Escuela Nacional de Sanidad (ENS)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/19613

La actividad docente de la Escuela Nacional de Sanidad se articula en los siguientes tipos de cursos: Máster: Programa formativo dirigido a orientar la carrera profesional de los alumnos en el campo de la Salud Pública y la Administración Sanitaria. Diplomaturas Superior y de Especialización: Programas formativos dirigidos a perfeccionar la carrera profesional de los alumnos en un campo de aplicación concreto de la Salud Pública, la Administración Sanitaria o disciplinas afines. Máster y Diplomaturas se conforman por la articulación de diferentes módulos o cursos cortos, a los cuales se pueden acumular los créditos obtenidos en otra diplomatura de la Escuela Nacional de Sanidad que se considere a dichos efectos vinculada. Cursos de Formación Continua. en epidemiología y bioestadística, ciencias sociales y del comportamiento, programas de salud, salud ambiental, medicina tropical, planificación y economía sanitaria, desarrollo directivo y gestión de servicios sanitarios, nutrición en salud pública y otras disciplinas afines.

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Working from Home and Indoor Environmental Quality: A Scoping Review.
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-12-26) Navas-Martin, Miguel Angel; Jimenez-Planet, Virginia; Cuerdo-Vilches, Teresa; Agencia Estatal de Investigación (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Consejo Superior de Investigaciones Científicas (España); Universidad del Atlántico Medio
The accelerated expansion of telework, driven by the COVID-19 pandemic, has transformed global work dynamics. Despite this, limited research exists on the implications of Indoor Environmental Quality (IEQ) on home workspaces. Factors like thermal comfort, lighting, air quality, and noise significantly influence the well-being, productivity, and health of teleworkers. Home spaces are often not designed to meet the environmental quality standards of traditional offices, altering indoor conditions. This scoping review investigates the IEQ–telework relationship, analyzing 41 studies from 18 countries. Findings show that elevated noise levels and insufficient lighting increase stress and fatigue, while inadequate air quality reduces cognitive performance and creativity. Conversely, access to natural light, pleasant views, and thermal comfort improves overall satisfaction and productivity. The study identifies a fragmented and poorly connected research network, with few active global groups studying IEQ in home workspaces. These results underscore the need for interdisciplinary research to address the societal and environmental challenges of teleworking and develop equitable, healthy remote environments. Future studies must consider cultural diversity and underrepresented regions to bridge existing knowledge gaps.
Monitoring effectiveness of nirsevimab immunization against RSV hospitalization using surveillance data: a test-negative case-control study, Spain, October 2024-March 2025.
(Cambridge University Press, 2025-12-09) Campos Mena, Sandra; Pérez-Gimeno, Gloria; Lorusso, Nicola; Álvarez Río, Virginia; Basile, Luca; Batalla Rebollo, Noa; García-Comas, Luis; Andreu Ivorra, Blanca; Pérez-Panadés, Jordi; Ramos Marín, Violeta; Castrillejo, Daniel; Fernández Ibáñez, Ana; Rafael de la Cruz López, María Ángeles; Nuñez, Olivier; Monge Corella, Susana; Grupo SiVIRA de vigilancia y efectividad vacunal en España
Effectiveness of nirsevimab against respiratory syncytial virus (RSV) hospitalization during the 2024/2025 season in Spain was estimated using a test-negative design (TND) and hospital-based respiratory infections surveillance data. Children born between 1 April 2024 and 31 March 2025 and hospitalized with severe respiratory infection between the start of the 2024 immunization campaign (regionally variable, between 16 September and 1 October 2024) and 31 March 2025 were systematically RT-PCR RSV-tested within 10 days of symptom onset and classified as cases if positive or controls if negative. Nirsevimab effectiveness ((1 - odds ratio) × 100) was estimated using logistic regression, adjusted for admission week, age, sex, high-risk factors, and regional RSV hospitalization rate. We included 199 cases (68.8% immunized) and 360 controls (86.4% immunized). Overall effectiveness was 65.5% (95% confidence interval: 45.2 to 78.3). Effectiveness was similar among infants born before and after the campaign start (63.6% vs. 70.4%, respectively). We found an unexpected early decrease in effectiveness with increasing time since immunization and age, albeit with wide confidence intervals for some groups. Strong age-period-cohort effects and potential sources of bias were identified, highlighting the need to further explore methodological challenges of implementing the TND in the dynamic population of newborns.
Asociación entre la región geográfica de origen y la mortalidad por COVID-19 en España.
(Instituto de Salud Carlos III (ISCIII). Escuela Nacional de Sanidad (ENS), 2024-07) Campos Mena, Sandra; Monge Corella, Susana
Introducción: La inmigración en España es un fenómeno reciente, ya que la mayoría de las personas nacidas en el extranjero han llegado al país en las últimas dos décadas. Desde el ámbito de la salud pública ha surgido un interés creciente por conocer su estado de salud y los patrones de mortalidad para detectar vulnerabilidades y áreas de mejora. Según la literatura internacional, los migrantes podrían haber enfrentado un mayor riesgo de morbilidad y mortalidad por COVID-19 debido a una posible mayor exposición al virus influenciada por determinantes sociales. Este estudio tiene como objetivo evaluar la relación entre la región geográfica de origen y la mortalidad por COVID-19 en España. Metodología: Estudio observacional basado en registros poblacionales. La fuente de información del evento objeto de estudio fueron las bases de microdatos de mortalidad anonimizados aportadas por el Instituto Nacional de Estadística (INE) correspondientes a los años 2020, 2021 y 2022, con cobertura en todo el territorio español. Se seleccionaron como fallecimientos debidos a COVID-19 aquellos cuya causa básica de defunción tuvo consignado el código CIE-10 (Clasificación Internacional de Enfermedades, 10ª revisión ) correspondiente a infección por SARS-CoV-2 confirmada (U07.1). El denominar, constituido por la población residente, se obtuvo de las Cifras de Población y la Estadística Continua de Población del INE. Las variables de exposición fueron el país de nacimiento y de nacionalidad, ambas agrupadas en las siguientes regiones de nacimiento y de nacionalidad, respectivamente: 1) España, 2) Europa occidental y otros países occidentales, 3) Europa del este, 4) África subsahariana, 5) Norte de África y países del Medio Oriente, 6) Centroamérica y Caribe, 7) Sudamérica, 8) Sudeste asiático. Se calcularon las tasas de defunción debida a infección por SARS-CoV-2 confirmada para cada región de nacimiento o nacionalidad y se estimaron las razones de tasas con sus correspondientes intervalos de confianza al 95% mediante un modelo de regresión binomial negativa ajustado por Comunidad Autónoma, sexo y edad. El análisis se llevó a cabo utilizando el programa estadístico Stata v16. Resultados: Se obtuvieron 130.024 fallecimientos por infección por SARS-CoV-2 confirmada para el análisis según región de nacimiento. En comparación con la población nacida en España, para el periodo global, la región de Sudamérica (SA) fue la única con un aumento significativo del riesgo de mortalidad, siendo un 30% superior en el grupo de edad de 40 y 64 años (RT: 1,30; IC95%: 1,09 - 1,55) y un 49% superior en el de 65 y 79 años (RT: 1,49; IC95%: 1,30 - 1,70). En el resto de regiones, hubo una tendencia hacia una reducción del riesgo en el grupo de ≥80 años. Por periodos, la mayoría de las regiones (excepto SA) mostraron un riesgo de mortalidad igual o inferior, especialmente en los periodos 1, 3 y 6. Sin embargo, se observó un aumento del riesgo en el periodo 2 para la región del Norte de África y Oriente Medio (NAOM) y especialmente en el periodo 4 para la mayoría de las regiones, coincidiendo con el verano y con el inicio de la vacunación generalizada. En el periodo 5, se mantuvo un aumento del riesgo solo en las regiones de Europa Occidental y Otros Países Occidentales y Europa del Este, mientras que en el periodo 6 el riesgo volvió a ser igual o menor en todas las regiones. Se registraron 130.424 fallecimientos por infección confirmada de SARS-CoV-2 para el análisis por región de nacionalidad. Los resultados fueron consistentes con los obtenidos para la región de nacimiento. Sin embargo, se observó un aumento del riesgo en las regiones que ya presentaban riesgo en el análisis previo, además de un mayor riesgo en otras regiones y grupos de edad que no mostraban riesgo anteriormente, como en el grupo de edad de 65 a 79 años en las regiones de NAOM y América Central y Caribe durante el periodo global. Conclusiones: Los migrantes nacidos en Sudamérica, la principal población migrante en España, exhibieron el mayor riesgo de mortalidad por infección por SARS-CoV-2. El mayor riesgo de mortalidad se ha relacionado con una sobreexposición al virus y un retraso en la búsqueda de atención sanitaria en relación a unas peores condiciones de vida. Este riesgo fue más pronunciado en el análisis por región de nacionalidad, sugiriendo una mayor vulnerabilidad a menor tiempo de residencia en el país. Es posible que entre la migración más reciente haya una mayor proporción de migrantes irregulares, forzados o con mayores necesidades. Estos hallazgos subrayan las disparidades de salud persistentes entre minorías incluso en sistemas de salud inclusivos como el español.
Inhibiting and protective factors of exclusive breastfeeding in an Island population in Spain: a longitudinal study.
(Springer, 2025-12-24) Llorente-Pulido, Seila; Custodio, Estefania; Otero Garcia, Laura
Abstract Background: Breastfeeding provides important health benefits for both mothers and infants. In Spain, the rate of exclusive breastfeeding (EBF) at 6 months is 47%, which remains below the 60% target proposed by the World Health Organization for 2030. The objective of this study was to identify the protective and inhibiting factors associated with EBF in a population of pregnant women in Tenerife (Canary Islands, Spain). Methods: We conducted a longitudinal, prospective study among women attending midwife consultations for pregnancy check-ups at a primary healthcare center between November 2018 and January 2021. We followed 83 women, collecting data at different time points during pregnancy and postpartum (hospital stay, 15 days, 1 month, 4 months, and 6 months). Descriptive statistics and univariable and multivariable logistic regression analyses were performed. Results: The inhibiting factors for EBF were pacifier use during the hospital stay, on EBF after birth (OR: 0.06, 95% CI: 0.02, 0.23), pacifier use at 15 days (OR: 0.13, 95% CI: 0.04, 0.42) and at 4 months (OR: 0.23, 95% CI: 0.07, 0.79), gynecological problems of the woman (OR: 0.14, 95% CI: 0.03, 0.61), the presence of nipple pain at 15 days affecting EBF at 4 months (OR: 0.18, 95% CI: 0.06, 0.56) and at 6 months (OR: 0.21, 95% CI: 0.07, 0.68), perception of insufficient milk at 15 days (OR: 0.15, 95% CI: 0.05, 0.49) and at 1 month (OR: 0.06, 95% CI: 0.02, 0.20), and giving birth in a privately managed hospital without Baby-Friendly Hospital Initiative (BFHI) accreditation (OR: 0.17, 95% CI: 0.05, 0.66). Protective factors for EBF were the woman’s prior knowledge of the benefits of breastfeeding for her child (OR: 5.25, 95% CI: 1.03, 26.80) and for herself (OR: 3.98, 95% CI: 1.31, 12.02), as well as having a foreign nationality (OR: 3.04, 95% CI: 1.05, 8.80). Conclusions: The factors impacting EBF can be addressed with improved care practices for women during pregnancy, childbirth, and the early postpartum period. It is essential to train healthcare professionals and implement the BFHI in Spain, where it is primarily carried out in public hospitals, but not in private ones.
Violent Content in Online Pornography Is Associated with Sexual Health of Women and Men.
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-11-27) Sanz-Barbero, Belén; Pérez-Martínez, Vanesa; Rico Gomez, Ana; Otero Garcia, Laura; Fernández-López, Marta; Cerdán-Torregrosa, Ariadna; Vives-Cases, Carmen; Instituto de Salud Carlos III
Sexual health includes psychosocial and physical competencies related to sexual well-being. It is unknown whether violent pornography is associated with sexual health. The objective of this study is to analyze whether different types of pornography are associated with sexual health in young adults. A cross-sectional study was conducted using an online survey with 3607 people aged 18–35 living in Spain. Association of pornography with the dependent variables was estimated with generalized linear and logistic models. Compared to exposure to pornography with no explicit violence, men exposed to pornography with physical violence scored lower on empathy (coef: −0.054) and sexual assertiveness (coef: −0.034) and higher on acceptance of violence against women (coef: 0.122). Women who watch physical violence pornography scored higher on acceptance of violence against women (coef: 0.076). In men, watching pornography with physical violence was associated with poorer sexual function (OR = 1.9). In women, pornography with physical violence was associated with difficulty having an orgasm in a relationship (OR = 1.7). Violent pornography could have wide negative effects on men sexual health. In both sexes, violent pornography was associated with greater acceptance of violence against women. Inequalities were observed between women and men in the enjoyment of sexual relations, to the detriment of women.
From fear of infection to awareness against stigma: A mixed-methods analysis of discourses on HIV in a parliamentary context.
(Public Library of Science (PLOS), 2025-10-06) González-Recio, Paule; Barba-Sánchez, Raquel; Granda, Édel; Guerras, Juan-Miguel; Moreno-García, Sara; Iglesias, Alex; Fuster-RuizdeApodaca, María José; García Expósito, Esther; Palma, David; Belza Egozcue, Maria Jose
Background and purpose: Parliamentary discourse holds significant relevance both socially, due to its impact on stigmatization, and because of its potential legislative consequences. However, despite the persistent stigma surrounding HIV and the numerous regulations that affect people living with HIV, there is a global lack of research on how this topic is addressed in parliamentary debates. This study provides a case analysis from the Madrid Regional Parliament, offering insights that may be applicable to other parliamentary contexts. The principal objective is to analyze the content of HIV-related initiatives in this context, along with its possible relationship to the political parties' ideology. Methods: A mixed-methods quantitative and qualitative study was conducted, including all parliamentary initiatives on HIV from the 12th Legislature of the Madrid Regional Parliament (2021-2023). Subthemes, initiative types, parliamentary groups ideologies, and debate dates were analyzed. Additionally, a Critical Discourse Analysis of the interventions in the plenary sessions was carried out and categorized based on the ideologies of the parliamentary groups, offering insights that may be reflective of broader political discourse trends.Results: In the analyzed legislature, 0.09% of all the initiatives addressed HIV. Of these, 83.3% were written, and only 16.7% were presented orally in plenary sessions. Two-thirds focused on prevention, while those concerning access to treatment accounted for 16.7%, and those addressing stigma made up 11.1%. All initiatives were presented by left-wing or center-left parliamentary groups. Right-wing groups discourses centered on fear and the perception of risk, with a strongly stigmatizing rhetoric. In contrast, left and center-left groups emphasized discrimination and stigma as issues and advocated for universal treatment access. Conclusions: HIV is minimally addressed in the Madrid Regional Parliament, and when it is, the focus is more on prevention than on addressing the needs of people living with HIV. The study highlights the significant role of political ideology in shaping parliamentary discourse, with stigmatizing rhetoric mainly present in right-wing groups. These findings may offer insights for other legislative bodies where HIV-related stigma and political ideologies intersect.
Short-Term Ozone Exposure and Daily Mortality in Suburban and Rural Areas of Southern Europe
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-05-20) Doronzo, Maria Angela; Martinez Fernandez, José Ramón; Gomez-Barroso, Diana; Alonso-Colón, María; Nuñez-Corcuera, Beatriz; Ramis, Rebeca; Unión Europea. Comisión Europea. H2020; Unión Europea. Comisión Europea. Horizonte Europa
Ozone (O3) is a major air pollutant with significant health effects, including increased respiratory and cardiovascular mortality. While previous research has largely focused on urban areas, this study assesses the association between maximum 8 h O3 concentrations and non-accidental mortality, including cardiovascular and respiratory mortality, in suburban and rural areas of Spain. We conducted a nationwide time-series analysis across 122 municipalities between April and September 2017 using Poisson regression models and adjusting for daily maximum temperature and provincial variability. Distributed lag models were applied to estimate the cumulative effects of ozone exposure on mortality, considering lags from 1 to 30 days. For each 10 µg/m3 increase in 8 h maximum O3 concentration, a significant increase in all-cause mortality risk of 2.3% was observed, with a peak at lag 2. Cardiovascular mortality increased by 2.4%, also peaking at lag 2, while respiratory mortality showed the strongest association, with a 4.3% rise at lag 1. A secondary mortality risk increase was observed at lags 24–28, suggesting the potential delayed effects of O3 exposure. These findings showed higher risk than those previously reported for urban populations and highlight the need for targeted public health interventions to mitigate the impact of ozone pollution in non-urban populations.
Cincuenta años del primer calendario común de vacunación
(Ministerio de Sanidad (España), 2024-12) Olmedo Lucerón, Carmen; Limia Sánchez, Aurora; Fernández Dueñas, Ana; Sánchez Afán de Rivera, Isabel; Bruña Vara, Judith; Cantero Gudino, Elena; Barba-Sánchez, Raquel
Influencia de los factores sociales en la adaptación al calor en España 1983-2018: un marco conceptual
(2025-06-05) Navas-Martin, Miguel Angel
El cambio de las condiciones climáticas que se considera causada, de forma directa o indirecta, por la actividad humana. Este estudio pretende analizar la adaptación de la población al calor a la largo plazo, se ha evaluado la adaptación al calor en función de los factores sociales como el territorio, el género y la edad.
Association Between Disability and Suicide Mortality in the Spanish Community-Dwelling Adult Population. A Population-Based Follow-Up Study
(Frontiers Media, 2024) Pastor-Barriuso, Roberto; Padron-Monedero, Alicia; Almazan-Isla, Javier; Garcia Lopez, Fernando Jose; Pedro-Cuesta, Jesus de; Damian, Javier; Instituto de Salud Carlos III
Objectives: To assess the association of disability with suicide mortality, separately for women and men by age group. Methods: Information was obtained from a representative national sample of 161,809 community-dwelling adults (≥18 years). Participants contributed to follow-up time from baseline interview (2008) until suicide, death by other causes, or 2017. We calculated, by sex, standardized suicide mortality differences (SSMD), comparing persons with and without disabilities standardized to sociodemographic distribution of disability population. Results: 29 women died by suicide during 800,754 person-years follow-up and 97 men during 735,709 person-years. Among women with disabilities, SSMD (95% Confidence interval) per 100,000 person-years at 5 years was 54.4 deaths (-17.2 to 126.1) [100.0 (-27.4 to 227.4) in women <65 years and -4.8 (-27.3 to 17.7) in women ≥65 years (P homogeneity = 0.11)]. Among men, SSMD increased by 122.2 deaths (4.1 to 240.3) [37.2 (-40.2 to 114.6) in men <65 years and 74.7 (-51.8 to 200.5) in men ≥65 years (P homogeneity = 0.62)]. Conclusion: Suicide risk was higher in women and men with disability. In women higher risk was only notable for those <65. Men presented similar effects in both age groups. Nevertheless, due to imprecision of estimates, results should be viewed cautiously.
Updating and Refining of Economic Evaluation of Rotavirus Vaccination in Spain: A Cost-Utility and Budget Impact Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-07-25) Imaz-Iglesia, Iñaki; Carmona, Montserrat; Garcia-Carpintero, Esther Elena; Pedrosa-Pérez, Lucía; Martínez-Portillo, Alejandro; Alcalde-Cabero, Enrique; Linertová, Renata; García-Pérez, Lidia; Instituto de Salud Carlos III; Ministerio de Sanidad (España)
Two vaccines against rotavirus diseases, Rotarix® and RotaTeq®, are being marketed in Spain; but rotavirus is not presently among the diseases covered by universal vaccination in Spain. The aim of this study was to assess the efficiency of extending Spain's current targeted rotavirus vaccination strategy including only preterm babies, to a policy of universal vaccination. A de novo cohort-based Markov model was built to evaluate the efficiency of three compared rotavirus vaccination strategies in Spain: targeted, universal, and no vaccination. Using Rotarix® or RotaTeq®, we compared the cost-utility of these strategies from both a societal perspective and Spanish National Health System (SNHS) perspective. The model represents the most important clinical events conceivably linked to rotavirus infection. Efficacy, effectiveness, safety, costs, and utilities were identified by systematic reviews. Incremental cost-utility ratio (ICUR) is EUR 23,638/QALY (Quality-Adjusted Life Year) for targeted vaccination with Rotarix® compared with no vaccination. The ICUR for the rest of the strategies evaluated are above EUR 30,000/QALY. The sensitivity analysis shows price as the only parameter that could make the universal vaccination strategy efficient. Considering a threshold of EUR 25,000/QALY, only targeted vaccination with Rotarix® would be efficient from societal perspective. Price drops of 36.9% for Rotarix® and 44.6% for RotaTeq® would make universal vaccination efficient.
I Was the Violence Victim, I Am the Perpetrator: Bullying and Cyberbullying Perpetration and Associated Factors among Adolescents
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-08-28) Jankowiak, Barbara; Jaskulska, Sylwia; Pérez-Martínez, Vanesa; Pyżalski, Jacek; Sanz-Barbero, Belén; Bowes, Nicola; De Claire, Karen; Neves, Sofia; Topa, Joana; Silva, Estefânia; Mocanu, Veronica; Vives-Cases, Carmen; Unión Europea. Comisión Europea; Centro de Investigación Biomédica en Red - CIBERESP (Epidemiología y Salud Pública)
Bullying and cyberbullying significantly threaten the development and mental health of both victims and perpetrators. This study aimed to analyze the associations between socioeconomic characteristics, personal experiences of violence, perceived social support from peers, and acceptance of violence and (cyber)bullying perpetration. The study involved 1146 secondary school students, consisting of 698 females and 448 males, aged 13 to 16. Prevalence ratios (PRs) were calculated using Poisson regression with robust variance. The results indicated that 12.32% of girls and 18.97% of boys reported engaging in bullying and/or cyberbullying. The likelihood of perpetration was lower among adolescents who had not experienced physical and/or sexual abuse before age 15, but higher among those in romantic relationships who had been victims of dating violence or had experienced (cyber)bullying victimization. Additionally, perceived social support from classmates was associated with a lower likelihood of becoming a perpetrator, whereas acceptance of violence was positively associated with (cyber)bullying perpetration. Preventing adolescents from becoming perpetrators of bullying and/or cyberbullying requires early intervention to prevent all forms of violence in childhood and adolescence, as well as bolstering personal and environmental resources by providing social support.
Examining Energy Poverty among Vulnerable Women-Led Households in Urban Housing before and after COVID-19 Lockdown: A Case Study from a Neighbourhood in Madrid, Spain
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-08-05) Cuerdo-Vilches, Teresa; Navas-Martin, Miguel Angel; Ministerio de Economía (España); Plan Nacional de I+D+i (España); Agencia Estatal de Investigación (España)
People with lower incomes often live in homes with poor thermal properties, making it difficult for them to maintain a comfortable indoor temperature. This vulnerability is closely related to the quality and maintenance of housing, which negatively affects indoor environmental comfort, especially in terms of energy usage, having an impact on health and well-being. Studying energy poverty from a qualitative perspective allows us to delve deeper into the experience of these people. A qualitative study was carried out through a case study of women in a situation of household vulnerability and energy poverty. Semi-structured interviews were conducted with five women-led households and two key informants before and after the COVID-19 confinement, in one of the most vulnerable neighbourhoods of Madrid. Unveiling the complexity of this topic, three categories were identified: household composition and economic resources, perception and proposals for household improvements, and household health and well-being. Furthermore, the results suggest that reliance on inefficient solutions such as electric radiators or butane-cylinder heaters for space heating in winter (more affordable in the short term, but unsustainable in the long one) shows evidence of energy precariousness, which, together with other poor housing conditions and users’ behaviours, impact clearly on health, generating or worsening chronic diseases. Research in vulnerable populations requires interventions beyond visibility, supported by key informants. Social workers and educators are essential to improving the living conditions of the most vulnerable people; however, they need social policies and adequate intervention plans and strategies to support and make their efforts effective.
Evolución de la presencia de mujeres en los órganos de decisión del Sistema Nacional de Salud en España
(Elsevier, 2024) Gil-Borrelli, Christian; Obón Azuara, Blanca; Rodriguez-Arenas, Maria de los Angeles; Chilet Rosell, Elisa; Latasa Zamalloa, Pello; Grupo de Trabajo sobre Género, Diversidad Afectivo-Sexual y Salud de la Sociedad Española de Epidemiología; Sanz-Barbero, Belén
[ES] Objetivo: Analizar la presencia de mujeres en los órganos del Consejo Interterritorial del Sistema Nacional de Salud (CISNS). Método: Se analizaron las memorias anuales del CISNS de los años 2005 a 2022. Se utilizó inteligencia artificial para asignar el sexo y se calcularon porcentajes de participación de mujeres. Se analizaron la evolución temporal, la segregación vertical y la segregación horizontal. Resultados: Entre 2005 y 2022 hubo 14.308 participaciones en 85 órganos, con un 52% de mujeres, ascendiendo del 42% en 2005 al 61% en 2022. Se observó una mayor participación de mujeres en órganos propositivos (54%), seguidos de los ejecutivos (50%) y los plenarios (40%). La Administración General del Estado tuvo un 61% de mujeres, frente al 48% en las comunidades autónomas. La participación de las mujeres varió según el tema abordado, siendo más alta (82%) en violencia de género y más baja (35%) en inspección. Conclusiones: Aunque hay una leve reducción en la brecha de participación entre mujeres y hombres, persisten las desigualdades. Las mujeres tienen menor presencia en los niveles jerárquicos más altos (plenarios), manteniendo la segregación vertical. Asimismo, la representación de las mujeres en ciertos temas sigue siendo baja, manteniendo la segregación horizontal. Se deben adoptar acciones concretas para continuar avanzando en la igualdad y mejorar los resultados de salud en la sociedad en su conjunto. [EN] Objective: To examine the presence of women in the organs of the Interterritorial Council of the Spanish National Health System (CISNS). Method: Annual reports of the CISNS from 2005 to 2022 were analyzed. Artificial intelligence was used to assign gender, and percentages of women's participation were calculated. Temporal evolution, vertical segregation, and horizontal segregation were analyzed. Results: Between 2005 and 2022, there were 14,308 participations in 85 organs, with 52% women, rising from 42% in 2005 to 61% in 2022. There was a higher participation of women in propositional organs (54%), followed by executive ones (50%), and plenary sessions (40%). The General State Administration had 61% women compared to 48% in autonomous communities. Women's participation varied by topic, being higher (82%) in gender violence and lower (35%) in inspection. Conclusions: Although there is a slight reduction in the participation gap between women and men, inequalities persist. Women have less presence in higher hierarchical levels (plenary sessions), maintaining vertical segregation. Additionally, women's representation in certain topics remains low, maintaining horizontal segregation. Concrete actions must be taken to continue advancing equality and improving health outcomes in society as a whole.
Characterizing myths of sexual aggression in the young population in Spain
(BioMed Central (BMC), 2024-07-19) Sanz-Barbero, Belén; Vives-Cases, Carmen; Vall-Llosera Casanovas, Laura; Serra Saurina, Laura; Saurina Canals, María Carme; Renart-Vicens, Gemma; Centro de Investigación Biomédica en Red - CIBERESP (Epidemiología y Salud Pública)
Background: Myths of sexual aggression have a negative influence in aggressive behavior against women, in the institutional approaches to sexual violence and in how women cope with it. The objective of this study is to describe acceptance of myths of sexual aggression in young women and men residing in Spain. Method: Cross-sectional study carried out online with 2,515 women (50.2%) and men (49.8%) ages 18-35 in Spain in 2020. Information on myths was collected using the Acceptance of Modern Myths About Sexual Aggression Scale (AMMSA). We described the myths most prevalent among women and men. The variables associated with myths were identified using multiple regression. The regression models were adjusted by sociodemographic and sexual orientation variables. Results: The average AMMSA values were higher among men [mean: 3.11; standard deviation (sd):1.23] than among women (mean 2.49 sd:1.11). In both sexes, the myths with greater acceptance showed the presence of patriarchal gender roles in sexual contacts. Men were more likely than women to accept myths that question allegations and severity of violence. Having a higher level of educational studies (β -0.350 sd: 0.046) was associated with lower average AMMSA values. Being born in Latin America (β 0.047 sd: 0.063) was associated with higher average AMMSA values. Among heterosexual men, AMMSA values were greater than among gay and bisexual men. Among women, there was no difference in average AMMSA values based on sexual orientation. Conclusions: Myths persist during youth that question and trivialize sexual violence against women. It is necessary to implement strategies that reduce these myths, particularly in heterosexual men, in those of foreign-born origin and among those with low levels of education.
Changes in Alcohol Intake by Educational Level Among Older Men and Women in Spain During the 21st Century
(Oxford University Press, 2024) Donat López, Marta; Politi, Julieta; Guerras Moreira, Juan Miguel; Sordo, Luis; Cea-Soriano, Lucía; Pulido, Jose; Ronda, Elena; Regidor, Enrique; Barrio, Gregorio; Belza Egozcue, Maria Jose; Plan Nacional de Drogas (España); Instituto de Salud Carlos III
Background and objectives: Despite alcohol use being very common in older adults, studies are scarce and suggest alcohol use may be increasing. Furthermore, despite the known relationship between education and alcohol consumption, there is limited evidence of educational differences in older adults. Our objective was to describe trends in alcohol consumption in individuals aged ≥65 by sex and educational level in Spain. Research design and methods: In total, 43,157 participants aged ≥65 years were drawn from Spain's national health surveys between 2001 and 2020, representing the noninstitutionalized population. The outcomes were various measures of self-reported past-year alcohol intake. Age-standardized rates and negative binomial regression models were used to examine trends and differences in alcohol intake by educational level, sex, and period (2001-2009 vs 2011-2020). Results: The average daily alcohol intake and prevalence of heavy average drinking (>20/10 g/day) decreased over time, especially among men, whereas moderate average drinking remained unchanged or even increased. Alcohol intake increased with increasing educational levels. All drinking measures showed educational inequalities, and these were greater in women than men. The mean amount of drinking showed the greatest inequality, with adjusted prevalence ratio of 2.6 in women and 1.1 in men between university relative to primary education level. Discussion and implications: Alcohol intake in older adults decreased over time in Spain for heavy average drinking and average drinking amount, although not for moderate average drinking. Consumption remains highest among the highest educational levels, which may negatively affect health. Programs addressing alcohol consumption among older adults are needed to minimize alcohol-related harm.
Prevalence and risk factors of hypertension in Mauritius: A cross-sectional study
(Public Library of Science (PLOS), 2024) Inyangetuk, Rachel Sunny; San Sebastián, Miguel; Heecharan, Jaysing; Ori, Bhushan; Zimmet, Paul; Söderberg, Stefan; Tuomilehto, Jaakko; Kowlessur, Sudhirsen; Fonseca-Rodríguez, Osvaldo
Hypertension, a highly prevalent non-communicable disease is a leading cause of death and disability worldwide. In the Republic of Mauritius, the growing number of elderly people along with a rise in overweight and obese populations indicate a looming increase in hypertension prevalence. Given its profound burden on the population and economy, updated insights into the burden and determinants of hypertension in Mauritius is crucial for developing interventions aimed at prevention, management and identifying of at-risk groups. Therefore, this study aimed to estimate the prevalence of hypertension and investigating associated risk factors for hypertension in Mauritius. A cross-sectional study was conducted using the nationally representative data from the 2021 Mauritius non-communicable diseases survey. The survey included 3,622 participants from a total of 4307 contacted individuals (84.1% response rate) aged 19-84 years from all nine districts of the country. The outcome, hypertension, was defined as blood pressure greater than or equal to 140 mmHg systolic and/or 90 mm Hg diastolic or the use of antihypertensive drugs. A log-binomial regression analysis was performed to examine the association between hypertension and a range of sociodemographic, socioeconomic, and behavioural factors, along with the presence of cardiovascular disease. The overall prevalence of hypertension was 35.1%. Older age, low education, high body mass index, occasional or frequent alcohol consumption, and history of cardiovascular disease were significantly associated with hypertension. There is a need to actively implement focused intervention strategies that target and tackle these risk factors to reduce the burden associated with hypertension in Mauritius.
Prevalence and factors linked to renal involvement in prediabetes patients across Europe in the ePREDICE trial
(Nature Publishing Group, 2024-12-05) Más-Fontao, Sebastián; Civantos, Esther; Boukichou-Abdelkader, Nisa; Moreno, Juan A; Tuomilehto, Jaakko; Gabriel-Sanchez, Rafael; Egido, Jesús; Unión Europea. Comisión Europea. 7 Programa Marco; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Centro de Investigación Biomédica en Red - CIBERDEM (Diabetes y Enfermedades Metabólicas asociadas); Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Merck KGaA; Boehringer Ingelheim Fonds
This sub-analysis of the ePREDICE trial, investigated the prevalence and determinants of renal complications, specifically glomerular hyperfiltration, albuminuria, and reduced kidney function, in individuals with prediabetes (PD). The cohort consisted of 967 participants from diverse backgrounds across seven countries. The kidney function was evaluated using the MDRD-4 equation, and the influence of various clinical and demographic factors on renal involvement was assessed by multivariable regression models. Additionally, insulinogenic and disposition indices were examined. Overall, the prevalence of renal abnormalities in this PD cohort was 9.2% (n = 89). Key findings included the detection of hyperfiltration in 20 (2%) individuals, albuminuria in 45 (4.7%), and CKD stage G3a in 29 (3%). Hyperfiltration was inversely correlated with age and height, while albuminuria showed a significant direct association with the disposition index (DI). Age and waist circumference were significantly and directly associated with estimated glomerular filtration rate (eGFR). The ePREDICE study highlights critical factors that affect renal involvement in PD individuals, revealing complex interactions among various parameters. These findings further emphasize the necessity for the search of early kidney abnormalities in people with PD especially in those in older age groups and with a large waist circumference.
Letalidad por dengue y desigualdades en la Región de las Américas entre el 2014 y el 2023
(Organización Panamericana de la Salud (OPS), 2024) Gallego-Munuera, Miguel; Colomé-Hidalgo, Manuel
[ES] Objetivo: Evaluar las diferencias en la letalidad del dengue entre las distintas subregiones de las Américas en el período 2014-2023 y explorar su relación con el índice de desarrollo humano (IDH) de cada región. Método: Estudio ecológico longitudinal realizado a partir de datos de acceso libre de cada país, que se agruparon en las subregiones correspondientes para calcular los distintos indicadores. Además, se realizó una regresión lineal entre la letalidad media en cada región y el IDH regional ponderado. Resultados: Existen grandes diferencias en la letalidad por dengue según la subregión y una variabilidad considerable según el año. Estas diferencias de letalidad no están directamente correlacionadas con la incidencia registrada en cada región. El IDH regional muestra una estrecha relación con la letalidad: un mayor IDH se asocia generalmente a una menor letalidad. Conclusiones: Las diferencias subregionales de letalidad y su relación con el nivel de desarrollo señalan que la estrategia de control del dengue debe ser diseñada desde una perspectiva amplia y multifactorial. [EN] Objective: Evaluate the differences in the dengue case fatality rate among the different subregions of the Americas in the period 2014-2023 and explore their relationship with the human development index (HDI) in each subregion. Methods: Longitudinal ecological study based on open-access data from each country, grouped into the corresponding subregions to calculate the different indicators. In addition, a linear regression was performed between the mean case fatality rate in each region and the weighted regional HDI. Results: There are large differences in dengue lethality by subregion and considerable variability by year. These differences in lethality are not directly correlated with the incidence recorded in each region. The regional HDI shows a close relationship with lethality: a higher HDI is generally associated with a lower case fatality rate. Conclusions: The observed differences in lethality and their relationship with subregional development levels indicate that a broad and multifactorial perspective should be taken when designing a dengue control strategy. [PT] Objetivo: Avaliar as diferenças na letalidade da dengue entre as diversas sub-regiões da Região das Américas no período de 2014 a 2023 e explorar sua relação com o índice de desenvolvimento humano (IDH) de cada sub-região. Método: Estudo ecológico longitudinal baseado em dados de acesso aberto de cada país. Os dados foram agrupados pelas sub-regiões correspondentes para calcular diversos indicadores. Além disso, foi feita uma regressão linear entre a letalidade média em cada sub-região e o IDH sub-regional ponderado. Resultados: Há grandes diferenças na letalidade da dengue entre sub-regiões, com uma variabilidade considerável conforme o ano. Essas diferenças na letalidade não estão correlacionadas diretamente à incidência registrada em cada sub-região. O IDH sub-regional teve uma relação estreita com a letalidade: um IDH mais alto geralmente está associado a uma letalidade menor. Conclusões: As diferenças sub-regionais na letalidade e sua relação com o nível de desenvolvimento indicam que a estratégia de controle da dengue deve ser elaborada a partir de uma perspectiva abrangente e multifatorial.
A pathway for skin NTD diagnostic development
(Public Library of Science (PLOS), 2024-11) Marks, Michael; Vedithi, Sundeep Chaitanya; van de Sande, Wendy W J; Levecke, Bruno; Solomon, Anthony W; Asiedu, Kingsley; Ducker, Camilla L; Lammie, Patrick; Dagne, Daniel Argaw; Cruz, Israel; WHO Diagnostic Technical Advisory Group on Neglected Tropical Diseases

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