Experiencias de coidadores principais de enfermos terminais: hospitalización a domicilio

[Resumen] Objetivo: conocer las experiencias de los cuidadores principales de pacientes terminales que han recibido cuidados paliativos a domicilio por parte de HADO. Metodología: estudio cualitativo fundamentado en los supuestos de la teoría crítica. Se empleará una estrategia de Investigación-Acción (I-A). Los participantes serán los cuidadores principales tras el fallecimiento del paciente en cuidados paliativos domiciliarios del Área Sanitaria de Ferrol.[Resumo] Obxectivo: coñecer as experiencias dos coidadores principais de pacientes termináis que recibiron coidados paliativos a domicilio por parte de HADO. Metodoloxía: estudo cualitativo fundamentado nos supostos da teoría crítica. Empregarase una estratexia de Investigación-Acción (I-A). Os participantes serán os coidadores principais tralo falecemento do paciente en cuidados paliativos domiciliarios da Área Sanitaria de Ferrol.[Abstract] Objective: to know the experiences of the main caregivers of terminally ill patients who have received home-based palliative care. Methodology: qualitative study based on the assumptions of critical theory. An Research-Action strategy (R-A) will be used. The participants will be the main caregivers after the death of the patient in home palliative care in Ferrol.Traballo fin de mestrado (UDC.FCS). Asistencia e investigación sanitaria. Especialidade en investigación clínica. Curso 2018/2019

El fraude en ciencia perjudica seriamente a la salud (y a la propia ciencia)

Artículo de divulgación publicado en The Conversation España el día 24/01/2023.El fraude en ciencia no es nuevo. Sin embargo, en lugar de disminuir, hay evidencias de que está aumentando. Sus consecuencias pueden ser nefastas.N

Does retraction after misconduct have an impact on citations? A pre–post study

Background: Retracted articles continue to be cited after retraction, and this could have consequences for the scientific community and general population alike. This study was conducted to analyse the association of retraction on citations received by retracted papers due to misconduct using two-time frames: during a postretraction period equivalent to the time the article had been in print before retraction; and during the total postretraction period. Methods: Quasiexperimental, pre-post evaluation study. A total of 304 retracted original articles and literature reviews indexed in MEDLINE fulfilled the inclusion criteria. Articles were required to have been published in a journal indexed in MEDLINE from January 2013 through December 2015 and been retracted between January 2014 and December 2016. The main outcome was the number of citations received before and after retraction. Results were broken down by journal quartile according to impact factor and the most cited papers during the preretraction period were specifically analysed. Results: There was an increase in postretraction citations when compared with citations received preretraction. There were some exceptions however: first, citations received by articles published in first-quartile journals decreased immediately after retraction (p<0.05), only to increase again after some time had elapsed; and second, postretraction citations decreased significantly in the case of articles that had received many citations before their retraction (p<0.05). Conclusions: The results indicate that retraction of articles has no association on citations in the long term, since the retracted articles continue to be cited, thus circumventing their retraction

Retracted papers originating from paper mills: cross sectional study

OBJECTIVES To describe retracted papers originating from paper mills, including their characteristics, visibility, and impact over time, and the journals in which they were published. DESIGN Cross sectional study. SETTING The Retraction Watch database was used for identification of retracted papers from paper mills, Web of Science was used for the total number of published papers, and data from Journal Citation Reports were collected to show characteristics of journals. PARTICIPANTS All paper mill papers retracted from 1 January 2004 to 26 June 2022 were included in the study. Papers bearing an expression of concern were excluded. MAIN OUTCOME MEASURES Descriptive statistics were used to characterise the sample and analyse the trend of retracted paper mill papers over time, and to analyse their impact and visibility by reference to the number of citations received. RESULTS 1182 retracted paper mill papers were identified. The publication of the first paper mill paper was in 2004 and the first retraction was in 2016; by 2021, paper mill retractions accounted for 772 (21.8%) of the 3544 total retractions. Overall, retracted paper mill papers were mostly published in journals of the second highest Journal Citation Reports quartile for impact factor (n=529 (44.8%)) and listed four to six authors (n=602 (50.9%)). Of the 1182 papers, almost all listed authors of 1143 (96.8%) paper mill retractions came from Chinese institutions and 909 (76.9%) listed a hospital as a primary affiliation. 15 journals accounted for 812 (68.7%) of 1182 paper mill retractions, with one journal accounting for 166 (14.0%). Nearly all (n=1083, 93.8%) paper mill retractions had received at least one citation since publication, with a median of 11 (interquartile range 5-22) citations received. CONCLUSIONS Papers retracted originating from paper mills are increasing in frequency, posing a problem for the research community. Retracted paper mill papers most commonly originated from China and were published in a small number of journals. Nevertheless, detected paper mill papers might be substantially different from those that are not detected. New mechanisms are needed to identify and avoid this relatively new type of misconduct

The Research Integrity Office in Spain. A pending issue

En los últimos años han salido a la luz muchos casos de mala conducta científica, algunos con importantes consecuencias, que han evidenciado las brechas que globalmente existen en cuanto a integridad científica. En España también se han dado casos notables de mala conducta científica en el ámbito de la investigación biomédica. Sin embargo, hasta el momento no se ha creado un organismo encargado de supervisar las fases de ejecución, análisis y publicación de las investigaciones biomédicas desde un punto de vista ético. Por lo tanto, en este contexto, consideramos que es necesaria la creación de una oficina que supervise la integridad científica en España y que actúe en caso de sospecha de mala conducta científica, llevando a cabo una investigación independiente y con capacidad sancionadora. La existencia de dicho organismo sería de especial importancia en el caso de las investigaciones financiadas con fondos públicos, ya que en ese caso el fraude en investigación supondría la malversación de dinero público. La creación de una oficina que realmente actúe frente a los casos detectados podría tener un efecto disuasorio sobre una potencial mala conducta de algunos investigadores, previniendo así situaciones de mala conducta científica.In recent years, many cases of scientific misconduct have come to light, some with considerable consequences, highlighting the existing breaches in the scientific integrity globally. In Spain, there have also been high-profile cases of scientific misconduct. However, so far, no organism or agency has been created to monitor the execution, analysis and publication phases of biomedical research from an ethical point of view. Therefore, in this context, we consider that there is a need for the creation of an office which supervises research integrity in Spain which would act in cases of suspected scientific misconduct, carrying out an independent investigation and proposing public sanctions. The existence of such an organism would be of particular importance in the case of publicly funded research, since in that case research fraud would involve the misappropriation of public funds. The creation of an office that would act on detected cases could have a deterrent effect on potential misconduct by some researchers, thus preventing cases of scientific misconduct.Este trabajo forma parte de la tesis doctoral de Cristina Candal-Pedreira, que ha recibido una beca PFIS (número de referencia FI21/00149) del Instituto de Salud Carlos III (ISCIII)

Estimations of smoking-attributable mortality in Spain at a regional level: comparison of two methods

Purpose: To estimate and discuss smoking-attributable mortality (SAM) for the 17 regions in Spain among the population aged ≥35 years in 2017, using two methods. Methods: A descriptive analysis of SAM was conducted using two methods, the prevalence-independent method (PIM) and the prevalence-dependent method (PDM). Observed mortality was obtained from the National Institute of Statistics; smoking prevalence from three National Health Surveys; lung cancer mortality rates from the Cancer Prevention Study-II; and relative risks from five US cohorts. SAM and percentages of change were estimated for each region overall, by sex, age and cause of death. Results: In 2017, tobacco caused 56,203 deaths in Spain applying the PIM. Using the PDM the number of deaths was 4.4% (95% CI: 3.4-5.5) lower (53,825 deaths). Except in four regions, the PIM estimated a higher overall SAM and the maximum percentage of change was 18.6%. Overall percentages of change were higher for women (15.7% 95% CI: 12.6-19.0) and for cardiovascular diseases-diabetes mellitus (13.8%; 95% CI: 11.5-16.2). Conclusions: At the national level, both methods estimate similar figures for SAM. However, the difference in estimates appears at the subnational level. Differences were higher in subgroups with lower smoking prevalence and for causes of death with periods of induction shorter than those for lung cancer.This paper forms part of the research conducting to the PhD degree of Julia Rey-Brandariz, who has received a FPU fellowship (reference number FPU20/00926), from the Ministry of Universities of Spain. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project “PI19/00288″ and co-funded by the European Union.S

Maternal smoking in pregnancy and blood pressure during childhood and adolescence: a meta-analysis

rterial hypertension during childhood or adolescence is rising, and smoking during pregnancy may constitute a modifiable risk factor. This study aims to evaluate the effect of maternal smoking during pregnancy on diastolic (DBP) and systolic blood pressure (SBP) in childhood and adolescence. A bibliographic search was conducted in PubMed, Embase, and CENTRAL databases in March 2022. Meta-analysis was performed with the difference in mean-adjusted SBP/DBP of children and adolescents aged 3–17 years, according to maternal smoking/non-smoking in pregnancy. A random effects model was applied; a leave-one-out analysis and meta-analysis by subgroups were performed. A modified Newcastle–Ottawa scale was used to assess the quality of the studies. Evidence levels were rated using the GRADE system. Fifteen studies were included in the meta-analysis; all of them evaluated the mean-adjusted SBP difference in children or adolescents (N = 73,448), and 6 also that of DBP (N = 31,459). Results showed that maternal smoking during pregnancy significantly increased SBP (β = 0.31 mmHg 95% CI 0.14–0.49). A greater increase in mean-adjusted SBP was observed in those studies that completed the recruitment before 1990, were conducted in non-European countries, used standard mercury or manual sphygmomanometry, adjusted for birth weight, and were in the lowest quality subgroup. No significant association was found for DBP. The GRADE level of evidence was low for SBP and very low for DBP. Conclusion: Smoking in pregnancy might increase SBP in childhood and adolescence. Due to the low level of evidence, solid inferences cannot be drawn about the clinical relevance of these findings.S

Home-based blood transfusion therapy: a systematic review

Home care is a healthcare alternative to hospitalisation. Different types of procedures are performed at home care services, such as home transfusion of blood products. However, home blood transfusion is not fully implemented and there is a great lack of knowledge about it. The aims of this study were thus to assess the safety and effectiveness of home blood transfusions and patient acceptance and satisfaction. A systematic literature review was conducted in the main biomedical databases. We included all studies that covered patients who had received a home blood transfusion, regardless of their baseline diagnosis. The literature search yielded 290 studies, 14 of which were included in this study as they met the predefined criteria. The main patient profile of a home-transfusion recipient was a person with anaemia associated with other diseases. Overall incidence of severe adverse events was 0.05%. No studies evaluated the effectiveness of home versus hospital transfusions. One study showed that 51% of patients would be willing to receive home transfusions. Home blood transfusion appears to be a feasible, safe, and well-accepted procedure. Existing studies are of low quality, however, and this is an important limitation when it comes to drawing definitive benefit–risk conclusionsS

Four Decades of COPD Mortality Trends: Analysis of Trends and Multiple Causes of Death

There is little information on chronic obstructive pulmonary disease (COPD) mortality trends, age of death, or male:female ratio. This study therefore sought to analyze time trends in mortality with COPD recorded as the underlying cause of death from 1980 through 2017, and with COPD recorded other than as the underlying cause of death. We conducted an analysis of COPD deaths in Galicia (Spain) from 1980 through 2017, including those in which COPD was recorded other than as the underlying cause of death from 2015 through 2017. We calculated the crude and standardized rates, and analyzed mortality trends using joinpoint regression models. There were 43,234 COPD deaths, with a male:female ratio of 2.4. Median age of death was 82 years. A change point in the mortality trend was detected in 1996 with a significant decrease across the sexes, reflected by an annual percentage change of −3.8%. Taking deaths into account in which COPD participated or contributed without being the underlying cause led to an overall 42% increase in the mortality burden. The most frequent causes of death when COPD was not considered to be the underlying cause were bronchopulmonary neoplasms and cardiovascular diseases. COPD mortality has decreased steadily across the sexes in Galicia since 1996, and age of death has also gradually increased. Multiple-cause death analysis may help prevent the underestimation of COPD mortalityS

Clinical characteristics of chronic obstructive pulmonary disease in never-smokers: A systematic review

Introduction Chronic Obstructive Pulmonary Disease (COPD) is the third cause of death worldwide. While tobacco smoking is a key risk factor, COPD also occurs in never-smokers (NS). However, available evidence on risk factors, clinical characteristics, and natural history of the disease in NS is scarce. Here, we perform a systematic review of the literature to better describe the characteristics of COPD in NS. Methods We searched different databases following the PRISMA guidelines with explicit inclusion and exclusion criteria. A purpose-designed quality scale was applied to the studies included in the analysis. It was not possible to pool the results due to the high heterogeneity of the studies included. Results A total of 17 studies that met the selection criteria were included, albeit only 2 of them studied NS exclusively. The total number of participants in these studies were 57,146 subjects, 25,047 of whom were NS and 2,655 of the latter had NS-COPD. Compared to COPD in smokers, COPD in NS is more frequent in women and older ages, and is associated with a slightly higher prevalence of comorbidities. There are not enough studies to understand if COPD progression and clinical symptoms in NS are different to that of ever-smokers. Conclusions There is a significant knowledge gap on COPD in NS. Given that COPD in NS account for about a third of all COPD patients in the world, particularly in low-middle income countries, and the decrease in tobacco consumption in high income countries, understanding COPD in NS constitutes a public-health priorityThis work was supported by the Instituto de Salud Carlos III (ISCIII)/PI20/00476/Cofinanciado Unión Europea (UE-FEDER) and Grupo de referencia competitiva Xunta de GaliciaS