Evaluar la efectividad de la intervención educativa de generación de podcasts para aumentar el grado de conocimiento sobre hàbitos saludables (actividad física, adicciones, salud mental, alimentación saludable y higiene del sueño) en alumnos de tercero d’ESO del Instituto de la Mina

Antecedents: La patologia cardíaca incrementa la seva freqüència exponencialment donat l’envelliment poblacional. Habitualment es diagnostica mitjançant ecocardiografia als serveis de cardiologia, amb la conseqüent llista
d’espera. Per possibilitar una primera valoració ecocardioscòpica, Societat Catalana de Cardiologia i Societat Catalana de Medicina Familiar i Comunitària acordaren un pla formatiu per Metges de Família.
Hipòtesis: (1)Una formació´ reglada en ecoscòpia cardíaca per a metges de família permetria assolir els coneixements necessaris per realitzar aquesta tècnica.
(2)Feta la formació es podria aconseguir un bon grau de concordança entre els estudis fets pels metges de família i els cardiòlegs.
Objectius: (1)Avaluar el nivell de coneixements adquirits en ecoscòpia cardíaca en una mostra de MF. (2)Avaluar el grau de concordança entre les ecoscòpies fetes per MF i ecocardiografies fetes per cardiòlegs en població real.
Metodologia: Estudi observacional prospectiu desenvolupat en 45 EAPs de Catalunya de setembre-2022 a desembre-2028. Pla formatiu teòric online (18hores lectives) i pràctic presencial, realitzant 60 ecografies en 70hores d’estada amb un tutor cardiòleg hospitalari

While the need for integrating palliative care (PC) services into heart failure (HF) care has been well recognised, as of yet this integration lacks behind, especially when compared to cancer care. Currently, only 5-7% of patients with HF utilise PC services, due to a focus on optimising therapy and an unpredictable disease trajectory with exacerbations which hampers prognosis. As a result, many symptoms and concerns that are not directly related to HF are not recognised and undertreated and patients are often referred to PC services only at the very end of their lives.

The RAPHAEL consortium sets out to take the next big step in integrating PC into HF care by integrating the RAPHAEL palliative care approach in existing HF care pathways. This flexible and patient centred approach starts with the identification of multidimensional symptoms and concerns, prioritise needs with patient and informal carer and formulate a proactive care plan. The symptoms and concerns will be monitored by the patient at home using the PAL@HEART application. The app can be used to evaluate interventions, support communication and earl identify new or increasing needs. As a result, the care needs of each individual patient with HF are addressed faster and better, improving their quality of life and autonomy. Moreover, this will lead to a reduction in emergency hospitalisations, unburdening the healthcare system and reducing costs.

The RAPHAEL project sets out to adapt the RAPHAEL approach to HF care within a European context and test and validate its (cost-)effectiveness via a feasibility and large-scale evaluation study performed in 7 EU countries, the UK and Switzerland. It brings together experts in palliative care, cardiology, and primary care as well as professional organisations and patient representatives. Together the RAPHAEL consortium is uniquely situated to demonstrate the (cost-)effectiveness of the RAPAHEL approach and launch its implementation in Europe and beyond.

There is a lack of epidemiological studies aimed to explore the impact of livestock activity on the environmental spread of antibiotic resistance genes (ARGs) and ultimately to the exposed population. Our hypothesis is that livestock activity significantly contributes to this spread into the environment and human population. From a One Health perspective, the general goal of this exploratory project is to evaluate the impact of intensive livestock activity on the spread of antibiotic-resistant bacteria and their associated genes in the environment and the nearby population, focusing on pregnant women and their offspring. To guarantee the success of the project, we have established a multidisciplinary team. We will create a cohort of 500 pregnant women and their babies in Central Catalonia, an area with high livestock farming activity. To estimate exposure to livestock activity and environmental ARGs in the study population, we will combine different methodologies in a novel way; first, we will use geographic information systems (GIS) to calculate exposure to livestock farming activities around the residence and workplace of the participants and generate a potential risk map of exposure to ARGs. Afterwards, this map will be complemented with environmental measurements (air samples) in which the presence of antibiotic-resistant bacteria and their resistance genes will be determined using culture-dependent and -independent (i.e., qPCR) approaches, respectively. The same determinations will be carried out on the fecal samples of the recruited mothers and their babies. The selection of antibiotic resistances will be based on the prevalent antibiotics used in human medicine and veterinary practices in the study area. We will apply logistic and linear regression models, adjusting for confounding factors. We will also create a Citizen Board that will contribute in different phases of the project.

Hipótesis/s
La alfabetización en salud digital en la población de 55 años o más reduce la brecha digital y proporciona herramientas que mejoran la accesibilidad de estas personas al sistema sanitario.
Objetivo/s
Objetivo principal:
Proporcionar a las personas participantes herramientas para acceder y gestionar críticamente las TIC y
minimizar la brecha digital.
Objetivos secundarios:
•
Ofrecer educación sanitaria sobre el uso de las TIC en salud (alfabetización en salud digital).
•
Mantener o mejorar la capacidad funcional de los participantes sobre el uso de nuevas tecnologías sanitarias.
•
Disminuir las barreras de accesibilidad y participación de este grupo de población en el sistema de salud.
•
Implementar los talleres de alfabetización en salud digital en el territorio a través de salud comunitaria.
•
Incrementar el uso de las TIC sanitarias (salud digital) entre este grupo de población.
•
Ofrecer educación sanitaria sobre la medicina basada a la evidencia, para mejorar la búsqueda de fuentes fiables de información y favorecer el pensamiento crítico.
•
Dar a conocer conceptos de salud digital como la co-creación o la toma de decisiones compartidas para avanzar hacia una medicina centrada en el paciente.
•
Promover la participación ciudadana a través de los grupos de co-creación.
•
Evaluar la implementación y el impacto del proyecto en el grado de alfabetización de las personas participantes

Antecedents
L’envelliment de la població està suposant un repte important de maneig per al sistema sanitari, i necessitem informació en base poblacional per a la detecció d’oportunitats de millora i que ajudin en la presa de decisions en els plans d’actuació dirigits a cobrir les necessitats d’atenció dels usuaris més vulnerables, com els usuaris de programes d’atenció domiciliària (ATDOM).
Objectius
Identificar els perfils dels pacients inclosos al programa ATDOM a la GAPiC Baix Llobregat des d’una perspectiva clínica, funcional i social amb anàlisi de “clusters”.
Metodologia
Estudi descriptiu transversal de tots els pacients inclosos en el programa ATDOM a la GAPiC Baix Llobregat durant l’any 2024
Variables principals: edat, sexe, índex de privació socioeconòmica AQuAs, grups de morbiditat ajustats (GMA), deteriorament cognitiu, malalties cròniques, síndromes geriàtriques, polifarmàcia, pacient crònic complexe (PCC), malaltia crònica avançada (MACA), Barthel, Pfeiffer, Braden, risc social (TIRS), Zarit, mitjana de visites per professionals sanitaris i d’atenció continuada i d’urgències.
S’extrauran les dades de la història clínica, segons registre de la pràctica assistencial habitual.
Anàlisi estadístic: Per a les variables quantitatives es calcularan les mitjanes de tendència central i de dispersió i per les variables qualitatives anàlisi de proporcions. Es calcularan intervals de confiança al 95%. En les anàlisis bivariades s’utilitzaran les proves paramètriques o no paramètriques corresponents en funció de si les variables a estudi segueixen una distribució normal o no, respectivament. En tots els casos es treballarà amb un error alfa del 5%
Es realitzarà una anàlisi multivariant de conglomerats (social, clínic i funcional) a partir de l’edat, sexe, TIRS, GMA, malalties cròniques, síndromes geriàtriques, polifarmàcia, malalties cròniques, PCC, MACA, Barthel i Pfeiffer) amb anàlisi de components principal (PCA) i de correspondència múltiple (MCA) amb clusterització.
Aplicabilitat
Els resultats permetran identificar els perfils i les necessitats d’atenció dels pacients atesos al programa ATDOM en tota la GAPIC Baix Llobregat, identificant necessitats comunes i particulars, o la presència de variabilitat en funció d’equips i àrees geogràfiques, que precisin d’adequació de recursos.
La identificació de perfils de pacients atesos en el programa ATDOM ens ajudarà a planificar plans adaptats a les necessitats complexes d’atenció des d’una perspectiva multidimensional.
Per altra banda, l’anàlisi de resultats permetrà una anàlisi global d’indicadors d’estructura, procés i resultat per a l’avaluació del programa ATDOM, i la valorar la seva idoneïtat per al seu us de forma periòdica i sistematitzada.
Rellevància
L’estudi analitzarà amb dades del mon real les característiques de tota la població de la GAPiC en programa ATDOM i facilitarà el disseny d’intervencions adaptades a les necessitats identificades amb aquests usuaris. L’ATDOM és un dels processos estratègics a la GAPiC i està alineada amb els continguts del Pla de salut de Catalunya i els plans de l’Agència d’Atenció Integrada Social i Sanitària.

There is a lack of epidemiological studies aimed to explore the impact of livestock activity on the environmental spread of antibiotic resistance genes (ARGs) and ultimately to the exposed population. Our hypothesis is that livestock activity significantly contributes to this spread. The general goal of this project is to evaluate the impact of intensive livestock activity on the spread of ARGs in the environment and the nearby population, focusing on pregnant women and their offspring. We will create a cohort of 500 pregnant women and their babies in Osona and Lluçanès (Central Catalonia), an area with high livestock farming activity. To estimate the exposure of the study population to livestock activity and environmental ARGs, we will apply geographic information systems (GIS) to calculate exposure to livestock farming activities around the residence and workplace of the participants to generate a potential risk map of exposure to ARGs. This map will be complemented with environmental measurements (air samples) in which the presence of antibiotic-resistant bacteria and their resistance genes will be determined using culture-dependent and -independent (i.e., qPCR) approaches, respectively. The same determinations will be carried out on the fecal samples of the recruited mothers and their babies. The selection of antibiotic resistances will be based on the prevalent antibiotics used in human medicine and veterinary practices in the study area. We will apply logistic and linear regression models, adjusting for confounding factors. We will also create a Citizen Board that will contribute in different phases of the project. RESISTANCE is embedded in the context of the implementation of a new line of research on Planetary Health – encompassing the One Health and EcoHealth approaches – at IDIAPJGol. In addition, RESISTANCE is an innovative project that will allow advancing knowledge on the contribution of livestock activities in the presence of ARGs in the environment and the potential transference to vulnerable populations living near these activiti

Background: The World Health Organization (WHO) has recognized antibiotic resistance as one of the top 10 global public health threats facing humanity. Antibiotic resistance remains a major global health challenge, primarily driven by inappropriate and excessive prescribing. Primary care plays an important role, accounting for 90% of total antibiotic prescription. In Spain, antibiotic consumption continues to rise, showing significant regional variability and remaining far from the European goal of a 20% reduction. Tackling this issue requires effectives and efficient implementation strategies to promote sustainable changes in prescribing behaviours.
Main Hypothesis: An adaptive intervention strategy based on a SMART design, combining educational interventions with tailored second-stage strategies for non-responders, will achieve a clinically relevant reduction in the number of antibiotics prescribed and dispensed per 100 GP visits over 12 months, compared with baseline prescribing levels and with less intensive intervention sequences.
Secondary Hypotheses
1. GPs receiving the Hybrid educational intervention will achieve a greater reduction in the number of antibiotics prescribed and dispensed per 100 visits at 12 months compared with those receiving the Moodle based intervention.
2. Among non-responders to the first-stage educational intervention, general practitioners receiving an intensified second-stage strategy (audit and feedback combined with a tailored face-to-face pharmacist intervention or a personalized detailed feedback report) will achieve a greater reduction in antibiotic prescribing and dispensing at 12 months compared with those receiving audit and feedback alone.
3. The tailored face to face intervention delivered by the Primary Care Pharmacist will be the most cost effective second stage strategy, followed by the Detailed Feedback Report and Audit & Feedback alone.
4. Specific GP related factors (e.g., baseline prescribing level, years of experience, diagnostic patterns) may predict which first stage or second stage intervention is most effective.
Objective: To develop and evaluate the effectiveness of an adaptive intervention in primary care, based on a SMART design that first applies educational strategies and subsequently provides audit and feedback (A&F) to all non responders, with A&F being either delivered alone or augmented with a tailored face to face intervention by the primary care pharmacist (PCP) or a personalized detailed feedback report, in reducing the number of antibiotics prescribed and dispensed per 100 general practitioner visits among patients aged over 14 years.
Methods: This study is a randomized controlled trial (RCT) using a Sequential, Multiple Assignment, Randomized Trial (SMART) design conducted in primary care settings across four Spanish regions (Balearic Islands, Catalonia, Galicia, and the Basque Country). In the first stage, randomization will occur at the level of the primary health care center (PHC), with each PHC allocated (1:1) to one of two educational strategies: Moodle based training or Hybrid training. The Hybrid strategy combines the Moodle online module with in person training sessions delivered at the PHC. Both strategies include visual educational materials displayed in the PHC to promote appropriate antibiotic use among patients. After four months, the second randomization will take place at the level of individual general practitioners (GPs). GPs will be classified as responders or non responders based on changes in their rate of dispensed antibiotic prescriptions per 100 GP visits. Non responders will undergo a second randomization (1:1:1) to one of three strategies: audit and feedback (A&F) alone, A&F augmented with a tailored face to face intervention delivered by a primary care pharmacist (PCP), or A&F augmented with a personalized detailed feedback report. Responders will continue with their initial educational strategy without further modification. The primary outcome is the number of antibiotics prescribed and dispensed per 100 GP visits at 12 months, obtained from regional e prescription databases. Secondary outcomes include total antibiotic consumption, adherence to PRAN rational use indicators, and the cost effectiveness of the intervention. Subgroup analyses will explore GP and patient characteristics influencing intervention outcomes.
Applicability and Transferability: This project has high immediate applicability within the Spanish National Health System, as the intervention is fully aligned with existing structures and can be implemented without regulatory changes. Its scalable and flexible design allows transferability to other regions, healthcare settings (including hospitals and emergency care), therapeutic areas, and the development of digital decision-support tools, supporting sustainable antimicrobial stewardship policies.
Relevance of the Proposal: Antibiotic resistance represents a critical global and national public health threat, largely driven by inappropriate antibiotic use in primary care, where prescribing variability between professionals remains high. This project directly addresses current gaps in antimicrobial stewardship by generating robust real-world evidence on the effectiveness, prioritization and cost-effectiveness of adaptive, data-driven interventions aligned with European and national strategic objectives.
Novelty of the Proposal: This study is conceptually innovative in applying a SMART (Sequential, Multiple Assignment, Randomized Trial) design to antimicrobial stewardship, enabling adaptive, personalized interventions based on individual prescribing behaviour rather than fixed uniform strategies. The strong alignment between hypothesis, objectives, sample size and advanced statistical methods ensures a rigorous and novel evaluation framework within a well-established research line of the RICAPPS network.

La Enfermedad Hepática Metabólica (EHMET) es un problema creciente de salud pública en todas las edades, con una incidencia en aumento y una compleja interacción
de factores metabólicos, genéticos y estilo de vida. Objetivos principales: P1. Establecer y consolidar una cohorte amplia, observacional, prospectiva y basada en la
población de niños y adolescentes para permitir la estadificación, monitorización y evaluación longitudinal de la progresión de la EHMET y sus factores de riesgo
metabólico asociados de la infancia a la edad adulta. P2. Evaluar la incidencia y la posible reversión de la fibrosis hepática significativa (mediante elastografía transitoria
controlada por vibración [VCTE]) y la EHMET (mediante el parámetro de atenuación controlada [CAP]) durante un período de seguimiento de 4 años en una cohorte previamente establecida de niños y adolescentes. Métodos: Este proyecto de base poblacional constará de 2 partes: Fase A: Transversal, Fase B: Estudio de cohorte longitudinal con seguimiento de 4 años. El estudio incluye a individuos de edades comprendidas de 9 a 16 años. Este proyecto surge del LiverKids, que ha recibido
financiación pública (PERIS 2021). Los participantes se someterán a: mediciones antropométricas, análisis de sangre, VCTE con CAP, Resonancia Magnética y cuestionarios (datos sociodemográficos, historial médico personal/familiar, evaluación del estilo de vida). Con una muestra de 2200 sujetos podemos tener una precisión de ±0,8% para una prevalencia/incidencia del 4% (como prevalencia de fibrosis) y una precisión de ±1,2% para una prevalencia/incidencia del 8% (como prevalencia de MASLD).
Resultados preliminares: Se analizaron 1.380 participantes (52,3% hombres; 47,4% mujeres). La prevalencia de esteatosis (CAP=225 dB/m) fue del 14,8% y la de fibrosis (VCTE=6,5 kPa) fue del 4,1. Se encontró una asociación significativa entre el valor medio de VCTE y tanto la edad como el Índice de Masa Corporal. Aplicabilidad:
Diagnosticar estadios precoces de fibrosis hepática es clave para evitar que progrese a estadios avanzados que conllevan un aumento de la mortalidad.
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