Association between physician burnout and patient safety: study protocol for an overview of systematic reviews and meta-analyses.

Introduction: Burnout, a disorder caused by chronic stress at work, involves emotional exhaustion, depersonalisation and reduced professional efficacy. The prevalence of burnout appears to be high among physicians worldwide. Burnout may affect different dimensions of healthcare, such as patient safety.

Risk of cancer development associated with disease-modifying therapies for multiple sclerosis: study protocol for a systematic review and meta-analysis of randomised and non-randomised studies.

Background: The association between cancer and multiple sclerosis has long been investigated. Several studies and reviews have examined the risk of cancer among patients with multiple sclerosis treated with disease-modifying therapies (DMTs) but with conflicting results. This study will aim to investigate the association between DMTs for multiple sclerosis and subsequent cancer risk using research synthesis methods.

Crossing the wicked frontier. Why sustainability science needs integrative research.

Integrative research approaches have lost prominence in the scientific literature, and related concepts of 'wicked problems' and 'post-normal science' complement but do not adequately replace them. From a detailed examination of the foundational literature, three key principles are shown to be central to integrative research: (i) the knowledge cycle; (ii) representativeness and participation; and (iii) knowledge exchange mechanisms at the science-policy interface. As an example of the importance of the integrative research framework in the context of policy-relevant science, it is argued that the shortcomings of current climate change mitigation efforts arise from inappropriately 'closing down' the science-policy interface and focusing on a few narrow options acceptable to powerful stakeholders.

Is air pollution exposure linked to household income? Spatial analysis of Community Multiscale Air Quality Model results for Madrid.

This study explores the potential correlation between income and exposure to air pollution for the city of Madrid, Spain and its neighboring municipalities. Madrid is a well-known European air pollution hotspot with a high mortality burden attributable to nitrogen dioxide (NO) and fine particulate matter (PM). Statistical analyses were carried out using electoral district level data on gross household income (GHI), and NO and PM concentrations in air obtained from a mesoscale air quality model for the study area.

Millennial climate oscillations controlled the structure and evolution of Termination II.

The controls that affect the structure and timing of terminations are still poorly understood. We studied a tufa deposit from the Iberian Peninsula that covers Termination II (T-II) and whose chronology was synchronized to speleothem records. We used the same chronology to synchronize ocean sediments from the North Atlantic to correlate major climate events in a common timescale.

The WHO active ageing pillars and its association with survival: Findings from a population-based study in Spain.

Background: The World Health Organization's active ageing model is based on the optimisation of four key "pillars": health, lifelong learning, participation and security. It provides older people with a policy framework to develop their potential for well-being, which in turn, may facilitate longevity. We sought to assess the effect of active ageing on longer life expectancy by: i) operationalising the WHO active ageing framework, ii) testing the validity of the factors obtained by analysing the relationships between the pillars, and iii) exploring the impact of active ageing on survival through the health pillar.

Parkinson's Disease Severity at 3 Years Can Be Predicted from Non-Motor Symptoms at Baseline.

Objective: The aim of this study is to present a predictive model of Parkinson's disease (PD) global severity, measured with the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD).

Methods: This is an observational, longitudinal study with annual follow-up assessments over 3 years (four time points). A multilevel analysis and multiple imputation techniques were performed to generate a predictive model that estimates changes in the CISI-PD at 1, 2, and 3 years.

Does Migrant Background Matter for Adolescents' Fertility Preferences? The Latin American 1.5 Generation in Spain.

This article examines the fertility preferences of Latin American adolescents of the 1.5 generation and their native peers in Spain. We compare their expected age at first birth as well as their expected family size.

Multitemporal Modelling of Socio-Economic Wildfire Drivers in Central Spain between the 1980s and the 2000s: Comparing Generalized Linear Models to Machine Learning Algorithms.

The socio-economic factors are of key importance during all phases of wildfire management that include prevention, suppression and restoration. However, modeling these factors, at the proper spatial and temporal scale to understand fire regimes is still challenging. This study analyses socio-economic drivers of wildfire occurrence in central Spain.

Quality of life of institutionalized older adults by dementia severity.

Background: The goal of the study was to analyze the factors associated with quality of life (QoL) in institutionalized older adults with dementia, based on self and proxy ratings, and if these characteristics differ by dementia severity.

Methods: Cross-sectional study of 525 people with dementia (PwD) and their caregivers (professional or family caregivers). Two different QoL questionnaires, leading to three measures, were used: QoL in Alzheimer's disease scale (QOL-AD), self and proxy-rated, and QoL in late-stage dementia scale (QUALID), proxy-rated.

A higher level of education amplifies the inverse association between income and disability in the Spanish elderly.

Background And Aims: This paper aims to estimate if the education level modifies the association of income with disability prevalence in the elderly. Education can have a confounding effect on income or interact with it as a health determinant. It is important to analyze the relationship between socio-economic status and disability in older people, because it helps to better understand health inequalities and organize appropriate social policies.

Components and determinants of quality of life in community-dwelling older adults.

The objectives of this study are to detect the main components of global quality of life (QoL) of community-dwelling older adults from their own perspective and to identify determinants of health-related and global QoL in the same population. This is a cross-sectional study covering a representative sample of 1,106 community-dwelling adults aged 60 years and older residing in Spain. The survey collected information on QoL through a face-to-face interview asking for QoL components in free-format, as well as the completion of two QoL measures, the EQ-5D and the Personal Wellbeing Index.

Design, measures and sample characteristics of the CadeViMa-Spain survey on quality of life in community-dwelling older adults.

Background: The survey "Quality of life in older adults-Spain" (CadeViMa-Spain) was designed to obtain information about objective and subjective determinants of Quality of Life (QoL) in old age, from a multidimensional perspective. This paper presents the overall description, methodology, sample characteristics and reliability of the measures used.

Methods: A cross-sectional survey was carried out in a representative sample of 1106 community-dwelling adults aged 60 years and over in Spain.

Mental health care and the politics of inclusion: a social systems account of psychiatric deinstitutionalization.

This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological care of the whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals.

Mental health care in the aftermath of deinstitutionalization: a retrospective and prospective view.

This paper offers a panoramic assessment of the significant changes experienced by psychiatric care in Western Europe and North America in the course of the last decades of deinstitutionalization and reform. Drawing on different comparative studies and an own review of relevant data and reports, the main transformations in the mental health field are analyzed around seven major topics: the expanding scope of psychiatry; the decline and metamorphosis of the asylum; the introduction of alternative and diversified forms of care; the new challenges posed by chronic mental illness; the emergence of modern psychopharmacology; the deployment of subspecialization; and the new forms of coercion implemented with community mental health practices. Following a renewed diagnosis on the essential features of the reformed mental health systems based on the pattern of social inclusion inherent to the new devices and philosophies of care, some major challenges for the future such as the overburdening of services or the overt exclusion of a significant part of potential users are also identified and briefly discussed.