Influence of gender determinants on informal care and health service utilization in Spain: Ten years after the approval of the equality law

The existence of gender inequalities in health, in the use of health services, and in the development of informal care has been demonstrated throughout scientific literature. In Spain, a law was passed in 2007 to promote effective equality between men and women. Despite this, different studies have shown that the previous gender inequalities are still present in Spanish society. For all these reasons, the objective of this paper is to study the differences by sex in informal care and in the use of emergency care, and to identify the existence of gender inequalities in Spain 10 years after the adoption of the aforementioned equality law. In this case, we development a cross-sectional study based on the 2017 Spanish National Health Survey of the Spanish population aged 16 and over. To analyze the influence of gender determinants on informal care and emergency care utilization, logistic regressions were performed, model 1 was adjusted for age, and model 2 was further adjusted too by the variables of the Andersen care demand model. The results showed that informal care and the use of the emergency care continues to be higher in women than in men. Informal care in women was related to a higher level of education. In emergency care, the older the age, the lower the probability of utilization, and living in a rural municipality was related to a higher probability of utilization for both sexes. Finally, we concluded that there is still a need for studies that analyze gender inequalities in different contexts, such as the informal care and the use of health services. This is especially relevant in Spain, where economic changes have led to a change in roles, mainly for women, and new management strategies are needed to achieve equity in care and effective equality between men and women

Self-rated health in Europe and its determinants: Does generation matter?

Objectives: To analyse the influence of micro- and macro-factors on self-rated health, and the role of generation on this relationship. Methods: Cross-sectional study using data from European Health Interview Surveys from 14 European countries. Individuals were divided into four generations (“silent generation”, “baby boomers”, and “generation X” and “Y”). We conducted multilevel analyses for each generation to study the influence of individual and national explanatory variables on self-rated health. Results: Age showed an exponential effect in older generations. Education and employment presented the strongest association with low self-rated health, especially in “baby boomers” and women (low education: OR 3.5; 95% CI 3.2–3.9). Tobacco showed a negative effect in younger generations. Overweight and low physical activity were negatively associated with self-rated health regardless of generation. Countries from the Eastern welfare system showed the highest risk of low self-rated health and this association was higher in men for “silent generation” (OR 4.7; 95% CI 3.0–7.6). Conclusions: The influence of individual and national factors on self-rated health varies regarding generation. The target generation and the demographic structure of a country should be taken into account to develop more accurate health policies

Recession, employment and self-rated health: a study on the gender gap

Objectives: Employment status and economic recession have been associated with negative effects on self-rated health, and this effect differs by gender. We analysed the effects of the Spanish economic recession in terms of self-rated health, its differential effect among genders and its influence on gender gap. Study design: Repeated cross-sectional study using Spanish health surveys (2001–2014). Methods: Logistic regression models were conducted to explore the association between self-rated health and employment status and its evolution over time and gender. To test the impact of the economic recession, pooled data regression models were conducted. Results: In this study, we considered 104,577 subjects. During the last 15 years, women have entered the labour market, leading to wide changes in the Spanish traditional family roles. Instead of an increasing proportion of women workers, gender employment differences persist. Therefore, in 2014, the prevalence of workers was 55.77% in men, whereas in women, it was 44.01%. Self-rated health trends during the economic recession differ by gender, with women improving slightly their self-rated health from a low self-rated health prevalence of 38.76% in 2001 to 33.78% in 2014. On the contrary, men seem more vulnerable to employment circumstances, which have led to substantial reduction in the gender gap. Conclusions: Although a gender gap persists, the change in socio-economic roles seems to increase women's self-rated health, reducing this gap. It is important to promote women's labour market inclusion, even in economic recession periods

Understanding the effect of economic recession on healthcare services: a systematic review

Background: We aimed to examine the available evidence about the impact of the crisis on the use of healthcare services in Europe. Methods: We developed a systematic review of scientific literature for the period 2008-2017. The researchers searched three databases Medline/PubMed, Scopus and Web of Knowledge. For manual searching, several spe-cialized journals of related scope as well as the finalized articles'' reference list were searched. Descriptive and thematic analyses were carried out. PRISMA quality criteria and the recommendations of the Centre for Reviews and Dissemination were followed. Results: Of 3, 685 studies, 35 met inclusion criteria. Regarding “Effects of the social structure” healthcare accessibility inequalities increased by socioeconomic levels, especially in unemployed, people with low educational levels and migrants. Regarding “Healthcare effect”, the impact of the recession was observed in unmet needs, pharmaceutical spending containment, reduction of hospital beds, and privatization of services. Conclusion: Austerity policies have contributed to increasing inequalities in the use of health services during the economic downturn. In the current economic climate, new management and health planning strategies such as hospitalisation at home, new models of integrated care and pharmaceutical management are needed to help achieve greater equity and equality in health

Diseño de un Regulador de Frecuencia en base a dispositivos PSoC

  Presently work is carried out the design of a Regulator of Frequency for micro, mini and small central hydroelectric isolated with a microcontrolador PSoC. For the realization of the design the Software ISIS Professional of the Proteus7 is used Professional and the development environment PSoC Designer v5.1 to compile the code source. A study of the microcontroladores PsoC is made and the characteristic of the PSoC CY8C27443-24PXI is detailed. Their digital and analogical blocks are described, as well as the E/S pines, the excitement ways and the configuration of interruptions. Finally a diagram is shown in blocks of the Regulator of Frequency and then the electric outline is designed of each one of the blocks. Being achieved the design of a Regulator of Frequency, for the load method ballasts for micro, mini and small central hydroelectric isolated, based on devices PSoC.   Index Terms—frequency controller, PSoC microcontrollers, power plan

Generation of a protocol for the synthesis of chitosan nanoparticles loaded with florfenicol through the ionic gelation method

La formación de nanopartículas de quitosano mediante el método de gelación iónica tiene un alto potencial para la carga, transporte y liberación controlada de moléculas. Es un método sencillo y las nanopartículas presentan buena absorción, estabilidad, biocompatibilidad y baja toxicidad. El florfenicol es uno de los antibióticos más utilizados en la industria acuícola y es administrado mezclado con el alimento en altas concentraciones, lo cual genera problemas de dosis efectivas y de residuos no deseados. De esta manera, la síntesis de nanopartículas de quitosano (Q) cargadas con florfenicol podría otorgar ventajas a la hora de proteger, transportar y liberar de forma controlada el fármaco en peces de interés económico. En el presente estudio se sintetizaron nanopartículas de quitosano y tripolifosfato de sodio (TPP) con y sin florfenicol para evaluar su carga efectiva y liberación. Los resultados obtenidos con espectrometría FTIR corroboran la formación de las nanopartículas de Q-TPP con los cambios observados en los patrones de espectros infrarojo entre el quitosano matriz y las nanopartículas sintetizadas. Las nanopartículas de Q-TPP pueden cargar entre 48 y 50% de florfenicol en su interior. El ensayo de liberación in vitro del antibiótico mostró una liberación controlada y estable en el tiempo en condiciones de pH ácido y temperatura controlada de 15° C de hasta 10 días. Finalmente, se muestra que las nanopartículas de Q-TPP tienen potencial para atrapar y liberar de forma controlada el fármaco evaluadoThe formation of nanoparticles of chitosan by the ionic gelation method has a high potential for loading, transport and controlled release of molecules. It is a simple method and the nanoparticles have good absorption, stability, biocompatibility and low toxicity. Florfenicol is one of the most used antibiotics in the aquaculture industry and is administered mixed with the feed in high concentrations, which generates problems of effective doses and unwanted residues. In this way, the synthesis of chitosan (Q) nanoparticles loaded with florfenicol could provide advantages when it comes to protecting, transporting and releasing the drug in fish of economic interest in a controlled manner. In the present study, nanoparticles of chitosan and sodium tripolyphosphate (TPP) with and without florfenicol were synthesized to evaluate their effective loading and release. The results obtained with FTIR spectrometry corroborate the formation of the Q-TPP nanoparticles with the changes observed in the infrared spectra patterns between the matrix chitosan and the synthesized nanoparticles. Q-TPP nanoparticles can carry between 48 and 50% of florfenicol inside. The in vitro release assay of the antibiotic showed a controlled and stable release over time under conditions of acid pH and controlled temperature of 15 degrees C for up to 10 days. Finally, it is shown that the Q-TPP nanoparticles have the potential to trap and release the evaluated drug in a controlled manne

Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial

The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012

The nurse’s role in educating pediatric patients on correct inhaler technique: an interventional study

The prevalence of pediatric respiratory diseases in Spain is 23%. Inhalation is the preferred route of administration but there are frequent errors in the performance of the inhalation technique leading a poor control of the disease. The aim of this research was to detect errors in the execution of the inhalation technique at a Pediatric Pulmonology Unit in a hospital of Aragón (Spain). In order to improve the administration of inhaled medication, an educational intervention for 1 year by nursing was conducted. This interventional study, including children aged 1 to 15 years with an inhalation therapy and who attended the Pediatric Pulmonology Unit, was conducted between September 2017 and September 2018. Logistic Regression models were conducted in SPSS. This study involved 393 children (61.1% boys). Before the intervention, 39.4% achieved a correct inhalation technique increasing up to 62.1% after the intervention. Those who had their first visit to the Unit, young children and girls had a higher risk of incorrect performance than those with subsequent visits, older children, and boys, respectively. The most common errors in the inhalation technique were not performing adequate apnoea after inhaling and not rinsing the mouth at the end of the procedure. The education given by nurses to pediatric patients improved the inhalation technique, achieving better control of the disease and use of the health system. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Noble gas signals in corals predict submarine volcanic eruptions

Deep-water corals growing in close proximity to the 2011 submarine eruption at Tagoro (El Hierro Island; Canary Archipielago, Spain) have revealed their ability to record the magmatic helium (3He) signal during a period of months prior to the eruption with magmatic 3He/4He ratios of 3.6-5.0 RA This is similar to the range of He isotope values (3-10 Ra) obtained from olivine samples from basinites erupted during the 2011 Tagoro eruption. Whip-like black corals (Anthozoa: Antipatharia: Antipathidae: Stichopathes) growing on basaltic rocks trapped 3He within their skeletons. We used a theoretical growth rate to estimate the time of trapping of 3He between release from the magmatic source at depth to trapping by the aquatic organisms. Our findings suggest that magmatic 3He emission occurred a few months before the beginning of the seismic activity in the region, the latter occurring four months in advance of the beginning of the eruption. This discovery implies that corals living in submarine volcanic areas may act as archives of noble gases released before the beginning of an eruption, and that the continuous monitoring of 3He may help to constrain the arrival time of a subaqueous eruption with potential applications in volcano eruption forecasting.En prens

EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol

Introduction: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. Methods: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40kg/m2), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. Discussion: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. Ethicsanddissemination: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614