Impact of the COVID-19 pandemic on cervical cancer screening participation, abnormal cytology prevalence and screening interval in Catalonia.

Background: The COVID-19 pandemic led to a national lockdown and the interruption of all cancer preventive services, including cervical cancer screening. We aimed to assess the COVID-19 pandemic impact on opportunistic screening participation, abnormal cytology (ASCUS+) prevalence and screening interval in 2020 and 2021 within the Public Health System of Catalonia, Spain. Methods: Individual data on cytology and HPV testing of women aged 25-65 from 2014 to 2021 were retrieved from the Information System for Primary Care Services (SISAP). Time-series regression models were used to estimate expected screening participation and abnormal cytology prevalence in 2020 and 2021. The impact was determined by comparing observed and expected values (ratios). Additionally, changes in screening interval trends between 2014 and 2021 were assessed by fitting a Piecewise linear regression model. Results: Cervical cancer screening participation decreased by 38.8% and 2.2% in 2020 and 2021, respectively, with the most significant impact on participation (-96.1%) occurring in April 2020. Among older women, participation was lower, and it took longer to recover. Abnormal cytology prevalence was 1.4 times higher than expected in 2020 and 2021, with variations by age (range=1.1-1.5). From June 2020 onwards, the screening interval trend significantly changed from an increase of 0.59 to 3.57 months per year, resulting in a median time of 48 months by December 2021. Conclusions: During the pandemic, fewer women have participated in cervical cancer screening, abnormal cytology prevalence has increased, and the screening interval is more prolonged than before. The potential cervical cancer lifetime risk implications highlight the need for organized HPV-based screening.

Prevalence and coexistence of type 2 inflammatory diseases.

BACKGROUND: Type 2 inflammation has been described as a pathophysiological basis common to some diseases, such as atopic dermatitis (AD), chronic rhinosinusitis with nasal polyps, and asthma (CRSwNP). OBJECTIVE: The present study used population-based prevalence in Catalonia to analyse the coexistence of type 2 inflammatory diseases in patients primarily diagnosed with the above mentioned conditions. RESULTS: We found a high degree of coexistence of type 2 inflammatory diseases among these patients, with the prevalence being higher in the severe forms, except for AD. For the severe forms of primary diseases, the proportion of patients with coexisting type 2 inflammatory diseases (severe or non-severe) was 16.2% for AD, 19.8% for asthma, and a striking 62.4% for CRSwNP. This patient population has the highest proportion of coexisting type 2 inflammatory diseases, both severe (48.9%) and non-severe (13.5%). CONCLUSION: Our findings have significant implications for the management of patients with AD, asthma, and CRSwNP.

[Cost-effectiveness analysis of fracture liaison services in Catalonia]. / Análisis de coste-efectividad de las Unidades de Coordinación de Fracturas en Cataluña.

OBJECTIVE: To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service. METHODS: Cost-utility assessment through a Markov model that simulated disease progression of a patients' cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses. RESULTS: Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case. CONCLUSIONS: The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.

Leishmania Infection in Wild Lagomorphs and Domestic Dogs in North-East Spain.

Leishmania infantum is a zoonotic protozoan parasite distributed worldwide that is transmitted by phlebotomine sandflies. Dogs are the main reservoir for human infections. However, in recent years, the capacity of lagomorphs to contribute to Leishmania transmission has been confirmed. The present study aimed to assess Leishmania spp. exposure and infection in lagomorphs and sympatric domestic dogs in NE Spain. Sera from European hares, European rabbits, and rural dogs were tested for antibodies against L. infantum using an in-house indirect ELISA. PCR analysis targeting Leishmania spp. was performed in spleens from L. europaeus. Antibodies against Leishmania spp. were detected in all the species analyzed. Total sample prevalence was significantly higher in O. cuniculus (27.9%) than in L. europaeus (2.0%). Results of the PCR were all negative. The present study expands knowledge about Leishmania infections in free-ranging lagomorphs in the Iberian Peninsula, suggesting a more important role of O. cuniculus in the study area. Given the strong correlation between lagomorph densities and human leishmaniasis outbreaks in Spain, the high rabbit and human densities in NE Spain, and the high Leishmania spp. seroprevalence in rabbits, it becomes imperative to establish surveillance programs for lagomorphs in this region.

Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis.

Background: Inflammatory bowel disease (IBD) has a major economic impact on healthcare costs. Objectives: The aim of this study was to evaluate the current healthcare expenditure associated with IBD in a population-wide study in Catalonia. Design: Retrospective observational study. Methods: All patients with IBD included in the Catalan Health Surveillance System (CHSS) were considered eligible. The CHSS compiles data on more than 7 million individuals in 2020 (34,823 with IBD). Data on the use of healthcare resources and its economic impact were extracted applying the International Classification of Diseases, 10th revision, Clinical Modification codes (ICD-10-CM codes). Health expenditure, comorbidities, and hospitalization were calculated according to the standard costs of each service provided by the Department of Health of the Catalan government. The data on the IBD population were compared with non-IBD population adjusted for age, sex, and income level. IBD costs were recorded separately for Crohn's disease (CD) and ulcerative colitis (UC). Results: Prevalence of comorbidities was higher in patients with IBD than in those without. The risk of hospitalization was twice as high in the IBD population. The overall healthcare expenditure on IBD patients amounted to 164M€. The pharmacy cost represents the 60%. The average annual per capita expenditure on IBD patients was more than 3.4-fold higher (IBD 4200€, non-IBD 1200€). Average costs of UC were 3400€ and 5700€ for CD. Conclusion: The risk of comorbidities was twice as high in patients with IBD and their use of healthcare resources was also higher than that of their non-IBD counterparts. Per capita healthcare expenditure was approximately 3.4 times higher in the population with IBD. Trial registration: The study was not previously registered.

Economic impact of inflammatory bowel disease in Catalonia The manuscript includes data of the most recent epidemiologic data about the high economic impact of IBD in Catalonia.

[The accuracy of the causes of death with judicial intervention in Catalonia in the period 2015-2020. Effect of declaration through IML-Web application]. / La precisión de las causas de defunción con intervención judicial en Cataluña en el periodo 2015-2020. Efecto de la declaración a través de la aplicación IML-Web.

OBJECTIVE: On January first, 2020, the Institutes of Legal Medicine and Forensic Sciences (IMLCF) began to inform the causes of death directly to the National Statistics Institute (INE) through a web application (IML-Web). The objective of this study was to evaluate the impact of the implementation of this application on the quality of the data collected. METHODS: A descriptive study using deaths data with judicial intervention that occurred in Catalonia was carried out. The data of the period 2015-2018 and 2019 was compared with 2020. The percentages, with confidence intervals, of the causes of death that were not specific, according to different classifications, were calculated on the total of cases by period and territory. RESULTS: The total percentage of non-specific deaths had decreased, not significantly, by 1.6 points between the period 2015-2018 and 2020. The same indicator between 2019 and 2020 had decreased by 13.4 points. The percentage of non-specific deaths from external causes showed significant drops between both periods and 2020. In general, the indicators displayed territorial differences. CONCLUSIONS: The roll-out of the IML-Web implies, compared to 2019, an improvement in the quality of the data. On the other hand, compared to the period 2015-2018, the data show a similar level of quality. Generally, it is assessed that the information provided by IMLCF of Catalonia through the IML-Web is accurate, but still has room for improvement.

OBJECTIVE: A partir del 1 enero de 2020, los Institutos de Medicina Legal y Ciencias Forenses (IMLCF) empezaron a declarar las causas de muerte directamente al Instituto Nacional de Estadística (INE) mediante una aplicación web (IML-Web). El objetivo de este trabajo fue evaluar el impacto de la implementación de esta aplicación en la calidad de los datos recogidos. METHODS: Se realizó un estudio descriptivo utilizando datos de las defunciones con intervención judicial ocurridas en Cataluña. Se comparó la información del período 2015-2018 y de 2019 con la de 2020. Se calcularon los porcentajes, con intervalo de confianza, de las causas de defunción poco específicas, según diferentes clasificaciones, sobre el total de causas por período y división judicial. RESULTS: El porcentaje total de causas de defunción poco específicas se redujo, de forma no significativa, 1,6 puntos entre el período 2015-2018 y el año 2020. El mismo indicador entre el año 2019 y 2020 se redujo 13,4 puntos. El porcentaje de defunciones poco específicas de causas externas mostró reducciones estadísticamente significativas entre ambos períodos. En general los indicadores mostraron diferencias territoriales. CONCLUSIONS: La implementación del IML-Web en el año 2020 supone, en comparación con 2019, una mejora en la calidad de la información notificada. En cambio, si se compara con el período 2015-2018, los datos muestran una calidad similar. A nivel general se valora que la información proporcionada por el IMLCF de Cataluña a través del IML-Web es precisa, pero todavía tiene margen de mejora.

High diversity, novel genotypes, and vertical transmission of hemotropic Mycoplasma in micromammals.

Hemotropic mycoplasmas (hemoplasmas) are emerging zoonotic pathogens. Micromammals have received little attention as hosts for hemoplasmas despite their ubiquitous presence, high population abundances, and close association with humans. A PCR protocol targeting a fragment of the 16 S rRNA gene and direct sequencing in blood samples of 189 adult specimens and 35 fetuses belonging to three species of Eulipotyphla (shrews) and seven species of Rodentia, captured in three ecologically diverse habitats in North-Eastern Spain (Steppe, High Mountain, Mediterranean) yielded and occurrence of 26%, including 36% of 39 shrews and 23% of 150 rodents. Sequencing revealed the presence of 14 nucleotide sequence types (ntST) among the 56 readable sequences. In general, each ntST was associated with a given host species, although in some cases, the same ntST was sequenced in different species (chiefly rodents). Most ntST were closely related to rodent and/or bat hemoplasmas, but one was identical with Mycoplasma haemocanis/haemofelis, and others can be considered novel genotypes. High sequence diversity was detected in rodents, whereas in the white-toothed shrew (Crocidura russula), 9/11 sequences from two distant areas were identical. Phylogenetic and network analyses classified our sequences in different clades including hemoplasmas of rodents, carnivores, bats, and humans. Twelve of the fetuses (34.2%) of 9/12 litters (75.0%) of shrews and rodents were hemoplasma-positive, indicating frequent vertical transmission. Our study contributes to expanding our knowledge about the distribution, diversity, and transmission of hemoplasmas.

La precisión de las causas de defunción con intervención judicial en Cataluña en el periodo 2015-2020. Efecto de la declaración a través de la aplicación IML-Web / The accuracy of the causes of death with judicial intervention in Catalonia in the period 2015-2020. Effect of declaration through IML-Web application

Fundamentos: a partir del 1 enero de 2020, los institutos de medicina legal y ciencias forenses (imlcf) empezaron a declarar las causas de muerte directamente al instituto nacional de estadística (ine) mediante una aplicación web (iml-web). El objetivo de este trabajo fue evaluar el impacto de la implementación de esta aplicación en la calidad de los datos recogidos. Métodos: se realizó un estudio descriptivo utilizando datos de las defunciones con intervención judicial ocurridas en cataluña. Se comparó la información del período 2015-2018 y de 2019 con la de 2020. Se calcularon los porcentajes, con intervalo de confianza, de las causas de defunción poco específicas, según diferentes clasificaciones, sobre el total de causas por período y división judicial. Resultados: el porcentaje total de causas de defunción poco específicas se redujo, de forma no significativa, 1,6 puntos entre el período 2015-2018 y el año 2020. El mismo indicador entre el año 2019 y 2020 se redujo 13,4 puntos. El porcentaje de defunciones poco específicas de causas externas mostró reducciones estadísticamente significativas entre ambos períodos. En general los indicadores mostraron diferencias territoriales. Conclusiones: la implementación del iml-web en el año 2020 supone, en comparación con 2019, una mejora en la calidad de la información notificada. En cambio, si se compara con el período 2015-2018, los datos muestran una calidad similar. A nivel general se valora que la información proporcionada por el imlcf de cataluña a través del iml-web es precisa, pero todavía tiene margen de mejora.(AU)

Background: on january first, 2020, the institutes of legal medicine and forensic sciences (imlcf) began to inform the causes of death directly to the national statistics institute (ine) through a web application (iml-web). The objective of this study was to evaluate the impact of the implementation of this application on the quality of the data collected.methods: a descriptive study using deaths data with judicial intervention that occurred in catalonia was carried out. The data of the period 2015-2018 and 2019 was compared with 2020. The percentages, with confidence intervals, of the causes of death that were not specific, according to different classifications, were calculated on the total of cases by period and territory.results: the total percentage of non-specific deaths had decreased, not significantly, by 1.6 points between the period 2015-2018 and 2020. The same indicator between 2019 and 2020 had decreased by 13.4 points. The percentage of non-specific deaths from external causes showed significant drops between both periods and 2020. In general, the indicators displayed territorial differences.conclusions: the roll-out of the iml-web implies, compared to 2019, an improvement in the quality of the data. On the other hand, compared to the period 2015-2018, the data show a similar level of quality. Generally, it is assessed that the information provided by imlcf of catalonia through the iml-web is accurate, but still has room for improvement.(AU)

Trends in the prevalence of gestational diabetes in Catalonia from 2010 to 2019.

INTRODUCTION: Gestational diabetes mellitus (GDM) is globally increasing due to changes in risk factors such as gestational age, obesity, and socioeconomic status (SES). This study examined trends of GDM prevalence over ten years using a real-world Primary Health Care database from Catalonia (Spain). METHODS: A retrospective analysis of pregnant women screened for GDM was conducted, using clinical and SES data from the SIDIAP database. RESULTS: Among 221,806 women studied from 2010 to 2019,17,587 had GDM, equating to a 7.9% prevalence (95% CI 7.8-8.04). GDM subjects were older (33.5 ± 5.1 vs. 31.2 ± 5.6 years; p < 0.001) and had higher BMI (29.2 ± 5.1 vs .27.8 ± 4.8 kg/m²; p < 0.001) than non-GDM individuals. Overall GDM prevalence remained unchanged throughout the study, although an increase was observed in younger women (below 20 years: 1.28% [95% CI 0.59-2.42] in 2010 to 2.22% [95% CI 0.96-4.33] in 2019, p = 0.02; ages 20-25.9 years: 3.62% [95% CI 3.12-4.17] in 2010 to 4.63% [95% CI 3.88-5.48)] in 2019, p = 0.02). Age, BMI ≥ 25 kg/m2, deprived SES, and previous hypertension and dyslipidaemia were positively associated with GDM. CONCLUSIONS: This study offers insights into GDM prevalence in Catalonia (Spain),showing overall stability except for a rising trend among younger women.

Análisis del intrusismo odontológico en Cataluña a través de sentencias judiciales, 1995-2020 / Analysis of intrusive dentistry in Catalonia through court rulings, 1995-2020

Introducción: El intrusismo en las profesiones sanitarias, y en la Odontología en concreto, sigue siendo un problema vigente a día de hoy, a pesar de los controles de la Administración y de los Colegios Profesionales. Este problema tipificado como delito en el Código Penal español afecta tanto a la Administración, que debe proteger a la sociedad de conductas nocivas, a los profesionales que ejercen dentro de la legalidad y también a la ciudadanía en general. Objetivo: Conocer la situación del delito de intrusismo en Odontología en las provincias de la Comunidad Autónoma de Cataluña entre los años 1995 y 2020. Material y método: Hemos utilizado las bases de datos de “Centro de Documentación del Consejo General del Poder Judicial” (CENDOJ) y “Westlaw de Aranzadi” para la búsqueda de sentencias judiciales utilizando los términos: intrusismo, odontólogo, estomatólogo, Barcelona, Lérida, Girona, Tarragona, Cataluña. Hemos realizado un estudio retrospectivo de las sentencias judiciales intentando conocer quince variables, entre otros, demandante, profesión del demandado, tipo de tratamientos odontológicos realizados y penas impuestas. Resultados: Se obtuvieron once sentencias y tres autos con diferentes resultados en las variables estudiadas. La profesión más habitual es el protésico dental seguido de odontólogos sin título homologado con la ayuda de un colaborador dentista. Los trabajos realizados son muy variados y las sanciones impuestas son muy bajas. Conclusiones: El papel de los Colegios de Dentistas es importante y necesario para que no se den este tipo de prácticas. Las sanciones no ejercen un efecto disuasorio sobre los intrusos. (AU)

Introduction: Intrusiveness in the health professions, and in Dentistry in particular, continues to be a current problem today, despite the controls of the Administration and Professional Associations. This problem classified as a crime in the Spanish Criminal Code affects both the Administration, which must protect society from harmful conduct, professionals who practice within the law and also the general public. Aim: To know the situation of the crime of intrusion in Dentistry in the provinces of the Autonomous Community of Catalonia between the years 1995 and 2020. Material and method: We have used the databases of the “Documentation Center of the General Council of the Judiciary” (CENDOJ) and “Westlaw de Aranzadi” to search for court rulings using the terms: intrusismo, odontólogo, estomatólogo, Barcelona, Lleida, Girona, Tarragona, Catalonia. We have carried out a retrospective study of the judicial sentences trying to know fifteen variables, among others, plaintiff, defendant's profession, type of dental treatment performed and sentences imposed Results: Eleven sentences and three orders were obtained with different results in the variables studied. The most common profession is the dental technician followed by dentists without an approved degree with the help of a dentist collaborator. The work carried out is very varied and the sanctions imposed are very low. Conclusions: The role of the Colleges of Dentists is important and necessary so that this type of practice does not take place. Penalties do not exert a deterrent effect on intruders.

Antibiotics in Catalan Primary Care: Prescription, Use and Remedies for a Crisis of Care.

Antimicrobial resistance is one of the twenty-first century's major health challenges. Linked to the extensive use of antibiotics and other antimicrobials, resistance occurs when microbes stop responding to medications. Rates of antibiotic consumption in Spain are among the highest in Europe. Drawing on research conducted in Catalonia, in this article we present findings from ethnographic fieldwork and semi-structured interviews with general practitioners, residents of Barcelona, and professionals who have worked in antibiotic stewardship. We argue that the circulation of antibiotics should be understood in relation to broader historical processes and the deficient systems of health and social care provision they have produced.

Relacionada amb l'ús extensiu d'antibiòtics i altres antimicrobians, la resistència als antimicrobians és un dels principals reptes de la salut del segle XXI. Les taxes de consum d'antibiòtics a Espanya es troben entre les més altes d'Europa. A partir de la recerca realitzat a la comunitat autònoma de Catalunya, aquest article informa de les conclusions del treball de camp etnogràfic i de les entrevistes semiestructurades amb metges, amb professionals que han treballat en política i recerca d'antibiòtics i amb residents de Barcelona. Defensem que la circulació d'antibiòtics s'ha d'entendre en relació amb els processos històrics més amplis i els sistemes deficients d'atenció sanitària i social que s'han produït al llarg d'aquests.

Assessment of badland susceptibility and its governing factors using a random forest approach. Application to the Upper Llobregat River Basin and Catalonia (Spain).

Badlands are considered hotspots of sediment production, contributing to large fractions of the sediment budget of catchments and river basins. The erosion rates of these areas can exceed 100 t ha-1 y-1, leading to significant environmental and economic impacts. This research aims to assess badland susceptibility and the relevance of its governing factors at different spatial scales using the well-known machine learning approach random forest (RF). The Upper Llobregat River Basin (ULRB, approx. 500 km2) and Catalonia (approx. 32,000 km2) have been selected as study areas. Previous studies stated that the RF approach is successful at making predictions for the same area where it has been trained, but the results of testing it in a different area remains unexplored. This work aims to evaluate the feasibility of upscaling to the large region of Catalonia a RF model trained in the small ULRB area. Two badland datasets of both small and large regions and a total of eleven governing factors have been used to determine the areas susceptible to badlands. Models performance has been analyzed through three different evaluation metrics: overall accuracy, kappa coefficient and area under receiver operating characteristic curve (AUC). The outcomes of this work confirmed that RF is a powerful tool for badland susceptibility analysis, specially when predictions are made in the same scale and spatial context where the model has been trained. Upscaling a RF model defined in the ULRB to the large area of Catalonia has been possible, but improved results have been obtained when the training of the models has directly been performed in the large region. Our final RF modelling results have facilitated the development of a large scale (32,000 km2) Badland Susceptibility Map for the full extension of Catalonia with a predictive overall accuracy of 97%, which strongly emphasizes lithology and Normalized Difference Vegetation Index (NDVI) as the main conditioning factors of badland distribution.

Food Waste and Power Relations in the Agri-Food Chain. The Fruit Sector in Lleida (Catalonia, Spain).

Studies of food waste claim that its main causes are technological and logistical deficiencies in the first stages of the agri-food chain. The present article discusses this statement using a specific case as a starting point: the production of fruit in Lleida (Catalonia, Spain). Since the 1980s, fruit production in this region has undergone a process of innovation and development. However, the agents who participate in the sector claim that the wasted volume of edible foodstuffs is greater than in previous times. This article argues that studies of food waste do not consider the power relations existing within the agri-food chain. When these relations are asymmetrical, technological innovation and logistics optimisation do not improve the efficiency of the system; rather, they help the hegemonic players to monopolise the commercial margin and transfer some of their running costs to the weaker agents. The ethnographic data for the study were obtained between 2017 and 2019 using qualitative research techniques.

Influences of Maternal Weight and Geographic Factors on Offspring Traits of the Edible Dormouse in the NE of the Iberian Peninsula.

The main goal of this study was to analyze the reproductive patterns of edible dormouse (Glis glis) populations in the northeast of the Iberian Peninsula using an 18-year period of data obtained from nest boxes collected between 2004 and 2021. The average litter size in Catalonia (Spain) was 5.5 ± 1.60 (range: 2-9, n = 131), with litter sizes between 5 and 7 pups as the more frequent. The overall mean weight in pink, grey and open eyes pups was 4.8 g/pup, 11.7 g/pup and 23.6 g/pup, respectively. No differences in offspring weights between sexes were found in any of the three age groups. Maternal body weight was positively associated with mean pup weight, whereas no correlation between the weight of the mothers and litter size was found. The trade-off between offspring number and size was not detected at birth. Regarding litter size variation across the geographic gradient (and their climatic gradient associated) from the southernmost populations of the Iberian Peninsula located in Catalonia to the Pyrenees region in Andorra, no evidence to suggest that geographic variables affect litter size was found, discarding (1) an investment in larger litters to compensate shorter seasons related to higher altitudes or northern latitudes, and (2) variation in litter size related to weather changes (e.g., temperature and precipitation) along latitudinal and/or altitudinal gradients.

Preliminary impact of the adoption of the Icelandic Prevention Model in Tarragona City, 2015-2019: A repeated cross-sectional study.

Background: There is a great need for effective primary prevention intervention strategies to reduce and delay onset of adolescent substance use. The Icelandic Prevention Model (IPM) showed great success in Iceland over the past twenty plus years, however, evidence for the transferability of model is still somewhat limited. Using data collected in Tarragona during regional efforts to begin adoption of the IPM in Catalonia, this study tested the transferability and stability of the core risk and protective factor assumptions of the IPM overtime and examined trends of lifetime smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use within the same time period. Methods: This study includes responses from 15- to 16-years-olds from two region-wide samples taken in 2015 and 2019 in Tarragona (N = 2,867). Survey questions assessed frequency of lifetime: smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use, and the core model assumptions. Demographic data were also collected. Logistic regression models of main effects with and without time interaction were used to test assumptions and their stability across time. Chi-square tests and Wilcoxon-Mann-Whitney U tests were used to compare prevalence of substance use and mean scores of primary prevention variables respectively. Results: Lifetime: smoking (-7%, p < 0.001) and cannabis-use (-4%, p < 0.001) decreased, and e-cigarette-use increased (+33%, p < 0.001) in Tarragona. Lifetime intoxication (-7%, p < 0.001) decreased in a single zone exclusively. Most core model assumptions held in their hypothesised direction across time. The strongest positive association was observed between time spent with parents during weekends and reduced odds of lifetime smoking (OR: 0.62, 95%CI: 0.57-0.67) and the strongest negative association was observed between being outside after midnight and increased odds of lifetime intoxication (OR: 1.41, 95%CI: 1.32-1.51). Mean scores of primary prevention variables also changed disproportionately in Tarragona. Conclusion: This study confirms that the core IPM assumptions are similar in Tarragona as in Iceland and other contexts previously examined. They also indicate that prevalence of lifetime smoking, intoxication, and cannabis-use decreased disproportionately in Tarragona between 2015 and 2019 during the first phase of regional adoption of the model. Thus, targeting model assumptions represents a viable primary prevention strategy for communities that hope to reduce smoking, alcohol-use, intoxication, and cannabis-use among adolescents.

Factors associated with PrEP knowledge and intention to use PrEP among HIV-negative men and trans women sex workers in Spain.

Lack of data regarding knowledge and intention to use pre-exposure prophylaxis (PrEP) among sex workers exists in Spain. We conducted a cross-sectional analysis based on data from SexCohort study, which included male (MSW) and trans women sex workers (TWSW), aged ≥18 and recruited in two community-based centres in Barcelona, Spain. Of 116 TWSW and 79 MSW, 49.1% and 58.2% had factual knowledge of PrEP, and 40.3% and 70.1% had the intention to use PrEP, respectively. In the multivariable analyses, we found that education and condomless anal sex with stable partners were associated with PrEP knowledge. Regarding intention to use PrEP, TWSW were less likely than MSW to report an intention to use it (aOR = 0.35, 95% CI: 0.16-0.74). Furthermore, intention to use PrEP was associated with being foreign-born, practicing chemsex, and visiting a medical service in the last 12 months. The results of this study inform future trans-specific guidance for PrEP to be effectively implemented in Spain.

Seafood consumption as a source of exposure to high production volume chemicals: A comparison between Catalonia and the Canary Islands.

Seafood plays an important role in diet because of its health benefits. However, the fact that chemical compounds such as high production volume chemicals may be present in seafood means that its consumption can be a potential risk for population. To assess the occurrence of HPVs and estimate the exposure and risk associated with their consumption, specimens of the most consumed seafood species in Catalonia and the Canary Islands, Spain, were collected and analysed. Results showed higher levels of HPVs in samples from Catalonia and a prevalence of phthalate esters and benzenesulfonamides over the other target compounds in samples from both locations. Multivariate analysis showed spatial differences between the mean concentration profiles of HPVs for the samples from Catalonia and the Canary Islands. Exposures were higher for the samples from Catalonia, although the intake of HPVs via seafood was not of any real concern in either of the locations.

Outcome of COVID-19 infection in people with diabetes mellitus or obesity in the primary care setting in Catalonia, Spain: A retrospective cohort study of the initial three waves.

AIM: We estimate the incidence and risk factors for fatal and non-fatal events among the COVID-19 infected subjects based on the presence of obesity or diabetes during the initial three epidemiological waves in our region. METHODS: This was a retrospective cohort study. A primary care database was used to identify persons with COVID-19. We stratified for subjects who either had diabetes mellitus or obesity. The follow-up period for study events was up to 90 days from inclusion. RESULTS: In total, 1238,710 subjects were analysed. Subjects with diabetes mellitus or obesity were older and had a worse comorbidity profile compared with groups without these conditions. Fatal events were more frequent among people with diabetes and during the first wave. In the second and third waves, the number of study events decreased. Diabetes was a risk factor for fatal events in all models, while obesity was only in the model adjusted for age, sex, diabetes and COVID-19 waves. HIV, cancer, or autoimmune diseases were risk factors for mortality among subjects with COVID-19 in the fully-adjusted model. CONCLUSIONS: Diabetes was an independent risk factor for mortality among people with COVID-19. The number of fatal events decreased during the second and third waves in our region, both in those with diabetes or obesity.

Prevalence and risk factors of diabetic foot disease among the people with type 2 diabetes using real-world practice data from Catalonia during 2018.

Background: Our study aimed to assess the prevalence of diabetic foot disease (DFD) and its associated risk factors among subjects attending primary care centers in Catalonia (Spain). Methods: We undertook a cross-sectional analysis of data from the primary health care (SIDIAP) database. The presence of comorbidities and concomitant medication were analyzed for subjects with or without DFD. DFD prevalence was estimated from 1st January 2018 to 31st December 2018. Results: During the 12-month observational period, out of 394,266 people with type 2 diabetes, we identified 3,277 (0.83%) active episodes of DFD in the database. The majority of these episodes were foot ulcers (82%). The mean age of patients with DFD was 70.3 (± 12.5) years and 55% were male. In the multivariable descriptive models, male gender, diabetes duration, hypertension, macrovascular, microvascular complications, and insulin and antiplatelet agents were strongly associated with DFD. A previous history of DFD was the stronger risk factor for DFD occurrence in subjects with T2DM (OR: 13.19, 95%CI: 11.81; 14.72). Conclusions: In this real-world primary care practice database, we found a lower prevalence of DFD compared to similar previous studies. Risk factors such as male sex, duration of diabetes, diabetes complications and previous history of DFD were associated with the presence of DFD.

Sequence diversity of the uniparentally transmitted portions of the genome in the resident population of Catalonia.

Genomic reference databases of residing populations are available in different countries and regions. Since they represent the whole genetic diversity of a geographical region, they have wide applications, from biomedical studies to forensic identifications. Uniparentally transmitted portions of the genome specifically are highly suitable for kinship analyses, mixed DNA cases and geographical ancestry inferences. We have sampled 808 individuals currently residing in Catalonia within the GCAT cohort, from which we have generated 808 high-quality whole mitochondrial DNA (mtDNA) genomes and 399 sequences of the male-specific part of the Y chromosome (MSY). We observe higher genetic diversity than in classical population genetics datasets. We test the robustness of whole sequences for unequivocal identifications, and we found that they have higher resolution than mitochondrial control region and Y chromosome short tandem repeats (Y-STRs), and that most of the variants they present are at low frequencies, increasing the discrimination capacity between individuals. These results confirm the forensic applicability of whole uniparental sequences and provide one of the largest high-quality reference datasets ever published.