Revista Espanola De Salud Publica最新文献

It is estimated that colorectal cancer is the cancer disease with the highest incidence in Spain  due to the increase in life expectancy and changes in the lifestyle of the population . Early detection through disease screening programs allows for more effective treatment and a higher survival rate . Advances in treatment have been made, such as targeted therapies, which focus on specifically attacking cancer cells and preventing their growth . However, much remains to be done in terms of prevention and treatment of colorectal cancer. More research and medical advances are required to combat this disease.

Objective: The set of exposures to chemical substances and their role as a cause of disease gives rise to the concept of the exposome, partially made up of chemical pollutants to which an individual is exposed, which is why, unlike the genome, it is an a priori modifiable factor, its study being crucial in terms of Public Health. The population of the Canary Islands has been studied in terms of its levels of chemical contamination, with numerous biomonitoring studies, which makes it necessary to characterise its exposome and its consequences in terms of disease, in order to implement specific corrective measures to minimize the impact on its health.

Methods: A review of scientific literature (MEDLINE and Scopus) was made, according to PRISMA criteria and PICO methodology, to include studies on biomonitoring of pollutants, or evaluating the effect of pollutants on diseases prevalent in the archipelago.

Results: Twenty-five studies, both population-based and hospital-based, were selected. The results show that the exposome is made up of at least 110 compounds or elements, 99 of which appear to be present from the intrauterine stage. The presence of chlorinated pollutants and metals stands out, which seems to be related to the high incidence of metabolic diseases (diabetes), cardiovascular diseases (hypertension) and certain types of neoplasms (breast cancer). In short, the consequences are conditioned by the genome of the exposed population, reinforcing the enormous importance of genome-exposome interactions in the development of pathologies.

Conclusions: Our results indicate that it is necessary to establish corrective measures on the sources of pollution that modify the exposome of this population.

The last World Breastfeeding Week (SMLM, its initials in spanish) was a proper moment to deliberate on the facts, values and duties that are related to breastfeeding in order to give it value as a human phenomenon capable of providing well-being and creating healthy, emotionally stable and more fair. Along with the indicators that show the consumption of breastmilk in the child population, facts and values of mothers, fathers, civil society are examined; the health system, labor and development models. The duties are organized in optimal outputs that are grouped in the steps of the Initiative for the Humanization of Birth and Breastfeeding Assistance (IHAN, its initials in spanish), the warm chain of support; as well as in the policies of humanization and quality of service of the governing bodies of health. The deliberation shows the mother as the center of attention and her duty in charity for her baby; also the responsibility of health personnel as protagonists of change, supporting, educating and basing the value that breastfeeding has for both development model.

Objective: Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin, occupational social class and gender, which is essential in order to designing public health strategies.

Methods: A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables.

Results: The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%).

Conclusions: The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.

Objective: Obesity is an inflammatory disease that is widely distributed in the world's population and is related to the leading causes of death. The use of prebiotics and probiotics can be an alternative treatment against obesity. Although there have been found physiological and biochemical effects of its use, the molecular mechanism remains unclear. The present review analyzed articles that suggested the activation of pathways related to the metabolism of the fatty acids, as well as the impact on anti-inflammatory mechanisms, as part of the mechanism of action of prebiotics and probiotics, to know therefore the possible pathways activated by the prebiotics and probiotics.

Methods: Exhaustive research was made on articles included in the period 2005-2021 related to the effect of prebiotics and probiotics in obesity, inflammatory diseases, and metabolic diseases. Identifying an effect on anti-inflammatory cytokines and PPAR modulation, with a consequent decrease in inflammation and fat degradation.

Results: A total of sixty-three articles were obtained, which were classified as basic information on molecular markers of obesity, the effect of prebiotics and probiotics in obesity, and articles related to anti-inflammatory effects and fatty acid metabolism observed in obesity and other inflammatory diseases.

Conclusions: The effect of prebiotics and probiotics in obesity can be linked to the anti-inflammatory mechanism produced, and this effect leads to an increase in the expression of genes related to fatty acid metabolism.

Objective: There are different socioeconomic variables which determine tuberculosis's epidemiology, diagnosis and treatment. The objective of this paper was to analize these effects in the last years in Spain.

Methods: A systematic review was conducted. Screened studies were original articles written in English or Spanish and published between 2007 and 2020. Searching was performed in Pubmed and Web of Science databases. STROBE criteria were followed to analyze studies's quality, and studies included in the review had 15 points or more.

Results: 23 articles were selected, and were classified in different topics. Foreigners's proportion with tuberculosis changed in different autonomous communities between 10%-50%. There were diagnostic delay for this group compared to natives. This group had higher incidence of resistance to isoniazid, but without a clear increase in multidrug resistance. There were less adherence to tuberculosis's treatment in case of immigration, drug addiction, HIV coinfection, or lack of family support. Under-reporting of tuberculosis cases varied between 18%-28%, and it was higher in cases of social marginality, HIV coinfection, Spanish nationality or male sex. There were also other social risk groups in which the diagnostic approach to tuberculosis was relevant, such as in schools and health centers. Tuberculosis was one of the most frequent HIV associated diseases, although screening tests were not performed in almost 18%, depending on the concurrence of social risk factors.

Conclusions: Tuberculosis's incidence, diagnosis, and treatment are influenced by a lot of social and economic factors, which determine the approach to this disease.

Objective: Pregnancy is an event in a woman's life with enormous potential to affect her health and the newborn health. The objective of this review was to study the contributions made by the different investigations on nutrition and physical activity (PA) in relation to obstetric and perinatal outcomes, as well as health status in adulthood from 2011 to 2021.

Methods: An exploratory review of the literature was carried out. Two blind reviewers performed the search, screening and inclusion of the articles (37).

Results: Bibliographic reviews (35.13%) and descriptive studies (21.6%) were collected. The extracted information was grouped into three thematic areas: health education (HE) (16 articles), diet (12 articles), physical activity (9 articles) and 4 sub-themes: macronutrients; micronutrients; type of exercise and intensity and frequency of exercise. The most reported obstetric and perinatal outcomes were premature birth (37.5%), fetal growth disturbance (37.5%) and gestational diabetes mellitus (GDM) (25%).

Conclusions: Results are in line with the published literature. Diet and PA play a relevant role in obstetric and perinatal outcomes, as well as in health status in adulthood. However, it's not clear which is the best educational intervention to improve adherence to a healthy lifestyle during and after pregnancy. This review may have incurred several biases including publication bias and selection bias. Future research on HE in pregnancy should adopt an approach focused on educational interventions that achieve greater adherence to a healthy lifestyle.

During the last decades, healthcare has undergone important changes. Increased life expectancy has given rise to an aging population that, according to the United Nations, is about to become one of the most important social transformations of the 21st century. Globally, there were 727 million people aged 65 or over in 2020 (9.3% of the total population) and this is estimated to increase to 16% by 2050 . In the European Union (EU), the percentage of the population aged 65 or over has increased from 9.6% in 1960 to 20.3% in 2019 and is projected to increase to 31.3% by 2100. We are also witnessing a process of aging of the elderly population, with a proportion of very old people (those aged 80 and over) in the total population of the European Union of 5.8% in 2019 . Spain is one of the countries with the highest proportion of older people, with a percentage of citizens aged 65 or over in 2020 of 19.6% of the total population, and with a projection of 26.5% for 2035. Almost a third of this population (6%) are 80 years or older.

Objective: Increasing emotional competence is a health promotion strategy that can be enhanced through school-based emotional education programs. This study aims to describe the participative process to design the emotional education program 1, 2, 3, emoció! aimed at children aged from 3 to 5 years and to analyze the results of the pilot test.

Methods: Existing international emotional education programs were reviewed. A participative process was carried out for its adaptation and a pilot test of the training and materials. Training and activity evaluation questionnaires were used to calculate mean scores for quantitative responses and percentages for categorical responses, and the Emotional Competence Profile Questionnaire for teaching staff was administered before and after the intervention and for which it was calculated whether there were significant differences between the two scores using Wilcoxon test.

Results: Eleven school programs were reviewed. The Social and Emotional Aspects of Learning (SEAL) program was selected. Seventeen professionals participated in working groups to carry out the adaptation to the Barcelona context. Eleven schools participated in the pilot test. The teachers increased their emotional competencies. The teachers' average evaluation of the activities was 8.18 out of 10. The result of the whole is the 1, 2, 3, emoció! program.

Conclusions: The 1, 2, 3, emoció! program is well received by the schools participating in the pilot test. Future studies should evaluate its effectiveness.