Perspectiva de las matronas sobre la atención en salud sexual y reproductiva a mujeres migrantes en España: estudio fenomenológico

Treball Final de Màster Universitari en Traducció Medicosanitària. Codi: SBA032. Curs: 2021/2022La globalización y la intensificación de las corrientes migratorias ha propiciado que vivamos en sociedades multilingües y multiculturales. En España, las mujeres migrantes, por amplio y diverso que sea este colectivo, son una población especialmente vulnerable, con problemas específicos relacionados con la salud sexual y reproductiva (SSR). Beneficiarse de los cuidados sanitarios en materia de SSR se ha asociado con una mejor nutrición, salud mental, el progreso en resultados sociales y económicos, así como con beneficios clínicos como tasas reducidas de infecciones de transmisión sexual (ITS) y embarazos no planificados. Sin embargo, las mujeres migrantes presentan una menor tasa de acceso, uso y permanencia en los servicios de SSR. El presente trabajo de investigación busca explorar la perspectiva de las matronas de Cantabria, País Vasco y La Rioja sobre las barreras y facilitadores que encuentran las mujeres migrantes para recibir una atención a la SSR equitativa y de calidad. Para ello, se han llevado a cabo 10 entrevistas en profundidad siguiendo la metodología fenomenológica hermenéutica. Como resultado se encontraron tres tipos de barreras: (i)lingüísticas, que causan la pérdida de información en el intercambio comunicativo entre las sanitarias y las mujeres; (ii) culturales, que ocasionan desencuentros entre las costumbres y expectativas de cuidados entre las comunidades de origen y acogida; (iii) organizativas, que evidencian las carencias de los sistemas de salud públicos para adaptarse a las necesidades diversas de profesionales sanitarios y pacientes. Asimismo, se exploraron y propusieron (iv) facilitadores para paliar las barreras identificadas anteriormente.Globalisation and the intensification of migratory flows have led us to live in multilingual and multicultural societies. In Spain, migrant women, as large and diverse as this group is, are a particularly vulnerable population, with specific problems related to sexual and reproductive health (SRH). Benefiting from SRH care has been associated with better nutrition, mental health, improved social and economic outcomes, as well as clinical benefits such as reduced rates of sexually transmitted infections (STIs) and unplanned pregnancies. However, migrant women have lower rates of access, use and stay in SRH services. This research aims to explore the perspective of midwives in Cantabria, the Basque Country and La Rioja on the barriers and facilitators that migrant women face in receiving equitable and quality SRH care. To this end, 10 in-depth interviews were carried out following the hermeneutic phenomenological methodology. As a result, three types of barriers were found: (i) linguistic, which cause the loss of information in the communicative exchange between health professionals and women; (ii) cultural, which provoke discrepancies regarding the customs and expectations of care between the communities of origin and host communities; (iii) organisational, which show the shortcomings of public health systems in adapting to the diverse needs of health professionals and patients. In addition, (iv) facilitators were explored and proposed to alleviate the barriers identified above

Prevención y comparación de infección por el virus de la gripe en la planta de neumología

Con el siguiente Plan de Mejora, queremos conocer la prevalencia de la gripe en la Unidad de Neumología del Hospital Universitario de Burgos y comparar las cifras de gripe en España durante dos años consecutivos. El principal objetivo de este proyecto, es identificar aquellos aspectos que faciliten la transmisión de la gripe debido a una mala actuación o por falta de información. Debido a esta situación, con este estudio queremos potenciar las medidas preventivas de contagio del virus y conseguir una menor incidencia de infecciones.With the following improvement plan, we want to learn about the prevalence of the influenza at the Pneumology Unit in the University Hospital of Burgos and compare the flu figures in Spain for two consecutive years. The main aim of this project, is to identify those aspects that facilitate flu transmission due to a bad action or lack of information. Because of this situation, with this research we would like to increase the preventive measures against the virus spread and achieve a lower incidence of infections

Language and Cultural Barriers and Facilitators of Sexual and Reproductive Health Care for Migrant Women in High-Income European Countries: An Integrative Review

Introduction: Dealing with intercultural communicative barriers in European countries' national health services is an increasing and necessary challenge to guarantee migrant women's right to health care. This integrative review describes the communication barriers and facilitators that migrant women encounter to access and use sexual and reproductive health (SRH) services in Europe. Methods: A literature search was performed to identify original studies in PubMed, CINAHL, PsycINFO, Web of Science, and Scopus, using keywords associated with migrant women and SRH services. This was supplemented by scanning the reference lists from relevant studies and similar reviews. Studies exploring the perspective of migrant women about communication barriers and facilitators to the access and use of SRH services were included, whereas those that solely explored health professional's experiences were excluded. Findings were organized into 4 themes: (1) verbal-linguistic barriers, (2) nonverbal language barriers, (3) cultural barriers, and (4) communication facilitators. Results: Nineteen studies met the inclusion criteria. Results showed that when women had problems understanding or being understood by health professionals, they experienced feelings of anxiety, fear, insecurity, and discrimination that discouraged them from using SRH services. The most requested facilitators by women were health education, access to professional interpreters and translation of written information, and increasing the practitioners' cultural competence. Discussion: Communication barriers undermine migrant women's right to benefit from preventive SRH programs and to make informed decisions concerning their health. It is necessary to establish tailored plans in each health care center to improve intercultural communication that integrate facilitators proposed by women. Future research should provide solid evidence on the effectiveness of each facilitator implemented

Prevalence and Genetic Characteristics of Staphylococcus aureus CC398 Isolates From Invasive Infections in Spanish Hospitals, Focusing on the Livestock-Independent CC398-MSSA Clade

Background: Livestock-associated (LA)-CC398-MRSA is closely related to pigs, being unfrequently detected in human invasive infections. CC398-MSSA is emerging in human invasive infections in some countries, but genetic and epidemiological characteristics are still scarcely reported. Objectives: To determine the prevalence of Staphylococcus aureus (SA) CC398, both MRSA and MSSA, among blood cultures SA isolates recovered in Spanish hospitals located in regions with different pig-farming densities (PD) and characterize the recovered isolates. Methods: One thousand twenty-two SA isolates (761 MSSA, 261 MRSA) recovered from blood cultures during 6–12 months in 17 Spanish hospitals (2018–2019) were studied. CC398 lineage identification, detection of spa-types, and antibiotic resistance, virulence and human immune evasion cluster (IEC) genes were analyzed by PCR/sequencing. Results: Forty-four CC398-MSSA isolates (4.3% of SA; 5.8% of MSSA) and 10 CC398-MRSA isolates (1% of SA; 3.8% of MRSA) were detected. Eleven spa-types were found among the CC398-MSSA isolates with t571 and t1451 the most frequent spa-types detected (75%). Most of CC398-MSSA isolates were Immune-Evasion-Cluster (IEC)-positive (88.6%), tetracycline-susceptible (95.5%) and erythromycin/clindamycin–inducible-resistant/erm(T)-positive (75%). No statistical significance was detected when the CC398-MSSA/MSSA rate was correlated to PD (pigs/km2) (p = 0.108). On the contrary, CC398-MRSA isolates were all IEC-negative, predominately spa-t011 (70%), and the CC398-MRSA/MRSA rate was significantly associated to PD (p < 0.005). Conclusion: CC398-MSSA is an emerging clade in invasive infections in Spanish hospitals. CC398-MRSA (mostly t011) and CC398-MSSA (mostly t571 and t1451) show important differences, possibly suggesting divergent steps in host-adaptation evolutionary processes. While CC398-MRSA is livestock-associated (lacking IEC-system), CC398-MSSA seems to be mostly livestock-independent, carrying human-adaptation markers.Agencia Estatal de Investigación (AEI) (project SAF2016-76571- R) and by the Fondo Europeo de Desarrollo Regional (FEDER

Biostimulants as an Alternative to Improve the Wine Quality from Vitis vinifera (cv. Tempranillo) in La Rioja

The application of biostimulants appears to be an environmentally friendly, innovative, and sustainable agronomical tool to mitigate the negative effects induced by adverse climatology in traditional grape-growing regions such as La Rioja (Spain). However, their mechanism of action in grapevines is still unclear. We evaluated how commercial substances (two from Ascophyllum nodosum extraction and one amino acids-based biostimulant) and the non-proteinogenic amino acid β-aminobutyric acid (BABA) affect the quality and quantity of musts and grapes in Vitis vinifera L. cv. Tempranillo from a semi-arid region of La Rioja during two seasons. We hypothesized an enhancement in organic metabolites in berries and leaves in response to these treatments, changing the organoleptic characteristics of the final products. The treatments altered the primary metabolites such as carbohydrates, organic acids (AcOrg), and free amino acids, first in the leaves as the effect of the foliar application and second in grapes and musts. As the main result, the biostimulant efficiency depended on the climatology and vineyard location to improve the final yield. Whereas biostimulant application enhanced the yield in 2018 (less dry year), it did not help production in 2019 (dry year). BABA was the most efficient biostimulant, enhancing plant production. Regarding yield quality, the biostimulant application improved the musts mainly by enhancing the fumaric acid content and by reducing carbohydrates, except in BABA-treated plants, where they were accumulated. These results corroborate biostimulants as an exciting approach in wine production, especially for improving wine quality.This work was funded by the ERDF project “Plants as a tool for sustainable global development” (no. CZ.02.1.01/0.0/0.0/16_019/0000827) within the program Research, Development and Education (OP RDE), and by the Basque Government, Research Groups of the Basque University System (project no. IT925-16)

¿Disminuye el Estrés Generado en la Sala de Disección la Formación sobre la Muerte y el Moribundo?

Positive effects on reducing students’ stress have been reported across numerous university settings when anatomy preparatory seminars have been provided. To date, this type of preparation for coping with cadaver dissection has not been studied in Spanish universities. The aim of this study is to evaluate how first-year Spanish medical students face the dissecting room and whether previous preparation about death and dying reduces the stress generated. We performed an interventional study with students who received preparatory classes before the dissection practices (Experimental Group, EG) and with students who did not (Control Group, CG). Sociodemographic data and a self-assessment on stress symptoms were collected through a questionnaire completed before and after the dissection practices. No differences were found in the self-report of symptoms of stress among students who consider themselves religious or not, or between students who had a family member in the healthcare environment or not. However, in the EG, the students who had ample experience with terminally ill patients or death reported fewer stress symptoms. Unexpectedly, the number of self- reported stress symptoms after the dissection practice was higher in EG students. In conclusion the stress levels of first-year Spanish medical students not only did not improve after receiving preparatory classes about death and dying and discussion groups, but it gets worse. We found a relationship between student stress measured and experience with terminally ill patients or death. Additional studies are needed to identify the most suitable preparation for Spanish medical students.Se han informado efectos positivos en la reducción del estrés en los estudiantes de numerosos entornos universitarios cuando se han impartido seminarios preparatorios de anatomía. Hasta la fecha, este tipo de preparación para hacer frente a la disección del cadáver no se ha estudiado en las universidades españolas. El objetivo de este estudio es evaluar cómo los estudiantes de medicina españoles de primer año se enfrentan a la sala de disección y si la preparación previa sobre la muerte y el moribundo reduce el estrés generado. Realizamos un estudio de intervención con estudiantes que recibieron clases preparatorias antes de las prácticas de disección (Grupo Experimental, GE) y con estudiantes que no las recibieron (Grupo de Control, GC). Se recogieron datos sociodemográficos y síntomas de estrés mediante un cuestionario de autoevaluación antes y después de las prácticas de disección. No se encontraron diferencias en los síntomas de estrés valorados, entre los estudiantes que se consideran religiosos y los que no, ni tampoco entre los estudiantes que tenían o no un familiar en el entorno sanitario. Sin embargo, en el GE, en los estudiantes que tenían una amplia experiencia con pacientes con enfermedades terminales o con la muerte se observaron menos sín- tomas de estrés. Inesperadamente, el número de síntomas de estrés recogidos después de la práctica de disección fue mayor en los estudiantes del GE. En conclusión, los niveles de estrés de los es- tudiantes españoles de medicina de primer año no solo no mejora- ron después de recibir las clases preparatorias sobre la muerte y el moribundo y establecer grupos de discusión, sino que empeoraron. Encontramos una relación entre la medición del estrés en los estudiantes y la experiencia con pacientes con enfermedades ter- minales o con la muerte. Se necesitan estudios adicionales para identificar la preparación más adecuada para los estudiantes de medicina españoles.Unidad Docente de Anatomía y EmbriologíaFac. de Óptica y OptometríaTRUEUniversidad Complutense de Madridpu

Hormones and bile acids as biomarkers for the characterization of animal management in prehistoric sheepfold caves: El Mirador case (Sierra de Atapuerca, Burgos, Spain

Early husbandry practices that include herd management and the use of livestock areas such as sheepfold caves can be analysed in the context of different disciplines (e.g. zooarchaeology, micromorphology, and archaeobotany). In this study, a new and standard method for the determination of bile acids and steroidal hormones that incorporates microwave extraction-liquid chromatography-mass spectrometry was used. This method has been applied successfully to analyse Neolithic fumier deposit facies from the El Mirador cave, a location that was used as a prehistoric sheepfold and is located in the Atapuerca range (Burgos, Spain). The results obtained demonstrated that the analysis of bile acids can be useful for the identification of remains of ruminant residues in the facies studied. In addition, the progesterone/deoxycholic acid ratio has been used as a possible biomarker to improve our understanding of flock management, including the separation of pregnant and nursing ewes from the rest of the herd to avoid the rejection of the lamb and keep them safe and healthy.The authors thank the technical and human support provided by the Alava Central Service of Analysis of SGIker (UPV/EHU, MINECO, GV/ EJ, ERDF, and ESF) and Paula Rivero for the elaboration of the graphical abstract. Patricia Martín is grateful for her postdoctoral fellowship to Juan de la Cierva Subprogramme (FJCI-2016-29045) with financial sponsorship from the Spanish Ministry of Economy, Industry, and Competitiveness and for her recent "Maria de Maeztu" excellenceaccreditation from the Spanish Minstry of Science and Innovation (CEX2019-000945-M), and to Ane Gorostizu-Orkaiztegi for her pre- doctoral fellowships to the University of the Basque Country. This work was funded by the Department of Industry, Innovation, Commerce, and Tourism of the Basque Government (SAI12/25 Project), the Spanish Ministry of Science, Innovation and University (PGC 2018-093925-B- C32 project) and by the Basque Government, Research Groups of the Basque University System (Project No. IT925-16)

Discovery and validation of an NMR-based metabolomic profile in urine as TB biomarker

Despite efforts to improve tuberculosis (TB) detection, limitations in access, quality and timeliness of diagnostic services in low- and middle-income countries are challenging for current TB diagnostics. This study aimed to identify and characterise a metabolic profile of TB in urine by high-field nuclear magnetic resonance (NMR) spectrometry and assess whether the TB metabolic profile is also detected by a low-field benchtop NMR spectrometer. We included 189 patients with tuberculosis, 42 patients with pneumococcal pneumonia, 61 individuals infected with latent tuberculosis and 40 uninfected individuals. We acquired the urine spectra from high and low-field NMR. We characterised a TB metabolic fingerprint from the Principal Component Analysis. We developed a classification model from the Partial Least Squares-Discriminant Analysis and evaluated its performance. We identified a metabolic fingerprint of 31 chemical shift regions assigned to eight metabolites (aminoadipic acid, citrate, creatine, creatinine, glucose, mannitol, phenylalanine, and hippurate). The model developed using low-field NMR urine spectra correctly classified 87.32%, 85.21% and 100% of the TB patients compared to pneumococcal pneumonia patients, LTBI and uninfected individuals, respectively. The model validation correctly classified 84.10% of the TB patients. We have identified and characterised a metabolic profile of TB in urine from a high-field NMR spectrometer and have also detected it using a low-field benchtop NMR spectrometer. The models developed from the metabolic profile of TB identified by both NMR technologies were able to discriminate TB patients from the rest of the study groups and the results were not influenced by anti-TB treatment or TB location. This provides a new approach in the search for possible biomarkers for the diagnosis of TB