and collegiate work environments., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study analyzes associated factors to self-perceived oral health and use of oral health services in native and immigrant adults from the PELFI cohort in Spain. A cross-sectional analysis was conducted (401 adults ≥ 18 years, from Spain, Ecuador, Colombia and Morocco). Frequencies for sociodemographic, self-perceived general and oral health variables were calculated. The association between oral health/oral health services use and origin country was estimated by logistic regression (adjusted odds ratio-aOR-; 95% confidence intervals -95%CI-). Ecuadorian men were more likely to report dental caries (aPR 2.75; 95%CI 1.30-5.80) and Moroccan women were more likely to report gingival bleeding (aPR 3.61; 95%CI 1.83-7.15) and the use of oral health services ≥ 1 year/never (aPR 1.69; 95%CI 1.06-2.69). Colombian women were less likely to report missing teeth (aPR 0.73; 95%CI 0.56-0.95). Poor self-perceived oral health indicators were observed in immigrants and were modified for sociodemographic and general health variables.

The main aim of the present study was to summarize the available literature on the topic of occupational health and safety (OH&S) among immigrant workers (IMWs) in Italy and Spain. We conducted a scoping review, searching Medline, Social Sciences Citation Index, PsycINFO, CINAHL Plus, SciELO, and EMBASE for peer-reviewed articles, published in English, Italian, or Spanish, between 1999-2018. 34 studies were included, 28 with quantitative methodology and 6 with qualitative. Main findings were that, compared to natives, IMWs in Italy and Spain showed higher prevalence of low-skilled jobs and of perceived discrimination at work; higher physical demands, poorer environmental working conditions, and more exposure to occupational risks (e.g., ergonomic and psychosocial hazards); a greater risk of occupational injuries; worse general and mental health; and a plausible worsening of their health status, especially in Spain, as a result of the economic crisis. The findings of the present scoping review constitute warning signs that indicate the need for a holistic global response to ensure that adverse OH&S outcomes among IMWs workers are improved and that equitable access to health care is guaranteed. Such a response will require a concrete and evidence-based approach to prevent and monitor occupational risk factors and associated outcomes in the workplaces.

The healthy migrant effect and its impact on mental health has been reported in the general population of many countries. Information is limited about its impact on working populations. The aim of this study is to estimate the incidence of common mental disorders over a one-year follow-up period among a cohort of Colombian and Ecuadorian employees in Spain, taking into account the duration of residence and comparing with Spanish-born workers. Data was from the Longitudinal Studies on Immigrant Families Project (PELFI), a follow-up survey of immigrants and Spanish-born workers interviewed in 2015 and 2016. Mental health was assessed using the 12-item general health questionnaire (GHQ-12). Crude and adjusted odds ratios (ORas) for common mental disorders by sociodemographic and employment characteristics were created. There were differences for immigrants with time of residence less than or equal to 15 years (time of residence 11-15 years: ORa = 0.06, 95% CI = (0.26-0.01); time of residence 1-10 years: ORa = 0.06, 95% CI = (0.36-0.01)). There was evidence of a healthy immigrant worker effect, as newer arrivals from Ecuador and Columbia to Spain had a lower incidence of common mental disorders than either the Spanish-born or immigrant workers who had lived in Spain for more than 15 years., Competing Interests: The authors declare no conflict of interest.

Quality of life and its relationship to oral health is an important consideration in the determinants of health of vulnerable groups. The aim of this study is to assess oral health-related quality of life (OHRQoL) and its related factors in native and immigrant population families from the Platform of Longitudinal Studies on Immigrant Families (PELFI) study in Spain. A cross-sectional study was conducted in a sample of 401 adults aged 18 years and older from Spain, Ecuador, Colombia, and Morocco. The OHIP-14 instrument was applied, and three summary variables were used (prevalence, extent, and severity). Sociodemographic and self-perceived health variables were included. Bivariate analyzes were carried out to summarize the variables of the OHIP-14 according to sociodemographic and health variables, and bivariate analyzes of the OHIP-14 dimensions was conducted by country of origin. Multivariate linear models were used to investigate predictors for the dimensions of the OHIP-14. Multivariate logistic models were used to estimate the association of OHRQoL with immigration status using crude and adjusted odds ratios with 95% confidence intervals (OR-95% CI). It was found that 14.8% of men and 23.8% of women reported negative impacts in terms of OHRQoL (statistically significant differences: p < 0.05). There were statistically significant differences according to the country of origin in the prevalence and severity outcomes of the OHIP-14 in women ( p < 0.05), and severe outcomes were observed in Moroccan women. In women, statistically significant differences ( p < 0.05) in OHRQoL were observed according to age and marital status. There were some differences between OHIP-14 summary outcomes according to the health variables. Some sociodemographic and health variables were predictors for the OHIP-14 and their dimensions with differences by sex. Multivariate analysis showed a statistically significant association between OHRQoL and immigration status for Moroccan women. Differences in OHRQoL were found according to sociodemographic and health variables. Further research could clarify the predictors of OHRQoL through epidemiological surveillance and longitudinal studies.

Diet is a principal determinant of health and is interrelated with socioeconomic factors and the acculturation of immigrants. The aim of this study was to examine the existing evidence on food, nutrition, and diet amongst immigrant populations in Spain, its relationships with their countries of origin, and to evaluate the methodological quality of these studies. A systematic review was carried out that included seventeen cross-sectional studies, 71% of them were of average quality and only one was excellent; seven dealt with adolescents and ten dealt with adults, with a total of 9,871 participants. Insights on immigrant diet and nutrition were heterogeneous because the participant groups in these studies were from several different countries, each of which has distinct cultural and geographical characteristics. Adolescent diet was of lower quality, positively correlated to socioeconomic level; acculturation and length of residence were related to both positive (such as healthier dietary patterns, better adhesion to intake recommendations) and negative aspects (higher intake of meat or bakery products, lower intake of vegetables or fish, among others). Adults show a better intake of macronutrients, but a lower intake of micronutrients and non-observance of some intake recommendations; acculturation and length of residence were related to healthier dietary patterns, significantly related to type of employment. Immigrants from Mediterranean countries show a healthier diet than other immigrants, although the quality of their diet is worse than that of their peers in their countries of origin. Finally, the quality of the diet of non-Mediterranean immigrants improves when they become resident in Spain.