Autonomous Region Of Madrid Research Articles

Intrathecal baclofen therapy as treatment for spasticity and dystonia: Review of cases in a pediatric palliative care unit

IntroductionPatients managed in the Pediatric Palliative Care Integral Unit (PPCIU) have serious neurological conditions that involve significant damage at central nervous system level. The movement disorder is a very common clinical problem and for the patients where an adequate control of muscle tone is not achieved with usual techniques or drugs, intrathecal baclofen therapy (IBT) should be considered. Materials and methodsDescriptive retrospective study based on the review of clinical records of patients who received IBT being followed by the PPCIU of Madrid Autonomous Region in the timeframe between September 2012 and February 2021. ResultsIBT was implanted in 8 patients affected by infantile cerebral palsy (ICP) with a Gross Motor Function Scale (GMFCS) IV–V, 3 patients was a Pantothenate kinase deficit-associated neurodegeneration (PKAN), 2 had Acquired Brain Damage, and the remaining 3 had, respectively, 2 glutaric aciduria type I (GA-1), and poly-malformative syndrome. In all patients we observed a period of clinical stability after IBT, we call this period “honeymoon”. Two patients died while in the honeymoon period, at 24.9 and 19.6 months from implantation of the pump; the median of duration of the honeymoon period in the remaining 14 was 14.4 months (IQ: 8.3–25.8). ConclusionsIBT was not only used in patients with non-progressive diseases, but also in the group of patients with neurodegenerative or progressive diseases. In all of them, after implantation of the device, we have objectified a period of clinical stability and a better control of muscle tone disorders.

Women Architects and Their Works in the Autonomous Region of Madrid, 1978-2008

This paper explores the periphery of the very centre of the architectural system in Spain, considering the work of women architects in the Autonomous Region of Madrid (Comunidad Autónoma de Madrid), the province of its capital, in the period 1978-2008, i. e., between the democratic restoration and the global financial crisis. The approach is threefold. Firstly, a quantitative analysis, according to various parameters, of a sufficiently representative sample (more than a hundred cases) of this female-authored production, either solo or in collaboration with other women colleagues. Secondly, an analysis of the presence of women and their works in the architectural media in terms of the prestige they represent. Thirdly, an evaluation based on a qualitative approach of these works, the account of their differential features, and the identification of the very interests that women architects expressed through them. To this end, a methodology is implemented that includes the collection of bibliographic sources, a call to the architects to invite them to submit their projects and field work, by visiting and collecting data from most of the works. The results reveal that most of their professional practice that solo and is mainly based on residential works—the most recognised— followed by interventions in public spaces. Most of the works correspond to new construction and are concentrated, in time, in the 1990s and, in space, to the south and east of both the capital and the wider Madrid Region. The work of women architects has hardly been reported in professional journals, although it has been more widely disseminated in institutional publications, especially in the case of female civil servants. Qualitatively, the attention paid to the programme, especially to the common and intermediate spaces, the suitability of the technical means to the ends and the context, the care taken in the design of inclusive public spaces and the commitment to sustainability are striking. All this speaks volumes about the value of authors and architectures that, even in the center itself, are relegated to the periphery. It is a political and cultural system, which gender-based research challenges to propose hopeful alternatives for the discipline.

Residencia en Anestesiología y Reanimación en la comunidad autónoma de Madrid, España: ¿qué conocimientos tienen los residentes y cuáles son los motivos de su elección de la especialidad?

BackgroundOver the past years, choice of specialization in Anaesthesiology and intensive care has become more popular in Spain among medical students. We designed a survey to study this trend, assessing theoretical knowledge and factors which participated to the choice of anaesthesia, among first-year residents in the region of Madrid. MethodsA survey was designed to evaluate the background, exposure to anaesthesia during medical school training, and motivation, followed by a test of knowledge based on 15 multiple choice questions. The questions were proposed to the seventy residents of the Madrid Autonomous Region who started their training program in 2022. Results60/70 (85,7%) residents answered the survey. Only 58,3% of respondents had studied in Madrid and 98,3% had chosen anaesthesia as their first option. During their medical degree, 65% of them had received theoretical lectures in anaesthesia and 66,7% did a clinical rotation. Choosing to specialize in Anaesthesiology was influenced by doing clinical rotations (p < 0,001), but not by receiving lectures (p=0,88). When asked about the main reasons for selecting anaesthesia, the variety of technical skills available had influenced 76,7% residents, the width of knowledge 75% and the career opportunities 73,3% of residents. The median score for the knowledge test reached 13/15 of correct answers. ConclusionMost of our first-year residents did a clinical rotation during their medical degree and were exposed to their future specialty, which oriented their choice. When considering anaesthesia as a choice, technical skills was the most influencing factor.

Progressive pollen calendar to detect long-term changes in the biological air quality of cities in the Madrid Region, Spain

Rhinoconjunctivitis and allergic asthma are among the most frequent diseases in the world, and pollen is their main cause. The incidence of respiratory allergic diseases is expected to grow in the coming years as a consequence of ambient pollution, changes in land use and land cover in cities, and climate change. In this context of global change, the environmental information provided by monitoring and warning networks must be as updated as possible in order to be useful to the end users in the cities. The Madrid Autonomous Region (central Spain) has suffered a noticeable change in its land-use configuration in recent decades and a significant upward temperature trend throughout the entire area. We found that the aerobiological stations in the Madrid Region Palynological Network, covering the most populated cities of this region in central Spain, registered a marked shift towards a greater airborne pollen load of the most abundant tree pollen taxa (Cupressaceae, Platanus and Quercus, but also Pinaceae, Olea and others). These temporal changes are very evident in the pollen calendar for two periods, 1994–2004 (past) and 2012–2022 (present), pointing to changes in the phenology and intensity of the airborne pollen dynamic in cities in the Madrid Region. Based on these findings, we present a technical proposal to the Madrid Region Palynological Network to generate pollen calendars for each city using the reference period of the last ten years, and to update this information every three years. Finally, we propose the latest pollen calendar for all the aerobiological stations in the Madrid Region Palynological Network for the last ten years (2013–2022), which is considered the reference aerobiological information at present for one of the most populated metropolitan areas in Europe.

Protection and assistance of human trafficking victims in the autonomous region of Madrid

Protection and assistance of human trafficking victims in the autonomous region of Madrid

Simuliids from Madrid Autonomous Region (Spain): update and new contributions

Simuliidae family in Spain has been studied irregularly: some enclaves have been widely investigated by both national and foreign experts, while others have been merely mentioned or addressed indirectly for various reasons. The Madrid Region in Spain has been recurrently investigated in this respect, yet many geographical areas remain to be studied regarding Simuliidae taxonomy, geographical distribution, and ecology. In this study, a thorough sampling was conducted based on searching for preimaginal stages of larva and pupa attached or fixed to any suitable support in different lotic water systems. The latter were chosen for their favourable conditions for hosting new and valuable information. The collected material was identified based on morphological characteristics. A total of 16 species were identified. The following is an update of the simuliid fauna and its altitudinal ranges from Spain’s central geographical area, including seven new records for the Madrid Region: Prosimulium rufipes (Meigen, 1830); Simulium (Nevermannia) naturale Davies, 1966; Simulium (Nevermannia) quasidecolletum Crosskey, 1988; Simulium (Nevermannia) urbanum Davies, 1966; Simulium (Simulium) trifasciatum Curtis, 1839; Simulium (Simulium) maximum (Knoz, 1961); Simulium (Simulium) variegatum Meigen, 1818. Following the update, the species with the narrowest altitudinal distribution were: S. (N.) naturale and S. (N.) urbanum: 1843-1844 meters (m), while Simulium (Nevermannia) cryophilum (Rubtsov, 1959) and Simulium (Simulium) intermedium Roubaud, 1906 presented the widest distribution: 870-2000 m. In this study, S. (N.) naturale and S. (N.) urbanum also displayed the narrowest altitudinal range, with 1 m, whereas S. (N.) cryophilum presented the broadest, with 603 m. The present study contributes to the knowledge of Spanish blackflies generally and from the Madrid Region in particular, providing new insights into the species composition and their altitudinal distribution. It thus lays the foundations for future works.

Assessment of environmental risk areas based on airborne pollen patterns as a response to land use and land cover distribution

Allergic respiratory diseases are considered to be among the most important public health concerns, and pollen is the main cause of allergic respiratory diseases worldwide. However, the biological component of air quality is largely underestimated, and there is an important gap in the legislation in this area. The aims of this study were to characterise the occurrence and incidence of pollen exposure in relation to potential pollen sources and to delineate the main areas of aerobiological risk in the Madrid Autonomous Region based on homogeneous patterns of pollen exposure. This study uses the historical aerobiological database of the Madrid Region Palynological Network (central Spain) from ten pollen stations from 1994 to 2022, and the land-use information from the Corine Land Cover. Multiple clustering approaches were followed to group the sampling stations and subsequently all the 1 × 1km pixels for the Madrid Autonomous Region. The clustering dendrogram for land-use distribution was compared to the dendrogram for historical airborne pollen data. The two dendrograms showed a good alignment with a very high correlation (0.95) and very low entanglement (0.15), which indicates a close correspondence between the distribution of the potential pollen sources and the airborne pollen dynamics. Based on this knowledge, the Madrid Autonomous Region was divided into six aerobiological risk areas following a clear anthropogenic gradient in terms of the potential pollen sources that determine pollen exposure in the Madrid Region. Spatial regionalisation is a common practice in environmental risk assessment to improve the application of management plans and optimise the air quality monitoring networks. The risk areas proposed by scientific criteria in the Madrid Autonomous Region can be adjusted to other operational criteria following a framework equivalent to other air quality networks.

Differentiation of personal income by the autonomous regions of Spain

Average per capita income of the population is one of the important indicators reflecting the standard of living in the country. It becomes relevant to determine reasons for differentiating income per capita and per household and to identify the causes that affect it. The paper considers the income of the population in the autonomous regions of Spain for 2008–2021 both per capita and per household. A comparative analysis of incomes with and without imputed rents has been carried out, that is, the share of rental expenditure in household income and the trend in its change over the last thirteen years have been determined. The results of the study revealed higher living standards in some industrialized regions of the North of the country, such as Navarra and the Basque Country, as well as in regions where large metropolitan areas are located. These are the Autonomous Region of Madrid with a population of 6.7 million people (directly Madrid – about 5 million people) and Catalonia with a population of 7.7 million people with the administrative center in Barcelona (4.5 million people). Slow growth of citizens’ expenditures on rental housing has also been revealed. Due to growing individualization of the population and reduction of the number of people in a family, the number of people in one household is decreasing on average in the country. The analysis of population change in Spain shows that the demographic situation remains positively stable. In general, there is population growth, but depopulation is occurring in the interior regions of the country, such as Extremadura, Castile-La Mancha, Castile and Leon, Aragon. In addition to living standards, other factors such as climate, proximity to the coast, and tourist attractiveness have an impact on migration processes.

Real-life safety and effectiveness outcomes of teriflunomide in patients with relapsing–remitting multiple sclerosis: The TERICAM study

Introduction and objectiveTeriflunomide is an oral immunomodulatory agent approved for the treatment of relapsing–remitting multiple sclerosis (RRMS). We examined teriflunomide outcomes in patients with RRMS under clinical practice conditions in Spain. Material and methodsNon-interventional, retrospective study at 15 sites in the Autonomous Region of Madrid and nearby regions. Effectiveness (relapses, EDSS, gadolinium-enhancing T1 lesions and new/enlarged T2-weighted lesions), safety (adverse events), and reasons for discontinuation during the 24 months after teriflunomide initiation were reported. ResultsA total of 776 patients were included (mean [SD] age was 43.3 (9.8) years; 69.3% were female). Two-thirds (67.7%) of patients had received a prior treatment, with beta-interferons or glatiramer acetate (BRACE) as the most frequent (93.5%) treatment. After 24 months, teriflunomide significantly reduced the annualized relapse rate (ARR) by 72% (mean [95% confidence interval] 0.12 [0.10, 0.14] vs 0.43 [0.40, 0.47] at baseline; P<.0001) and 81.8% of patients were relapse-free. The number of patients with gadolinium-enhancing T1 lesions and new/enlarged lesions on T2 was also reduced after 24 months of teriflunomide treatment (P<.001). Mean EDSS (SD) score was 1.9 (1.5) at teriflunomide initiation and 2.0 (1.6) at month 24. Half of patients (n=388) reported at least 1 adverse event (AE; gastrointestinal disorders: 26.2%; hair thinning: 25%; and elevation of ALT values: 12.9%). Most patients (91.5%) did not show fatigue increase during teriflunomide treatment. Among patients who discontinued treatment (n=262; 34.2%), the most common reasons were lack of effectiveness (58.0%), AEs (31.9%; n=82), and pregnancy desire (6.6%; n=17). ConclusionsMost RRMS patients treated with teriflunomide in clinical practice had received prior treatments. Teriflunomide resulted in decreased clinical and radiological activity and disability stabilization. AE frequency and type were in line with prior reports. Most patients did not experience fatigue increases after teriflunomide initiation.

Community pharmacists' perceptions about their performance and professional involvement in the dispensing and free delivery of antigen tests for COVID-19 self-diagnosis to the Madrid Autonomous Region population

In 2021, the Community of Madrid intensified their fight against the pandemic by incorporating the community pharmacy network to its public health program for the early detection, surveillance, and control of Covid-19. Specifically, pharmacies participated in the performance of rapid antigen testing for the diagnosis of SARS-CoV-2 infection and provided the population with free self-testing kits. From the Official College of Pharmacy of Madrid ("Colegio Oficial de Farmacéuticos de Madrid"), a study was conducted to evaluate the professional involvement and role of community pharmacists, as well as the degree of information demanded by the public during the distribution of self-testing kits. This was an observational, cross-sectional, prospective study that employed online surveys collected between May 4th and 17th 2022. 76.8 % of pharmacists offered technical information to approximately 58 % of users that came to retrieve their self-testing kits. 26 % of users returned for additional advice, and 1/3 of users asked for the test to be conducted in the pharmacy. The most frequent intervention (61 %) was providing information on test usage and interpretation. In most cases (56.7 %), pharmacists spent between 1-5 minutes in the distribution of self-testing kits, with a lower percentage (20.3 %) spending between 5-10 minutes. Notably, 98.3 % of pharmacists identified that this public health campaign altered their daily workflow, with 86 % considering that there should have been financial compensation for their involvement.. This study highlighted the crucial role that pharmacists played in the public health campaign against Covid-19. Moreover, it reflected the pharmacists' opinions on their involvement in this novel role, separate from their traditional workflow, that ultimately contributed to improving population health.

Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region

BackgroundA number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013–2018. MethodologyLongitudinal ecological time series study analysed by Generalised Linear Models with Poisson regression, with the dependent variable being daily Emergency Hospital Mental Health Admissions (EHMHA) in the MAR, and the independent variable being mean daily concentrations of chemical pollutants, noise levels and meteorological variables. ResultsEHMHA were related statistically significantly in the short term with diurnal noise levels. Relative risks (RRs) for total admissions due to mental disorders and self-inflicted injuries, in the case of diurnal noise was RR: 1.008 95%CI (1.003 1.013). Admissions attributable to diurnal noise account for 5.5% of total admissions across the study period. There was no association between hospital admissions and chemical air pollution. ConclusionNoise is a variable that shows a statistically significant short-term association with EHMHA across all age groups in the MAR region. The results of this study may serve as a basis for drawing up public health guidelines and plans, which regard these variables as risk factors for mental disorders, especially in the case of noise, since this fundamentally depends on anthropogenic activities in highly urbanised areas with high levels of traffic density.

Intrathecal baclofen therapy as treatment for spasticity and dystonia: Review of cases in a pediatric palliative care unit

IntroductionPatients managed in the Pediatric Palliative Care Integral Unit (PPCIU) have serious neurological conditions that involve significant damage at central nervous system level. The movement disorder is a very common clinical problem and for the patients where an adequate control of muscle tone is not achieved with usual techniques or drugs, intrathecal baclofen therapy (IBT) should be considered. Materials and methodsDescriptive retrospective study based on the review of clinical records of patients who received IBT being followed by the PPCIU of Madrid Autonomous Region in the timeframe between September 2012 and February 2021. ResultsIBT was implanted in 8 patients affected by infantile cerebral palsy (ICP) with a Gross Motor Function Scale (GMFCS) IV–V, 3 patients was a Pantothenate kinase deficit-associated neurodegeneration (PKAN), 2 had Acquired Brain Damage, and the remaining 3 had, respectively, 2 glutaric aciduria type I (GA-1), and poly-malformative syndrome. In all patients we observed a period of clinical stability after IBT, we call this period “honeymoon”. Two patients died while in the honeymoon period, at 24.9 and 19.6 months from implantation of the pump; the median of duration of the honeymoon period in the remaining 14 was 14.4 months (IQ: 8.3–25.8). ConclusionsIBT was not only used in patients with non-progressive diseases, but also in the group of patients with neurodegenerative or progressive diseases. In all of them, after implantation of the device, we have objectified a period of clinical stability and a better control of muscle tone disorders.

Protected areas as a double edge sword: An analysis of factors driving urbanisation in their surroundings

Protected areas (PAs) are the most effective tools to protect biodiversity and ecosystem services. They have proven to be effective in stopping extensive land use conversion in well-conserved terrestrial ecosystems. However, land cover changes around PAs threaten biodiversity and ecosystem services within their limits and reduce ecological connectivity. In this study, we analysed the urban sprawls on the boundaries of 159 PAs (national, regional, and natural parks) in Spain, using 2.5 and 5 km non-protected buffer zones from 1990 to 2018. We clustered PAs based on biophysical and socio-economic characteristics and modelled urban sprawl in different buffers and periods. Hierarchical clustering revealed three groups of PAs: (a) proximate urban parks, (b) mountainous parks, and (c) parks in the Madrid autonomous region. We found that urbanisation in the surroundings of PAs in Spain has nearly doubled since 1990. General linear models explained a significant proportion of the urbanisation trends observed, with the number of municipalities in the boundary of the PA, the distance to a main road, and the distance to a big city acting as the most important drivers of urban sprawl. Our results also show that some PAs exert significant effects on urbanisation trends in their surroundings through the park-view effect. Finally, we highlight three coexisting phenomena that might explain the observed urban sprawl processes: (a) PAs attracting urbanisation in their surroundings due to the park-view effect, (b) PAs as a deterrent for urban sprawl within their limits, and (c) PAs occupying residual areas among previously urbanised lands.

Problematic internet use: the preference for online social interaction and the motives for using the Internet as a mediating factor

The preference for online social interaction has been seen as an antecedent for problematic use of the Internet and social networks, which is associated with problems of social anxiety and a lack of social skills. Based on a survey with a representative sample of 524 students in Compulsory Secondary Education (aged 12-14) in the Autonomous Region of Madrid (Spain), the role of motives of use as a factor that explains the problematic use of the Internet has been analysed as a mediating component between such problematic use and the preference for online social interaction. The results show that only when social networks are used to expand relationships and as a form of self-expression are there negative consequences for the individual, but not when such networks are used to maintain close relationships. Finally, is has been observed that such motives, which moderately predict problematic use, only slightly explain in part the relationship between the preference for online social interaction and problematic use. Therefore, further research is needed to investigate other motives for use that mediate this association, as well as the connection between the motive to expand social relationships together with self-expression, and other pre-existing personality factors that might lead to problematic use of the Internet and social networks.

Late Stage Decomposition of Embalmed Cadavers

Decomposition is a natural process that begins approximately four minutes after death and continues until the body is degraded to simpler biochemical components which are gradually recycled back to the environment. This process is dependent on extrinsic and intrinsic factors. Embalming is a chemical preservation technique that aims to preserve the external appearance of the body in good condition for an indeterminate period. In Spain, there is a lack of experimental studies carried out to analyse the variables that affect decomposition in embalmed bodies, therefore, in accordance with the conclusions reached by previous authors, it is hypothesised that embalmed bodies show quantifiable characteristics during the late stage decomposition which distinguish them from control, unembalmed, cadavers. An anthropological and statistical analysis was performed on 14 individuals from Cementerio Sur de Madrid exhumed after ten years according to the Mortuary Health Law of the Autonomous Region of Madrid. The preliminary results obtained showed that there is a qualitative and statistically significant relationship between the variables evaluated, being the presence or absence of soft tissue the most notable difference. The mortuary or thanatopraxy treatments performed before the burial and the microenvironmental conditions of the burial positively influence the soft tissue preservation on embalmed bodies. These results contribute to the understanding about the decomposition rate of an embalmed cadavers in cemeteries, and the related extrinsic variables.

Differentiated Uses of Social Networking Platforms among Young People in the Autonomous Region of Madrid

Young people make intensive and varied use of social networks, which depends on individual differences and use motives. This study analyses the different ways in which young people use the main social media platforms and the role that gender, age and social class play in users’ behaviour with a representative sample of young people aged 17–24 in the Community of Madrid (Spain) (N = 533). Women and the youngest people (17–19 years of age) used social networks more consistently. Instagram and Facebook were the most widely used social networks with greater diversity of use in the areas of sociability and entertainment. While women and the younger age group spent more time using Instagram, young people from the upper class and upper-middle class used Facebook more often in a variety of ways. YouTube was used less frequently, and it was used mainly for entertainment purposes. Snapchat played a small role in this segment of the population. We conclude that age and social class play an important role in defining the different ways in which young people in the Region of Madrid use social media, and such influences vary depending on the platform under study and the types of activities being carried out.

Absence of IgG antibodies among high-risk contacts of two confirmed cases of Crimean-Congo haemorrhagic fever in the autonomous region of Madrid (Spain)

Crimean-Congo haemorrhagic fever (CCHF) is a widely distributed tick-borne disease. In Spain, the disease has emerged as outbreak associated with high-risk exposures. Our goal was to evaluate the prevalence of antibodies against the CCHF virus (CCHFV) in high-risk contacts. A cross-sectional study was conducted. Three hundred eighty-six high-risk contacts were identified comprising family contacts and hospital workers who had attended the cases. Fifty-seven cases with closer exposure were selected. However, forty-nine cases participated in the study. IgG antibodies were detected by immunoenzymatic techniques. All determinations tested negative for anti-CCHFV IgG antibodies. Most of the responders were women (73.5%), and belong to the intensive care department (53.1%). In relation to other possible sources of exposures, 18.4% travelled to countries with CCHF transmission risk. No CCHF positivity was recorded among selected high-risk contacts. This highlights the importance of standard precautions which might have protected healthcare workers and care providers from CCHF infection.

Internet visibility of university institutions

La presente investigación realiza un análisis metodológico y de contenido acerca de las causas que rigen la visibilidad en la Red a través del posicionamiento orgánico que realizan los motores de búsqueda (SEO) de las universidades. Para ello, se utilizan distintas herramientas de cómputo bajo demanda o cloud computing que permiten conocer, por un lado, el grado de optimización técnica de los diferentes sitios web y, por otro lado, el alcance y repercusión de sus comunidades online en redes sociales. Las conclusiones reflejan las múltiples causas por las que un sitio web tiene mayor visibilidad en la Red, tomando como referencia los entornos digitales de la Universidad Complutense de Madrid y la Universidad Rey Juan Carlos en el ámbito de la Comunidad de Madrid.

Updated pest categorisation of Xylellafastidiosa.

Following a request from the European Commission, the EFSA Plant Health Panel updated its pest categorisation of Xylella fastidiosa, previously delivered as part of the pest risk assessment published in 2015. X. fastidiosa is a Gram‐negative bacterium, responsible for various plant diseases, including Pierce's disease, phony peach disease, citrus variegated chlorosis, olive quick decline syndrome, almond leaf scorch and various other leaf scorch diseases. The pathogen is endemic in the Americas and is present in Iran. In the EU, it is reported in southern Apulia in Italy, on the island of Corsica and in the Provence‐Alpes‐Côte d'Azur region in France, as well as in the Autonomous region of Madrid, the province of Alicante and the Balearic Islands in Spain. The reported status is ‘transient, under eradication’, except for the Balearic Islands, Corsica and southern of Apulia, where the status is ‘present with a restricted distribution, under containment’. The pathogen is regulated under Council Directive 2000/29/EC and through emergency measures under http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32015D0789 (as amended http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32017D2352). The pest could enter the EU via host plants for planting and via infectious insect vectors. The host range includes hundreds of host species listed in the EFSA host plant database. In the EU, host plants are widely distributed and climatic conditions are favourable for its establishment. X. fastidiosa can spread by movement of host plants for planting and infectious insect vectors. X. fastidiosa is known to cause severe direct damage to major crops including almonds, citrus, grapevines, olives, stone fruits and also forest trees, landscape and ornamental trees, with high impacts. The criteria assessed by the Panel for consideration as a potential Union quarantine pest are met (the pathogen is present in the EU, but it has a restricted distribution and is under official control). X. fastidiosa is not considered as a regulated non‐quarantine pest (RNQP) as the pathogen may spread also via insect vector transmission.

Tipologías de los madrileños ante la etapa final de la vida mediante un análisis de clusters

ObjectiveTo establish typologies within Madrid's citizens (Spain) with regard to end-of-life by cluster analysis. MethodThe SPAD 8 programme was implemented in a sample from a health care centre in the autonomous region of Madrid (Spain). A multiple correspondence analysis technique was used, followed by a cluster analysis to create a dendrogram. A cross-sectional study was made beforehand with the results of the questionnaire. ResultsFive clusters stand out. Cluster 1: a group who preferred not to answer numerous questions (5%). Cluster 2: in favour of receiving palliative care and euthanasia (40%). Cluster 3: would oppose assisted suicide and would not ask for spiritual assistance (15%). Cluster 4: would like to receive palliative care and assisted suicide (16%). Cluster 5: would oppose assisted suicide and would ask for spiritual assistance (24%). ConclusionsThe following four clusters stood out. Clusters 2 and 4 would like to receive palliative care, euthanasia (2) and assisted suicide (4). Clusters 4 and 5 regularly practiced their faith and their family members did not receive palliative care. Clusters 3 and 5 would be opposed to euthanasia and assisted suicide in particular. Clusters 2, 4 and 5 had not completed an advance directive document (2, 4 and 5). Clusters 2 and 3 seldom practiced their faith. This study could be taken into consideration to improve the quality of end-of-life care choices.