Are we leaving someone behind? A critical discourse analysis on the understanding of public participation among people with experiences of participatory research

Participatory research (PR) is on the rise. In Spain, PR is scarce in the field of health, although there is an increasing interest in the matter. A comprehensive understanding of the meanings and practical implications of "public participation" is essential to promote participation in health research. The aim of the study is to explore the discursive positions on PR among individuals with experience in participatory processes in different areas and how this understanding translates into practice. We conducted a critical discourse analysis of 21 individuals with experience in PR and participatory processes (13 women, 8 men), mainly from the field of health and other areas of knowledge. Sixteen were Spanish and the rest were from the United Kingdom (3), United States (1), and Canada (1). Interviews were conducted in person or by telephone. The fieldwork was conducted between March 2019 and November 2019. The dominant discourses on public participation are situated along two axes situated on a continuum: the purpose of public participation and how power should be distributed in public participation processes. The first is instrumental public participation, which sees participatory research as a tool to improve research results and focuses on institutional interests and power-decision making is hold by researchers and institutions. The second, is transformative public participation, with a focus on social change and an equitable sharing of decision-making power between the public and researchers. All discursive positions stated that they do not carry out specific strategies to include the most socially disadvantaged individuals or groups. A shift in the scientific approach about knowledge, along with time and resources, are required to move towards a more balanced power distribution in the processes involving the public

Epidemiology of Occupationally-Caused carpal Tunnel Syndrome in the Province of Alicante, Spain 1996-2004

Fundamento: El síndrome del túnel carpiano es uno de los principales problemas de salud de los trabajadores que desarrollan tareas relacionadas con esfuerzos manuales intensos y movimientos repetitivos del miembro superior. Los objetivos del estudio son conocer su frecuencia de aparición en la provincia de Alicante, describir las características laborales de las personas afectadas, analizar el proceso seguido para el tratamiento y rehabilitación y mostrar la situación de los afectados en su reincorporación laboral. Métodos: Estudio descriptivo transversal. La población estudiada estuvo constituida por todos los trabajadores cuyo parte de enfermedad profesional se remitió al Gabinete de Seguridad e Higiene desde 1996 hasta 2004. Resultados: Se declararon 266 partes de enfermedad profesional por síndrome del túnel carpiano. La incidencia fue de 4,2 casos por cada 100.000 trabajadores. El 62,8% de los casos eran mujeres, de las cuales el 25% tenía menos de 30 años. La antigüedad media en la empresa era de 132,3 meses. Conclusiones: Los factores de riesgo más frecuentemente referidos son la realización de movimientos repetitivos y de actividades que requieren fuerza manual.Background: Carpal tunnel syndrome is one of the major health problems of workers who perform tasks entailing intense manual stress and repetitive movements of the upper limbs. The implementation of regulations and social changes, as well as the incorporation of women into the working world bring to bear the need of ascertaining whether any changes have taken place in the pattern of occurrence of this syndrome and in the factors conditioning the same. The objectives of this study are to know the frequency with which this syndrome occurs in the province of Alicante, to discover the work-related characteristics of those individuals affected thereby, to analyze the procedure followed for treatment and rehabilitation and to delve into the situation of those affected upon their return to work. Methods: Descriptive, cross-sectional study. The population studies was comprised of all those workers for whom an occupational disease report was remitted to the Safety and Health Commission within the 1996-2004 period. Results: A total of 266 reports of occupational disease due to carpal tunnel syndrome were filed. The incidence rate was 4.2 cases per 100,000 workers. A total of 62.8% of the cases were females, 25% of whom were under 30 years of age. The average length of employment at the company was 132.3 months. Conclusions: The risk factors most often mentioned are performing repetitive movements and activities requiring manual strength.Trabajo financiado parcialmente por la Escuela Valenciana de Estudios para la Salud (EVES). Expediente: PI003/2004

Epidemiological profile of occupational diseases in Alicante, 2002-2005

Artículos originales[ES] Objetivo: Describir el patrón epidemiológico de las enfermedades profesionales (EEPP) en la provincia de Alicante entre los años 2002-2005. Métodos: Estudio transversal. La fuente de información procede de los partes del registro de EEPP notificadas en Alicante. Las enfermedades incluidas han sido los trastornos musculoesqueléticos (TME) del miembro superior, dermatitis y asma. Como factores laborales y personales se han considerado la edad, el sexo, el puesto de trabajo, el tamaño de la empresa, y la antigüedad laboral. Se han estimado las tasas de incidencia utilizando los datos de población ocupada de la provincia, así como las razones de incidencia con los intervalos de confianza al 95% (IC 95%) para las distintas variables consideradas. Resultados: Se registraron 645 casos de EEPP, de éstas 607 corresponden a las patologías seleccionadas con una incidencia de 22,67 casos por 100.000 trabajadores. 525 son TME del miembro superior, 68 dermatitis y 14 de asma. Conclusiones: Los TME del miembro superior representan en la provincia de Alicante la principal EEPP declarada. Se observan diferencias entre los tres grupos de EEPP en Alicante entre 2002-2005, según sexo, edad, actividad económica de la empresa y antigüedad en el puesto de trabajo.[EN] Objective: Describe the epidemiological pattern of the occupational diseases in the province of Alicante between 2002-2005. Methods: Cross-sectional study. The source of information comes from the reports of the occupational diseases registration notified in Alicante 2002-2005. The diseases have been included upper limb musculoskeletal disorders (UL-MSD), dermatitis and asthma. As working and personal factors have been considered age, sex, occupation, firm size and length of employment. The incidence rates were estimated, using workers report of Alicante, and the reasons for incidence with the confidence intervals yours (CI 95%) for the different variables considered. Results: 645 cases of occupational diseases were recorded, of which 607 was for the selected pathologies with an incidence of 22.67 cases per 100,000 workers. 525 are of UL-MSD, 68 of Dermatitis and 14 of Asthma. Conclusions: The UL-MSD represents the main occupational diseases declared in Alicante. There are differences among three groups of occupational diseases between 2002-2005 in Alicante, according to sex, age, economical activity of company and the labour antiquity.N

The natural history of symptomatic COVID-19 during the first wave in Catalonia

The natural history of coronavirus disease 2019 (COVID-19) has yet to be fully described. Here, we use patient-level data from the Information System for Research in Primary Care (SIDIAP) to summarise COVID-19 outcomes in Catalonia, Spain. We included 5,586,521 individuals from the general population. Of these, 102,002 had an outpatient diagnosis of COVID-19, 16,901 were hospitalised with COVID-19, and 5273 died after either being diagnosed or hospitalised with COVID-19 between 1st March and 6th May 2020. Older age, being male, and having comorbidities were all generally associated with worse outcomes. These findings demonstrate the continued need to protect those at high risk of poor outcomes, particularly older people, from COVID-19 and provide appropriate care for those who develop symptomatic disease. While risks of hospitalisation and death were lower for younger populations, there is a need to limit their role in community transmission

“The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis”

Persistent symptoms following the acute phase of COVID-19 present a major burden to both the affected and the wider community. We conducted a cohort study including over 856,840 first COVID-19 cases, 72,422 re-infections and more than 3.1 million first negative-test controls from primary care electronic health records from Spain and the UK (Sept 2020 to Jan 2022 (UK)/March 2022 (Spain)). We characterised post-acute COVID-19 symptoms and identified key symptoms associated with persistent disease. We estimated incidence rates of persisting symptoms in the general population and among COVID-19 patients over time. Subsequently, we investigated which WHO-listed symptoms were particularly differential by comparing their frequency in COVID-19 cases vs. matched test-negative controls. Lastly, we compared persistent symptoms after first infections vs. reinfections.Our study shows that the proportion of COVID-19 cases affected by persistent post-acute COVID-19 symptoms declined over the study period. Risk for altered smell/taste was consistently higher in patients with COVID-19 vs test-negative controls. Persistent symptoms were more common after reinfection than following a first infection. More research is needed into the definition of long COVID, and the effect of interventions to minimise the risk and impact of persistent symptoms.</p

Per- and polyfluoroalkyl substances (PFAS) exposure and thyroid cancer risk

BACKGROUND: Although per- and polyfluoroalkyl substances (PFAS) exposure is a potential contributor to the increasing thyroid cancer trend, limited studies have investigated the association between PFAS exposure and thyroid cancer in human populations. We therefore investigated associations between plasma PFAS levels and thyroid cancer diagnosis using a nested case-control study of patients with thyroid cancer with plasma samples collected at/before cancer diagnosis. METHODS: 88 patients with thyroid cancer using diagnosis codes and 88 healthy (non-cancer) controls pair-matched on sex, age (±5 years), race/ethnicity, body mass index, smoking status, and year of sample collection were identified in the BioMe population (a medical record-linked biobank at the Icahn School of Medicine at Mount Sinai in New York); 74 patients had papillary thyroid cancer. Eight plasma PFAS were measured using untargeted analysis with liquid chromatography-high resolution mass spectrometry and suspect screening. Associations between individual PFAS levels and thyroid cancer were evaluated using unconditional logistic regression models to estimate adjusted odds ratios (OR adj) and 95% confidence intervals (CI). FINDINGS: There was a 56% increased rate of thyroid cancer diagnosis per doubling of linear perfluorooctanesulfonic acid (n-PFOS) intensity (OR adj, 1.56, 95% CI: 1.17-2.15, P = 0.004); results were similar when including patients with papillary thyroid cancer only (OR adj, 1.56, 95% CI: 1.13-2.21, P = 0.009). This positive association remained in subset analysis investigating exposure timing including 31 thyroid cancer cases diagnosed ≥1 year after plasma sample collection (OR adj, 2.67, 95% CI: 1.59-4.88, P < 0.001). INTERPRETATION: This study reports associations between exposure to PFAS and increased rate of (papillary) thyroid cancer. Thyroid cancer risk from PFAS exposure is a global concern given the prevalence of PFAS exposure. Individual PFAS studied here are a small proportion of the total number of PFAS supporting additional large-scale prospective studies investigating thyroid cancer risk associated with exposure to PFAS chemicals. FUNDING: National Institutes of Health grants and The Andrea and Charles Bronfman Philanthropies

Improving zebrafish embryo xenotransplantation conditions by increasing incubation temperature and establishing a proliferation index with ZFtool

Background Zebrafish (Danio rerio) is a model organism that has emerged as a tool for cancer research, cancer being the second most common cause of death after cardiovascular disease for humans in the developed world. Zebrafish is a useful model for xenotransplantation of human cancer cells and toxicity studies of different chemotherapeutic compounds in vivo. Compared to the murine model, the zebrafish model is faster, can be screened using high-throughput methods and has a lower maintenance cost, making it possible and affordable to create personalized therapies. While several methods for cell proliferation determination based on image acquisition and quantification have been developed, some drawbacks still remain. In the xenotransplantation technique, quantification of cellular proliferation in vivo is critical to standardize the process for future preclinical applications of the model. Methods This study improved the conditions of the xenotransplantation technique – quantification of cellular proliferation in vivo was performed through image processing with our ZFtool software and optimization of temperature in order to standardize the process for a future preclinical applications. ZFtool was developed to establish a base threshold that eliminates embryo auto-fluorescence and measures the area of marked cells (GFP) and the intensity of those cells to define a ‘proliferation index’. Results The analysis of tumor cell proliferation at different temperatures (34 °C and 36 °C) in comparison to in vitro cell proliferation provides of a better proliferation rate, achieved as expected at 36°, a maintenance temperature not demonstrated up to now. The mortality of the embryos remained between 5% and 15%. 5- Fluorouracil was tested for 2 days, dissolved in the incubation medium, in order to quantify the reduction of the tumor mass injected. In almost all of the embryos incubated at 36 °C and incubated with 5-Fluorouracil, there was a significant tumor cell reduction compared with the control group. This was not the case at 34 °C. Conclusions Our results demonstrate that the proliferation of the injected cells is better at 36 °C and that this temperature is the most suitable for testing chemotherapeutic drugs like the 5-FluorouracilThis research was funded by the Fondo de Investigación Sanitaria (Instituto Carlos III) - FIS project (PI13/01388). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing of this manuscriptS

A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and has become an important field of biomedical inquiry. We aimed to determine whether European countries have mounted an adequate public health response to NAFLD and non-alcoholic steatohepatitis (NASH). Methods: In 2018 and 2019, NAFLD experts in 29 European countries completed an English-language survey on policies, guidelines, awareness, monitoring, diagnosis and clinical assessment in their country. The data were compiled, quality checked against existing official documents and reported descriptively. Results: None of the 29 participating countries had written strategies or action plans for NAFLD. Two countries (7%) had mentions of NAFLD or NASH in related existing strategies (obesity and alcohol). Ten (34%) reported having national clinical guidelines specifically addressing NAFLD and, upon diagnosis, all included recommendations for the assessment of diabetes and liver cirrhosis. Eleven countries (38%) recommended screening for NAFLD in all patients with either diabetes, obesity and/or metabolic syndrome. Five countries (17%) had referral algorithms for follow-up and specialist referral in primary care, and 7 (24%) reported structured lifestyle programmes aimed at NAFLD. Seven (24%) had funded awareness campaigns that specifically included prevention of liver disease. Four countries (14%) reported having civil society groups which address NAFLD and 3 countries (10%) had national registries that include NAFLD. Conclusions: We found that a comprehensive public health response to NAFLD is lacking in the surveyed European countries. This includes policy in the form of a strategy, clinical guidelines, awareness campaigns, civil society involvement, and health systems organisation, including registries. Lay summary: We conducted a survey on non-alcoholic fatty liver disease with experts in European countries, coupled with data extracted from official documents on policies, clinical guidelines, awareness, and monitoring. We found a general lack of national policies, awareness campaigns and civil society involvement, and few epidemiological registries.International Liver Foundation through grants from Gilead Sciences Europe Ltd., Allergan Pharmaceutical International Ltd., Bristol-Myers-Squibb Company, Pfizer Inc., and Resoundant Inc. JVL is a Miguel Servet-funded researcher at ISGlobal, Hospital Clínic, University of Barcelona. QMA and VR are members of the EPoS (Elucidating Pathways of Steatohepatitis) consortium funded by the Horizon 2020 Framework Program of the European Union under Grant Agreement 634413. QMA, VR, HCP, ME, MRG, HCP are members of the LITMUS (Liver Investigation: Testing Marker Utility in Steatohepatitis) consortium funded by the IMI2 Program of the European Union under Grant Agreement 777377. QMA is a Newcastle NIHR Biomedical Research Centre investigator

Long-term follow-up including extensive complement analysis of a pediatric C3 glomerulopathy cohort

BACKGROUND: C3 glomerulopathy (C3G) is a rare kidney disorder characterized by predominant glomerular depositions of complement C3. C3G can be subdivided into dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). This study describes the long-term follow-up with extensive complement analysis of 29 Dutch children with C3G. METHODS: Twenty-nine C3G patients (19 DDD, 10 C3GN) diagnosed between 1992 and 2014 were included. Clinical and laboratory findings were collected at presentation and during follow-up. Specialized assays were used to detect rare variants in complement genes and measure complement-directed autoantibodies and biomarkers in blood. RESULTS: DDD patients presented with lower estimated glomerular filtration rate (eGFR). C3 nephritic factors (C3NeFs) were detected in 20 patients and remained detectable over time despite immunosuppressive treatment. At presentation, low serum C3 levels were detected in 84% of all patients. During follow-up, in about 50% of patients, all of them C3NeF-positive, C3 levels remained low. Linear mixed model analysis showed that C3GN patients had higher soluble C5b-9 (sC5b-9) and lower properdin levels compared to DDD patients. With a median follow-up of 52 months, an overall benign outcome was observed with only six patients with eGFR below 90 ml/min/1.73 m(2) at last follow-up. CONCLUSIONS: We extensively described clinical and laboratory findings including complement features of an exclusively pediatric C3G cohort. Outcome was relatively benign, persistent low C3 correlated with C3NeF presence, and C3GN was associated with higher sC5b-9 and lower properdin levels. Prospective studies are needed to further elucidate the pathogenic mechanisms underlying C3G and guide personalized medicine with complement therapeutics. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00467-021-05221-6