ISCIII - Artículos
http://hdl.handle.net/20.500.12105/2089
2024-03-28T12:48:44ZViolencia sexual y jóvenes: «no es algo con lo que naces, sino con lo que aprendes»
http://hdl.handle.net/20.500.12105/19075
[ES] Objetivo: Analizar las percepciones y experiencias de la población joven en España sobre la violencia sexual (VS), sus posibles causas, víctimas y perpetradores. Método: Estudio cualitativo basado en entrevistas semiestructuradas a 22 jóvenes de entre 18 y 24 años. Se llevó a cabo un análisis del contenido cualitativo. Resultados: En las narrativas juveniles destacan la indefinición y la inconcreción sobre lo que es la VS, excepto cuando mencionan la violación, la falta de consentimiento y el uso de la fuerza en las relaciones sexuales. Las chicas, interpeladas como principales víctimas, aportan una visión más amplia y vinculada a las desigualdades de género. En general, predomina la idea de que la VS es perpetrada por hombres contra mujeres en relaciones heterosexuales dentro y fuera de la pareja. En las explicaciones, conviven las referencias a factores tanto contextuales (ligados a las desigualdades de género y la construcción social de las relaciones sexuales) como conductuales (que incluyen el visionado de pornografía). También emergen algunas estrategias relacionadas con la educación sexual y afectiva. Conclusiones: En las percepciones de las personas jóvenes participantes en este estudio parecen convivir la ambigüedad con referencias explícitas a las diferentes formas en las que se manifiesta la VS y la influencia de las desigualdades de género. El sexo y la experiencia vital parecen influir en estas narrativas. Se requiere el fomento de una perspectiva más crítica sobre la construcción social de la VS y las relaciones íntimas en la población joven. [EN] Objective: To analyse the perceptions and experiences of young people in Spain about sexual violence (SV), its possible causes, victims and perpetrators. Method: Qualitative study based on semi-structured interviews with 22 young people between 18 and 24 years old. A qualitative content analysis was carried out. Results: In the juvenile narratives, the lack of definition and accuracy about what SV is stands out, except for mentioning rape, lack of consent and use of force in sexual relations. The girls, self-perceived as the main victims, also break with these narratives by providing a broader vision and gender inequalities related. In general, the most prevailed idea is that VS is perpetrated by men against women in heterosexual relationships inside and outside the couple. Regarding explanations, references coexist to both contextual factors (linked to gender inequalities and the social construction of sexual relationships) and behavioural factors (which includes the viewing of pornography). Tentatively proposals for improvement related to sexual and affective education emerge. Conclusions: In the perceptions of the young people, ambiguity seems to coexist with explicit references to the different ways in which it manifests itself and the influence of gender inequalities. Sex and life experience appear to influence these narratives. It is necessary to promote a more critical perspective on the social construction of SV and intimate relationships in the young population.
2024-02-23T00:00:00ZPornography, sexual orientation and ambivalent sexism in young adults in Spain
http://hdl.handle.net/20.500.12105/19074
Background: On line platforms offer access to an almost unlimited variety of pornographic material that shows high levels of sexism. Despite this fact, there are still few studies that assess the effect of pornography on sexism in young adults The aim of this study is to analyze the association of pornography consumption and sexual orientation with benevolent sexism (BS) and hostile sexism (HS) in young men and women. Methods: We surveyed 2,346 people aged 18-35 years old. Multiple regression models were carried out for BS and HS. The independent variables: current pornography consumption and sexual orientation. Covariates: socio-demographic variables -age, sex, level of education and place of birth-. Results: A) HS: Men who consumed pornography had higher median values of HS than those who did not [β(95%CI):2.39(0.67;4.10)]. Homosexual/ bisexual men displayed lower values of HS than heterosexual men [β(95%CI):-2.98(-4.52;-1.45)]. The increase in HS levels associated with pornography consumption was notably greater in homosexual and bisexual women relative to heterosexual women, where that pattern was not observed [β(95%CI for interaction): 2.27(0.11; 4.43)]. B) BS: Mean values of BS were observed to be lower for both women [β(95%CI):-2.16(-2.99;-1.32)] and men [β(95%CI):-4.30(-5.75;-2.86)] who consumed pornography compared to those who did not. Homosexual/bisexual men recorded mean values of BS lower than heterosexual men [β(95%CI):-3.10(-4.21;-1.99)]. Conclusions: Pornography consumption is related to sexism and differs according to sex and sexual orientation. As sexism is the substratum of inequality between men and women, it is urgent to launch affective-sexual education programs for young people that take into account the determinants of sexism.
2024-02-05T00:00:00ZEvaluación del rendimiento y compensación en centros sanitarios de gestión directa. Parte 2: el Sistema Nacional de Salud. Informe SESPAS 2024
http://hdl.handle.net/20.500.12105/19069
[ES] En España, el modelo retributivo para el personal estatutario es complejo, heterogéneo y orientado más a compensar funciones y actividades complementarias que a recompensar el buen desempeño mostrado en las tareas específicas del puesto de trabajo. Las diversas tentativas de incorporar complementos incentivadores han sido desnaturalizadas ante una cultura igualitarista de la función pública y una débil gobernanza sistémica. Los atractores externos (v.g. actividad privada) para los profesionales sanitarios están siendo importantes y neutralizan muchos incentivos intramurales. Hay pocas expectativas de cambios relevantes o estructurales, ya que los principales agentes implicados no apuestan por trasformaciones; sin embargo, algunos factores del entorno pueden propiciar mejoras incrementales en los sistemas de contratación, en la información disponible para mejorar la fijación comparativa de objetivos y en la creación
de espacios de buena gobernanza y gestión clínica. El escenario económico, crecientemente preocupado por las tendencias inflacionarias y los riesgos de sostenibilidad, así como la trasformación digital, pueden tener un efecto dinamizador de algunas reformas en la gobernanza y la gestión. [EN] In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.) for healthcare professionals are becoming more important and neutralize many intramural incentives. There are few prospects of relevant or general changes, since the main actors involved are reforms-averse; but some environmental factors can lead to incremental improvements in employment contracts, in the information available to improve benchmarking, and in the creation of islands of good clinical governance and management. The economic scenario, increasingly concerned about inflationary trends and sustainability risks, may have a revitalizing effect of some governance and management reforms.
2024-02-13T00:00:00ZEvaluación del rendimiento y compensación en centros sanitarios de gestión directa. Parte 1: marco general. Informe SESPAS 2024
http://hdl.handle.net/20.500.12105/19068
[ES] La dificultad para evaluar y compensar el rendimiento en las organizaciones profesionales se extrema en entornos de gestión pública directa de servicios sanitarios. La evaluación del rendimiento es compleja por razones técnicas y por la existencia de múltiples principales en las relaciones de agencia, que influyen en la fijación de objetivos. Los incentivos son una palanca para generar direccionalidad y motivación, tanto los estructurales (que atraen y retienen trabajadores) como los específicos (que retribuyen el desempeño y orientan el comportamiento hacia metas institucionales). Los incentivos influyen de forma diversa en el comportamiento de los trabajadores, y su efectividad parece débil y controvertida en entornos públicos sanitarios. Abordar con éxito los problemas de determinación y evaluación del desempeño requiere tanto instrumentos de buen gobierno como la revitalización de la gestión contractual. Para mejorar la efectividad de los modelos de incentivos es conveniente: 1) ampliar el marco conceptual de los incentivos, para incorporar los aspectos estructurales del empleo y la remuneración; 2) mejorar los diseños a partir de una mayor comprensión de los determinantes de la motivación; y 3) contemplar los factores extramurales que alteran el comportamiento de los trabajadores y tratar de contrarrestarlos. [EN] Assessing and compensating performance in professional organizations is extremely difficult in direct public management settings of health services. Performance assessment is technically complex and, more so, with multiplicity of principals influencing goal setting. Incentives are a lever to generate directionality and motivation, both structural (for attracting and retaining workers) and specific ones (rewarding performance and directing behavior towards institutional goals). Incentives influence the behavior of workers in various ways, and their effectiveness seams weak and controversial in publicly run health services. To overcome the problems of deciding and evaluating performance, both good governance models and the revitalization of contractual management are required. To improve the effectiveness of incentive models, it is convenient to: 1) widen the conceptual framework of incentives, to incorporate the structural aspects of employment contract and payment; 2) improve the designs from a greater understanding of the determinants of motivation; and 3) broaden the lens to survey the extra-mural factors that alter the behavior of workers, trying to counter them.
2024-01-01T00:00:00ZGenetic drivers of heterogeneity in type 2 diabetes pathophysiology
http://hdl.handle.net/20.500.12105/19067
Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P < 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.
2024-03-01T00:00:00ZComparing glycemic traits in defining diabetes among rural Chinese older adults
http://hdl.handle.net/20.500.12105/19066
Background: We sought to identify the optimal cut-off of glycated hemoglobin (HbA1c) for defining diabetes and to assess the agreements of fasting plasma glucose (FPG), fasting serum glucose (FSG), and HbA1c in defining diabetes among rural older adults in China. Methods: This population-based cross-sectional study included 3547 participants (age ≥61 years, 57.8% women) from the Multidomain Interventions to Delay Dementia and Disability in Rural China from 2018-2019; of these, 3122 had no previously diagnosed diabetes. We identified the optimal cut-off of HbA1c against FPG ≥7.0 mmol/L for defining diabetes by using receiver operating characteristic curve and Youden index. The agreements of FPG, FSG, and HbA1c in defining diabetes were assessed using kappa statistics. Results: Among participants without previously diagnosed diabetes (n = 3122), the optimal HbA1c cut-off for defining diabetes was 6.5% (48 mmol/mol), with the sensitivity of 88.9%, specificity of 93.7%, and Youden index of 0.825. The correlation coefficients were 0.845 between FPG and FSG, 0.574 between FPG and HbA1c, and 0.529 between FSG and HbA1c in the total sample (n = 3547). The kappa statistic for defining diabetes was 0.962 between FSG and FPG, and 0.812 between HbA1c and FPG. Conclusions: The optimal cut-off of HbA1c for diagnosing diabetes against FPG >7.0 mmol/L is ≥6.5% in Chinese rural-dwelling older adults. The agreement in defining diabetes using FPG, FSG, and HbA1c is nearly perfect. These results have relevant implications for diabetes research and clinical practice among older adults in China. Clinical trial registration: The protocol of MIND-China was registered in the Chinese Clinical Trial Registry (ChiCTR, www.chictr.org.cn; registration no.: ChiCTR1800017758).
2024-01-01T00:00:00ZDifferences in children's exposure to television advertising of unhealthy foods and beverages in Spain by socio-economic level
http://hdl.handle.net/20.500.12105/19033
Background: The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. Methods: Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. Results: The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). Conclusion: Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television.
2024-03-07T00:00:00ZSituación epidemiológica prepandémica de la campilobacteriosis en España entre los años 2013-2019
http://hdl.handle.net/20.500.12105/18981
[ES] La campilobacteriosis es la enfermedad gastrointestinal más notificada en la Unión Europea (UE). En este trabajo se analizaron las características epidemiológicas de la campilobacteriosis en España antes de la pandemia de COVID-19.Se realizó un estudio observacional descriptivo retrospectivo en el que se estudiaron los casos individualizados y los brotes de campilobacteriosis notificados a la Red Nacional de Vigilancia Epidemiológica (RENAVE) y los datos registrados en el Conjunto Mínimo Básico de Datos de Altas Hospitalarias (CMBD) entre 2013 y 2019. Se notificaron 114 273 casos de forma individualizada, 211 brotes y 16 636 altas hospitalarias de campilobacteriosis. La incidencia acumulada (IA) anual de los casos individualizados aumentó hasta 2018, siendo este aumento para todo el periodo en las altas hospitalarias. Las mayores incidencias se dieron en los menores de 5 años y la edad mediana fue mayor en los hospitalizados. El número de casos individualizados, de brotes y de altas hospitalarias fue mayor en los meses cálidos. El alimento notificado con mayor frecuencia en los brotes fue la carne de pollo y el ámbito de ocurrencia el hogar. La campilobacteriosis en España presenta una incidencia al alza en los últimos años, a diferencia de la UE, por lo que habría que reforzar las medidas de prevención y control, teniendo en cuenta los grupos de edad más afectados y en los que es más grave (menores de 5 años y ancianos). La incorporación de otras fuentes de datos como los registros electrónicos de las altas hospitalarias, puede enriquecer la vigilancia epidemiológica al añadir otros datos relevantes para la toma de decisiones, teniendo en cuenta las posibles diferencias en la vigilancia entre Comunidades Autónomas (CC.AA.). [EN] Campylobacteriosis is the most reported gastrointestinal disease in the European Union (EU). In this work, the epidemiological characteristics of campylobacteriosis in Spain before the COVID-19 pandemic were analyzed. A retrospective descriptive observational study was carried out, in which cases and epidemic outbreaks of campylobacteriosis reported to the Spanish Epidemiological Surveillance Network (RENAVE), as well as information related to the data registered in the Minimum Basic Data Set of Hospital Discharges (CMBD) between 2013 and 2019 were studied. A total of 114 273 cases, 211 outbreaks and 16 636 hospital discharges of campylobacteriosis were reported. The cumulative incidence of cases increased until 2018, hospital discharges increased as well for the entire period. The highest incidences appeared in children under 5 years, and the median age was higher in those hospitalized. The number of cases, outbreaks, and hospital discharges was higher in the warmer months. The food item most frequently reported in foodborne outbreaks was chicken meat, and the household was the most frequent setting reported. Campylobacteriosis in Spain has shown an increasing incidence in recent years, in contrast to the EU, so prevention and control measures should be strengthened, considering the most affected age groups and the groups where it is most severe (under 5 years and the elderly). The incorporation of other data sources, such as hospital discharges, can improve epidemiological surveillance by adding other relevant data for decision-making and considering possible differences in surveillance between Autonomous Regions (AA.RR). [PT] A campilobacteriose é a doença gastrointestinal mais relatada na União Europeia (UE). Neste trabalho, foram analisadas as características epidemiológicas da campilobacteriose na Espanha antes da pandemia de COVID-19. Foi realizado um estudo observacional descritivo retrospectivo em que foram estudados os casos individualizados e surtos de campilobacteriose notificados à Rede Nacional de Vigilância Epidemiológica (RENAVE), bem como os dados registrados no Conjunto Mínimo de Dados Básicos de Altas Hospitalares (CMBD) entre 2013 e 2019.Foram notificados 114 273 casos individualizados, 211 surtos e 16 636 altas hospitalares de campilobacteriose. A incidência cumulativa (IA) anual de casos individualizados aumentou até 2018, sendo esse aumento para todo o período nas altas hospitalares. As maiores incidências ocorreram em crianças menores de 5 anos e a mediana de idade foi maior nas internadas. O número de casos individualizados, surtos e altas hospitalares foi maior nos meses mais quentes. O alimento mais relatado nos surtos foi a carne de frango e o local de ocorrência foi o domicílio.A campilobacteriose em Espanha tem apresentado uma incidência crescente nos últimos anos, ao contrário da EU, pelo que as medidas de prevenção e controlo devem ser reforçadas, tendo em conta as faixas etárias mais afetadas e aquelas em que é mais grave (menores de 5 anos e idosos). A incorporação de outras fontes de dados, como registros eletrônicos de altas hospitalares, pode enriquecer a vigilância epidemiológica ao agregar outros dados relevantes para a tomada de decisões, levando em consideração possíveis diferenças de vigilância entre Comunidades Autônomas (CC.AA.).
2023-01-01T00:00:00ZActualización del coste de vacunar a lo largo de toda la vida en España para el año 2023
http://hdl.handle.net/20.500.12105/18976
[ES] Fundamentos: En el calendario de vacunación a lo largo de toda la vida del Consejo Interterritorial del Sistema Nacional de Salud (CISNS) se introdujeron cuatro modificaciones importantes en 2023. El objetivo de este estudio fue estimar el coste de la vacunación a lo largo de toda la vida a una persona sana y a ciertos grupos de riesgo tomando como referencia el calendario de 2023 y compararlo con una estimación previa de 2019. Métodos: Se realizo un estudio descriptivo del coste de administrar las vacunas incluidas en el calendario de vacunación a lo largo de toda la vida para el año 2023 y en el calendario para grupos de riesgo. Resultados: El coste estimado de vacunar a una persona sana a lo largo de toda la vida en 2023 es de 1.541,56 euros en mujeres y 1.498,18 euros en hombres, lo que supondría un incremento del 125% con respecto al coste en 2019. Las condiciones de riesgo con el coste más alto son asplenia además de déficit del complemento e inmunodeficiencias primarias, suponiendo 3.159.82 euros y 2.566 euros, respectivamente, de media. Vacunar a toda la población sana en España en un año costaría unos 565 millones de euros y vacunar a la cohorte de recién nacidos de 2023 a lo largo de toda la vida unos 500 millones de euros. Conclusiones: A pesar del incremento en el coste en 2023, considerando el impacto económico de las enfermedades prevenibles por vacunación en la sociedad, la vacunación sigue siendo una intervención barata que aporta múltiples beneficios. [EN] Background: Four modifications were introduced in the Lifetime Vaccination Schedule of the Interterritorial Council of the National Health System (CISNS) in 2023.The aim of this study was to estimate the cost of vaccinating a healthy person and people with certain risk conditions throughout life in Spain and to compare with a previous estimation from 2019. Methods: A descriptive study of the cost of administering the vaccines included in the Lifetime Vaccination Schedule for the year 2023 and in the schedule for risk groups was carried out. Results: The estimated cost to immunize a healthy person throughout life in 2023 is 1,541.56€ for a woman and 1,498.18€ for a men, which corresponds to an increase of 125% compared to the cost in 2019. The risk conditions with the highest cost are asplenia and complement deficiency and primary immunodeficiencies, with a cost of 3,159.82 euros and 2,566 euros respectively on average. The cost of vaccinating the whole healthy population in Spain in a year is around 565M€. Moreover, the cost of vaccinating the new-borns cohort of 2023 was estimated at 500M€. Conclusions: Despite the cost increase in 2023, immunization is still a very cheap intervention, considering the economic impact of immunopreventable diseases in the society. The relative low cost of immunization throughout life makes this health intervention useful and worthwhile.
2023-12-29T00:00:00ZTransparency, openness, and reproducible research practices are frequently underused in health economic evaluations
http://hdl.handle.net/20.500.12105/17385
Objectives: To investigate the extent to which articles of economic evaluations of healthcare interventions indexed in MEDLINE incorporate research practices that promote transparency, openness, and reproducibility. Study design and setting: We evaluated a random sample of health economic evaluations indexed in MEDLINE during 2019. We included articles written in English reporting an incremental cost-effectiveness ratio in terms of costs per life years gained, quality-adjusted life years, and/or disability-adjusted life years. Reproducible research practices, openness, and transparency in each article were extracted in duplicate. We explored whether reproducible research practices were associated with self-report use of a guideline. Results: We included 200 studies published in 147 journals. Almost half were published as open access articles (n = 93; 47%). Most studies (n = 150; 75%) were model-based economic evaluations. In 109 (55%) studies, authors self-reported use a guideline (e.g., for study conduct or reporting). Few studies (n = 31; 16%) reported working from a protocol. In 112 (56%) studies, authors reported the data needed to recreate the incremental cost-effectiveness ratio for the base case analysis. This percentage was higher in studies using a guideline than studies not using a guideline (72/109 [66%] with guideline vs. 40/91 [44%] without guideline; risk ratio 1.50, 95% confidence interval 1.15-1.97). Only 10 (5%) studies mentioned access to raw data and analytic code for reanalyses. Conclusion: Transparency, openness, and reproducible research practices are frequently underused in health economic evaluations. This study provides baseline data to compare future progress in the field.
2024-01-01T00:00:00ZThe Novel Ceramide- and Phosphatidylcholine-Based Risk Score for the Prediction of New-Onset of Hypertension
http://hdl.handle.net/20.500.12105/17217
Ceramides and other sphingolipids are implicated in vascular dysfunction and inflammation. They have been suggested as potential biomarkers for hypertension. However, their specific association with hypertension prevalence and onset requires further investigation. This study aimed to identify specific ceramide and phosphatidylcholine species associated with hypertension prevalence and onset. The 2002 FINRISK (Finnish non-communicable risk factor survey) study investigated the association between coronary event risk scores (CERT1 and CERT2) and hypertension using prevalent and new-onset hypertension groups, both consisting of 7722 participants, over a span of 10 years. Ceramide and phosphatidylcholine levels were measured using tandem liquid chromatography-mass spectrometry. Ceramide and phosphatidylcholine ratios, including ceramide (d18:1/18:0), ceramide (d18:1/24:1), phosphatidylcholine (16:0/16:0), and the ratio of ceramide (d18:1/18:0)/(d18:1/16:0), are consistently associated with both prevalence and new-onset hypertension. Ceramide (d18:1/24:0) was also linked to both hypertension measures. Adjusting for covariates, CERT1 and CERT2 showed no-longer-significant associations with hypertension prevalence, but only CERT2 predicted new-onset hypertension. Plasma ceramides and phosphatidylcholines are crucial biomarkers for hypertension, with imbalances potentially contributing to its development. Further research is needed to understand the underlying mechanisms by which ceramides will contribute to the development of hypertension.
2023-12-06T00:00:00ZTraffic Density Exposure, Oxidative Stress Biomarkers and Plasma Metabolomics in a Population-Based Sample: The Hortega Study
http://hdl.handle.net/20.500.12105/16937
Exposure to traffic-related air pollution (TRAP) generates oxidative stress, with downstream effects at the metabolic level. Human studies of traffic density and metabolomic markers, however, are rare. The main objective of this study was to evaluate the cross-sectional association between traffic density in the street of residence with oxidative stress and metabolomic profiles measured in a population-based sample from Spain. We also explored in silico the potential biological implications of the findings. Secondarily, we assessed the contribution of oxidative stress to the association between exposure to traffic density and variation in plasma metabolite levels. Traffic density was defined as the average daily traffic volume over an entire year within a buffer of 50 m around the participants' residence. Plasma metabolomic profiles and urine oxidative stress biomarkers were measured in samples from 1181 Hortega Study participants by nuclear magnetic resonance spectroscopy and high-performance liquid chromatography, respectively. Traffic density was associated with 7 (out of 49) plasma metabolites, including amino acids, fatty acids, products of bacterial and energy metabolism and fluid balance metabolites. Regarding urine oxidative stress biomarkers, traffic associations were positive for GSSG/GSH% and negative for MDA. A total of 12 KEGG pathways were linked to traffic-related metabolites. In a protein network from genes included in over-represented pathways and 63 redox-related candidate genes, we observed relevant proteins from the glutathione cycle. GSSG/GSH% and MDA accounted for 14.6% and 12.2% of changes in isobutyrate and the CH2CH2CO fatty acid moiety, respectively, which is attributable to traffic exposure. At the population level, exposure to traffic density was associated with specific urine oxidative stress and plasma metabolites. Although our results support a role of oxidative stress as a biological intermediary of traffic-related metabolic alterations, with potential implications for the co-bacterial and lipid metabolism, additional mechanistic and prospective studies are needed to confirm our findings.
2023-12-15T00:00:00ZNoise Perception and Health Effects on Population: A Cross-Sectional Study on COVID-19 Lockdown by Noise Sources for Spanish Dwellings
http://hdl.handle.net/20.500.12105/16819
An online questionnaire on the subjective response to noise was created to collect national experiences from households during the first COVID-19 wave (from 14 March to 21 June). In this study, different noise sources (general noise, but also noise from neighbors, common areas, facilities, premises, and traffic) and self-declared health effects (stress, lack of concentration, sleep disturbance, anxiety, irritability, or their absence) reported from 582 participants were analyzed (before and during quarantine). A descriptive and statistical analysis between variables was established to observe relational trends for the two periods. The results associated stress and sleep disturbance with most of the noise sources before the pandemic. Sleep disturbance was not significant in confinement, maybe due to habit changes and staying home. Uncertainty linked to the pandemic could explain why stress showed significance during quarantine. Irritability showed an inverse relation with noise sources since their values were greater for declared noise sources and more annoying before the pandemic in all cases. Finally, anxiety showed an association with fewer noise sources, maybe also conditioned by other factors. However, the extreme situation and the uncertainty generated, the presence of cohabitants at home, and building factors (such as acoustic insulation) conditioned the households’ experience.
2023-01-01T00:00:00ZNatural ventilation as a healthy habit during the first wave of the COVID-19 pandemic: An analysis of the frequency of window opening in Spanish homes
http://hdl.handle.net/20.500.12105/16818
Since SARS-CoV-2 spread worldwide in early 2020, many countries established lockdowns for protection. With a main transmission by aerosols, ventilation was promoted. This article analyses natural ventilation of Spanish housing during the spring 2020. An online questionnaire was launched, obtaining for this study 1502 responses. The comparative window opening before and during confinement, and households, dwellings and home activity variables, were analysed. The binary logistic regression model before pandemic indicated that ventilating properly related to: a worse perceived IAQ (OR = 1.56); thermal adaptation measures, especially those that prefer to open/close windows (OR = 1.45); not having heating system (OR = 1.15); and using power to heat water (OR = 1.60). For the confinement period, the model highlighted: being an employee (OR = 1.88); using heavy clothing in the home (OR = 2.36); and again, open/close windows for adaptation (OR = 2.24). According to specific tasks in quarantine, frequent ventilation was boosted by: an increasing use of oven (OR = 14.81); and alteration of work-habits (OR = 2.70), sport-habits (OR = 1.79), and outdoor-activities (OR = 1.60). Thus, an adequate natural ventilation pattern during the quarantine was linked to low environmental comfort in general, by virtue of indoor air quality. This is corroborated by less acoustic-thermal insulation, worse indicators of heating use, and the adaptive response to opening/closing windows when external temperature changed.
2023-01-01T00:00:00ZShort-term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment
http://hdl.handle.net/20.500.12105/16813
Introduction: The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013-2018, and its economic impact. Methods: Time series study analysing emergency hospital admissions in the MAR due to all causes (ICD-10: A00-R99), respiratory causes (ICD-10: J00-J99) and circulatory causes (ICD-10: I00-I99) across the period 2013-2018. The main independent variables were mean daily PM2.5, PM10, NO2, 8-h ozone concentrations, and noise. We controlled for meteorological variables, Public Holidays, seasonality, and the trend and autoregressive nature of the series, and fitted generalised linear models with a Poisson regression link to ascertain the relative risks and attributable risks. In addition, we made an economic assessment of these hospitalisations. Results: The following associations were found: NO2 with admissions due to natural (RR: 1.007, 95% CI: 1.004-1.011) and respiratory causes (RR: 1.012, 95% CI: 1.005-1.019); 8-h ozone with admissions due to natural (RR: 1.049, 95% CI: 1.014-1.046) and circulatory causes (RR: 1.088, 95% CI: 1.039-1.140); and diurnal noise (LAeq7-23h) with admissions due to natural (RR: 1.001, 95% CI: 1.001-1.002), respiratory (RR: 1.002, 95% CI: 1.001-1.003) and circulatory causes (RR: 1.003, 95% CI: 1.002-1.005). Every year, a total of 8246 (95% CI: 4580-11,905) natural-cause admissions are attributable to NO2, with an estimated cost of close on €120 million and 5685 (95% CI: 2533-8835) attributed to LAeq7-23h with an estimated cost of close on €82 million. Conclusions: Nitrogen dioxide, ozone and noise are the main pollutants to which a large number of hospitalisations in the MAR are attributed, and are thus responsible for a marked deterioration in population health and high related economic impact.
2023-02-15T00:00:00ZDoes the meteorological origin of heat waves influence their impact on health? A 6-year morbidity and mortality study in Madrid (Spain)
http://hdl.handle.net/20.500.12105/16811
Background: In Spain, two synoptic-scale conditions influence heat wave formation. The first involves advection of warm and dry air masses carrying dust of Saharan origin (North African Dust (NAF) = 1). The second entails anticyclonic stagnation with high insolation and stability (NAF) = 0). Some studies show that the meteorological origin of these heat waves may affect their impact on morbidity and mortality. Objective: To determine whether the impact of heat waves on health outcomes in Madrid (Spain) during 2013-2018 varied by synoptic-scale condition. Methodology: Outcome data consist of daily mortality and daily hospital emergency admissions (morbidity) for natural, circulatory, and respiratory causes. Predictors include daily maximum and minimum temperatures and daily mean concentrations of NO2, PM10, PM2.5, NO2, and O3. Analyses adjust for insolation, relative humidity, and wind speed. Generalized linear models were performed with Poisson link between the variables controlling for trend, seasonality, and auto-regression in the series. Relative Risks (RR) and Attributable Risks (AR) were determined. The RRs for mortality attributable to high temperatures were similar regardless of NAF status. For hospital admissions, however, the RRs for hot days with NAF = 0 are higher than for days with NAF = 1. We also found that atmospheric pollutants worsen morbidity and mortality, especially PM10 concentrations when NAF = 1 and O3 concentrations when NAF = 0. Results: The effect of heat waves on morbidity and mortality depends on the synoptic situation. The impact is greater under anticyclonic stagnation conditions than under Saharan dust advection. Further, the health impact of pollutants such as PM10 and O3 varies according to the synoptic situation. Conclusions: Based on these findings, we strongly recommend prevention plans to include data on the meteorological situation originating the heat wave, on a synoptic-scale, as well as comprehensive preventive measures against the compounding effect of high temperatures and pollution.
2023-01-10T00:00:00Z