https://hdl.handle.net/10481/31060 Wed, 08 Apr 2026 02:39:46 GMT 2026-04-08T02:39:46Z https://hdl.handle.net/10481/112389 Baseline Hepatitis B Immunity and Vaccination Booster Response Among Medical Residents: A Longitudinal Study in a Spanish Tertiary Hospital Salguero-Cano, Victoria; Martínez Martínez, Silvia; González Alcaide, Manuel; Valero Ubierna, Carmen; Martínez Ruiz, Virginia Ana; Rivera Izquierdo, Mario; Guerrero Fernández de Alba, Inmaculada Background: Despite universal infant hepatitis B virus (HBV) vaccination, declining circulating anti-HBs levels are increasingly observed in young healthcare professionals, a high-risk group for occupational exposure. Although several studies have evaluated HBV antibody persistence in healthcare workers, data specifically addressing newly incorporated medical residents in the Spanish context remain limited. This study evaluated baseline anti-HBs levels and serological response to a vaccination booster dose in medical residents at a Spanish tertiary hospital. Methods: A retrospective longitudinal observational study was conducted among medical residents attending the Preventive Medicine Service of Hospital Universitario San Cecilio (Granada, Spain) between 2021 and 2024. Anti-HBs antibody titers were obtained at baseline and ≥10 mIU/mL were considered the conventional protective threshold. Residents with anti-HBs < 10 mIU/mL received an Engerix-B booster followed by repeat serology. Demographic and occupational variables were analyzed. Measles serostatus was collected for comparisons. Results: A total of 275 residents were included (mean age 25.4 years, SD = 2.3 years; 64% females). Baseline serology showed anti-HBs levels < 10 mIU/mL in 53.1% of participants. Lower baseline anti-HBs levels were associated with younger age (adjusted OR = 0.75; 95% CI: 0.64–0.88) and earlier residency year (R1–R2) (adjusted OR = 0.28; 95% CI: 0.13–0.61). Among 116 residents receiving a booster, 94.8% achieved anti-HBs ≥ 10 mIU/mL after booster administration. Measles serology was negative in 54.6% of participants. Conclusions: More than half of newly incorporated medical residents had anti-HBs levels below the conventional protective threshold (10 mIU/mL), yet almost all demonstrated a strong anamnestic response, supporting the persistence of immunological memory despite reduced circulating antibody concentrations. Systematic baseline screening combined with targeted booster vaccination appears to be an effective strategy to ensure occupational protection. Further research incorporating cellular immunity markers may refine future vaccination policies and booster strategies. https://hdl.handle.net/10481/112389 https://hdl.handle.net/10481/111798 Sociodemographic and Lifestyle Factors Associated with Historical Exposure to Persistent Flame Retardant Concentrations in a Spanish Cohort Linares Ruiz, Eduardo; Pérez-Díaz, Celia; Perez Carrascosa, Francisco M; Gonzalez, Sara; Ramos Rodríguez, Juan José; Salcedo Bellido, Inmaculada; Arrebola Moreno, Juan Pedro The aim of this study was to estimate the historical exposure to a selection of polybrominated diphenyl ethers (PBDEs) and Dechlorane Plus (DP) concentrations and to identify the potential sociodemographic and lifestyle factors associated with this exposure. The study population (n = 134) was a subcohort of the GraMo Study, recruited in 2003–04 in Granada (Spain). Information on potential exposure-associated factors was collected through face-to-face interviews and a review of clinical records. Historical exposure was estimated by analyzing adipose tissue concentrations of 12 PBDEs and 2 DPs by means of gas chromatography coupled to a mass spectrometer. Data analyses included multivariable linear regression analyses. Median (interquartile range) pollutant concentrations ranged from 0.13 (0.09, 0.23) ng/g lipid for BDE-99 to 1.34 (0.92, 2.43) ng/g lipid for BDE-153. The body mass index was inversely associated with anti-DP, syn-DP, and BDE-153, -183, and -197 concentrations. Males exhibited higher levels of BDE-28, -47, -153, and -209 than females. Compared to non-manual workers, manual workers exhibited increased BDE-154, anti-DP, and syn-DP concentrations but lower BDE-28 levels. These findings highlight the elevated prevalence of PBDE/DP exposure and the heterogeneous exposure patterns observed across the study population. Further research is warranted to elucidate the long-term implications for human health. Research was funded by research grants from the CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain (PI16/01858), co-funded by the European Union (FEDER). Celia Pérez-Díaz is under contract PFIS (FI21/00269, Predoctoral Health Research Training Contracts, Instituto de Salud Carlos III, Spain). https://hdl.handle.net/10481/111798 https://hdl.handle.net/10481/111672 Health belief model-based educational interventions for knowledge, beliefs, and intentions on mammography: a systematic review Shaker Abu Abed, Ahmad; Garcia-Valdes, Luz María; Taha, Hana; Amezcua Prieto, María Del Carmen Background Breast cancer (BC) is a significant global health issue and the most common cancer among women. Early detection via mammography is crucial for improving survival rates. This systematic review (SR) explores the impact of educational interventions based on the Health Belief Model (HBM) on women’s BC knowledge, beliefs, and intentions regarding mammography among women aged 40 and older.lease be informed that I submitted Methods The SR was registered on PROSPERO (CRD42023402436) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2020) guidelines. A comprehensive search was conducted across f ive databases—PubMed, CINAHL, Embase, Web of Science, and PsycINFO—for relevant English-language studies published from January 2003 to December 2024. The study quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) and the Revised Risk of Bias Assessment 2 (RoBANS 2) tools. A narrative synthesis was conducted following established methodological guidance. Results Eight studies were included, consisting of five randomized controlled trials (RCTs) and three non-randomized controlled trials (NRCTs), with a total of 1,439 participants. The interventions included individual, group, and multimedia education and consultations. Six studies showed significant improvement in knowledge, while seven showed improvement in one or more constructs of the CHBMS related to beliefs about mammogram screening. Key factors influencing screening intentions were embarrassment, cost, income level, health insurance, age, and immigration status. Limitations of the studies included small sample sizes, reliance on self-reported data, lack of control groups, and short follow-up periods. Conclusion Educational interventions based on HBM generally improve BC knowledge, beliefs, and intentions about mammography in women aged 40 years and older. Interventions that incorporate multiple strategies within healthcare settings show the most significant improvements. Future approaches should be multifaceted, sensitive to cultural and socioeconomic contexts, and include ongoing follow-up to promote screening adherence and early BC detection. https://hdl.handle.net/10481/111672 https://hdl.handle.net/10481/111657 Walking promotion in healthy pregnant women and perinatal outcomes: a multivariate analysis comparing active and sedentary mothers Benito Villena, Rebeca; Cano Ibáñez, Naomi; Gallardo Vera, Andrea; Mozas Moreno, Juan; Saeed Khan, Khalid; Puertas Prieto, Alberto; Amezcua Prieto, María Del Carmen Background: regular physical activity during pregnancy is associated with important maternal health benefits, yet the specific impact of walking on labour and neonatal outcomes remains unclear. Although walking is the most common form of exercise among pregnant women, evidence linking walking levels to obstetric and neonatal results is still limited. We aim to explore the relationship between walking activity level in the third trimester of pregnancy (t3) and obstetric and neonatal outcomes. Methods: this was a secondary analysis of the Walking_Preg Project (WPP) randomised clinical trial registered in the U.s. National Library of Medicine trials registry (https:// clinicaltrials.gov/study/Nct03735381). Participants were healthy, low-risk pregnant women who were not previously physically active. they were given pedometers and physical activity recommendations. the sample was classified at t3 as physically active (≥7,500 steps/day) or sedentary (<7,500 steps/day) according to tudor-Locke and bassett’s index to classify pedometer-determined physical activity in healthy adults. Multivariate analyses were conducted to compare obstetric and neonatal outcomes between active and sedentary women. Results: 41 pregnant women walked at least 7,500 steps per day in t3, while 137 did not reach that activity level. the crude and adjusted multivariate models showed an inverse relationship between walking ≥7,500 steps/day in t3 and unplanned caesarean delivery (adjusted Or 0.27, 95% ci 0.05–1.47) as well as a positive relationship with induction of labour (adjusted Or 1.10, 95% ci 0.46–2.61) and neonatal weight (adjusted b coef = 97.55, 95% ci −64.03-259.14; p = 0.23). However, statistical significance was not reached. Conclusions: in this secondary analysis, no statistically significant associations were observed between walking activity during the third trimester and obstetric or neonatal outcomes. Given the low adherence to the walking program and the exploratory nature of the analysis, these findings should be interpreted with caution and require confirmation in larger, adequately powered studies. https://hdl.handle.net/10481/111657 https://hdl.handle.net/10481/110905 Pregnancy-related factors and risk of breast cancer in daughters: A systematic review and meta-analysis Olmedo Requena, María Rocío; Puebla, Iratxe Inés; Lozano Lorca, Macarena; Ávila-Cabreja, José Alejandro; González-Palacios Torres, Carla; Castillo-Hermoso, María Ángeles; Jiménez Moléon, José Juan; Barrios Rodríguez, Rocío Background and aim: Pregnancy-related exposures have been proposed as potential risk factors for breast cancer later in life, but findings remain inconclusive. This study aimed to update evidence on the associations between the exposure to pregnancy-related factors occurring up to birth—maternal and paternal age, gestational age at birth, twin status, and maternal preeclampsia—and breast cancer risk in daughters. Material and methods: A systematic review and meta-analysis were conducted. Searches were performed in MEDLINE (via PubMed), Web of Science, and Scopus. We included observational analytical studies assessing associations between parental age, gestational age, twin status, and maternal preeclampsia and breast cancer risk in daughters, reporting effect measures with 95% confidence intervals (CI) or sufficient data for calculation. Study quality was assessed using the Newcastle-Ottawa Scale. A dose-response meta-analysis evaluated the effects of maternal and paternal age, while random-effects models assessed the effects of gestational age, twin status, and maternal preeclampsia. Heterogeneity was assessed using the I2 statistic and publication bias through funnel plots and Egger's tests. Results: Fifty-two studies met the inclusion criteria; 57.7% were high quality. Breast cancer risk increased with maternal age up to 30 years (I2 = 10.7%, P = .26). A possible association for paternal age (I2 = 33.8%, P = .08) disappeared in subgroup analysis (I2 = 1.0%). No associations were found for gestational age (pooled OR [pOR] 0.96, 95% CI 0.84 to 1.10), twin status (pOR 1.19, 95% CI 0.97 to 1.46), or maternal preeclampsia (pOR 1.08, 95% CI 0.71 to 1.64). Conclusions: Increased maternal age may influence breast cancer risk in daughters. No associations were found for paternal age, gestational age, or twin status; conclusions for maternal preeclampsia remain uncertain due to heterogeneity. https://hdl.handle.net/10481/110905