Cost-effectiveness analysis of a multiple health behaviour change intervention in people aged between 45 and 75 years: a cluster randomized controlled trial in primary care (EIRA study)

Background: Multiple health behaviour change (MHBC) interventions that promote healthy lifestyles may be an efficient approach in the prevention or treatment of chronic diseases in primary care. This study aims to evaluate the cost-utility and cost-effectiveness of the health promotion EIRA intervention in terms of MHBC and cardiovascular reduction. Methods: An economic evaluation alongside a 12-month cluster-randomised (1:1) controlled trial conducted between 2017 and 2018 in 25 primary healthcare centres from seven Spanish regions. The study took societal and healthcare provider perspectives. Patients included were between 45 and 75 years old and had any two of these three behaviours: smoking, insufficient physical activity or low adherence to Mediterranean dietary pattern. Intervention duration was 12 months and combined three action levels (individual, group and community). MHBC, defined as a change in at least two health risk behaviours, and cardiovascular risk (expressed in % points) were the outcomes used to calculate incremental cost-effectiveness ratios (ICER). Quality-adjusted life-years (QALYs) were estimated and used to calculate incremental cost-utility ratios (ICUR). Missing data was imputed and bootstrapping with 1000 replications was used to handle uncertainty in the modelling results. Results: The study included 3062 participants. Intervention costs were €295 higher than usual care costs. Five per-cent additional patients in the intervention group did a MHBC compared to usual care patients. Differences in QALYS or cardiovascular risk between-group were close to 0 (- 0.01 and 0.04 respectively). The ICER was €5598 per extra health behaviour change in one patient and €6926 per one-point reduction in cardiovascular risk from a societal perspective. The cost-utility analysis showed that the intervention increased costs and has no effect, in terms of QALYs, compared to usual care from a societal perspective. Cost-utility planes showed high uncertainty surrounding the ICUR. Sensitivity analysis showed results in line with the main analysis. Conclusion: The efficiency of EIRA intervention cannot be fully established and its recommendation should be conditioned by results on medium-long term effects. Trial registration: Clinicaltrials.gov NCT03136211. Registered 02 May 2017 – Retrospectively registered © 2021, The Author(s)

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Influencia del ámbito geográfico en la regulación normativa sobre metales trazas en los suelos. Aplicación en la Comunidad Autónoma de Madrid

Relation between critical heavy metals concentration in soil, allowed by European and USA regulations of protection of the environment when sewage sludge is used in agriculture, and climate is discussed in this paper. Later, Madrid region case is studied. The altitude in Madrid region and the latitude in European continent have a similar influence over pedoclimate, increasing both oligotrophic and acid properties of soil when the altitude and latitude rise. Therefore, Guadarrama Mountains soils are as vulnerable to heavy metals application as North European soils.[es] Las condiciones geográficas de los países desarrollados de Europa y los EEUU de América son estudiadas en relación con su influencia en las regulaciones normativas que determinan las concentraciones máximas de metales trazas en los suelos agrícolas receptores de lodos de estaciones depuradoras de aguas. Se ha encontrado una conexión significativa entre las regulaciones normativas y las características climatológicas y edáficas de cada lugar. El posterior análisis de las condiciones existentes en la Comunidad de Madrid revela su comportamiento como un minicontinente donde la altitud del terreno tiene una influencia parecida a la de la latitud en el continente europeo; así, el exceso de humedad que lava el suelo y causa su carácter oligotrófico y ácido se acentúa con la altitud, de manera que los suelos de la Sierra de Guadarrama tienen una vulnerabilidad respecto a la adición de metales trazas que es parecida a la de los suelos de los países del norte europeo. [fr] Les caractéristiques géographiques des pays de l'Europe, EEUU et la Communauté de Madrid ont été rapportées avec les ordonnances sur les polluants du sol et les teneurs extremes en métaux traces des boues de stations d'épuration des eaux. L'altitude du terrain en Madrid et la latitude en l'Europe ont une similaire influence sur le climat et l'évolution pédologique du sol. Le facteur eau exerces ses fonctions de façon prépondérante et similaire sur la migration des bases solubles et l'acidification du sol en la chaîne de montagnes de Guadarrama et dans l'Europe Central

Social Prescribing Schemes in Primary Care in Spain (EvalRA Project): a mixed-method study protocol to build an evaluation model

Abstract Background Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people’s health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. Methods In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. Discussion Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety

Anales de Edafología y Agrobiología Tomo 41 Número 9-10

Suelos. Características petroquímicas y micromorfológicas de Haploxeralfs, por P. Arévalo. J. Gallardo y J. Benayas.-- Determinación de manganeso total en suelos, por J. Moreno Caselles, M. Guillén y M. Romero.-- Rendolles de la Sierra de María (Almería), por L J. Alias y J. Martínez.-- Estudio de tres perfiles de suelos de La Alpujarra, por Barahona. E., García Chicano. J. L. Guardiola. J. L. lriarte. A, Pérez-Pujalte, A. y Quirantes, J.-- Detección de concordancias fisonómico-edáficas por J. M. Gómez. R. Rodríguez González. A. García Miranda y C. de Hoyos Alonso.-- Suelos y sedimentos de zonas semiáridas, por A. García Rodríguez, J. Forteza Bonnin y L F. Lorenzo Martín.-- Suelos sobre jumillita de la Sierra de las Cabras (Albacete), por Joaquín Hernández Bastida, María Teresa Fernández Tapia y Francisco Alcaraz Ariza.-- Estudio microscópico de aridisoles de las Islas Canarias, por A. Rodríguez Rodríguez, M. C. Pérez Angles. M. C. Díez de la Lastra Bosch y E. Fernández Caldas.-- El material original: propiedades de los suelos de Galicia, por F. Macias. R. M. Calvo, C. García. E. García-Rodeja y B. Silva.-- Las sierras de Queixa e invernadeiro y sus estribaciones, por Grupo de Edafólogos de Santiago.-- Suelos forestales de la cordillera costero-catalana, por A. Escuredo. V. R. Vallejo y J. Bech.-- Materia orgánica de suelos forestales, por A. Escuredo. V. Vallejo y J. Bech.--Dificultades en el empleo del sistema "USDA-Soil Taxonomy", por Carlos Roquero de Laburu.-- Nematodos fitoparásitos de la superfamilia "criconematoidea", por A. Bello y Ma. Paz Lara.—Silicatos. Retención del diazinon por montmorillonita, sepiolita y caolinita, por G. Dios Cancela, S. González García y M. Martín Aguilar.—Geoquímica. Alteración de minerales de estaño, por Guijarro, J. Casas, J. y Hoyos, M.A.—Nutrición y Fisiología Vegetal.-- Capacidad fotosintética de maíz, por U. Velázquez, M. Lasaña y J. Cardus.-- El alerce en Chile. II. Su nutrición mineral, por M. Lachica, C. González O. y M. Baez. C. Anomalías por deficiencias de Ca o de Mg en raíces de plantas de zea mays L., por José Manuel Pozuelo Guanche.-- Competencia de avena sterilis L .. por R. González Ponce.-- Abcisión de las hojas de phaseolus vulgaris, por Ana María Vieitez y María Luisa Vieitez. El castaño y su resistencia a phytophthora cinnamomi y Ph. cambivora, por Ernesto Vieitez, María Luisa Vieitez y Ana María Vieitez.-- Observaciones sobre el injerto juvenil.del castaño, por María Luisa Vieitez y Ana María Vieitez.-- Crecimiento y nutrición del trébol violeta, por J. Arines y R. Fábregas.-- La proliferación celular en meristemos. por G. Giménez-Manín, J. F. López-Sáez, A. González-Fernández. C. de la Torre y M. H. Navarrete.—Microbiología.-- Formaciones quiméricas anómalas en cultivos bacterianos, por Román de Vicente. Análisis.-- Determinación de fenoles y formas de N en aguas, por Bolarin, M. C. Romero, M. y Caro, M.-- Agua Reutilización de aguas y lodos residuales. I., por Sa/got, M. y Cardus, J. II por Felipo M. T., Garau, M. A., Pascual, M. D. y Cardus, J.-- Ecología. Aspectos ecológicos de sotos y riberas, por Pedro Montserrat Recoder.-- Control Sanitario.Evolución de clorobencilato en brotes de limonero, por J. Ma. Abrisqueta, A. Onuño, J. Gómez y A. Hernansáez.-- Riesgos de los productos químicos potencialmente tóxicos, por Eugenio Laborda. Eduardo de la Peña y Elina Valcarece.-- Geografía. Otra crítica del neomalthusianismo, por María Isabel Bodega Fernández, Sici/ia Gutiérrez Ronco, María Asunción Martín Lou, Antonio Higueras Arnal y José Manuel Casas Torres.-- Notas.-- BibligrafíaPeer reviewe