El efecto de los parques urbanos sobre las desigualdades socioeconómicas en diabetes: un estudio en la ciudad de Madrid

Incluye: PDF de la presentación y video del seminario.El estudio pretende establecer una posible relación entre el nivel socioeconómico y la diabetes, en toda la población de la ciudad de Madrid, evaluar si los parques interaccionan con el nivel socioeconómico actuando como un factor “equigénico”, y evaluar si las asociaciones o interacciones son diferentes en hombres y mujeres. Las conclusiones a las que se llegaron son: 1. Se observa relación: a mayor nivel socioeconómico, menor diabetes. 2. Se observa que el Índice relativo de desigualdad en la diabetes aumenta a medida que aumentan los espacios verdes. 3. En el grupo de mujeres el Índice relativo de desigualdad es casi el doble que en el de hombres y tiene una mayor pendiente, aumentando en los cuartiles de mayor densidad de parques. Estos resultados abren nuevas cuestiones sobre el papel del género en el desarrollo de la diabetes y en sus factores de riesgo contextuales asociados.N

Relación de la distancia y la densidad de parques con la actividad física y los factores de riesgo cardiovascular en el Municipio de Madrid: un estudio transversal

Trabajo fin de master reaizado en el Máster en Salud Pública 2018-2019. Escuela Nacional de Sanidad. Instituto de Salud Carlos III.Las enfermedades no transmisibles (ENT) son la principal causa de muerte en el mundo y, una de las ENT más frecuentes es la enfermedad cardiovascular (ECV), cuyos factores de riesgo (FRCV) son: inactividad física, obesidad, hipercolesterolemia, hipertensión arterial (HTA) y diabetes mellitus 2 (DM2). Estudiar los FRCV en relación con factores urbanos es apropiado, ya que las ciudades tienen gran densidad de habitantes; de hecho, varios estudios han relacionado los parques y espacios verdes con la disminución del riesgo cardiovascular, mejoría en la salud mental y la autopercepción de salud, a través de diferentes vías, entre ellas, la actividad física (AF). La hipótesis general del estudio es que la presencia de parques cerca del lugar de residencia se asocia con mayores niveles de actividad física en el tiempo libre (AFTL), así como con una menor probabilidad de tener obesidad, hipercolesterolemia , HTA o DM2

Evolution of physical function, cognition, depressive mood, and quality of life during the Covid-19 pandemic in prefrail elderly people: A longitudinal cohort study (Covid-Mefap)

Confinement due to the COVID-19 pandemic has had a major impact on the living habits and health of the population, notably in the pre-frail elderly. This study aimed to study the effect of the COVID-19 pandemic on the physical function, mental function (cognition and mood), and quality of life of pre-frail elderly individuals over 70 years of age following confinement as well as to analyze the variables associated with the observed changes. Methods: Observational study of a cohort of pre-frail community-dwelling older adults over 70 years of age during the COVID-19 pandemic conducted in primary care. Variables: The main outcome variables were recorded during face-to-face interviews between December 14 of 2020 and August 12 of 2021 using scales for the evaluation of physical function (Short Physical Performance Battery), cognition (Lobo's Mini-Examen Cognoscitivo), depressive mood (Geriatric Depression Scale), and quality of life (EuroQol-5D-3L). Covariates: sociodemographic data and variables related to the pandemic and general health (social support network, COVID-19 infection, exercising, and leisure activities) were also collected. Analysis: The Student's t-test for paired samples and multivariate linear regression models were employed for the statistical analyses. Results: Ninety-two subjects were included in the study. Physical function, cognition, and depressive mood improved during the pandemic, whereas no changes were observed in quality of life. Suffering from COVID-19 was associated with deterioration of the cognitive function (−1.460; CI95%: −2.710 to −0.211). Conclusion: Confinement due to the COVID-19 pandemic was not associated with a decline in physical function, cognition, depressive mood, or quality of life in pre-frail individuals over 70 years of ageThis study has been partially funded by the Instituto de Salud Carlos III (ISCIII) (project ref.: PI17/01887) and co-funded by the European Union. The study also received funds from the Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP) and the Regional Health Ministry of the Community of Madrid through non-refundable grants from the credits awarded to the Community of Madrid by the Spanish Government Fund COVID-19, included in Law HAC/667/2020. The funders had no role in the study design or decision to publish this articl

A New Hierarchy of Research Evidence for Tumor Pathology: A Delphi Study to Define Levels of Evidence in Tumor Pathology

The hierarchy of evidence is a fundamental concept in evidence-based medicine, but existing models can be challenging to apply in laboratory-based health care disciplines, such as pathology, where the types of evidence and contexts are significantly different from interventional medicine. This project aimed to define a comprehensive and complementary framework of new levels of evidence for evaluating research in tumor pathology-introducing a novel Hierarchy of Research Evidence for Tumor Pathology collaboratively designed by pathologists with help from epidemiologists, public health professionals, oncologists, and scientists, specifically tailored for use by pathologists-and to aid in the production of the World Health Organization Classification of Tumors (WCT) evidence gap maps. To achieve this, we adopted a modified Delphi approach, encompassing iterative online surveys, expert oversight, and external peer review, to establish the criteria for evidence in tumor pathology, determine the optimal structure for the new hierarchy, and ascertain the levels of confidence for each type of evidence. Over a span of 4 months and 3 survey rounds, we collected 1104 survey responses, culminating in a 3-day hybrid meeting in 2023, where a new hierarchy was unanimously agreed upon. The hierarchy is organized into 5 research theme groupings closely aligned with the subheadings of the WCT, and it consists of 5 levels of evidence-level P1 representing evidence types that merit the greatest level of confidence and level P5 reflecting the greatest risk of bias. For the first time, an international collaboration of pathology experts, supported by the International Agency for Research on Cancer, has successfully united to establish a standardized approach for evaluating evidence in tumor pathology. We intend to implement this novel Hierarchy of Research Evidence for Tumor Pathology to map the available evidence, thereby enriching and informing the WCT effectively.The overall project, International Agency for Research on Cancer, and beneficiaries (German Heart Centre Munich, Maria Sklodowska-Curie National Research Institute of Oncology, and Instituto de Salud Carlos III) are funded by the European Commission (HORIZON grant no. 101057127). R.C. and F.C. are funded by UK Research and Innovation. S.H. has received research funding or honoraria from Roche, BMS, Merck, Sysmex, Thermo, Volition, Trillium, Medica, and Instand and is a founder of SFZ BioCoDE and CEBIO. P.H.T. has received honoraria from AstraZeneca.S

Cómo poner puertas al campo : tres revisiones panorámicas sobre el uso de biomarcadores en prevención personalizada de enfermedades crónicas

Se incluye PDF de la presentación y vídeo del seminario.El seminario trata de dar respuesta a qué biomarcadores hay disponibles o en desarrollo para la prevención personalizada de enfermedades crónicas en la población general. Las revisiones realizadas resumen las principales características y conclusiones de la bibliografía sobre este tema. Abarca los tres principales grupos de enfermedades crónicas:11 tipos de cáncer, 9 enfermedades cardiovasculares y 7 enfermedades neurodegenerativas.N

Biological signatures of chronic inflammation biomarkers identified using data reduction methods in adult population: A scoping review

This project involves conducting a comprehensive scoping review on biological signatures of inflammation identified through data reduction statistical methods. It focuses on the adult population in clinical or epidemiological contexts. The aim is to evaluate existing literature on inflammation biomarkers, examining the statistical techniques used and the specific biological markers involved. The project seeks to understand the characteristics of these biological signatures, how they are identified, and their potential relevance to the human population

How to stem the tide? Development of three scoping reviews in biomarkers and personalized prevention

XLI Reunión anual de la Sociedad Española de Epidemiología (SEE) y XVIII Congresso da Associação Portuguesa de Epidemiología (APE). Porto (Portugal), del 5 al 8 de septiembre de 2023.The “PeRsOnalized Prevention roadmap for the future HEalThcare” (PROPHET) project, seeks to assess the effectiveness, clinical utility and existing gaps in current personalized preventive approaches, and to develop a Strategy Research and Innovation Agenda (SRIA) for the European Union. The first draft of the SRIA concept paper needs to incorporate the state of the art of personalized prevention carried out through scoping reviews. Among them, our work aimed to answer whether there is any biomarker or combination of biomarkers that can help to better identify subgroups of individuals with different risks of developing a particular disease for primary or secondary prevention. These results were needed at early stage of the project; despite covering such a broad topic, it had to be carried out in record time (4 months) by a geographically dispersed team (Granada, Madrid, United Kingdom). Our challenge has been to maintain effective coordination and speed without losing scientific rigor. Between Feb-June 2023, our team conducted three independent scoping reviews (for cardiovascular diseases, neurodegenerative diseases and cancer, respectively) that involved quick and difficult decisions to narrow down the inclusion criteria, study populations, biomarkers included, and types of prevention. To maintain consistency, we created different glossaries and had multiple meetings and constant contact between team members. As a first step, we identified key terms on the topics of interest, helped by expert consultations, identification of significant publications and several specific tools (SR-Accelerator, etc.). A pilot study was conducted to refine the search matrix and to initiate coordination among reviewers. However, in order to shorten timeframes, we limited peer review to 10% of the records in all phases. The protocol, published in OSF, served as a guide for the report. All phases, when possible, overlapped to deliver the report on time. In addition, we made interactive evidence maps to show the results graphically, thanks to the creation of a script, using R and Python, to allow the input of the datasheet extraction file into the mapping application. Despite these challenges, we successfully met the project deadlines.Funding: HE No 10105772. UKRI No 10040946.N

Blood Selenium Concentrations Are Inversely Associated with the Risk of Undernutrition in Older Adults

Background: Selenium is an essential trace element with an antioxidant and anti-inflammatory capacity that has been associated in experimental studies with beneficial effects on appetite control, the regulation of the gut microbiota, and control of the anabolic–catabolic balance. The main aim of the present study was to evaluate the association between circulating selenium concentrations and the risk of developing undernutrition in older adults. Methods: This was a cohort study with 1398 well-nourished community-dwelling individuals aged ≥ 65 years residing in Spain in 2017, who were followed for a mean of 2.3 years. Whole blood selenium was measured at baseline using inductively coupled plasma-mass spectrometry. Undernutrition was assessed at baseline and at follow-up, and defined as having at least one of the three GLIM phenotypic criteria (involuntary weight loss, a low body mass index, and a reduced muscle mass) and at least one of the two etiologic criteria (reduced food consumption or nutrient assimilation and inflammation/disease burden). Results: During the follow-up, 142 participants (11%) developed moderate undernutrition and 113 (8.8%) severe undernutrition. The standardized relative risks of moderate and severe undernutrition at the 75th percentile of Se levels versus the 25th were 0.90 and 0.70, respectively. In dose–response analyses, the risk of severe undernutrition decreased linearly with increasing selenium concentrations. This association was independent of protein intake or diet quality and was stronger among participants with a diagnosis of a musculoskeletal disorder. Conclusions: The results suggest that an adequate dietary selenium status is needed to prevent undernutrition in older adults. Also, this may open the door for clinical trials with selenium supplementation, at doses considered as safe, to prevent undernutrition

Biomarkers for personalised prevention of chronic diseases: a common protocol for three rapid scoping reviews

Dataset disponible en: http://hdl.handle.net/20.500.12105/19630Introduction: Personalised prevention aims to delay or avoid disease occurrence, progression, and recurrence of disease through the adoption of targeted interventions that consider the individual biological, including genetic data, environmental and behavioural characteristics, as well as the socio-cultural context. This protocol summarises the main features of a rapid scoping review to show the research landscape on biomarkers or a combination of biomarkers that may help to better identify subgroups of individuals with different risks of developing specific diseases in which specific preventive strategies could have an impact on clinical outcomes. This review is part of the "Personalised Prevention Roadmap for the future HEalThcare" (PROPHET) project, which seeks to highlight the gaps in current personalised preventive approaches, in order to develop a Strategic Research and Innovation Agenda for the European Union. Objective: To systematically map and review the evidence of biomarkers that are available or under development in cancer, cardiovascular and neurodegenerative diseases that are or can be used for personalised prevention in the general population, in clinical or public health settings. Methods: Three rapid scoping reviews are being conducted in parallel (February-June 2023), based on a common framework with some adjustments to suit each specific condition (cancer, cardiovascular or neurodegenerative diseases). Medline and Embase will be searched to identify publications between 2020 and 2023. To shorten the time frames, 10% of the papers will undergo screening by two reviewers and only English-language papers will be considered. The following information will be extracted by two reviewers from all the publications selected for inclusion: source type, citation details, country, inclusion/exclusion criteria (population, concept, context, type of evidence source), study methods, and key findings relevant to the review question/s. The selection criteria and the extraction sheet will be pre-tested. Relevant biomarkers for risk prediction and stratification will be recorded. Results will be presented graphically using an evidence map. Inclusion criteria: Population: general adult populations or adults from specific pre-defined high-risk subgroups; concept: all studies focusing on molecular, cellular, physiological, or imaging biomarkers used for individualised primary or secondary prevention of the diseases of interest; context: clinical or public health settings. Systematic review registration: https://doi.org/10.17605/OSF.IO/7JRWD (OSF registration DOI).The PROPHET project has received funding from the European Union’s Horizon Europe research and innovation program under grant agreement no. 101057721. UK participation in Horizon Europe Project PROPHET is supported by UKRI grant number 10040946 (Foundation for Genomics & Population Health).S

Exposure to residential traffic and trajectories of unhealthy ageing: results from a nationally-representative cohort of older adults

Abstract Background Traffic exposure has been associated with biomarkers of increased biological ageing, age-related chronic morbidities, and increased respiratory, cardiovascular, and all-cause mortality. Whether it is associated with functional impairments and unhealthy ageing trajectories is unknown. Methods Nationally representative population-based cohort with 3,126 community-dwelling individuals aged ≥60 years who contributed 8,291 biannual visits over a 10 year period. Unhealthy ageing was estimated with a deficit accumulation index (DAI) based on the number and severity of 52 health deficits, including 22 objectively-measured impairments in physical and cognitive functioning. Differences in DAI at each follow-up across quintiles of residential traffic density (RTD) at 50 and 100 meters, and closest distance to a petrol station, were estimated using flexible marginal structural models with inverse probability of censoring weights. Models were adjusted for sociodemographic and time-varying lifestyle factors, social deprivation index at the census tract and residential exposure to natural spaces. Results At baseline, the mean (SD) age and DAI score of the participants were 69.0 (6.6) years and 17.02 (11.0) %, and 54.0% were women. The median (IQR) RTD at 50 and 100 meters were 77 (31-467) and 509 (182-1802) vehicles/day, and the mean (SD) distance to the nearest petrol station of 962 (1317) meters. The average increase in DAI (95%CI) for participants in quintiles Q2-Q5 (vs Q1) of RTD at 50 meters was of 1.51 (0.50, 2.53), 0.98 (-0.05, 2.01), 2.20 (1.18, 3.21) and 1.98 (0.90, 3.05), respectively. Consistent findings were observed at 100 meters. By domains, most of the deficits accumulated with increased RTD were of a functional nature, although RTD at 50 meters was also associated with worse self-reported health, increased vitality problems and higher incidence of chronic morbidities. Living closer to a petrol station was associated with a higher incidence of functional impairments and chronic morbidities. Conclusions Exposure to nearby residential traffic is associated with accelerated trajectories of unhealthy ageing. Diminishing traffic pollution should become a priority intervention for adding healthy years to life in the old age