Spanish Language Studies Research Articles

The management of polypharmacy in people living with HIV.

Antiretroviral therapy (ART) has modified the prognosis of HIV which has evolved into a chronic condition. People living with HIV (PLWH) are living longer presenting an increased number of comorbidities leading to polypharmacy. Literature on the prevalence, associated factors, drug-drug interactions (DDIs), effects on ART-outcomes, geriatric conditions, and nutritional status together with health-interventions aimed to reduce it is presented in this review. A literature search was conducted on the MEDLINE database for all relevant English- and Spanish-language studies since 2006. Studies providing data of interest were identified and ordered in groups: (i) prevalence and associated factors (n = 37), (ii) DDIs (n = 19), (iii) Effects on ART-outcomes (n = 12), (iv) Effects on health conditions (n = 13), and (V) Health-interventions to assess and/or reduce it (n = 9). Polypharmacy occurs in 9-91% of PLWH (2.6-19.5% affected by severe polypharmacy). Main factors associated with polypharmacy are older age, a higher number of comorbidities, frailty, deteriorated renal function, and previous hospitalizations. DDIs were present in 19.15-84% of cases (1.3-12.2% for the most severe types). Mainly involved non-ART drugs were antihypertensives, statins, antithrombotic agents, corticosteroids, divalent cations, and antiacids. Polypharmacy can affect ART selection, adherence, and outcomes and has been related to some geriatric conditions such as falls, frailty, and poor nutritional status. Potentially prescribing issues are present in up to 87.9% of cases according to the STOPP-START and Beers criteria and some pharmacist-led interventions have been shown to reduce it. Considering these findings, polypharmacy should be considered a clinical concern in this population and treatment-optimization programs are needed to reduce its burden.

Ehlers-Danlos Syndrome and Fibromyalgia: Beyond Pain and Fatigue

Introduction: Ehlers-Danlos syndrome (EDS) is a genetic disorder that affects the connective tissue. Hypermobile subtype (hEDS), which is the most common, is characterized by joint hyperlaxity, diffuse generalized pain, and chronic fatigue. Meanwhile, fibromyalgia is a pain regulation disorder of chronic, widespread musculoskeletal pain, fatigue, cognitive disturbance, psychiatric and multiple somatic symptoms. Objective: To examine the similarities and differences between hEDS, fibromyalgia and highlight the importance of their proper diagnosis and treatment. Methods: A systematic search of PubMed and Scopus databases was performed for all English - Spanish language studies published between 2013 and May 2023. Two reviewers independently selected studies, extracted data and applied quality criteria. Study quality was assessed using PRISMA and a synthesis of the best evidence was obtained. Results: A total of 20 studies met the criteria and were therefore analyzed. Conclusion: Diagnosing EDS and fibromyalgia can be challenging in medical practice as their clinical manifestations can overlap, and they may even coexist in the same patient.

Protocol for a Scoping Review of Traditional and Complementary Medicine Governance Across Sub-Saharan Africa

Background: Since 1978, the World Health Organization (WHO) has repeatedly called on Member States to recognize the role of traditional and complementary medicine (T&CM) in primary healthcare, improve safety, and accessibility by governing T&CM. In the 2019 Global Report on T&CM, the WHO reported that 40 out of 47 (85%) Member States from African Region had enacted governance policies, and 20 out of 47 (43%) had regulatory policies on herbal medicines. The primary barriers to implementing T&CM policy were identified as an absence of data and inadequate financial support for research. The objective of this protocol was to detail how to perform a scoping review that will examine the policy, legislative, and regulatory landscape for T&CM practitioners and products in sub-Saharan Africa.Methods: Databases will be searched (AMED, CINAHL Plus with Full Text, MEDLINE Plus with Full text, Web of Science, Scopus, PubMed, Google Scholar) for relevant articles. Searches will be limited to English, French, Portuguese, and Spanish language studies in peer-reviewed journals (1963-2023) that substantively report on legislation, bills, policies, governance approaches and regulations on T&CM (including successes and/or challenges in their design and implementation). Actual legislation, policies, and regulatory documents on T&CM and peer-reviewed studies with emphasis on integrating T&CM and biomedicine into healthcare systems will be excluded.Expected Outcomes: This protocol has formulated the objectives for a scoping review to identify, map, and synthesize evidence on the governance of T&CM in sub-Saharan Africa.

Pilot Testing Transcreated Spanish-Language Study Materials for Symptom Research With Infants and Parents in the Neonatal Intensive Care Unit

Pilot Testing Transcreated Spanish-Language Study Materials for Symptom Research With Infants and Parents in the Neonatal Intensive Care Unit

Pilot Testing Transcreated Spanish-Language Study Materials for Symptom Research With Infants and Parents in the Neonatal Intensive Care Unit.

Rising admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) have increased the number of non-English-speaking individuals who may wish to participate in research studies. However, a lack of appropriately translated research study materials may limit the opportunity for these families to be involved in research that could impact the care that infants and families receive in the NICU. The primary purpose was to pilot test study materials that were transcreated from English to Spanish with the assistance of a bilingual community advisory board with Spanish-speaking parents of NICU infants. A total of 19 Spanish-speaking parents (15 mothers and 4 fathers) who were representative of the population of interest completed paper-and-pencil surveys, along with a cognitive interview. Preliminary data related to decision-making and goals of care, infant symptoms, and their experiences in the NICU were also collected. The internal reliability of the transcreated study instruments ranged from good to excellent (α= 0.82-0.99). Participants reported that study materials were not offensive and did not make them feel uncomfortable; however, they found some words/phrases to be confusing. Parents had the opportunity to provide suggested wording changes. Language barriers and a lack of cultural responsiveness can affect the care that infants and their families receive. More accurate and culturally appropriate transcreation of study materials can remove barriers to research participation and facilitate better communication with non-English-speaking families, which may lead to the development of better-informed evidence-based interventions and clinical practices in the NICU.

Validity of the Spanish-Language Patient Health Questionnaires 2 and 9

Reliable screening for major depressive disorder (MDD) relies on valid and accurate screening tools. To examine the validity, accuracy, and reliability of the Spanish-language Patient Health Questionnaires 2 and 9 (PHQ-2 and PHQ-9) to screen for MDD. PubMed, Web of Science, Embase, and PsycINFO from data initiation through February 27, 2023. English- and Spanish-language studies evaluating the validity of the Spanish-language PHQ-2 or PHQ-9 in screening adults for MDD compared with a standardized clinical interview (gold standard). Search terms included PHQ-2, PHQ-9, depression, and Spanish. Two reviewers performed abstract and full-text reviews, data extraction, and quality assessment. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Random-effects meta-analyses of sensitivity, specificity, and area under the curve (AUC) were performed. Internal consistency was evaluated using Cronbach α and McDonald ψ. Test accuracy and internal consistency. The PHQ-2 is composed of the first 2 questions of the PHQ-9 (targeting core depression symptoms of depressed mood and anhedonia; a score of 3 or higher (score range, 0-6) is generally considered a positive depression screen. If a patient screens positive with the PHQ-2, a follow-up assessment with the PHQ-9 and a clinical diagnostic evaluation are recommended. Once depression is diagnosed, a PHQ-9 score of 10 or higher (score range, 0-27) is often considered an acceptable threshold for treating depression. Ten cross-sectional studies involving 5164 Spanish-speaking adults (mean age range, 34.1-71.8 years) were included; most studies (n = 8) were in primary care settings. One study evaluated the PHQ-2, 7 evaluated the PHQ-9, and 2 evaluated both the PHQ-2 and PHQ-9. For the PHQ-2, optimal cutoff scores ranged from greater than or equal to 1 to greater than or equal to 2, with an overall pooled sensitivity of 0.89 (95% CI, 0.81-0.95), overall pooled specificity of 0.89 (95% CI, 0.81-0.95), and overall pooled AUC of 0.87 (95% CI, 0.83-0.90); Cronbach α was 0.71 to 0.75, and McDonald ψ was 0.71. For the PHQ-9, optimal cutoff scores ranged from greater than or equal to 5 to greater than or equal to 12, with an overall pooled sensitivity of 0.86 (95% CI, 0.82-0.90), overall pooled specificity of 0.80 (95% CI, 0.75-0.85), and overall pooled AUC of 0.88 (95% CI, 0.87-0.90); Cronbach α was 0.78 to 0.90, and McDonald ψ was 0.79 to 0.90. Four studies were considered to have low risk of bias; 6 studies had indeterminate risk of bias due to a lack of blinding information. In this systematic review and meta-analysis, limited available evidence supported the use of the Spanish-language PHQ-2 and PHQ-9 in screening for MDD, but optimal cutoff scores varied greatly across studies, and few studies reported on blinding schemes. These results suggest that MDD should be considered in Spanish-speaking individuals with lower test scores. Given the widespread clinical use of the tools and the heterogeneity of existing evidence, further investigation is needed.

HIV Prevention Intervention-related Research with Adult, Sexual Minority Hispanic Men in the United States: A Systematic Review.

The systematic review describes aims to synthesize the HIV prevention intervention-related research conducted among adult, US sexual minority Hispanic men since 2012. Following PRISMA guidelines, 15 articles representing 14 studies were included in the review: 4 randomized controlled trials, 5 pilots, and 5 formative projects. Two interventions had PrEP-related outcomes whereas 7 focused on behavioral (e.g., condoms, testing) and/or educational outcomes. Few studies used digital health. All but one study was theoretically guided. Community engagement was a common and important thread in the included studies, with community-based participatory research being the most prevalent framework. The inclusion of cultural factors varied widely, as did the availability of Spanish language or bilingual study materials. Future research opportunities are discussed and recommendations to bolster HIV prevention interventions (e.g., tailoring) are presented. These include the need for greater integration of cultural factors (e.g., nuances related to the heterogeneity of Hispanic subgroups) and mitigating critical barriers to help improve uptake of evidence-based strategies in this population.

Computerized clinical decision support systems for prescribing in primary care: main characteristics and implementation impact—protocol of an evidence and gap map

BackgroundComputerized clinical decision support systems are used by clinicians at the point of care to improve quality of healthcare processes (prescribing error prevention, adherence to clinical guidelines, etc.) and clinical outcomes (preventive, therapeutic, and diagnostics). Attempts to summarize results of computerized clinical decision support systems to support prescription in primary care have been challenging, and most systematic reviews and meta-analyses failed due to an extremely high degree of heterogeneity present among the included primary studies. The aim of our study will be to synthesize the evidence, considering all methodological factors that could explain these differences, and build an evidence and gap map to identify important remaining research questions.MethodsA literature search will be conducted from January 2010 onwards in MEDLINE, Embase, the Cochrane Library, and Web of Science databases. Two reviewers will independently screen all citations, full text, and abstract data. The study methodological quality and risk of bias will be appraised using appropriate tools if applicable. A flow diagram with the screened studies will be presented, and all included studies will be displayed using interactive evidence and gap maps. Results will be reported in accordance with recommendations from the Campbell Collaboration on the development of evidence and gap maps.DiscussionEvidence behind computerized clinical decision support systems to support prescription use in primary care has so far been difficult to be synthesized. Evidence and gap maps represent an innovative approach that has emerged and is increasingly being used to address a broader research question, where multiple types of intervention and outcomes reported may be evaluated. Broad inclusion criteria have been chosen with regard to study designs, in order to collect all available information. Regarding the limitations, we will only include English and Spanish language studies from the last 10 years, we will not perform a grey literature search, and we will not carry out a meta-analysis due to the predictable heterogeneity of available studies.Systematic review registrationThis study is registered in Open Science Framework https://bit.ly/2RqKrWp

Axiological aspects of teaching Spanish in the Soviet Union

Objectives. The paper analyzes core axiological aspects of Spanish teaching in higher educational institutions of the Soviet Union from the 1930s to the early 1980s based on various sources including textbooks, tutorials, etc. Methods. The study is based on textual-analytic, historical-comparative, and structural methods.Results. Scientific-pedagogical and sociological aspects of the subject are distinguished. The former are limited to the internal developmental logic of Spanish studies, while the latter refers to external circumstances, including ideological factors. The literature review shows that Spanish teaching in the USSR progressed topically from simple manuals aimed at consolidating linguistic basics to a more rigorous pedagogical development of Spanish language studies (grammar, phonetics, vocabulary, etc.) The authors identify two significant periods in the development of Soviet Spanish studies, with the first phase extending from the 1930s to the early 1960s, and the second—from the 1960s to the early 1980s.Conclusions. The analysis showed that the formation and development of each period is associated with such events as the Spanish Civil War and the victory of the Cuban Revolution, which are not directly related to Spanish teaching. The first event coincided with the beginning of systematic Spanish teaching at the USSR universities, while the second redirected this process from Castilian to Latin American Spanish. However, the analysis of textbook and tutorial materials convincingly demonstrates that this process of redirection, which mainly concerns the selection of textual materials, remains incomplete. This supports a conclusion concerning the limited impact of ideology on the internal logic of the Spanish studies development in the USSR.

Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review.

Chloroquine (CQ) and hydroxychloroquine (HCQ) have recently become the focus of global attention as possible treatments for Coronavirus Disease 2019 (COVID-19). The current systematic review aims to assess their safety in short treatments (≤14 days), whether used alone or in combination with other drugs. Following the PRISMA and SWiM recommendations, a search was conducted using four health databases for all relevant English-, Chinese-, and Spanish-language studies from inception through 30 July 2021. Patients treated for any condition and with any comparator were included. The outcomes of interest were early drug adverse effects and their frequency. A total of 254 articles met the inclusion criteria, including case and case-control reports as well as cross-sectional, cohort, and randomised studies. The results were summarised either qualitatively in table or narrative form or, when possible (99 studies), quantitatively in terms of adverse event frequencies. Quality evaluation was conducted using the CARE, STROBE, and JADAD tools. This systematic review showed that safety depended on drug indication. In COVID-19 patients, cardiac adverse effects, such as corrected QT interval prolongation, were relatively frequent (0–27.3% and up to 33% if combined with azithromycin), though the risk of torsade de pointes was low. Compared to non-COVID-19 patients, COVID-19 patients experienced a higher frequency of cardiac adverse effects regardless of the regimen used. Dermatological adverse effects affected 0–10% of patients with autoimmune diseases and COVID-19. A broad spectrum of neuropsychiatric adverse effects affected patients treated with CQ for malaria with variable frequencies and some cases were reported in COVID-19 patients. Gastrointestinal adverse effects occurred regardless of drug indication affecting 0–50% of patients. In conclusion, CQ and HCQ are two safe drugs widely used in the treatment of malaria and autoimmune diseases. However, recent findings on their cardiac and neuropsychiatric adverse effects should be considered if these drugs were to be proposed as antivirals again.

Detecting symptom exaggeration and minimization using translated versions of the MMPI-2 and MMPI-2-RF: A systematic review and preliminary meta-analysis.

This systematic review and preliminary meta-analysis examined the effectiveness of translated versions of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI-2 Restructured Form (MMPI-2-RF) in detecting response distortion (i.e., symptom exaggeration and minimization), a central concern in forensic assessment. We hypothesized that translated versions of the MMPI-2 and MMPI-2-RF would generate significantly weaker effect sizes in detecting response distortion than those observed with English-language studies. We identified 26 studies, representing seven language translations of the MMPI-2 (k = 20) and two of the MMPI-2-RF (k = 6). We calculated effect sizes (Cohen's ds) based on the mean score difference between honest and nongenuine responders for each study on each symptom exaggeration (e.g., F/F-r, Fp/Fp-r) and minimization (e.g., L/L-r, K/K-r) scale examined, along with mean effect size estimates (Hedges' g) for the Spanish and Italian translations (no other translation had more than two published studies). Spanish-language studies generally produced large (d ≥ 1.25) to very large (d ≥ 1.75) effect sizes when detecting both symptom exaggeration and minimization. Italian-language studies generally produced small to moderate effect sizes when detecting symptom exaggeration and predominately moderate (d ≤ 1.25) effect sizes when detecting minimization. Significant variability within and across scales was observed in both Spanish-language and Italian-language studies. Most studies utilizing a translated version of the MMPI-2 other than Spanish or Italian produced very large (d ≥ 1.75) effect sizes when detecting symptom exaggeration and weaker (d ≤ 1.00) effect sizes when detecting minimization. This systematic review and preliminary meta-analysis demonstrated effect sizes that overlapped with those observed in English-language studies. Although clearly preliminary, given the limited published research to date, these data suggest that the MMPI instruments retain some utility in detecting response distortion when translated. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Role of Citrus Fruit Juices in Prevention of Kidney Stone Disease (KSD): A Narrative Review.

To explore the relationship between citrus fruit juices (oranges, grapefruits, and lemonades) and kidney stone disease (KSD). Methods: A systematic review was performed using the Medline, EMBASE, and Scopus databases, in concordance with the PRISMA checklist for all English, French, and Spanish language studies regarding the consumption of citrus fruit juices and the relationship to urinary stone disease. The main outcome of interest was the association of citrus fruit juices with KSD. Results: Thirteen articles met the criteria for inclusion in the final review. Three large epidemiological studies found that grapefruit juice was a risk factor for stone formation, while orange juice did not increase the risk for KSD. Ten small prospective clinical studies found that orange, grapefruit, and lemon juices all increased urinary citrate levels. Only orange and grapefruit juices had an alkalinizing effect and while lemon juice has a protective effect by raising urinary citrate levels, it lacked a significant alkalinizing effect on urine pH. Orange juice and grapefruit juices significantly increased urinary oxalate levels, while orange juice also had a high carbohydrate content. Conclusion: While orange juice seems to play a protective role against stone formation, grapefruit was found to raise the risk of KSD in epidemiological studies but had a protective role in smaller clinical studies. Lemon juice had a smaller protective role than orange juice. Larger amounts of, as well as more accurate, data is needed before recommendations can be made and a high carbohydrate content in these juices needs to be taken into consideration.

CLASSROOM LEARNERS’ ACQUISITION OF THE SPANISH COPULA WITH ADJECTIVES

AbstractResearch on the second language (L2) acquisition of the Spanish copulas has been central to our understanding of key concepts and issues in the field of SLA such as stages of development and variability in L2s. However, this research has focused nearly exclusively on native English-speaking learners. The present study examined native Korean-speaking learners’ acquisition and use of the Spanish copulas with adjectives in oral production. Analyses of the range and frequency of copula forms produced across four levels of Spanish language study revealed an increase inserandestaruse and a decrease in developmental omission as learner level increased. Predicate type, resultant state, and Spanish grammar score significantly influenced use ofestaroverser.Comparison with native English-speaking learners revealed differences between first language groups in terms of rates of form use, but similar developmental trends and predictors ofestaruse overall.

A decade of community-based participatory research: from a tentative start to a fruitful approach in the field of mental health: a scoping review

AimsThis scoping review aimed to identify and analyse studies utilising Community-Based Participatory Research (CBPR) to design and/or disseminate a mental health (MH) intervention with underserved communities around the globe. This was with the intention of updating the knowledge base on this area, and identifying both areas of promise in this field as well as any gaps for future work to fill.MethodThis scoping review was conducted using the Joanna Briggs Institute's Scoping Review Manual and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Three databases, Scopus, PubMed and Sage Journals, were searched to identify relevant studies, using the three terms ‘CBPR’, ‘underserved’ and ‘mental health’, and words to the equivalent.ResultThe search identified 607 English-language sources published between 1st January 2010 and 30th June 2020. Following duplicate removal, screening and bibliography scanning, 34 highly relevant studies remained. The studies were varied in their chosen context, MH gap, how they gave meaning to the participatory approach, how they defined their successes, and what strengths and challenges were encountered in CBPR's application to this field. Briefly, all bar one of the studies were focused on underserved communities within high-income countries (HICs); many focused solely on women and youth groups; and finally, the use of technology and talking therapies were noted to achieve particular success.ConclusionCBPR is commonly used to engage the underserved through long-term partnership building and equitable stakeholder involvement, shifting the dialogue from research on to research with communities. This unique, needs-oriented approach harbours mutual ownership of the research, empowering historically disenfranchised individuals to become actively involved in reducing identified health disparities. In the field of MH, this is of great importance and need in many underserved communities due to issues of access, heightened by a distrust in mainstream services as well as by the stigma attached to MH conditions.As compared to studies in this field ten years ago, CBPR has become much more established, with this review noting a remarkable increase in MH projects utilising this approach. Furthermore, the addition of new technologies to this field was shown to offer significant promise in overcoming access barriers, hoping to ultimately narrow identified MH gaps. Nonetheless, further work on the prevailing gender and HIC biases, and for a review including relevant Spanish-language studies, are still required in order to form a more global overview of this field.

Tea and coffee consumption and the risk of urinary stones—a systematic review of the epidemiological data

To explore the relationship between the consumption of coffee and tea with urolithiasis. We evaluated large epidemiological and small clinical studies to draw conclusions regarding their lithogenic risk. A systematic review was performed using the Medline and Scopus databases, in concordance with the PRISMA statement. English, French, and Spanish language studies regarding the consumption of caffeinated and decaffeinated coffee and tea, and the relationship to urinary stone disease were reviewed. Case reports and letters, unpublished studies, posters, and comments were excluded. As per the inclusion criteria, 13 studies were included in the final review. Most studies, including four large prospective studies and one meta-analysis, reported a reduced risk of stone formation for coffee and tea. Caffeine has a diuretic effect and increases the urinary excretion of calcium, but if these losses are compensated for, moderate caffeine intakes may have little or no deleterious effects. Green and Herbal teas infused for short time had low oxalate content compared to black tea. There is no evidence that moderate consumption of coffee raises the risk for stone formation in healthy individuals, provided the recommended daily fluid intake is maintained. The currently available literature supports in general a protective role for tea against the stone formation, mainly for green tea. However, heterogeneity of published data and lack of standardization needs to be addressed before final and clear conclusions can be given to patients and to the public in general.

Tea and coffee consumption and pathophysiology related to kidney stone formation: a systematic review.

To explore the mechanisms behind the potential protective effect of coffee and tea consumption, regarding urinary stone formation, previously demonstrated in large epidemiological studies. A systematic review was performed using the Medline, Cochrane library (CENTRAL) and Scopus databases, in concordance with the PRISMA statement. English, French and Spanish language studies, regarding the consumption of caffeinated and decaffeinated coffee and tea, and the relationship to urinary stone formation were reviewed. Meta-analyses, systematic reviews, case reports and letters, unpublished studies, posters and comments abstracts were excluded. As per the inclusion criteria, 13 studies were included in the final review. The major findings show that caffeine increases urinary excretion of calcium, sodium and magnesium, in addition to a diuretic action with consumption > 300-360mg (approximately four cups of coffee). Together with other components of coffee, this beverage might have potential protective effects against the formation of urinary stones. Tea exerts many protective effects against stone formation, through the accompanying water intake, the action of caffeine and the effects of components with antioxidant properties. Caffeine has a hypercalciuric effect, balanced partially by a diuretic effect which appears after consumption of large quantities of caffeine. The current available literature supports in general, a potentially protective role for tea against stone formation, mainly for green tea. Additional standardization in this field of research, through specification of tea and coffee types studied, and their respective compositions, is needed for further clarification of the relation between coffee, tea and urinary stones.

Imperiofobia y leyenda negra: Roma, Rusia, Estados Unidos y el Imperio español by María Elvira Roca Barea, and: Imperiofilia y el populismo nacional-católico by José Luis Villacañas

Reviewed by: Imperiofobia y leyenda negra: Roma, Rusia, Estados Unidos y el Imperio español by María Elvira Roca Barea, and: Imperiofilia y el populismo nacional-católico by José Luis Villacañas Duncan Wheeler María Elvira Roca Barea. Imperiofobia y leyenda negra: Roma, Rusia, Estados Unidos y el Imperio español. SIRUELA, 2016. 460 PP. José Luis Villacañas Imperiofilia y el populismo nacional-católico. LENGUA DE TRAPO, 2019. 264 PP. AS RECENTLY AS 2014, I argued that the dictatorship's co-option of the Golden Age had been rejected to an extent that it was seen as even more politically suspect for Spanish cinema to present life in early modern Spain in a positive light than to cast any approving glance at Francoist Spain (Duncan Wheeler, "Back to the future: repackaging Spain's troublesome past for local and global audiences," (Re)Viewing Creative, Critical and Commercial Practices in Contemporary Spanish Cinema, edited by Duncan Wheeler and Fernando Canet, Intellect, 2014, pp. 205–33, p. 227). Spain was long thought to be an outlier in relation to its European neighbors for not having a party of the extreme right. Progressive Spaniards were (too) quick to mock Vox as a kitsch anachronism, a refuge for oddballs nostalgic for Francoism. Establishing initial strongholds in Andalusia and Murcia, promotional videos featured party leader, Santiago Abascal, riding horseback and announcing a new Reconquest. Islamophobia was further promoted through Trump-like promises to build walls to prevent Moroccans and sub-Saharan Africans from crossing the frontier. Spurred on by a resurgent nationalism in the face of the [End Page 183] Catalan secessionist movement, the aggressively nationalist Vox was the third most voted-for party in the 2019 general elections. Abascal has described the Black Legend as "obra de los enemigos de España" (Fernando Sánchez Dragó and Santiago Abascal, España vertebrada, Planeta, 2019, p. 124) and cites María Elvira Roca Barea's Imperiofobia approvingly (254). This surprise best seller (over one hundred thousand copies sold in Spain) by a secondary-school teacher from Murcia with a doctorate (and a nebulous connection to Harvard University) has also been championed by the Instituto Cervantes, a Madrid-based government agency created in 1991 in the buildup to the quincentenary celebrations of Columbus's voyage to the Americas, with the aim of promoting the study and teaching of Spanish language and culture. The reception of Roca Barea's polemic, described in José Luis Villacañas's rebuttal as "populismo intelectual reaccionario" (14), warrants attention, even and perhaps especially for those unsympathetic to its claims. Roca Barea has opted not to respond to the arguments made in Villacañas's book—"Agradezco al autor que se haya tomado tantas molestias con mi trabajo, pero lamento decir que no voy a hacer lo mismo con el suyo" (cited in El País, 4 Jun 2019, p. 28)—but putting the publications into dialogue serves to cast light on the privileged role the early modern period occupies in the cultural wars of contemporary Spain. With a plethora of footnotes and references to literature and philosophy, Imperiofobia constitutes a (pseudo-)erudite correlative to the rhetoric rehearsed as early as 2008 by Santiago Abascal and Gustavo Bueno, long before they and their party Vox became major political players: "España es, sobre todo, la realización de esa gran empresa imperial por lo que, y como corolario suyo, se llega a comprobar que el planeta es una esfera, un globo circunvalado por primera vez precisamente por España: 'tú me diste la vuelta', tal es la divisa que regala Carlos I al vasco Elcano" (En defensa de España. Razones para el patriotismo español, Fundación para la defensa de la nación española y Ediciones Encuentro, 2008, pp. 33–34). The resurrection of such neo-Francoist rhetoric has been facilitated by Spanish democracy's selective memory. It was under the PSOE government in the 1980s that 12 October—the date that Columbus first set foot on American soil—was declared a national bank holiday, the "día de la raza" (baptized thus by King Alfonso XIII in 1918 and subsequently celebrated with fanfare throughout...

Strategies for communicating oral and oropharyngeal cancer diagnosis: why talk about it?

This review aimed to explore the paradigms of disclosing a cancer diagnosis with a focus on oral and oropharyngeal cancer and patient-related considerations. A search of MEDLINE, Embase, and Scopus was conducted using the following keywords: oral cancer; mouth lesions; oncology; breaking bad news; truth disclosure; and communication skills training. English and Spanish language studies published through October 2019 were included. The way bad news is conveyed to patients with cancer may affect their comprehension of information, emotional distress, treatment adherence, and health outcomes. Models of communication that are focused on patients' preferences may result in better treatment outcomes. Available protocols, such as SPIKES and ABCDE, have useful recommendations for health care professionals communicating an oral cancer diagnosis. However, it is important to be attentive to the particular information needs of patients. When communicating a cancer diagnosis, providers should employ validated methods of information delivery and support for oncology patients. Further studies are needed to evaluate the experiences and preferences of patients with oral cancer during these communications.

Rectovaginal group B streptococcus colonization among pregnant women in Nicaragua: a systematic review and meta-analysis

Background Maternal colonization with group B Streptococcus (GBS) is a predictor of neonatal sepsis. In Nicaragua, neonatal sepsis is a major cause of hospitalization, but it can be prevented with intrapartum antibiotic prophylaxis. We undertook this study to estimate the pooled prevalence of rectovaginal GBS colonization among pregnant women 35–40-week gestation in Nicaragua, and sensitivity of GBS isolates to various antibiotics. Methods We systematically searched electronic databases of peer-reviewed and unpublished literature using prespecified search terms. We included English- and Spanish-language studies of rectovaginal GBS colonization and/or antibiotic sensitivity of GBS isolates that followed internationally-recognized diagnostic standards, from various sites and years. Two reviewers independently abstracted data and assessed risk of study bias. We then meta-analyzed the pooled prevalence of rectovaginal GBS colonization and antibiotic sensitivity of GBS isolates. We performed subgroup analyses by geographic location, urbanicity, and study risk of bias. Main results Prevalence of rectovaginal GBS colonization from 13 samples in 11 studies was 0.14 (95% CI: 0.09, 0.21). Effect size heterogeneity was identified between coastal (0.12 [95% CI: 0.07, 0.19]) and central study sites (0.23 [95% CI: 0.18, 0.28]), and between predominantly rural (0.06 [95% CI: 0.02, 0.10]) and urban (0.28 [95% CI: 0.19, 0.37]) samples of pregnant women. GBS sensitivity to penicillin, the first-line antibiotic for intrapartum prophylaxis, was 0.89 (95% CI: 0.71, 1.00) based on seven studies. Conclusions Maternal GBS colonization was substantial in some study sites. Most GBS isolates are sensitive to recommended antibiotics, and intrapartum antibiotic prophylaxis may effectively prevent neonatal sepsis in Nicaragua.

PRINCIPALES PROBLEMAS METODOLÓGICOS EN LA ENSEÑANZA DEL SUBSISTEMA FONÉTICO-FONOLÓGICO ESPAÑOL EN EL ÁMBITO DE LOS ESTUDIOS UNIVERSITARIOS POLACOS

The problems concerning teaching methodology in the domain of phonetics and phonology of Spanish have not as yet been properly addressed within the considerably young Polish studies of the Spanish language. The author of the present article, based on his own research and teaching experience, suggests a number of solutions and practical remarks related to teaching methodology of contemporary Spanish phonetics and phonology within Spanish language and literature studies in Poland. The so-called ”comprehensive approach” has been verified for compliance with the most recent achievements of modern Spanish phonetic and phonological studies.