User satisfaction in the spanish health system: trend analysis

OBJETIVO: Analizar la tendencia de indicadores de opinión y satisfacción del sistema nacional de salud español de 2005 a 2017 MÉTODOS: Estudio ecológico de series temporales analizando la tendencia de ocho indicadores de opinión y satisfacción sobre el sistema nacional de salud y sus comunidades autónomas de 2005 a 2017. Los datos se obtuvieron del Ministerio de Sanidad, Servicios Sociales e Igualdad y del Barómetro Sanitario. Se utilizó el método de autoregresión de Prais-Winsten. RESULTADOS: Se observó una tendencia estática en la percepción de los usuarios sobre el funcionamiento del sistema sanitario (APC = 1,898; IC95% -0,954–4,751) y decreciente sobre la opinión en la mejora de la atención primaria (APC = -0.283; IC95% -0,335– -0.121), especializada (APC = -0,241; IC95% -0.74– -0.109) y hospitalización (APC = -0.171; IC95% -0,307– -0,036). La satisfacción con el conocimiento y seguimiento por el médico de familia y pediatra mostró una tendencia creciente (APC = 7,939; IC95% 3,965–11,914). La satisfacción con los profesionales de medicina y enfermería fue estática. No se observaron grandes diferencias en las tendencias de los indicadores estudiados en las comunidades autónomas. CONCLUSIONES: Se observó una tendencia negativa en la opinión de los usuarios del sistema nacional de salud español. Financiación, recursos humanos, sistemas de gestión de calidad y diferencias en las comunidades autónomas pueden ser algunas de las causas.OBJECTIVE: To analyze the trend of opinion and satisfaction indicators of the Spanish national health system from 2005 to 2017 METHODS: Ecological study of time series analyzing the trend of eight indicators of opinion and satisfaction on the Spanish national health system and its autonomous communities from 2005 to 2017. The data was obtained from the Ministry of Health, Social Services and Equality and from the Health Barometer. The Prais-Winsten regression method was used. RESULTS: A static tendency was observed in the perception of users on how the health system works (APC = 1.898, 95%CI -0.954 – 4.751) and decreasing opinion on the improvement of primary care (APC = -0.283; 95%CI -0.335 – -0.121), specialized (APC = -0.241, 95%CI -0.74 – -0.109) and hospitalization (APC = -0.171, 95%CI -0.307 – -0.036). Satisfaction with knowledge and follow-up by the family doctor and pediatrician showed an increasing trend (APC = 7.939, 95%CI 3.965 – 11.914). Satisfaction with medical and nursing professionals was static. No large differences were observed in the trends of the indicators studied in the autonomous communities. CONCLUSIONS: A negative trend was observed in the opinion of the Spanish national health system users. Financing, human resources, quality management systems and differences in the autonomous communities may be some of the causes

Advanced Proteomic Approaches to Elucidate Somatic Embryogenesis

Somatic embryogenesis (SE) is a cell differentiation process by which a somatic cell changes its genetic program and develops into an embryonic cell. Investigating this process with various explant sources in vitro has allowed us to trace somatic embryo development from germination to plantlets and has led to the generation of new technologies, including genetic transformation, endangered species conservation, and synthetic seed production. A transcriptome data comparison from different stages of the developing somatic embryo has revealed a complex network controlling the somatic cell’s fate, suggesting that an interconnected network acts at the protein level. Here, we discuss the current progress on SE using proteomic-based data, focusing on changing patterns of proteins during the establishment of the somatic embryo. Despite the advanced proteomic approaches available so far, deciphering how the somatic embryo is induced is still in its infancy. The new proteomics techniques that lead to the quantification of proteins with different abundances during the induction of SE are opening this area of study for the first time. These quantitative differences can elucidate the different pathways involved in SE induction. We envisage that the application of these proteomic technologies can be pivotal to identifying proteins critical to the process of SE, demonstrating the cellular localization, posttranslational modifications, and turnover protein events required to switch from a somatic cell to a somatic embryo cell and providing new insights into the molecular mechanisms underlying SE. This work will help to develop biotechnological strategies for mass production of quality crop material

Tailoring Organic-Organic Poly(vinylpyrrolidone) Microparticles and Fibers with Multiwalled Carbon Nanotubes for Reinforced Composites

Polymeric-based microparticles and fibers are tailorable for a wide range of common industrial and biomedical applications, while multiwalled carbon nanotubes (MWCNTs) are among the most useful macromolecules based on their outstanding electronic, mechanical, and optical properties at the nanoscale. If one combines these nanostructures with various polymeric precursors, their range of potential applications becomes even greater. One of the simplest and most affordable methods for fabricating micro- and nanostructures is electrospinning. Herein we demonstrate how MWCNTs may be used to produce tailor-made organic-organic poly(vinylpyrrolidone) (PVP) microparticles and fibers via electrospinning by studying their structural, vibrational, rheological, and mechanical properties' dependence on their solvent (ethanol (EtOH) or dimethylformamide (DMF)) and resulting morphology. Specifically, we find clear differences in morphologies from perfectly spherical and isolated microparticles to fibers mats, or a combination of fibers with entangled beads, with solvent type and concentration. On the basis of our findings, we propose that the mechanism governing the shape and size of the particles is a competition between the solvent's surface tension, dielectric constant, and viscoelastic properties. We show, based on both our experimental results and density functional theory (DFT) calculations, that OH functionalization of the MWCNTs is essential for achieving high PVP coverages and promoting the stability of the resulting PVP/MWCNT nanocomposite. Finally, by fabricating PVP/MWCNT fiber mats, we demonstrate that low concentrations (0.01-0.1 wt %) of MWCNTs led to a qualitative improvement (â250%) in the resulting mechanical properties, i.e., a reinforced composite. These results show how by controlling the solvent's dielectric constant, surface tension, and polymer concentration, one may produce tailor-made polymeric nanomaterials in combination with other organic/inorganic nanoparticles, i.e., silver, gold, or carbon allotropes, for next-generation applications

Spanish nursing and medical students' knowledge, confidence and willingness about COVID-19: A cross-sectional study

Background: COVID-19 challenges world governments. In Spain, measures to contain the pandemic are novel, and include the possibility of contracting Nursing and Medical students who might not be ready or willing to treat infected cases. Objectives: To study Spanish Nursing and Medical students' knowledge about COVID-19 community transmission prevention measures, treating infected patients, and their confidence and willingness to treat cases. To learn their views about the first public health policy measures adopted by the Spain government to contain the pandemic. Design: Cross-sectional study. Settings and participants: 237 Spanish Nursing and Medical students. Methods: An online questionnaire was designed on the knowledge, confidence and willingness to treat, and the suitability of the public health policy measures adopted in Spain. The data were collected through social net-works. The results were compared according to their university degree. Results: Knowledge about community prevention was suitable, unlike knowledge about treating infected patients. Students had little confidence in treating cases, but their willingness and moral responsibility were high. Very few significant differences were found in their university degrees. Medical students evaluated the measures taken in Spain more favorably. Conclusions: Students' knowledge about COVID-19 community prevention measures was adequate, but not about preventive measures when treating patients with COVID-19. They felt little confidence despite being willing to treat infected patients. The sample agreed with the public health measures adopted in Spain

Can Virtual Reality Help Improve Motor and Cognitive Function in Active Aging in Older Adults? A Scoping Review

Background: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. Methods: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. Results: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). Conclusions: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates

Integrated molecular signaling involving mitochondrial dysfunction and alteration of cell metabolism induced by tyrosine kinase inhibitors in cancer

Cancer cells have unlimited replicative potential, insensitivity to growth-inhibitory signals, evasion of apoptosis, cellular stress, and sustained angiogenesis, invasiveness and metastatic potential. Cancer cells adequately adapt cell metabolism and integrate several intracellular and redox signaling to promote cell survival in an inflammatory and hypoxic microenvironment in order to maintain/expand tumor phenotype. The administration of tyrosine kinase inhibitor (TKI) constitutes the recommended therapeutic strategy in different malignancies at advanced stages. There are important interrelationships between cell stress, redox status, mitochondrial function, metabolism and cellular signaling pathways leading to cell survival/death. The induction of apoptosis and cell cycle arrest widely related to the antitumoral properties of TKIs result from tightly controlled events involving different cellular compartments and signaling pathways. The aim of the present review is to update the most relevant studies dealing with the impact of TKI treatment on cell function. The induction of endoplasmic reticulum (ER) stress and Ca2+ disturbances, leading to alteration of mitochondrial function, redox status and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt)-mammalian target of rapamycin (mTOR) and AMP-activated protein kinase (AMPK) signaling pathways that involve cell metabolism reprogramming in cancer cells will be covered. Emphasis will be given to studies that identify key components of the integrated molecular pattern including receptor tyrosine kinase (RTK) downstream signaling, cell death and mitochondria-related events that appear to be involved in the resistance of cancer cells to TKI treatments.This study was funded by Institute of Health Carlos III (ISCiii) (PI16/00090, PI19/00838 and PI19/01266), Spanish Ministry of Economy and Competitiveness (BFU2016-80006-P), Andalusian Ministry of Economy, Innovation, Science and Employment (BIO-216 and CTS-6264), Andalusian Ministry of Equality, Health and Social Policies (PI-0198-2016) and Valencian Ministry of Education, Culture and Sports (PROMETEO/2019/027). P de la C-O was supported by FPU predoctoral fellowship (FPU17/00026) from Spanish Ministry of Education, Culture and Sports. E N-V was supported by the the predoctoral i-PFIS IIS-enterprise contract in science and technologies in health (IFI18/00014) from ISCiii. We thank the Biomedical Research Network Center for Cardiovascular Diseases (CIBERcv), and the Biomedical Research Network Center for Liver and Digestive Diseases (CIBERehd) founded by the ISCiii and co-financed by European Regional Development Fund (ERDF) "A way to achieve Europe" for their financial support

One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry

Background: The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored. Methods: This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ?18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included. Patients were classified into two cohorts depending on the nasopharyngeal swab result and clinical status: confirmed COVID-19 (positive RT-PCR) and control (without suggestive symptoms and negative RT-PCR). Data were obtained from electronic records, and clinical follow-up was performed at 1-year. The primary outcome was CV death at 1-year. Secondary outcomes included arterial thrombotic events (ATE), venous thromboembolism (VTE), and serious cardiac arrhythmias. An independent clinical event committee adjudicated events. A Cox proportional hazards model adjusted for all baseline characteristics was used for comparing outcomes between groups. A prespecified landmark analysis was performed to assess events during the post-acute phase (31-365 days). Results: A total of 4,427 patients were included: 3,578 (80.8%) in the COVID-19 and 849 (19.2%) control cohorts. At one year, there were no significant differences in the primary endpoint of CV death between the COVID-19 and control cohorts (1.4% vs. 0.8%; HRadj 1.28 [0.56-2.91]; p = 0.555), but there was a higher risk of all-cause death (17.8% vs. 4.0%; HRadj 2.82 [1.99-4.0]; p = 0.001). COVID-19 cohort had higher rates of ATE (2.5% vs. 0.8%, HRadj 2.26 [1.02-4.99]; p = 0.044), VTE (3.7% vs. 0.4%, HRadj 9.33 [2.93-29.70]; p = 0.001), and serious cardiac arrhythmias (2.5% vs. 0.6%, HRadj 3.37 [1.35-8.46]; p = 0.010). During the post-acute phase, there were no significant differences in CV death (0.6% vs. 0.7%; HRadj 0.67 [0.25-1.80]; p = 0.425), but there was a higher risk of deep vein thrombosis (0.6% vs. 0.0%; p = 0.028). Re-hospitalization rate was lower in the COVID-19 cohort compared to the control cohort (13.9% vs. 20.6%; p = 0.001). Conclusions: At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death