Reply to Comment on Cobo-Cuenca, A.I.; Laredo-Aguilera, J.A.; Rodríguez-Borrego, M.-A.; Santacruz-Salas, E.; Carmona-Torres, J.M. Temporal Trends in Fecal Occult Blood Test: Associated Factors (2009–2017). Int. J. Environ. Res. Public Health 2019, 16, 2120

In this study [...

Temporal Trends in Fecal Occult Blood Test: Associated Factors (2009–2017)

A cross-sectional study with 27,821 records of non-institutionalized people in Spain aged between 50–69 years old (59.94 ± 5.8 years), who participated in the European Health Survey in Spain (2009, 2014) and National Health Survey (2011/12, 2017). Fecal occult testing, the reason for performing the test, age, sex, nationality, social status, marital status, education level, body mass index (BMI), and place of residence. Overall, 54% were women, 93.9% were Spanish, 47.8% had a secondary study, and 66.4% were married. Across the years, the rate of the fecal occult blood test (FOBT) increased significantly (p < 0.001). This increase can be accounted for a letter campaign advising testing (45%, p < 0.001). FOBT was associated with more age (odds ratio—OR 1.04, 95% confidence interval—CI 1.04–1.05, p < 0.001), Spanish nationality (OR 1.91, 95% CI 1.25–2.93, p = 0.003), being married (OR 1.13, 95% CI 1.02–1.25, p = 0.025), having a higher level of education (OR 2.46, 95% CI 2.17–2.81, p < 0.001), belonging to high social classes (OR 1.35, 95% CI 1.12–1.64, p = 0.001), and BMI <25 (OR 1.72, 95% CI 1.25–2.37). Frequency of FOBT has increased in recent years. Performing FOBT is associated with age, nationality, marital status, higher education level, and social class

Levels of Physical Activity, Obesity and Related Factors in Young Adults Aged 18–30 During 2009–2017

The objective of this study was to analyze the temporal trend of physical activity and body mass index in young adults aged 18–30 in Spain and to ascertain their relationship with sociodemographic and psychosocial variables in the period of 2009–2017. Methods: A descriptive study with a sample of 10,061 young adults aged 18–30 years was performed. The data were obtained from the European Health Survey in Spain in 2009 and 2014 and the National Health Survey in 2011/2012 and 2017. The chi-square test was used for qualitative variables, and multiple linear regression analysis was performed for physical activity. Results: Sedentary levels had decreased in 2017 as compared to 2011/2012 (p < 0.001); smokers were more sedentary than non-smokers (p < 0.001); men were more active than women (p < 0.001); and the year with the highest physical activity was 2014. Body mass index in the total sample increased from 2009 to 2017 (p < 0.01), showing a significant increase in obesity in women (p < 0.05) and no difference in men (p ≥ 0.05). Conclusions: In the period 2011/2012–2017, the sedentary lifestyle of young adults was reduced and physical activity was increased, with men being more active than women

Relación entre el tipo de lactancia suministrada y el gasto sanitario generado

La lactancia materna (LM) ha alcanzado la consideración del mejor alimento que puede recibir un recién nacido (RN) debido a sus propiedades nutricionales y ofrecer beneficios a todos los niveles, individuales, familiares y sociales. Actualmente se necesita un cambio respecto a las prácticas del amamantamiento ya que las tasas actuales aún continúan por debajo de las recomendaciones ofrecidas por la OMS y UNICEF. Teniendo en cuenta el ahorro económico que proporciona para nuestro Sistema de Salud frente a otros tipos de alimentación, se llevó a cabo este estudio de cohortes prospectivo (observacional, analítico y longitudinal), con el objetivo principal de ¿estimar el impacto sobre el coste directo sanitario, derivado de la morbilidad infantil, asociado a la introducción y mantenimiento de la Lactancia Materna Exclusiva (LME) frente a otras formas de alimentar al bebé, al mes, a los 3 y a los 6 meses de edad”; La muestra fueron madres residentes en la provincia de Toledo entrevistadas tras el parto, al mes y 6 meses. Los resultados muestran una prevalencia de LME a los 6 meses de 19,49%, características que favorecen su mantenimiento y/o aumentan el riesgo de abandono y una reducción de 128,96% de los costes sanitarios al ofrecer LME 6 meses frente a no hacerlo, debido al exceso de la morbilidad, mayor utilización de los recursos sanitarios y aumento del consumo farmacológico. Se estima un ahorro de 51.255.769 €/año en el Sistema Sanitario Español sólo aumentando al 50% la tasa de LME 6 meses. CONCLUSIONES: la prevalencia de LME continúa siendo baja y además esta práctica ofrece datos de rentabilidad y eficiencia que hacen necesario continuar recabando información para fomentar y promoverla desde todos los niveles sociales y profesionales

03 Evaluación de las actividades en los entornos virtuales de aprendizaje

Debido a la incorporación continúa de las nuevas Tecnologías de Información y Comunicación (TIC), la actividad docente del profesorado, así como la de aprendizaje del alumnado, está actualmente en constante cambio. Por tanto, la incorporación de diferentes metodologías docentes en marcos relacionales síncronos (presenciales) y asíncronos (no presenciales o virtuales), no puede llevar implícito el manejo y uso de las mismas estrategias de enseñanza, ni tampoco evaluativas, en los nuevos marcos educativos. Hacer esto, demostraría no sólo nuestra deficiente capacidad como docente, y poca capacidad adaptativa al entorno, sino que además constituiría un grave error. Los entornos virtuales de aprendizaje (EVA) incluyen diferentes actividades y difieren de la forma tradicional de evaluación de la metodología clásica de enseñanza-aprendizaje

Mothers' Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months.

The aims were to determine Spanish women's expectations about exclusive breastfeeding (EB) and the effect of expectations and other factors on EB during the first 6 months. A prospective cohort study was conducted with 236 participants. Variables were maternal age, marital status, occupation, expectations about breastfeeding, knowledge about breastfeeding, type of delivery, type of feeding, and duration of EB. Data were collected through three personal interviews, at the hospital (before delivery) and in two telephone calls in the first and sixth months postpartum. Average age was 32.3 years (SD = 5.3); average duration of EB was 2.73 months (SD = 2.49). Of 236 women who had decided to breastfeed before birth, 201 (85.2%) offered EB after delivery. Achievement of expectations was most influenced by the decision to continue breastfeeding 'as long as I can' (OR: 5.4; CI: 2.0-14.6) and previous experience (OR: 3.2; CI: 1.2-8.5). Knowledge of breastfeeding acquired from relatives (OR: 9.2; CI: 3.0-27.9), caesarean delivery (OR: 4.6; CI: 1.7-12.8) and maternal age (36-40 years old) (OR: 7.5; CI: 1.8-30.9) were associated with failure to achieve EB. Achievement of EB may depend on a woman's confidence in her ability to do so and on knowledge obtained in the social environment

Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models

Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but main taining EBF for the minimum recommended time of 6 months is challenging. Aims: This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. Method: This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. Results: The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experience with practicing EBF for more than 6 months (p = 0.00). The reason for the earliest EBF cessation (mean 52.63 ± 56.98 days) was the mother’s lack of self-efficacy (p = 0.05). Conclusion: Knowing the reasons for EBF cessation among mothers is important for helping mothers and preventing early weaning. A safe environment and support can prevent early weaning.This research was funded by a grant from the European Regional Development Fund (ERDF) (Fondo Europeo de Desarrollo Regional (FEDER), (DOCM 26/02/20)).Ye

Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis.

The evidence about the best body position to prevent ventilator-associated pneumonia (VAP) is unclear. The aim of this study was to know what the best body position is to prevent VAP, shorten the length of intensive care unit (ICU) and hospital stay, and reduce mortality among patients undergoing mechanical ventilation (MV). We performed a network meta-analysis of randomized controlled trials including intubated patients undergoing MV and admitted to an ICU. The assessed interventions were different body positions (i.e., lateral, prone, semi-recumbent) or alternative degrees of positioning in mechanically ventilated patients. Semi-recumbent and prone positions showed a risk reduction of VAP incidence (RR: 0.38, 95% CI: 0.25-0.52) and mortality (RR: 0.70, 95% CI: 0.50-0.91), respectively, compared to the supine position. The ranking probabilities and the surface under the cumulative ranking displayed as the first best option of treatment the semi-recumbent position to reduce the incidence of VAP (71.4%), the hospital length of stay (68.9%), and the duration of MV (67.6%); and the prone position to decrease the mortality (89.3%) and to reduce the ICU length of stay (59.3%). Cautiously, semi-recumbent seems to be the best position to reduce VAP incidence, hospital length of stay and the duration of MV. Prone is the most effective position to reduce the risk of mortality and the ICU length of stay, but it showed no effect on the VAP incidence. Registration PROSPERO CRD42021247547