Metropolitan Area Of Barcelona Research Articles

Factores que influyen en la elección de la especialidad de Medicina Familiar y Comunitaria

AimTo analyze the perceptions, motives and reasons that influence the election of Family and Community Medicine (FCM) speciality, thus exploring possible proposals for change in the health system model and university training. DesignDescriptive–interpretative qualitative research from a socio-constructivist perspective. EmplacementMedical speciality training departments in the Metropolitan Area of Barcelona. Participants and context55 first year junior doctors belonging to the FCM Barcelona Ciutat ICS training department were contacted; 25 agreed to participate. They were segmented into two groups depending on if the choice of FCM had been their first option or not. Through snowball sampling 11 more junior doctors from other specialities were recruited. MethodThree focus groups were formed: (a) first choice FCM, (b) not first choice FCM and (c) other specialities. Semi-structured 2-h long interviews took place with each of the groups. Literal transcription and inductive codification with a first triangulation within each group and a second one between the three of them and thematic content analyses. ResultsThe choice of speciality is lived as an academic milestone and is thought determining professional and personally. It is a complex weave of influencing elements but some of main factors were university training, health system model, professional prospects and the social appreciation of the speciality. Analyzing the relation between these elements puts light on a phenomena we have called “the discredit of Primary Care (PC)”. ConclusionThe FCM specialty will not be attractive in a hospital-centric health and training system that does not bet on PC organizationally or economically.

Mobility Trends before and after the Pandemic Outbreak: Analyzing the Metropolitan Area of Barcelona through the Lens of Equality and Sustainability

The spatial arrangement of a metropolis is of utmost importance to carry out daily activities, which are constrained by space and time. Accessibility is not only shaped by the spatial and temporal dimension, but it is also defined by individual characteristics, such as gender, impairments, or socioeconomic characteristics of the citizens living or commuting in this area. This study analyzes mobility trends and patterns in the metropolitan area of Barcelona before and after the COVID-19 pandemic outbreak, with special emphasis on gender and equality. The study draws on multiple sources of information; however, two main datasets are analyzed: two traditional travel surveys from the transport metropolitan area of Barcelona and two coming from smartphone data. The results show that gender plays a relevant role when analyzing mobility patterns, as already highlighted in other studies, but, after the pandemic outbreak, some population groups were more likely to change their mobility patterns, for example, highly educated population groups and those with higher income. This study also highlights that e-activities may shape new mobility patterns and living conditions for some population segments, but some activities cannot be replaced by IT technologies. For all these reasons, city and transport planning should foster sustainable development policies, which will provide the maximum benefit for society.

Transnational family ties and networks of support for unaccompanied immigrant youths in Spain: The role of youth mentoring in Barcelona

The growing number of unaccompanied immigrant youths arriving through Mediterranean routes from North and West African countries to Spain is challenging established political and social interventions. Their transition to adulthood and resettlement is made more difficult by the physical and geographical distance with their parents and the availability of networks of support in the host country. This qualitative study examines the transnational family support that unaccompanied youths receive, and the complementary support received from formal mentors in the new context. A focus group was conducted to explore the needs at this stage of life and to construct the interview guidelines. Our findings from twenty semi-structured interviews with mentored and non-mentored youth in the Barcelona Metropolitan Area during 2019 shows how the formal support provided by institutional agents is insufficient to fulfil their emotional needs. We conclude that the virtual presence of family caregivers and the different kinds of support received by adult mentors encourages them in overcoming challenges regarding their well-being.

A Cost-Benefit Analysis of the COVID-19 Asymptomatic Mass Testing Strategy in the North Metropolitan Area of Barcelona.

Background: The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. Objective: To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. Methodology: Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. Results: Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. Conclusion: Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.

REMOTE SENSING AND NIGHT TIME URBAN HEAT ISLAND

Abstract. The urban climate literature has highlighted the remarkable prominence of nighttime UHI phenomenon. During nighttime the UHI effects become more evident due to the greater thermal inertia of the materials used in urban fabric. It is during the night when the heat accumulated in urban materials, especially in contexts of heat waves, can generate significant health risks. The low cooling capacity of urban construction materials negatively affects the comfort and the health of urban dwellers. However, and despite the great importance of night stress due to heat, the study of night UHIs is still underdeveloped. In this context, this paper aims to determine nighttime LST contrasting Landsat's very limited nighttime images with daytime ones. The example developed refers to heat wave situations during the summer 2015. The case study is the Metropolitan Area of Barcelona (35 municipalities, 636 km2, 3.3 million inhabitants).

Incorporating user preferences in rooftop food-energy-water production through integrated sustainability assessment * *Discover how to benefit from urban rooftops implementing food, energy and water systems for self-sufficient cities.

With the overall aim to design successful implementation strategies of food-energy-water production systems on urban roofs, we propose an integrated process that includes participatory processes and a multi-dimensional sustainability assessment of environmental, social and economic indicators. The proposed framework was applied to a typical housing estate in the Metropolitan Area of Barcelona made up of 201 buildings and 13,466 inhabitants and characterized by a high share of low-income families. We assess several future scenarios of joint electricity production (photovoltaic panels), vegetable production (through open-air farming and greenhouses), green roof implementation and rainwater harvesting and rank them according to non-participatory and participatory approaches. In general, there was a tendency for residents to choose strategies providing energy and water rather than the food production potential of rooftops. However, the environmental assessment indicated that the least impacting alternatives from a life cycle approach were those promoting vegetable production, meeting 42 to 56% of the residents’ fresh produce demand and reducing environmental impacts by 24 to 37 kg CO2eq m−2 of rooftop/year. Hence, we found that residents were mainly concerned with energy expenses and not so much with food insecurity, social cohesion or the impacts of long-distance supply chains. Our assessment supports urban sustainability and helps identify and breach the gap between scientific and user preferences in urban environmental proposals by informing and educating residents through a participatory integrated assessment.

Detection of Beta-Lactam-Resistant Escherichia coli and Toxigenic Clostridioides difficile Strains in Wild Boars Foraging in an Anthropization Gradient.

Simple SummaryThe wild boar (Sus scrofa) has been identified as a reservoir of zoonoses and food-borne pathogens. Wild boar populations are growing worldwide, also near urban centers such as Barcelona (Catalonia, Spain). The aim of this study was to assess the presence of zoonotic agents in the wild boar populations from the Metropolitan Area of Barcelona (MAB). The detection of Escherichia coli carrying critical antimicrobial resistance genes to β-lactams and, for the first time in Spain, the detection of toxigenic Clostridioides difficile strains in wild boars foraging in urban areas show the value of this game species as a sentinel of antimicrobial-resistant bacteria (AMRB) and zoonotic agents in the environment. Moreover, the wild boars foraging in urban and peri-urban locations were more exposed to AMRB sources than the wild boars dwelling in natural environments. The responsible health agencies should undertake specific actions to fully assess the potential implications for the human population and/or environmental health. Zoonotic diseases and hazards beyond the compulsory surveillance diseases should be specifically targeted in the growing human–wildlife interface of urban environments such as the MAB under the One Health approach.Disease transmission among wild boars, domestic animals and humans is a public health concern, especially in areas with high wild boar densities. In this study, fecal samples of wild boars (n = 200) from different locations of the Metropolitan Area of Barcelona were analyzed by PCR to explore the frequency of β-lactamases and extended cephalosporin and carbapenem resistance genes (ESBLs) in Escherichia coli strains and the presence of toxigenic Clostridioides difficile. The prevalence of genes conferring resistance to β-lactam antimicrobials was 8.0% (16/200): blaCMY-2 (3.0%), blaTEM-1b (2.5%), blaCTX-M-14 (1.0%), blaSHV-28 (1.0%), blaCTX-M-15 (0.5%) and blaCMY-1 (0.5%). Clostridioides difficile TcdA+ was detected in two wild boars (1.0%), which is the first report of this pathogen in wild boars in Spain. Moreover, the wild boars foraging in urban and peri-urban locations were more exposed to AMRB sources than the wild boars dwelling in natural environments. In conclusion, the detection of E. coli carrying ESBL/AmpC genes and toxigenic C. difficile in wild boars foraging in urban areas reinforces the value of this game species as a sentinel of environmental AMRB sources. In addition, these wild boars can be a public and environmental health concern by disseminating AMRB and other zoonotic agents. Although this study provides the first hints of the potential anthropogenic sources of AMR, further efforts should be conducted to identify and control them.

P531 SARS-CoV-2 infection in Elderly patients with Inflammatory Bowel Disease with or without immunosuppressants during the first year of the pandemic. An observational, descriptive, cohort study

BackgroundOlder age has been confirmed as a risk factor for severe clinical presentation of SARS-CoV-2 disease (COVID-19). The prevalence of confirmed SARS-CoV-2 infection in Catalonia among people over 60 years is 6.6%. Biological agents have not been associated with a higher incidence nor a worse prognosis of COVID-19. However, the role of immunosuppressants (IMS) on this issue is still to be elucidated. Moreover, there are scarce data related about COVID-19 in inflammatory bowel disease (IBD) patients under IMS, and none focusing in elderly IBD. Our aim was to describe and to compare the incidence and severity of COVID-19 in patients over 65 years of age with IBD, particularly in relation to the use of IMS.MethodsWe performed a retrospective cohort study including IBD patients over 65 years since January 2020, from two referral centres in the Barcelona metropolitan area (Catalonia, Spain). Patients were grouped in two cohorts regarding the use or not of IMS (thiopurines or methotrexate). Patients on biological treatment were excluded. We identified those cases with confirmed infection with SARS-CoV-2 (positive PCR) during the period from 1st of March 2020 (the beginning of the pandemic in Catalonia) to 1st March 2021 (the beginning of vaccination in the elderly). Demographic data, IBD comorbidities, concomitant non-IBD related treatments, and SARS-CoV-2 infection outcomes were recorded.ResultsFour-hundred and eighteen elderly IBD patients were included. The median age was 74 years (IQR 69–78), 52% were male; 70% had ulcerative colitis, 28% Crohn’s disease and 2% IBD unclassified, 62% had arterial hypertension, 22% diabetes mellitus, 22% cardiovascular disease, 15% chronic obstructive pulmonary disease, 10% chronic renal disease, 5% were active smokers. There were no differences regarding comorbidities and non-IBD treatments between the two study groups. From the whole cohort, 89 (21.3%) patients were on IMS (86 with thiopurines, 3 with methotrexate). The median time on IMS was 121 months (IQR 60–162). During the study period, 32 patients (7.7%) had confirmed SARS-CoV-2 infection (7 of whom were on IST; 7.6% not on IMS vs. 7.9% on IMS, P=0.933). Seventeen (53%) patients required hospital admittance (4% not IMS vs. 4.5% on IMS; P=0.818); 4 of them developed COVID-19 related complications (3 patients not on IMS vs. 1 on IMS), and 7 (22%) patients died (6 not on IMS vs. 1 patient on IMS).ConclusionThe rate of SARS-CoV-2 infection among elderly IBD patients is quite similar to that reported in the elderly background population. In elderly IBD patients, SARS-CoV-2 infection was associated with a high admission rate and mortality, regardless of the use of IMS.

Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

BackgroundGrowing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool.MethodsThe MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months.ResultsThe tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000).ConclusionsThe results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.

Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: study protocol of the FIVALIN project

BackgroundChildhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 5–19 years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal.MethodsWe will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 8–12 years and 600 parents will be recruited during 3 consecutive editions (1st – 2019/2020; 2nd – 2020/2021; 3rd – 2021/2022) of 10 months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups.DiscussionThere is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status.Trial registrationISRCTN Registry: ISRCRN12682870. Registered 9 July 2020. Retrospectively registered.Protocol version: 30 April 2021, version 5.

Mentoring for Improving the Self-Esteem, Resilience, and Hope of Unaccompanied Migrant Youth in the Barcelona Metropolitan Area

In the last few years, the number of unaccompanied youths arriving in Europe has increased steadily. During their settlement in host countries, they are exposed to a great variety of vulnerabilities, which have an impact on their mental health. This research examines the effects of participation in a mentoring programme on the psychological and educational outcomes among unaccompanied migrant youths who live in the Barcelona metropolitan area. Data in this mixed-methods study were obtained from 44 surveys with mentored (treatment group) and non-mentored (control group) male youths who had recently turned 18, as well as through thirty semi-structured interviews with mentored youths, their adult mentors, and non-mentored youths. Our findings indicated that participation in the mentoring programme improved the mentored youths’ self-esteem, resilience, and hope, as well as their desired or expected educational outcomes in this new context. We conclude that well-targeted and problem-specific mentoring programmes have positive and marked effects on unaccompanied migrant youths’ mental health. The social and political implications of these outcomes are also discussed, providing information on how interventions can offer effective networks of support for the settlement and social inclusion of unaccompanied migrant youths.

Nine Mechanisms of Job-Searching and Job-Finding Through Contacts Among Young Adults

Since Granovetter’s seminal works, the influence of personal networks on the labour market has attracted widespread attention. This article analyses the role played by contacts in the context of the labour trajectories of young people in Spain, for whom the use of personal networks represents one of the most important job-searching methods. Using narrative data extracted from a life-history grid and ego-network generator, the analysis brings to light nine mechanisms in which personal contacts intervene in job-searching and job-finding in a sample of 90 young people living in the Barcelona Metropolitan Area. The article emphasizes that contacts play primarily three roles in these processes as informers, employers, or influencers. This distinction offers a renewed framework for the study of networks in the labour market, further complementing the debate on the strength of ties. Using this framework allows me to create a map of the mechanisms that shed light on personal networks as tools with which to deal with labour insecurity and unemployment among young people, thus providing resources that to a large extent reaffirm the objective character of class differences. The article offers innovative insights into how social capital operates in the labour market and helps understand how youth precarity, which is widespread in Spain, is experienced in a relational way.

Short-term effect of air pollution on attention function in adolescents (ATENC!Ó): A randomized controlled trial in high schools in Barcelona, Spain.

The recent evidence of the short-term impact of air pollution on youth cognitive functions is based primarily on observational studies. We conducted a randomized controlled trial to assess whether purifying the air of the classrooms produced short-term changes in attention processes of adolescents. We recruited a total of 2,123 adolescents (13-16years old) in 33 high schools in Barcelona metropolitan area (Spain). In each school, adolescents from each class were randomly split into two equal-sized groups and assigned to two different classrooms. A set of two air cleaner devices with the same appearance (one recirculating and filtrating the air and the other only recirculating the air) was used. Each one of the devices was placed at random at one of the two classrooms. Students were masked to intervention allocation and had to complete several computerized activities for 1.5h, including an attention test (Flanker task) to be performed at baseline and at the end of the intervention. The response speed consistency, expressed as hit reaction time standard error (HRT-SE, in ms), was measured as the primary outcome. Analyses were conducted using conditional linear regressions with classroom as strata, adjusted for variables that may differ from one class to another such as temperature, humidity and carbon dioxide concentration. Average levels of PM2.5 and black carbon throughout the 1.5h of experiment were 89% and 87%, respectively, lower in the classrooms with air cleaner than in the control classrooms. No differences were found in the median of HRT-SE between classrooms with cleaned air and normal air (percent change: 1.37%, 95% confidence interval: -2.81%, 5.56%). Sensitivity analyses with secondary attention outcomes resulted in similar findings. Cleaning the air of a classroom to reduce exposure to air pollutants for 1.5h did not have an impact on the attention function of adolescents. Still, in light of previous evidence suggesting an association between air pollution and attention, further experimental studies should explore other short-term timescales of exposure and age ranges.

SARS-CoV-2 contact tracing among disadvantaged populations during epidemic intervals should be a priority strategy: results from a pilot experiment in Barcelona

ObjectivesThe aim of this study was to trace contacts of coronavirus disease 2019 (COVID-19) hospitalised patients and determine the risk factors of infection in urban areas. Study designLongitudinal analysis of contacts identified from index cases. MethodsA contact tracing study was carried out in the Northern Metropolitan area of Barcelona, Spain, during the inter-epidemic lapse of May to July 2020, a period of low SARS-CoV-2 incidence. Index cases were notified from the referral hospital. Contacts were traced and followed up for 14 days. Reverse transcription polymerase chain reaction was performed on day 0 and day 14 for contacts. ResultsIn total, 368 contacts were identified from 81 index cases (median of seven contacts per index case), from which 308 were traced successfully. The median age of contacts was 28 years, 62% (223 of 368) were men. During the follow-up period, 100 contacts tested positive for COVID-19 (32.5% [95% confidence interval {CI} = 27.3–38.0]), with a secondary infection rate of 48.3% (95% CI = 40.8–55.9) among housemates. Clusters of index and respective contacts tended to aggregate within disadvantaged neighbourhoods (P < 0.001), and non-national index cases (N = 28, 34.1%) resulted in higher secondary infection rates compared with nationals (51.0% [95% CI = 41.0–60.9] vs 22.3% [95% CI = 16.8–28.8]; P < 0.001). ConclusionsDisadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.

Abating heat waves in a coastal Mediterranean city: What can cool roofs and vegetation contribute?

The frequency and intensity of heat waves (HW) in cities are on the rise due to climate change as well as urban fabric materials and anthropogenic activities that affect heat accumulation. The efficacy of HW mitigation strategies depends on a city's specific and unique morphology, land use, building materials, climate and geography. In this study, we show the effectiveness of cool roofs and vegetation in reducing temperature in the Metropolitan Area of Barcelona (AMB). We use the Weather and Research Forecasting (WRF) model with the urban scheme BEP+BEM, including11 urban classes to simulate a HW that occurred in August 2015. We find that cool roofs reduce temperature best during the day (0.67 °C average and 2.22 °C maximum reductions), while additional green areas moderate temperatures to a lesser degree but also more evenly during the day and at night (average reductions of 0.15 °C and 0.17 °C, respectively). However, when irrigation is increased, the temperature reduction during the day is intensified due to the cooling effect of more evapotranspiration. The thermal regulation of combining the two strategies is the most evenly distributed over the AMB and has the highest impact, with an average and maximum reduction of 1.26 °C and 4.73 °C at 13:00UTC.

Estado de salud de personas inmigrantes en Cataluña desde una perspectiva de género: Proyecto PELFI

ObjectiveThe objective of the study is to assess the health status of immigrant men and women from non-EU countries living in the Metropolitan Area of Barcelona (Catalonia, Spain) and to identify the social determinants of health from a gender perspective. MethodCross-sectional analysis from a cohort of immigrant families recruited in Badalona and Santa Coloma de Gramenet, in Spain (PELFI cohort). In 2015–2016, 167 immigrants answered the baseline epidemiological questionnaire and the 5-level EuroQol instrument (EQ-5D) which measures health status. To identify health determinants, Tobit models were constructed to the EQ-5D index. ResultsWomen rated poorer self-perceived health (p=0.005). To be diagnosed with and illness was only associated with poor self-perceived health among men (p<0.05). Length of residence, domestic work, and especially double workload deteriorated women's health. After adjusting models by demographics and social determinants, permanent administrative status (−0.136; p=0.015) and social support (0.182; p=0.02) were associated with health status in both sexes. To have a job was associated with better health only in men. ConclusionsNon-EU immigrants living in the Metropolitan Area of Barcelona are a socially vulnerable group of population and present inequalities in health by sex. Social support and occupation are key factors of their health status. Interventions to reduce immigrant vulnerabilities and inequalities in health should promote their social inclusion and cohesion from a gender perspective.

Integrating climate change adaptation in coastal governance of the Barcelona metropolitan area

Coastal cities are exposed to high risks due to climate change, as they are potentially affected by both rising sea levels and increasingly intense and frequent coastal storms. Socio-economic drivers also increase exposure to natural hazards, accelerate environmental degradation, and require adaptive governance structures to moderate negative impacts. Here, we use a social network analysis (SNA) combined with further qualitative information to identify barriers and enablers of adaptive governance in the Barcelona metropolitan area. By analyzing how climate change adaptation is mainstreamed between different administrative scales as well as different societal actors, we can determine the governance structures and external conditions that hamper or foster strategical adaptation plans from being used as operational adaptation tools. We identify a diverse set of stakeholders acting at different administrative levels (local to national), in public administration, science, civil society, and the tourism economy. The metropolitan administration acts as an important bridging organization by promoting climate change adaptation to different interest groups and by passing knowledge between actors. Nonetheless, national adaptation planning fails to take into account local experiences in coastal protection, which leads to an ineffective science policy interaction and limits adaptive management and learning opportunities. Overcoming this is difficult, however, as the effectiveness of local adaptation strategies in the Barcelona metropolitan area is very limited due to a strong centralization of power at the national level and a lack of polycentricity. Due to the high touristic pressure, the legal framework is currently oriented to primarily meet the demands of recreational use and tourism, prioritizing these aspects in daily management practice. Therefore, touristic and economic activities need to be aligned to adaptation efforts, to convert them from barriers into drivers for adaptation action. Our work strongly suggests that more effectively embedding adaptation planning and action into existing legal structures of coastal management would allow strategic adaptation plans to be an effective operational tool for local coastal governance.

Time Evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic Wave of COVID-19 in the Metropolitan Area of Barcelona, Spain.

Two large wastewater treatment plants (WWTP), covering around 2.7 million inhabitants, which represents around 85% of the metropolitan area of Barcelona, were sampled before, during, and after the implementation of a complete lockdown. Five one-step reverse transcriptase quantitative PCR (RT-qPCR) assays, targeting the polymerase (IP2 and IP4), the envelope (E), and the nucleoprotein (N1 and N2) genome regions, were employed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in 24-h composite wastewater samples concentrated by polyethylene glycol (PEG) precipitation. SARS-CoV-2 was detected in a sewage sample collected 41 days ahead of the declaration of the first COVID-19 case. The evolution of SARS-CoV-2 genome copies in wastewater evidenced the validity of water-based epidemiology (WBE) to anticipate COVID-19 outbreaks, to evaluate the impact of control measures, and even to estimate the burden of shedders, including presymptomatic, asymptomatic, symptomatic, and undiagnosed cases. For the latter objective, a model was applied for the estimation of the total number of shedders, evidencing a high proportion of asymptomatic infected individuals. In this way, an infection prevalence of 2.0 to 6.5% was figured. On the other hand, proportions of around 0.12% and 0.09% of the total population were determined to be required for positive detection in the two WWTPs. At the end of the lockdown, SARS-CoV-2 RNA apparently disappeared in the WWTPs but could still be detected in grab samples from four urban sewers. Sewer monitoring allowed for location of specific hot spots of COVID-19, enabling the rapid adoption of appropriate mitigation measures.IMPORTANCE Water-based epidemiology (WBE) is a valuable early warning tool for tracking the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among the population, including not only symptomatic patients but also asymptomatic, presymptomatic, and misdiagnosed carriers, which represent a high proportion of the infected population. In the specific case of Barcelona, wastewater surveillance anticipated by several weeks not only the original COVID-19 pandemic wave but also the onset of the second wave. In addition, SARS-CoV-2 occurrence in wastewater evidenced the efficacy of the adopted lockdown measures on the circulation of the virus. Health authorities profited from WBE to complement other inputs and adopt rapid and adequate measures to mitigate the effects of the pandemic. For example, sentinel surveillance of specific sewers helped to locate COVID-19 hot spots and to conduct massive numbers of RT-PCR tests among the population.

Microplastics from headwaters to tap water: occurrence and removal in a drinking water treatment plant in Barcelona Metropolitan area (Catalonia, NE Spain).

Nowadays, the presence of microplastics in drinking water is of concern worldwide due to potential impacts on human health. This paper has examined the presence of microplastics along the Llobregat river basin (Catalonia, Spain) and studied their behaviour and elimination along the drinking water treatment plant (DWTP). Due to different water composition, different sampling and sample preparation protocols were used to determine microplastics from river water and in the DWTP. Identification of microplastics of size range from 20 μm to 5 mm was performed by fourier-transform infrared spectroscopy (FTIR). Microplastics were detected in 5 out of 7 points along the Llobregat basin, with concentrations ranging between non-detected and 3.60 microplastics/L. In the intake of the DWTP, the mean concentration was 0.96 ± 0.46 microplastics/L (n=5), with a predominance of polyester (PES) and polypropylene (PP) and at the outlet the mean concentration was of 0.06 ± 0.04 microplastics/L with an overall removal efficiency of 93 ± 5%. Sand filtration was identified as the key stage in microplastic removal (78 ± 9%). Furthermore, the results showed that ultrafiltration/reverse osmosis (advanced treatment) is more effective for microplastic removal than ozonation/carbon filtration stage (upgraded conventional treatment). In addition, a preliminary migration test of the different materials used in the DWTP has been performed to identify potential sources of microplastics in each treatment step.

Urban Groundwater Contamination by Non-Steroidal Anti-Inflammatory Drugs

Pharmaceuticals, such as non-steroidal anti-inflammatory drugs (NSAIDs) and their metabolites, have become a major concern due to their increasing consumption and their widespread occurrence in the environment. In this paper, we investigate the occurrence of NSAIDs and their metabolites in an urban aquifer, which may serve as a potential resource for drinking water, and propose a methodology to assess the removal of these substances in the river–groundwater interface. Then, risk quotients (RQs) are computed, in order to determine the risk posed by the single NSAIDs and their mixture to human health. To this end, six NSAIDs and two metabolites were collected from an urban aquifer located in the metropolitan area of Barcelona (NE, Spain), in which the major pollution source is a contaminated river. All of the target NSAIDs were detected in groundwater samples, where the concentrations in the aquifer were higher than those found in the river water (except for ibuprofen). Diclofenac, ketoprofen, propyphenazone and salicylic acid were detected at high mean concentrations (ranging from 91.8 ng/L to 225.2 ng/L) in the aquifer. In contrast, phenazone and mefenamic acid were found at low mean concentrations (i.e., lower than 25 ng/L) in the aquifer. According to the proposed approach, the mixing of river water recharge into the aquifer seemed to some extent to promote the removal of the NSAIDs under the sub-oxic to denitrifying conditions found in the groundwater. The NSAIDs that presented higher mean removal values were 4OH diclofenac (0.8), ibuprofen (0.78), salicylic acid (0.35) and diclofenac (0.28), which are likely to be naturally attenuated under the aforementioned redox conditions. Concerning human health risk assessment, the NSAIDs detected in groundwater and their mixture do not pose any risk for all age intervals considered, as the associated RQs were all less than 0.05. Nevertheless, this value must be taken with caution, as many pharmaceuticals might occur simultaneously in the groundwater.