Introduction: Patients’ and companions’ participation in healthcare could help prevent adverse events, which are a significant cause of disease and disability. Before designing interventions to increase participation, it is first necessary to identify attitudes to patient safety. This study aimed to explore patients’ and companions’ perceptions, attitudes and experiences of patient safety, taking into account contextual factors, such as cultural background, which are not usually captured in the literature.Methods: We conducted a qualitative study with a theoretical sampling of 13 inpatients and 3 companions in a university hospital in Barcelona, Spain. Information was obtained from individual and triangular interviews. A descriptive thematic content analysis was conducted by four analysts and a consensus was reached within the research team on the key categories that were identified. We also conducted a card-sorting exercise.Results: All informants emphasized the role of good communication with health professionals, a calm environment and the need for patient education. Discursive positions differed by cultural background. Informants from a Pakistani-Bangladeshi background emphasized language barriers, while those from European and Latin-American backgrounds stressed health professionals’ lack of time and the need for more interdisciplinary teamwork. The card-sorting exercise identified several opportunities to enhance participation: checking patient identification and medication dispensation, and maintaining personal and environmental hygiene.Conclusion: This exploration of informants’ discourse on patient safety identified a wide variety of categories not usually considered from institutional perspectives. The findings of this study could enrich interventions in areas with diverse cultural backgrounds, as well as current frameworks based exclusively on institutional perspectives.Patient or Public Contribution: The results of the study were communicated to patients and accompanying persons via telephone or email. Similarly, a focus group was held with a patient forum to comment on the results. In the design of subsequent interventions to improve patient safety at the hospital, the proposals of patients and companions for their participation will be included together with healthcare professionals’ opinions.

BackgroundImported schistosomiasis is an emerging issue in European countries as a result of growing global migration from schistosomiasis-endemic countries, mainly in sub-Saharan Africa. Undetected infection may lead to serious long-term complications with an associated high cost for public healthcare systems especially among long-term migrants. ObjectiveTo evaluate from a health economics perspective the introduction of schistosomiasis screening programs in non-endemic countries with high prevalence of long-term migrants. MethodologyWe calculated the costs associated with three approaches-presumptive treatment, test-and-treat and watchful waiting-under different scenarios of prevalence, treatment efficacy and the cost of care resulting from long-term morbidity. Costs were estimated for our study area, in which there are reported to reside 74,000 individuals who have been exposed to the infection. Additionally, we methodically reviewed the potential factors that could affect the cost/benefit ratio of a schistosomiasis screening program and need therefore to be ascertained. ResultsAssuming a 24% prevalence of schistosomiasis in the exposed population and 100% treatment efficacy, the estimated associated cost per infected person of a watchful waiting strategy would be euro2,424, that of a presumptive treatment strategy would be euro970 and that of a test-and-treat strategy would be euro360. The difference in averted costs between test-and-treat and watchful waiting strategies ranges from nearly euro60 million in scenarios of high prevalence and treatment efficacy, to a neutral costs ratio when these parameters are halved. However, there are important gaps in our understanding of issues such as the efficacy of treatment in infected long-term residents, the natural history of schistosomiasis in long-term migrants and the feasibility of screening programs. ConclusionOur results support the roll-out of a schistosomiasis screening program based on a test-and-treat strategy from a health economics perspective under the most likely projected scenarios, but important knowledge gaps should be addressed for a more accurate estimations among long-term migrants.
Author summaryAt present, screening for schistosomiasis among long-term migrants to non-endemic countries is relatively uncommon, despite growing evidence of the burden to healthcare systems associated with chronic disease. In this article we estimate the costs of systematically screening an exposed population for schistosomiasis infection. Though our results support the implementation of such a program from a cost perspective, they are hampered by important gaps in our ability to estimate costs, particularly with regard to the efficacy of treatment of chronic Schistosoma infection in adults. Therefore the implementation of any screening program should be aligned with further research regarding these costs. Screening programs would also benefit from the development of in-situ diagnostic tests and an appropriate Point-of-Care strategy.

OBJECTIVE: The feminization of migration, the need to provide health care to an increasingly diverse population, seeking optimal health data led to considering this research. The objective was to determine the characteristics (socio-demographic profile, obstetric and gynecological record, and monitoring) of migrated pregnant women with a pregnancy process completed in 2019 in Catalonia compared to native women, in public centers (ASSIR-ICS). METHODS: This descriptive study was based on computerized clinical records of women in the 28 centers dependent on the ICS. A descriptive analysis of the variables was carried out to compare the origin of the pregnant women. The Pearson Chi-Square test at 5% and the corrected standardized residual was used to compare the groups and an analysis of variance for the comparison of means also at 5%. RESULTS: 36.315 women were analyzed and the resulting mean age was 31.1 years. The BMI at the beginning of pregnancy was 25.4 on average. Smoking habit was 18.1% among Spanish 17.3% among European. Sexist violence was 4% in Latin American women, being statistically higher than the rest. The risk of preeclampsia was 23.4% in sub-Saharan women. Gestational diabetes was diagnosed mainly among Pakistanis (18.5%). The prevalence of Sexually Transmitted Infections (STIs) was detected in Latin Americans (8.6%), Spanish (5.8%) and Europeans (4.5%). Sub-Saharan women performed insufficient ultrasound control (58.2%) and had the lowest percentage of visits with 49.5%. Pregnancy monitoring was insufficient in 79.9% of all rural pregnant women. CONCLUSIONS: There are differences derived from the geographical origins of pregnant women that condition access to health services.

BACKGROUND //The feminization of migration, the need to provide health care to an increasingly diverse population, seeking optimal health data led to considering this research. The objective was to determine the characteristics (socio-demographic profile, obstetric and gynecologi-cal record, and monitoring) of migrated pregnant women with a pregnancy process completed in 2019 in Catalonia compared to native women, in public centers (ASSIR-ICS). METHODS // This descriptive study was based on computerized clinical records of women in the 28 centers dependent on the ICS. A descriptive analysis of the variables was carried out to compare the origin of the pregnant women. The Pearson Chi-Square test at 5% and the corrected standardized residual was used to compare the groups and an analysis of variance for the comparison of means also at 5%. RESULTS // 36.315 women were analyzed and the resulting mean age was 31.1 years. The BMI at the beginning of pregnancy was 25.4 on average. Smoking habit was 18.1% among Spanish 17.3% among European. Sexist violence was 4% in Latin American women, being statistically higher than the rest. The risk of preeclampsia was 23.4% in sub-Saharan women. Gestational diabetes was diagnosed mainly among Pakistanis (18.5%). The prevalence of Sexually Transmitted Infections (STIs) was detected in Latin Americans (8.6%), Spanish (5.8%) and Europeans (4.5%). Sub-Saharan women performed insufficient ultrasound control (58.2%) and had the lowest percentage of visits with 49.5%. Pregnancy monito-ring was insufficient in 79.9% of all rural pregnant women. CONCLUSIONS // There are differences derived from the geographical origins of pregnant women that condition access to health services.

During pregnancy, thyroid function disorders are associated with multiple complications, both maternal and foetal. In recent years, numerous Clinical Practice Guidelines have been developed to facilitate the identification and correct management of thyroid disease in pregnant women. However, this proliferation of guidelines has led to confusion by proposing different cut-off points for reference values and different recommendations for similar situations. For this reason, the Sociedad Espanola de Endocrinologia y Nutricion and theSociedad Espanola de Ginecologia y Obstetricia have prepared this Consensus Document, withthe aim of creating a framework for joint action to unify criteria for the diagnosis and treatment of thyroid dysfunction in these patients. The document is structured to answer the mostfrequently asked questions in clinical practice, grouped into five sections: 1/Reference valuesfor thyroid function tests and screening during pregnancy 2/Iodine nutrition 3/Hypothyroidismand pregnancy 4/Hyperthyroidism and pregnancy 5/Thyroid autoimmunity. (c) 2022 SEEN and SED. Published by Elsevier Espana, S.L.U. All rights reserved.

Objective: The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants’ characteristics, loss of follow-up, stratification of efficacy and safety results).Methods: We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them.Results: Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants’ characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females’ health.Conclusions: Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.

BackgroundEarly detection of symptoms and prompt diagnosis of ovarian cancer are considered important avenues for improving patient experiences and outcomes. MethodsThis qualitative study used a phenomenological approach to perform patient interviews, collecting individual accounts of the prediagnostic phase in women diagnosed and treated for ovarian cancer in 2016-2017. Purposive sampling was used to obtain a diverse sample of 24 participants, while thematic content analysis was used to extract themes and subthemes from interview data. ResultsThree themes and nine subthemes were identified. The first theme was women’s delay in recognizing symptoms and seeking care, with subthemes on the lack of knowledge about early signs of ovarian cancer, gender-related barriers and false reassurance from negative test results. A second theme was missed opportunities during healthcare encounters, due to misattribution of women’s symptoms by their physicians, underestimation of symptom severity and need for mediation and inadequate tests and/or false negative results. Finally, interviews highlighted the use of resources and alternative healthcare pathways, including complementary/alternative medicines, access to private health care and women’s capacity for action and decision-making (agency) about their health. ConclusionDelayed diagnosis of ovarian cancer is rooted in both individual factors (lack of health literacy, reluctance to seek care) and systemic issues (missed opportunities in healthcare encounters, access to timely specialist care). Further research is needed to investigate the extent to which traditional gender roles and socioeconomic inequalities condition women’s ability to manage their own health and to interact with health professionals and the health system. Patient and Public ContributionIn addition to the patient participation during the interviews, one author was a representative of a patient association.

BACKGROUND: Available evidence suggests that menstrual health and management have been impaired during the COVID-19 syndemic. However, research in this area is scarce, and it is failing to voice the experiences of women and people who menstruate regarding their menstrual experiences. OBJECTIVES: This study aimed to explore the experiences of menstrual health and menstrual management among women and people who menstruate in the Barcelona area (Spain) during the COVID-19 syndemic. DESIGN: This is a qualitative study, conducted taking a critical feminist approach, is embedded in the ‘Equity and Menstrual Health in Spain’ project. METHODS: It includes photo-elicitation individual interviews with 34 women and people who menstruate in the area of Barcelona (Spain). Data were collected in person and through telephone calls between December 2020 and February 2021. Analyses were performed using Thematic Analysis. RESULTS: Main findings navigated through the menstrual changes experienced by some participants, especially women living with long COVID-19, and the barriers to access healthcare and menstrual products during COVID-19. While some participants experienced menstrual poverty, this did not appear to be exacerbated during COVID-19. Instead, access to menstrual products was compromised based on products’ availability and mobility restrictions. Menstrual management and self-care were generally easier, given that menstrual experiences were almost exclusively relegated to private spaces during lockdown periods. CONCLUSIONS: Our findings highlight the need to further research and policy efforts towards promoting menstrual health and equity, considering social determinants of health, and taking intersectional and gender-based approaches. These strategies should be further encouraged in social and health crises such as the COVID-19 syndemic.

??Objective: To explore experiences related to health-oriented behaviours during lockdown in the Spanish resident population from a gender perspective. Method: Qualitative research with a critical and feminist approach. Twenty-nine semi-structured inter-views (17 women and 12 men) were conducted between June and July 2020 via telephone with people who had previously answered an online survey. The interviews were transcribed and a thematic content analysis was carried out, differentiating between the experiences of women and men. The data were triangulated by the research team. Results: Among women, greater diversity emerged in terms of health behaviours. Among them, the dif-ficult experiences related to COVID-19, the complexity of living together and doing unpaid care work, as well as the importance of support networks, stood out. Among men, there were different attitudes towards sport, self-care and having time for healthy eating were positively valued, and there was a good assessment of coexistence and organisation in household chores. In both men and women, work over-load and economic problems were related to emotional distress and difficulties in carrying out healthy activities.

The website Sexe Joves is a website on sexuality of the Department of Health of the Government of Catalonia (Spain). This study aims to understand the experiences and opinions of people aged 14 to 25 regarding this website, taking into account sex, gender identity, sexual orientation, socioeconomic status and location within Catalonia (urban, semiurban and rural areas). With the objective of improving the website and adpating the resources allocated to it, this study evaluates whether this population is familiar with it and uses it, as well as the website’s usability and accessibility (digital equity), usefulness and the relevance of its content. A parallel convergent triangulation design is used: a qualitative study using a social constructivist perspective, and an observational, descriptive and cross-sectional quantitative study. We conduct a discourse analysis of participants and use an “ad hoc” questionnaire to collect quantitative data. A descriptive analysis of all variables is carried out. Affective-sexual education aimed at young people must stem from their participation and the whole range of sexual and gender diversity in order to reach the entire population equally. This analysis will contribute to the design of new strategies for the wesbite Sexe Joves, a public health resource, in order to improve affective-sexual education for young people.