IDIAP Jordi Gol - IDIAP

Clusters of Comorbidities in Multiple Sclerosis and Their Influence on Healthcare Resource Usage

2026-03-07T20:12:05Z

Clusters of Comorbidities in Multiple Sclerosis and Their Influence on Healthcare Resource Usage Cárdenas-Robledo, Simón; García, Juan David; López-Matons, Nuria; Carbonell Mirabent, Pere; Rodríguez-Barranco, Marta; Passarell-Bacradit, Maria-Angels; Montalban, Xavier; Otero-Romero, Susana; Guío-Sánchez, Claudia; Carvajal, René; Sastre Garriga, Jaume; Tintore, Mar Cardiovascular diseases; Clustering; Comorbidity; Malalties cardiovasculars; Agrupació; Comorbiditat; Enfermedades cardiovasculares; Agrupamiento; Comorbilidad; Introduction MS patients are at increased risk of comorbidities and use more healthcare resources. Multimorbidity approached as the number of conditions is flawed by classifying patients with different needs as equal. We aimed to explore how comorbidities cluster and their impact on healthcare resource usage. Methods We used latent-class models of up to 10 clusters in a population-based sample of MS patients. The optimal number of clusters was determined using model metrics and similarity/entropy measures, and cluster stability was assessed by bootstrapping. Sociodemographic characteristics and healthcare-resource usage according to the clusters assigned were compared to each other and to patients without comorbidities using univariable and adjusted linear regression models. Results In 5548 MS cases, of which 60% had comorbidities, the optimal number of comorbidity clusters was two, comprising a high frequency of cardiovascular comorbidities and psychiatric disorders. Patients in the cardiovascular cluster were older, and in the psychiatric cluster were more frequently female. After adjusting for sociodemographic variables, healthcare resource usage was higher for patients with comorbidities, particularly for nurse (1.1 more average yearly visit; [95% CI 0.41–1.8]; p = 0.002), primary care (1.8 more visits; [95% CI 1.4–2.1]; p < 0.001), and medication dispensation (336 more dosage units; [95% CI 260–402]; p < 0.001) in the cardiovascular cluster, and annual sick-leave days (3.8 more days; [95% CI 0.25–7.3]; p = 0.036) in the psychiatric cluster. Discussion We observed clustering of comorbidities around cardiovascular comorbidities and mental disorders, which impacted healthcare resource usage differently. Further research is needed to assess the influence of these clusters on the prognosis of MS.; This work was supported by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol.

The Associated Factors of Work Engagement, Work Overload, Work Satisfaction, and Emotional Exhaustion and Their Effect on Healthcare Workers: A Cross-Sectional Study

2026-01-28T20:30:54Z

The Associated Factors of Work Engagement, Work Overload, Work Satisfaction, and Emotional Exhaustion and Their Effect on Healthcare Workers: A Cross-Sectional Study Moreno-Martínez, Marina; Sánchez Martínez, Iván Work engagement; Emotional exhaustion; Healthcare workers;; Compromís laboral; Esgotament emocional; Satisfacció laboral; Compromiso laboral; Agotamiento emocional; Satisfacción laboral; In today's fast-paced work environment, work engagement is crucial for both organizational success and individual well-being. Objective: Our aim is this study was to analyze the associated factors of work engagement, work overload, work satisfaction, and emotional exhaustion and describe their effect on nurses and physicians in the Central Catalonia Health Region during 2023. Methods: A multicenter cross-sectional study was conducted using an online questionnaire at the Territorial Management of Central Catalonia (Spain). The questionnaire was accessible from 28 November 2022 to 12 March 2023. The analysis was performed using the SPSS software. CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines were followed for communicating research results. Results: A total of 321 professionals answered the questionnaire, 60.7% of whom were nursing professionals and 39.3% of whom were medical professionals. Work overload, work satisfaction, and emotional exhaustion were associated with work engagement. Being a physician, permanent contracts, irregular work shifts, overtime, and salary were related to work overload and emotional exhaustion. Being a woman, salary, academic level, and irregular work shifts were related to work satisfaction. There was a gender inequality in work engagement among nursing professionals to the detriment of men. In terms of class inequality, there was a difference between occupational groups with respect to work overload and emotional exhaustion among women. Conclusions: Organizational practices need to be improved to promote greater engagement and work satisfaction, as well as to reduce emotional overload and exhaustion. This may include regulating unpaid overtime and promoting more stable working hours.

Mediterranean Diet Modulates Gene Expression of Cholesterol Efflux Receptors in High-Risk Cardiovascular Patients

2026-01-28T20:30:53Z

Mediterranean Diet Modulates Gene Expression of Cholesterol Efflux Receptors in High-Risk Cardiovascular Patients Hernando-Redondo, Javier; Hernáez, Álvaro; Sanllorente Melenchon, Albert; Pintó, Xavier; Estruch, Ramon; Salas-Salvadó, Jordi Dieta Mediterrània; Expressió Gènica; Receptors de Colesterol; Mediterranean Diet; Gene Expression; Cholesterol Receptors; Dieta Mediterránea; Expresión Génica; Receptores de Colesterol; In this study, we investigated gene expression related to cholesterol efflux receptors in individuals at high cardiovascular risk undergoing Mediterranean dietary interventions. Through transcriptomic analysis, we examined samples from two randomized controlled trials: PREDIMED and PREDIMED-Plus, with 151 and 89 elderly adults, respectively. Blood cells were isolated at baseline and after a 12-month intervention. In the PREDIMED trial, participants followed different Mediterranean diets: one supplemented with extra-virgin olive oil (traditional Mediterranean diet enriched with extra-virgin olive oil [MedDiet-EVOO]), another with nuts (MedDiet enriched with nuts MedDiet-Nuts [MedDiet-Nuts]), and a low-fat control diet. The PREDIMED-Plus trial compared an energy-reduced Mediterranean diet (Er-MedDiet) with physical activity to an ad libitum Mediterranean diet. Over time, mild but significant upregulation of genes like ATP binding cassette subfamily A member 1 (ABCA1), retinoid X receptor alpha (RXRA), retinoid X receptor beta (RXRB), and Nuclear Receptor Subfamily 1 Group H Member 3 (NR1H3) was observed in response to MedDiet-EVOO, MedDiet-Nuts, and Er-MedDiet. Notably, RXRA expression was higher in both MedDiet-EVOO and MedDiet-Nuts compared to the control diet. Differences in gene expression, particularly RXRA, ATP binding cassette subfamily G member 1 (ABCG1), NR1H3, and Peroxisome Proliferator Activated Receptor Delta (PPARD), were evident between MedDiet-Nuts and the control diet. In the PREDIMED-Plus trial, no significant differences in gene expression were found between dietary groups. Principal component analysis (PCA) and linear discriminant analysis (LDA) showed overlapping gene expression profiles across different Mediterranean diet interventions. In conclusion, our study highlights the cardiovascular health benefits of long-term adherence to a Mediterranean diet, both normocaloric and hypocaloric, primarily reflected by mild upregulation of cholesterol efflux-related genes-specifically involving RXRA, RXRB, ABCA1, ABCG1, Nuclear Receptor Subfamily 1 Group H Member 2(NR1H2), and PPARD-among elderly adults at high cardiovascular risk. This suggests a potential mechanism by which these diets may exert cardiovascular protective effects.; Diet, Mediterranean Gene Expression Regulation Cholesterol Efflux Cardiovascular Diseases Receptors, Lipoprotein; This work was framed within projects (PI18/00020; PI19/00017; PI16/00533; PI13/00233; PI20/00012; PI17/00214) funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union. This work was supported by grant CP21/00097 from Instituto de Salud Carlos III-Fondo Social Europeo Plus (FSE+); and by Agència de Gestió d'Ajuts Universitaris i de Recerca (2021 SGR 00144). This work was also supported by CB06/03/0028 from Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición. Amb el suport de la Fundació La Marató de TV3 (202312-30-31-32-33). The funders played no role in the study design, collection, analysis, or interpretation of data, and neither in the process of writing the manuscript and its publication. Javier Hernando-Redondo had received the Contrato Rio Hortega CM20/00085 grant.

Evaluating Families' Opinions of Routine Influenza Vaccination in Children Under 5 Years of Age in Spain

2026-01-28T20:30:52Z

Evaluating Families' Opinions of Routine Influenza Vaccination in Children Under 5 Years of Age in Spain Burgaya Subirana, Sílvia; RUIZ COMELLAS, ANNA; Miró Catalina, Queralt; Balaguer, Monica Vacunació Infantil; Antivacunes; Grip Estacional; Childhood Vaccination; Vaccine hesitancy; Seasonal Influenza; Vacunación Infantil; Antivacunas; Gripe Estacional; Influenza vaccination is the main method for preventing influenza. The objectives of this study are to evaluate the opinions of families on influenza vaccination and to determine the acceptance of influenza vaccination as a routine vaccine in children under 5 years of age. The method used was a descriptive cross-sectional study based on an ad-hoc survey. Between October 2023 and January 2024, an online survey was conducted among families with children between 6 months and 14 years of age attending paediatric consultations at a health centre. A total of 388 families were surveyed. Out of these, 22.68% reported having ever vaccinated their children against influenza. The main reason for having them vaccinated was having received the recommendation from the paediatrician (68.18%). While 53.61% agreed with routine influenza vaccination, 53.09% did not intend to vaccinate their children against influenza in the 2023/24 period. The reasons for not vaccinating in 2023/24 were unawareness of the disease (29.41%), fear of unwanted effects of vaccination (27.94%) and lack of information about vaccination (19.61%). The reasons for vaccination in 2023/24 were protection of the child (81.87%), recommendation by the paediatrician (43.41%) and protection of the general population and susceptible persons (20.33%). Routine influenza vaccination is accepted by half of the parents. A lack of risk perception of the disease, concern about vaccine safety and lack of information are the main reasons for not vaccinating. It is essential to follow the health professionals' recommendation to vaccinate.; This research has received a predoctoral grant from IDIAP Jordi Gol. The financial provision was 9015 euros. Number of Register: 21256. Code: 7Z24/004.