Sun exposure habits, sun protection practices, knowledge and attitudes of andalusian teenagers

La historia de quemaduras solares y la exposición solar acumulativa durante la infancia y la adolescencia son los factores de riesgo más importantes para el desarrollo de cáncer de piel. Se conoce que el 85% de esta neoplasia podría evitarse reduciendo la exposición solar, especialmente durante la adolescencia. En este grupo de edad se han intensificado las prácticas de riesgo relacionadas con la exposición solar, motivadas por el deseo del bronceado, el tiempo que pasan al aire libre, la baja percepción del riesgo a desarrollar cáncer de piel y la falta de control paterno. Las campañas de prevención de cáncer de piel tienen como objetivo mejorar los hábitos de exposición solar, reducir las quemaduras solares y la incidencia de cáncer de piel. Los adolescentes son un grupo prioritario al que debe ir dirigidas estas campañas. En el presente trabajo se realiza un recorrido por los hallazgos más significativos sobre los hábitos de exposición solar, las prácticas de protección solar, las actitudes y comportamientos de riesgo de los adolescentes, de las intervenciones educativas que se han llevado a cabo en Andalucía y las perspectivas futuras.A history of sunburn and cumulative sun exposure during childhood and adolescence are the most important risk factors for the development of skin cancer. Nevertheless, 85% of the cases of skin cancer could be prevented by reducing sun exposure, particularly during adolescence. In fact, persons in this age group have now increased their sun exposure practices, motivated by the desire for a suntan, and the fact that they spend more time outdoors, have a poor perception of the risk of developing skin cancer, and the lack of parental control. Skin cancer prevention campaigns aim to improve sun protection habits, and reduce sunburns and incidence of skin cancer. In this work, we do a summary about the most significant findings on the sun exposure habits, sun protection practices, attitudes and risk behaviors of adolescents, as well as, educational interventions that have been carried out in Andalusia and the future prospects.Los autores agradecen el apoyo del equipo de investigación del Hospital Costa del Sol y al Programa del Doctorado de Medicina Clínica y Salud Pública de la Universidad de Granad

Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study

Background: Health questionnaires must present accredited measurement properties such as validity, reliability and sensitivity to change, the latter being essential for interventions to be planned and for evaluating their effectiveness. The aim of this study was to evaluate the sensitivity to change of a Beach Questionnaire.Methods: Quasi-experimental before-after study carried out in 2011, for a study population of adolescents attending schools in the Costa del Sol. First, the questionnaire was administered to the adolescents, after which a multicomponent educational intervention was carried out; finally, three months later, the same questionnaire was re-administered to the same adolescents. Changes were assessed in the categories of each item, using the McNemar test, and the changes in the scores, standardised to a range of 0–100, using the Student t test for paired samples, and including the mean of the differences and the 95% confidence interval. The level of statistical significance was set at p < 0.05.Results: 228 adolescents, aged 14–17 years, and 55.3% were girls. Statistically significant changes were observed in sunburn experiences, exposure to the sun at mid-day and attitudes to sun exposure and suncreams. For the seven items related to knowledge about sun exposure, a higher rate of correct answers was observed. The analysis of changes, within the standardised range, revealed a significant improvement in the scores for sun exposure habits (MD 4.33; CI 95% 2.2-6.5), attitudes to sun exposure (MD 2.22; CI 95% 1.2-3.2) and knowledge (MD 9.10; CI 95% 7.1-11.1), but not in those for sun-protection practices (MD 0.23; CI 95% -1.2-1.7).Conclusions: The Beach Questionnaire on behaviour, attitudes and knowledge related to sun exposure is the first such instrument in Spanish language to provide sufficient sensitivity to change. It constitutes a useful tool for epidemiologic research into photoprotection and for skin cancer prevention programmes.The authors would like to acknowledge support from the Research Department of the Costa del Sol Hospital

Evaluation of habits, attitudes and awareness concerning sun exposure in adolescents

In recent decades, the incidence of skin cancer has grown faster than that of any other malignant neoplasia. It is estimated that 80% of skin cancers could be prevented by reducing sun exposure, particularly at early ages of life. Teenagers form a population group that is at special risk of developing skin cancer later in life, mainly due to their habits of recreational sun exposure, the greater availability of leisure t ime, the high rates of sunburn experienced, a lack of parental control, changing values and, especially, the culture of body image and the importance given to a suntanned appearance. Accordingly, these young people are considered a priority group that should be targeted in prevention campaigns. To evaluate educational interventions and to conduct population studies in the fields of photoprotection and skin cancer prevention, validated questionnaires are needed. To achieve their purpose, such questionnaires must present accredited measurement properties, namely validity (the ability to measure the concept for which they are designed), reliability (the ability to obtain measurements without errors) and sensitivity to change (the ability to detect changes). Th e latter quality is essential if the questionnaire is to be used to evaluate the effectiveness of an intervention. The Beach Questionnaire is a Spanish-language document that is valid and reliable, but its sensitivity to change has yet to be assessed. One of the goals of our study was to examine adolescents’ behaviour, attitudes and knowledge with respect to sun exposure, both on the beach and during sports activities. In addition, we evaluated the sensitivity to change of a questionnaire on sun exposure for use in future interventions in the field of skin cancer prevention.Tesis Univ. Granada. Programa Oficial de Doctorado en: Medicina Clínica y Salud Públic

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts