Maria Feijoo-Cid

Sylvatic rabies and the perception of vampire bat activity in communities in the Ecuadorian Amazon

An outbreak of sylvatic rabies was reported in indigenous communities located in the Ecuadorian Amazon in November 2011. The objective of this study was to analyze family dwelling characteristics and other sociodemographic factors associated with the perception of an increase in hematophagous bat bites in humans and domestic animals to assist the implementation of intervention policies in the region. A total of 381 households from communities covered by the outbreak response activities were surveyed. Despite being associated with poorer dwelling conditions, the possession of domestic animals is associated with the perception of an increase in bat bites among animals. Better dwelling conditions, use of protective measures, access to electricity, and no domestic animals are variables associated with the perception of a rise in attacks on humans. The analysis of perceptions of bite frequency is fundamental to improve the effectiveness of vaccination programs and strategies to promote the adoption of preventive measures against rabies among the population.

The effect of information about the benefits and harms of mammography on women’s decision-making: study protocol for a randomized controlled trial

BackgroundThe decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences.The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening.MethodsA two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP.The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2–3 weeks after the intervention.DiscussionThis is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the impact of information on several decisional outcomes and to contribute to paving the road towards shared decision-making in breast cancer screening in our country.Trial registrationClinicalTrials.gov registry, ID: NCT03046004. Retrospectively registered on 4 February 2017. Trial name: InforMa study.

Validación de la versión española de la HIV Related Fatigue Scale y aplicación en personas con hepatitis C

OBJECTIVES To validate the American fatigue scale HIV-Related Fatigue Scale (HRFS) and present the Spanish version called Integrated Fatigue Assessment Scale to assess fatigue in HCV and co-infected patients. METHOD Psychometric study with cross-sectional design was used. The HRFS was translated into Spanish using the back-translation method-later to be validated. Participants completed the questionnaire adapted to a self-report form, as well as a sociodemographic questionnaire. The reliability and validity of the Spanish version was evaluated. RESULTS A total of 7 public service hospitals and two prisons in Catalonia participated in the evaluation. The sample consisted of 122 subjects selected by consecutive sampling in the fourth week of treatment of hepatitis C with combination therapy or triple therapy. The Cronbach alpha for the total scale was 0.958. Content Validity Index (I-CVI) varied from 0.5 to 1. Validity Scale Content-level (S-CVI) was 0.85. Pearson correlations between the three dimensions were between 0.49 and 0.68. CONCLUSIONS The process followed for the cultural adaptation and validation shows that the Spanish version of the HRFS) is a valid and reliable instrument that can be used in clinical practice and in the investigation of fatigue in patients with hepatitis C.

Participants’ safety versus confidentiality: A case study of HIV research

Background When conducting qualitative research, participants usually share lots of personal and private information with the researcher. As researchers, we must preserve participants’ identity and confidentiality of the data. Objective To critically analyze an ethical conflict encountered regarding confidentiality when doing qualitative research. Research design Case study. Findings and discussion one of the participants in a study aiming to explain the meaning of living with HIV verbalized his imminent intention to commit suicide because of stigma of other social problems arising from living with HIV. Given the life-threatening situation, the commitment related to not disclosing the participant’s identity and/or the content of the interview had to be broken. To avoid or prevent suicide, the therapist in charge of the case was properly informed about the participant’s intentions. One important question arises from this case: was it ethically appropriate to break the confidentiality commitment? Conclusion confidentiality could be broken if a life-threatening event is identified during data collection and participants must know that. This has to be clearly stated in the informed consent form.

Rabia selvática y percepción de la actividad del murciélago vampiro en las comunidades amazónicas ecuatorianas

An outbreak of sylvatic rabies was reported in indigenous communities located in the Ecuadorian Amazon in November 2011. The objective of this study was to analyze family dwelling characteristics and other sociodemographic factors associated with the perception of an increase in hematophagous bat bites in humans and domestic animals to assist the implementation of intervention policies in the region. A total of 381 households from communities covered by the outbreak response activities were surveyed. Despite being associated with poorer dwelling conditions, the possession of domestic animals is associated with the perception of an increase in bat bites among animals. Better dwelling conditions, use of protective measures, access to electricity, and no domestic animals are variables associated with the perception of a rise in attacks on humans. The analysis of perceptions of bite frequency is fundamental to improve the effectiveness of vaccination programs and strategies to promote the adoption of preventive measures against rabies among the population.

Raiva silvestre e percepção da atividade de morcegos vampiros em comunidades amazônicas equatorianas

An outbreak of sylvatic rabies was reported in indigenous communities located in the Ecuadorian Amazon in November 2011. The objective of this study was to analyze family dwelling characteristics and other sociodemographic factors associated with the perception of an increase in hematophagous bat bites in humans and domestic animals to assist the implementation of intervention policies in the region. A total of 381 households from communities covered by the outbreak response activities were surveyed. Despite being associated with poorer dwelling conditions, the possession of domestic animals is associated with the perception of an increase in bat bites among animals. Better dwelling conditions, use of protective measures, access to electricity, and no domestic animals are variables associated with the perception of a rise in attacks on humans. The analysis of perceptions of bite frequency is fundamental to improve the effectiveness of vaccination programs and strategies to promote the adoption of preventive measures against rabies among the population.

Proyecto de educación sanitaria en la autoadministración de interferón pegilado en la coinfección VIH/VHC usando el método PRECEDE como herramienta de diagnóstico de la conducta

Resumen En Espana, la prevalencia de coinfeccion por el virus de la inmunodeficiencia humana-virus de la hepatitis C (VIH-VHC) es una de las mas elevadas, ya que tanto la infeccion por el VHC como por VIH comparten vias de transmision. La curacion del VHC en pacientes coinfectados depende del genotipo de VHC, y el tratamiento que se recomienda se basa en interferon pegilado de administracion subcutanea y ribavirina en comprimidos. El tratamiento se realiza durante un tiempo determinado (de 6 meses a 1 ano), pero tiene efectos secundarios limitantes en la vida diaria que hacen necesario un proceso de educacion sanitaria. La metodologia PRECEDE es un modelo que permite realizar diagnosticos comportamentales individuales y de grupo que tiene por objetivo conseguir el cambio de comportamientos, actitudes y conocimientos del paciente. Un buen diagnostico conductual, previo a la intervencion, garantiza la adecuacion y la eficacia de las intervenciones para apoyar a las personas coinfectadas de VIH-VHC en la adherencia al tratamiento.