Search Results (13)

Background: Disorders of gut–brain interaction (DGBI) are multifactorial. Early-life events are proposed as factors involved in their etiopathogenesis. The relationship between mode of delivery, prematurity, and DGBI development remains unclear. This study examines whether cesarean delivery and prematurity contribute to early childhood DGBI. Methods: Caregivers of children aged 1 month to 4 years from four Colombian cities participated in a cross-sectional study. Pediatricians completed the Spanish-validated Questionnaire of Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV). Data of children born by cesarean delivery and prematurity were compared with controls. Categorical data were analyzed using Fisher’s exact test, and odds ratios (ORs) with 95% confidence intervals (CIs). Results: DGBIs were identified in 26.6% of children, with functional constipation (FC) being the most prevalent (22.3%). Among children born via cesarean section (54.3%), 30.4% of them had a DGBI (OR = 1.54, 95% CI = 1.20–1.96, p = 0.00), and 26.3% had FC (OR = 1.67, 95% CI = 1.29–2.18, p = 0.00). Prematurity was observed in 12.6% of children and was associated with a higher prevalence of DGBI (35.7%, (OR = 1.64, 95% CI = 1.16–2.29, p = 0.00), with FC affecting 30.8% (OR = 1.66, 95% CI = 1.16–2.35, p = 0.00). Conclusions: Cesarean delivery and prematurity were found to be associated with DGBI in early childhood, particularly FC. These findings highlight the need for further research to explore potential mechanisms and confirm these associations. Full article

Given the critical role of fatherhood in child development and the significant challenges faced by fathers in underserved communities, there is a pressing need to better understand the specific barriers they encounter. This exploratory mixed-methods study examines the prevalence of adverse childhood experiences (ACEs) among fathers, including English, Spanish, and Creole speakers, and explores how social determinants of health exacerbate these barriers. Quantitative data were collected from June 2022–2023 using REDCap survey software. Additionally, three focus groups were conducted with 18 fathers residing in Palm Beach County (PBC), each group based on the primary language spoken at home. The focus groups were conducted in person via the Healthy Mothers Healthy Babies Coalition (HMHB) outreach team at community centers within the PBC. Stated barriers to fatherhood were thematically classified according into three main themes: (1) limited access to and knowledge of resources in the community; (2) challenges in navigating new roles, resources, and fatherhood responsibilities; and (3) important values in parenting. Over 40% of the fathers reported barriers to being involved in their child’s life. The most frequent barriers included work (35.4%) and lack of transportation distance (12.5%). Bivariate analysis using the fisher’s exact test showed a significant association between scoring greater than 4 on the ACE criteria checklist and experiencing barriers to being involved in the child’s life (p-value = 0.013). Findings from this study aim to inform the development of culturally tailored interventions that address disparities in fatherhood support, ultimately contributing to improved outcomes for both fathers and their children. Full article

Background/Objectives: The objective was to compare the results of segmentectomy and lobectomy in the treatment of c-stage IA lung cancer in terms of tumor recurrence and 5-year survival. Methods: An observational study was performed using 3533 patients included in the registry of the Spanish VATS Group (GEVATS) of the Spanish Society of Thoracic Surgery (SECT) between 2016 and 2018. A total of 1004 lobectomies and 83 segmentectomies in c-stage IA were selected. Two comparable groups were selected through 2:1 propensity score matching with patient-, tumor- and surgery-related variables, leaving 166 lobectomies and 83 segmentectomies. Tumor recurrence was analyzed by Fisher’s test and overall, cancer-specific, recurrence-free and disease-free survival by Kaplan-Meier and Log-rank tests. Results: Overall recurrence was 23.7% in both groups, with a predominance of locoregional recurrence in segmentectomy (16.2% vs. 11.2%) and distant recurrence in lobectomy (12.5% vs. 7.5%). There was no difference between the two groups in any of the survival types. Overall survival at 5 years was 73.5% (95% CI: 65.5–82.4%) in the lobectomy group vs. 73.1% (95% CI: 60.1–88.9%) in the segmentectomy group. Conclusions: Anatomic segmentectomy may be a valid option in the treatment of c-stage IA lung cancer since the recurrence and long-term survival outcomes compared to lobectomy are equivalent. Full article

Background/Objectives: Moral distress is commonly experienced by healthcare professionals (i.e., nurses) as ethical conflict. Previous literature suggests that moral distress contributes to emotional exhaustion in these professionals. We aimed to synthesize and analyze studies that examined the relationship between moral distress and emotional exhaustion in healthcare professionals. Methods: Web of Science, Scopus, PubMed, Medline, and PsycInfo were used to search targeted studies written in English, Spanish, French, Italian, and Portuguese. The correlation coefficients of each study were extracted and converted into Fisher’s z. Finally, pooled r was calculated by Fisher’s z and standard error. The meta-analysis was performed with the R statistical program. Results: A total of 14 studies with 2425 healthcare professionals were included. The Moral Distress Scale Revised (MDS-R) and the Maslach Burnout Inventory (MBI) were the most used scales to measure moral distress and emotional exhaustion, respectively. The pooled correlation coefficient between moral distress and emotional exhaustion was 0.33 (p < 0.001, 95%CI: 0.27, 0.39). Conclusions: Moral distress is strongly correlated to emotional exhaustion in healthcare professionals. Future studies should focus on exploring the causal relationships between both variables as well as investigating potential moderators. Full article

Background: In the transition to a professional learning environment, healthcare professionals in their first year of specialized postgraduate clinical training (known as residents in Spain) are suddenly required to handle confidential information with little or no prior training in the safe and appropriate use of digital media with respect to confidentiality issues. The aims of this study were: (1) to explore the usefulness of an advanced clinical simulation program for educating residents from different healthcare disciplines about confidentiality and the dissemination of clinical data or patient images; (2) to explore the use of social networks in healthcare settings; and (3) to explore participants’ knowledge and attitudes on current regulations regarding confidentiality, image dissemination, and the use of social networks; Methods: This was a cross-sectional study. Data were collected from all 49 first-year residents of different health professions at a Spanish hospital between June and August 2022. High-fidelity clinical simulation sessions designed to address confidentiality and health information dissemination issues in hospital settings, including the use of social networks, were developed and implemented. Data were assessed using a 12-item ad hoc questionnaire on confidentiality and the use of social media in the healthcare setting. Descriptive of general data and chi-square test or Fisher’s exact test were performed using the SPSS 25.0 software; Results: All the participants reported using the messaging application WhatsApp regularly during their working day. A total of 20.4% of the participants stated that they had taken photos of clinical data (radiographs, analyses, etc.) without permission, with 40.8% claiming that they were unaware of the legal consequences of improper access to clinical records. After the course, the participants reported intending to modify their behavior when sharing patient data without their consent and with respect to how patients are informed; Conclusions: The use of advanced simulation in the training of interprofessional teams of residents is as an effective tool for initiating attitudinal change and increasing knowledge related to patient privacy and confidentiality. Further follow-up studies are needed to see how these attitudes are incorporated into clinical practice. Full article

The fishing sector is facing major economic and environmental challenges worldwide. However, at least in developed countries, it is also undergoing a major social crisis. This research has tried to quantify and validate this subjective feeling of deep crisis, based on objective and quantitative data referring to the Spanish Mediterranean. Indeed, the results show alarming data. Different scattered databases have been analyzed and it has been exposed that in only 15 years the number of vessels, power and tonnage has decreased by about 40%; as for fishermen, their number has decreased by about 30%, also revealing a serious problem of generational replacement, since in only 10 years, the average age of fishermen has increased by 3 years. A simple linear regression model shows that this downward trend in the number of boats and fishermen will continue at least in the short term. The data obtained invite a deep reflection on the future or even the very survival of fishing in the Spanish Mediterranean in the medium term. This reflection is not limited to this specific area but can be extrapolated to many other fishing areas. Full article

We developed and applied a method to quantify spearfisher effort and catch, shark interactions and shark depredation in a boat-based recreational spearfishing competition in the Great Barrier Reef Marine Park in Queensland. Survey questions were designed to collect targeted quantitative data whilst minimising the survey burden of spearfishers. We provide the first known scientific study of shark depredation during a recreational spearfishing competition and the first scientific study of shark depredation in the Great Barrier Reef region. During the two-day spearfishing competition, nine vessels with a total of 33 spearfishers reported a catch of 144 fish for 115 h of effort (1.25 fish per hour). A subset of the catch comprised nine eligible species under competition rules, of which 47 pelagic fish were weighed. The largest fish captured was a 34.4 kg Sailfish (Istiophorus platypterus). The most common species captured and weighed was Spanish Mackerel (Scomberomorus commerson). The total weight of eligible fish was 332 kg and the average weight of each fish was 7.1 kg. During the two-day event, spearfishers functioned as citizen scientists and counted 358 sharks (115 h effort), averaging 3.11 sharks per hour. Grey Reef Sharks (Carcharhinus amblyrhynchos) comprised 64% of sightings. Nine speared fish were fully depredated by sharks as spearfishers attempted to retrieve their catch, which equates to a depredation rate of 5.9%. The depredated fish included four pelagic fish and five reef fish. The shark species responsible were Grey Reef Shark (C. amblyrhynchos) (66%), Bull Shark (Carcharhinus leucas) (11%), Whitetip Reef Shark (Triaenodon obesus) (11%) and Great Hammerhead (Sphyrna mokarran) (11%). There were spatial differences in fish catch, shark sightings and rates of depredation. We developed a report card that compared average catch of fish, sightings of sharks per hour and depredation rate by survey area, which assists recreational fishers and marine park managers to assess spatio-temporal changes. The participating spearfishers can be regarded as experienced (average 18 days a year for average 13.4 years). Sixty percent of interviewees perceived that shark numbers have increased in the past 10 years, 33% indicated no change and 7% indicated shark numbers had decreased. Total fuel use of all vessels was 2819 L and was equivalent to 6.48 tons of greenhouse gas emissions for the competition. Full article

Background: Early Childhood Caries (ECC) is a prevalent chronic pathology, and it has a negative impact on the oral and general health of the child patient. Aim: To evaluate the knowledge, attitudes and practices of Spanish paediatricians regarding early childhood caries according to the professional’s years of experience. Material and Methods: A cross-sectional questionnaire was conducted by Spanish paediatricians via WhatsApp and e-mails from January to April 2021. Data were analysed using Chi-squared test, Fisher’s exact test and Cramer’s V test. Results: There were a total of 359 participants. Most respondents were women (81.3%) with up to 10 years of professional experience (31.2%) in primary health care and public health. In most cases, participants had an excellent knowledge of primary dentition (90.8%), but they ignored (56%) when the first visit to the dentist should occur. Regarding the aetiological factors of caries, oral hygiene and prevention, a lower rate of knowledge was observed. The majority of participants (80.8%) were not able to identify white spot lesions and enamel defects (76%). They considered that their knowledge in oral health was deficient, highlighting the need to increase their training. Less experienced paediatricians were found to have higher success rates. Conclusions: The level of knowledge and attitudes regarding early childhood caries of the evaluated paediatricians should be improved. Paediatricians had difficulties in identifying early caries lesions and enamel defects. Nevertheless, a higher level of knowledge and positive attitudes towards dental caries has been detected among paediatricians with fewer years of professional experience. Full article

Diagnosis of type I hypersensitivity reactions (IgE-mediated reactions) to penicillins is based on clinical history, skin tests (STs), and drug provocation tests (DPTs). Among in vitro complementary tests, the fluoro-enzyme immunoassay (FEIA) ImmunoCAP^® (Thermo-Fisher, Waltham, MA, USA) is the most widely used commercial method for detecting drug-specific IgE (sIgE). In this study, we aimed to analyze the utility of ImmunoCAP^® for detecting sIgE to penicillin G (PG) and amoxicillin (AX) in patients with confirmed penicillin allergy. The study includes 139 and 250 patients evaluated in Spain and Italy, respectively. All had experienced type I hypersensitivity reactions to penicillins confirmed by positive STs. Additionally, selective or cross-reactive reactions were confirmed by DPTs in a subgroup of patients for further analysis. Positive ImmunoCAP^® results were 39.6% for PG and/or AX in Spanish subjects and 52.4% in Italian subjects. When only PG or AX sIgE where analyzed, the percentages were 15.1% and 30.4%, respectively, in Spanish patients; and 38.9% and 46% in Italian ones. The analysis of positive STs showed a statistically significant higher percentage of positive STs to PG determinants in Italian patients. False-positive results to PG (16%) were detected in selective AX patients with confirmed PG tolerance. Low and variable sensitivity values observed in a well-defined population with confirmed allergy diagnosis, as well as false-positive results to PG, suggest that ImmunoCAP^® is a diagnostic tool with relevant limitations in the evaluation of subjects with type I hypersensitivity reactions to penicillins. Full article

Client conversations in contact centers are nowadays routinely recorded for a number of reasons—in many cases, just because it is required by current legislation. However, even if not required, conversations between customers and agents can be a valuable source of information about clients or future clients, call center agents, markets trends, etc. Analyzing these recordings provides an excellent opportunity to be aware about the business and its possibilities. The current state of the art in Automatic Speech Recognition (ASR) allows this information to be effectively extracted and used. However, conversations are usually stored in highly compressed ways to save space and typically contain packet losses that produce short interruptions in the speech signal due to the common use of Voice-over-IP (VoIP) in these systems. These effects, and especially the last one, have a negative impact on ASR performance. This article presents an extensive study on the importance of these effects on modern ASR systems and the effectiveness of using several techniques of data augmentation to increase their robustness. In addition, ITU-T G.711, a well-known Packet Loss Concealment (PLC) method is applied in combination with data augmentation techniques to analyze ASR performance improvement on signals affected by packet losses. Full article

Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in five Spanish NHs. UI (measured with Minimum Data Set 3.0), sociodemographic, and health-related variables were collected. Chi-square (or Fisher’s) or Student’s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6–77.2) in incontinent (n = 45, mean age 84.04, SD = 7.7) and continent (n = 23, mean age 83.00, SD = 7.7) groups. UI was significantly associated with frailty (PR = 1.84; 95%CI 0.96–3.53), faecal incontinence (PR = 1.65; 95%CI 1.02–2.65), anxiety (PR = 1.64; 95%CI 1.01–2.66), physical performance (PR = 1.77; 95%CI 1.00–3.11), and cognitive state (PR = 1.95; 95%CI 1.05–3.60). Statistically significant differences were found between incontinent and continent NH residents for limitations in activities of daily living (ADL), mobility, quality of life, sedentary behaviour, and handgrip strength. It can be concluded that two out of three of the residents experienced UI, and significant associated factors were mainly physical (sedentary behaviour, frailty, physical performance, ADL limitations, mobility, faecal incontinence, and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety, and quality of life). Full article

The United Kingdom has played a prominent role in the Common Fisheries Policy—by contributing to fisheries activities and also by participating in the design of the fisheries policy. Brexit is certain to have significant repercussions for European fisheries activities and their management. This study analyses the views held by companies linked to the fisheries sector in Galicia (fishing, wholesale trade, canned fish, aquaculture, and fish processing), one of the European regions most affected by Brexit given that more than 80% of the Spanish fishing fleet working on UK waters is located in this region. We adopt a quantitative methodology based on the Pearson’s chi-squared test, the likelihood ratio, and the Fisher’s exact test for analyzing opinions about various topics. Results indicate that companies engaged in marine fisheries or trade in fishing goods hold a mostly negative view of Brexit’s effects. In total, 30% of those surveyed anticipate that Brexit will have negative consequences for EU workers in UK fishery companies; a slightly higher percentage of these respondents expect the United Kingdom’s exit from the EU to depress Spain’s foreign trade; over half of those surveyed perceived Brexit as resulting in the adverse scenario of reduced access to fisheries’ resources and were in favor of reformulating the current system of total allowable catches (TACs) and quotas among the remaining post-Brexit member states. Most respondents also agreed that Brexit will have negative repercussions on vessels of the Galician fleet operating under the British flag. Our statistical analysis identifies a significant relationship between negative attitudes and the firm’s size for fisheries’ sectors as a whole; however, no relation between those attitudes and firm size or turnover is identified when the particular fishing companies’ perceptions are evaluated. Full article

Feeding biomass-fueled gas engines (BFGEs) with olive tree pruning residues offers new opportunities to decrease fossil fuel use in road vehicles and electricity generation. BFGEs, coupled to radial distribution systems (RDSs), provide renewable energy and power that can feed electric vehicle (EV) charging stations. However, the combined impact of BFGEs and EVs on RDSs must be assessed to assure the technical constraint fulfilment. Because of the stochastic nature of source/load, it was decided that a probabilistic approach was the most viable option for this assessment. Consequently, this research developed an analytical technique to evaluate the technical constraint fulfilment in RDSs with this combined interaction. The proposed analytical technique (PAT) involved the calculation of cumulants and the linearization of load-flow equations, along with the application of the cumulant method, and Cornish-Fisher expansion. The uncertainties related to biomass stock and its heating value (HV) were important factors that were assessed for the first time. Application of the PAT in a Spanish RDS with BFGEs and EVs confirmed the feasibility of the proposal and its additional benefits. Specifically, BFGEs were found to clearly contribute to the voltage constraint fulfilment. The computational cost of the PAT was lower than that associated with Monte-Carlo simulations (MCSs). Full article