Associations of serum phthalate metabolites with thyroid hormones in GraMo cohort, Southern Spain

These results would not have been achieved without the selfless collaboration of the staff from Santa Ana and San Cecilio Hospitals and the participants who took part in the study. Dr. JP Arrebola is under contract within the Ramon y Cajal Program (RYC-2016-20155, Ministerio de Economia, Industria y Competitividad, Spain) and Dr. C Donat-Vargas is under contract within the Atraccion de Talento (from the community of Madrid, Spain) . This study was supported by research grants from Instituto de Salud Carlos III (PI20/01568, PI16/01858) .The general population is continuously exposed to phthalates via various consumer products. Epidemiological research relating phthalate exposure to thyroid function during non-developmental periods is limited. This study aimed to investigate the associations between specific serum phthalate metabolites and indicators of thyroid function in adults. We measured 10 serum phthalate metabolites and thyroid hormones - total triiodothymnine (TT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) - in a subsample of 207 adults from the GraMo cohort. This subsample was made up of men and women (in equal proportions) of middle age (49 +/- 17 years) and from Southern Spain (province of Granada). Data on age, sex, body mass index, residence area, tobacco use, alcohol consumption and attained education were obtained from a questionnaire. Phthalate metabolites were log-transformed and categorized into tertiles. Cross-sectional associations of each metabolite with thyroid hormones were analyzed using multivariable-adjusted linear regression models. The mixture effect of metabolite phthalates was assessed using weighted quantile sum regression. After multivariable-adjustment, the following phthalate metabolites were significantly associated with TT3 in a dose-response manner: MMP (beta = 0.90: 95% confidence interval 0.68,1.12), MEP (beta = 0.67: 0.44, 0.90), MiBP (beta = 0.49: 0.21, 0.77), MiDP (beta = 0.27: 0.03, 0.52), MBzP (beta = 0.51: 0.28, 0.73), MEHP (beta = -0.59: -0.82, -0.35) and MiNP (beta = -0.43: -0.71, -0.14), when comparing highest vs. lowest exposed. The sum of all metabolites was also linked to FT4 levels. No significant associations were observed for TSH except for MiNP. Although phthalate metabolites with different molecular weight showed opposite associations, overall metabolite concentrations seem to associate with increased TT3 and FT4 serum levels. The cross-sectional nature of this analysis limits causal inference.Ramon y Cajal Program (Ministerio de Economia, Industria y Competitividad, Spain) RYC-2016-20155Instituto de Salud Carlos III European Commission PI20/01568 PI16/0185

Factors Associated with Exposure to Dietary Bisphenols in Adolescents

Obesogenic endocrine-disrupting chemicals, such as bisphenol A (BPA) and its analogue bisphenol S (BPS), seem to play an important role in the development of obesity, although contradictory results have been reported. The aim of the present study was to conduct a gender analysis of the factors associated with exposure to dietary bisphenols in 585 Spanish adolescents. Dietary BPA and BPS exposure was assessed using a food frequency questionnaire. Foods and macronutrients accounting for more than 95% of energy intake were selected for analysis. Stepwise regression was used to estimate the foods that most contributed to dietary bisphenol exposure in the sample. Gender-related factors associated with greater dietary bisphenol exposure were evaluated using multivariate logistic regression models. Canned tuna was the main dietary source of BPA and BPS in both adolescent boys and girls. Overweight/obese girls showed a higher risk of high dietary exposure to BPA (odds ratio (OR): 3.38, 95% confidence interval (CI): 1.25–9.07) and total bisphenols (OR: 2.81, 95% CI: 1.03–7.67) in comparison with girls with a BMI lower than 25 kg/m2 . Present results indicate a positive association of dietary exposure to both total bisphenols and BPA with being overweight/obese in adolescent girls.GP/EFSA/ENCO/380 2018/03/G04: OBEMIRISK: Knowledge platform for assessing the risk of bisphenol on gut microbiota and its role in obesogenic phenotypes: looking for biomarkers’ frameworkPlan Estatal de I + D + I 2013–2016FEDER-ISCIII PI17/01758FEDER-Consejería de Salud y FamiliasJunta de Andalucía PE-0250–2019FEDER-Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades/ Proyecto P18-RT-4247Fundación Mapfre MAPFRE201

Dietary exposure to parabens and body mass index in an adolescent Spanish population

This work was carried out in line with 'GP/EFSA/ENCO/380 2018/03/G04: OBEMIRISK: Knowledge platform for assessing the risk of Bisphenols on gut microbiota and its role in obesogenic phenotype: looking for biomarkers'. This research was also funded by Plan Estatal de I + D + I 2013-2016 and co-funded by FEDER-ISCIII PI17/01758, FEDER-Consejeria de Salud y Familias, Junta de Andalucia PE-0250-2019, FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades/Proyecto P18-RT-4247. All individuals participating in this research signed an informed consent form and the study protocol was approved by the Ethics Com-mittee of the University of Granada.Parabens are alkyl esters of p-hydroxybenzoic acid which are extensively used in cosmetics, pharmaceuticals and foodstuffs due to their antimicrobial properties. The most commonly used parabens are methyl-(MeP), ethyl- (EtP), propyl-(PrP) and butyl-(BuP) paraben. Most human exposure to parabens is achieved through the consumption of food or pharmaceutical products and the use of personal care products. However, studies on dietary parabens exposure and the associated factors are very scarce. The main aim of the present study was to explore factors associated with dietary exposure to parabens in Spanish adolescents according to gender. Dietary data and anthropometric measures were collected from 585 adolescents (53.4% boys) aged 12–16 years. Parabens exposure through diet was assessed using a food frequency questionnaire with food products providing more than 95% of energy and macronutrient intake being included in analysis. Stepwise regression was used to identify the foods that most contributed to parabens intake. Logistic regression was used to evaluate factors predicting higher dietary exposure to parabens. The main contributors to dietary MeP, EtP, PrP and BuP exposure in adolescent boys were eggs (41.9%), canned tuna (46.4%), bakery and baked goods products (57.3%) and pineapple (61.1%). In adolescent girls, the main contributors were apples and pears (35.3%), canned tuna (42.1%), bakery and baked goods products (55.1%) and olives (62.1%). Overweight/obese girls were more likely to belong to the highest tertile of overall parabens intake (odds ratio [OR]: 3.32; 95% confidence interval [95% CI]: 1.21–9.15) and MeP (OR: 3.05; 95% CI: 1.14–8.12) than those with a body mass index lower than 25 kg/m2. These findings suggest a positive association between dietary exposure to parabens and overweight/obesity in adolescent girls.Plan Estatal de I + D + I 2013-2016FEDER-ISCIII PI17/01758FEDER-Consejeria de Salud y FamiliasJunta de Andalucia PE-0250-2019FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades/Proyecto P18-RT-424

Responsabilidad Social Empresarial en el sector financiero del Ecuador durante el período 2016 - 2019

Corporate social responsibility, an agent of change for the growth and development of the environment and a new form of business action that seeks the well-being of stakeholders, contributing to sustainability. In recent years, corporate social responsibility has become a global trend where companies, through the application of tools and instruments appropriate to their needs, in such a way that their actions carried out with transparency and efficiency have responded to the challenges and opportunities that the organization faced. Consequently, looking at corporate social responsibility from a different perspective, from the perspective of financial institutions takes on significant importance. The article shows a descriptive-correlational research, whose objective was to determine the relationship between corporate social responsibility and business profitability on certain Ecuadorian financial institutions, member companies of the Ecuadorian Consortium for Social Responsibility in the period 2016-2019 by reviewing academic literature, sustainability reports and hypothesis testing (one-factor analysis of variance). Analyzing the results, it was evidenced that corporate social responsibility does not have a major impact on the economic performance of the institutions under study, despite the commitment and socially responsible management of the institutions.La responsabilidad social empresarial, es un agente de cambio para el crecimiento y desarrollo del entorno y una nueva forma de actuación empresarial que busca el bienestar de los grupos de interés contribuyendo a la sostenibilidad. Durante los últimos años la responsabilidad social empresarial se ha convertido en una tendencia global donde las empresas a través de la aplicación de herramientas e instrumentos apropiados a sus necesidades han llevado a cabo acciones con transparencia y eficiencia respondiendo a los retos y oportunidades que se le presenten a la organización. Consecuentemente mirar a la responsabilidad social empresarial desde una perspectiva diferente, desde la óptica de las instituciones financieras cobra una importancia significativa. El artículo muestra una investigación descriptiva-correlacional, cuyo objetivo fue determinar la relación entre la responsabilidad social empresarial y la rentabilidad empresarial sobre determinadas instituciones financieras ecuatorianas, empresas miembros del Consorcio Ecuatoriano para la Responsabilidad Social en el período 2016-2019 mediante la revisión de literatura académica, memorias de sostenibilidad y prueba de hipótesis (Análisis de varianza de un factor). Analizando los resultados, se evidenció que la responsabilidad social empresarial no tiene mayor impacto sobre los rendimientos económicos de las instituciones objeto de estudio, pese al compromiso y gestión socialmente responsable de las instituciones

Capsule Switching among C:2b:P1.2,5 Meningococcal Epidemic Strains after Mass Immunization Campaign, Spain

A mass immunization campaign for 18-month to 19-year-olds was undertaken in Spain in 1996–1997 because of an epidemic of serogroup C meningococcal disease associated with a C:2b:P1.2,5 strain belonging to the A4 lineage. Surveillance for the “capsule-switching” phenomenon producing B:2b:P1.2,5 isolates was undertaken. Of 2,975 meningococci characterized, B:2b:P1.2,5 and B:2b:P1.2 antigenic combinations were found in 18 isolates; 15 meningococci were defined as serogroup B belonging to the A4 lineage

Public healthcare costs associated with long-term exposure to mixtures of persistent organic pollutants in two areas of Southern Spain: A longitudinal analysis

Background: Polychlorinated biphenyls and organochlorine pesticides are persistent organic pollutants (POPs) that had been banned or restricted in many countries, including Spain. However, their ubiquity still poses environmental and human health threats. Objective: To longitudinally explore public healthcare costs associated with long-term exposure to a mixture of 8 POPs in a cohort of residents of two areas of Granada Province, Southern Spain. Methods: Longitudinal study in a subsample (n = 385) of GraMo adult cohort. Exposure assessment was performed by analyzing adipose tissue POP concentrations at recruitment. Average primary care (APC) and average hospital care (AHC) expenditures of each participant over 14 years were estimated using the data from their medical records. Data analyses were performed by robust MM regression, weighted quantile sum regression (WQS) and G-computation analysis. Results: In the adjusted robust MM models for APC, most POPs showed positive beta coefficients, being Hexachlorobenzene (HCB) significantly associated (beta 1.87; 95% Confidence interval (95%CI): 0.17, 3.57). The magnitude of this association increased (beta: 3.72; 95%CI: 0.80, 6.64) when the analyses were restricted to semirural residents, where p-HCH was also marginally-significantly associated to APC (beta: 3.40; 95%CI: -0.10, 6.90). WQS revealed a positive but non-significant mixture association with APC (beta: 0.14; 95%CI: -0.06, 0.34), mainly accounted for by p-HCH (54%) and HCB (43%), that was borderline-significant in the semi-rural residents (beta: 0.23; 95%CI: -0.01, 0.48). No significant results were observed in G-Computation analyses. Conclusion: Long-term exposure to POP mixtures might represent a modifiable factor increasing healthcare costs, thus affecting the efficiency of the healthcare systems. However, and owing the complexity of the potential causal pathways and the limitations of the present study, further research is warranted to fully elucidate ascertain whether interventions to reduce human exposure should be considered in healthcare policies.CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III, Spain PI16/01858 PI18/01573 PI20/01568European CommissionRamon y Cajal Program (Ministerio de Economia, Industria y Competitividad, Spain) RYC-2016-20,155PFIS (Instituto de Salud Carlos III, Spain) FI17/00310Universidad de Granada/CBU

GuíaSalud, el organismo del Sistema Nacional de Salud para impulsar la práctica basada en la evidencia

VIII Congreso Iberoamericano de Nutrición. ¿Nutrición basada en la videncia o en la evidencia

Informe de la salud visual y ocular de los países que conforman la Red Epidemiológica Iberoamericana para la Salud Visual y Ocular (REISVO), 2009 y 2010

A pesar de que se han hecho importantes progresos en el cuidado de la salud ocular, la prevalencia de la ceguera evitable sigue siendo inaceptablemente alta en muchos países y comunidades (OMS, 2009). La salud visual es un tema de la agenda política en algunos países; sin embargo, aún no se cuenta con un sistema de información que permita identificar la situación de morbilidad en salud visual en Iberoamérica, para poder priorizar y planificar la orientación de los servicios de atención en optometría y oftalmología. Para que existan planes de salud, deben establecerse líneas de base a través de un diagnóstico epidemiológico y de necesidades de la población; por esta razón, REISVO ha desarrollado, en esta primera fase, una descripción retrospectiva de la frecuencia y distribución de las alteraciones visuales y oculares, para lo cual ha tenido en cuenta que los errores refractivos son la segunda causa de ceguera prevenible y la primera de las deficiencias visuales.Facultad de Ciencias Exacta

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat