Imperial College London

Dr Enrique Castro Sánchez

Faculty of MedicineDepartment of Infectious Disease

Honorary Lecturer
 
 
 
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Contact

 

+44 (0)20 3313 2072e.castro-sanchez Website

 
 
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Location

 

8.N17Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

146 results found

Charani E, McKee M, Ahmad R, Balasegaram M, Bonaconsa C, Merrett GB, Busse R, Carter V, Castro-Sanchez E, Franklin BD, Georgiou P, Hill-Cawthorne K, Hope W, Imanaka Y, Kambugu A, Leather AJM, Mbamalu O, McLeod M, Mendelson M, Mpundu M, Rawson TM, Ricciardi W, Rodriguez-Manzano J, Singh S, Tsioutis C, Uchea C, Zhu N, Holmes AHet al., 2021, Optimising antimicrobial use in humans-review of current evidence and an interdisciplinary consensus on key priorities for research, LANCET REGIONAL HEALTH-EUROPE, Vol: 7, ISSN: 2666-7762

Journal article

Cabellos-Garcia AC, Martinez-Sabater A, Diaz-Herrera MA, Gea-Caballero V, Castro-Sanchez Eet al., 2021, Health literacy of patients on oral anticoagulation treatment-individual and social determinants and effect on health and treatment outcomes, BMC PUBLIC HEALTH, Vol: 21

Journal article

Zhu J, Ferlie E, Castro-Sánchez E, Birgand G, Holmes A, Atun R, Kieltyka H, Ahmad Ret al., 2021, Macro level factors influencing strategic responses to emergent pandemics: a scoping review, Journal of Global Health, Vol: 11, Pages: 1-16, ISSN: 2047-2978

Background: Strategic planning is critical for successful pandemic management. This study aimed to identify and review the scope and analytic depth of situation analyses conducted to understand their utility, and capture the documented macro-level factors impacting4pandemic management. Methods: To synthesise this disparate body of literature, we adopted a two-step search and 6review process. A systematic search of the literature was conducted to identify all studies since 2000, that have 1) employed a situation analysis;and2) examined contextual factors influencing pandemic management. The included studies are analysed using a seven-domain systems approach rom the discipline of strategic management. Findings: Nineteen studies were included in the final review ranging from single country (6) to regional, multi-country studies (13). Fourteen studies had a single disease focus, with 5 studies evaluating responses to one or more of COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS),Influenza A (H1N1),Ebola virus disease, and Zika virus disease pandemics. Six studies examined a single domain from political, economic, sociological, technological, ecological or wider industry(PESTELI), 5 studies examined two to four domains, and8studies examined five or more domains. Methods employed were predominantly literature reviews. The recommendations focus predominantly on addressing inhibitors in the sociological and technological domains with few recommendations articulated in the political domain. Overall, the legislative domain is least represented. Conclusions: Ex-post analysis using the seven-domain strategic management framework provides further opportunities for a planned systematic response to pandemics which remains critical as the current COVID-19 pandemic evolves.

Journal article

Ahmad R, Atun R, Birgand G, Castro-Sánchez E, Charani E, Ferlie E, Hussain I, Kambugu A, Labarca J, Levy Hara G, Mckee M, Mendelson M, Singh S, Varma J, Zhu J, Zingg W, Holmes Aet al., 2021, Macro level influences on strategic responses to the COVID-19 pandemic – an international survey and tool for national assessments, Journal of Global Health, Vol: 11, Pages: 1-11, ISSN: 2047-2978

Background Variation in the approaches taken to contain the SARS-CoV-2 (COVID-19) pandemic at country level has been shaped by economic and political considerations, technical capacity, and assumptions about public behaviours. To address the limited application of learning from previous pandemics, this study aimed to analyse perceived facilitators and inhibitors during the pandemic and to inform the development of an assessment tool for pandemic response planning.Methods A cross-sectional electronic survey of health and non-healthcare professionals (5 May - 5 June 2020) in six languages, with respondents recruited via email, social media and website posting. Participants were asked to score inhibitors (-10 to 0) or facilitators (0 to +10) impacting country response to COVID-19 from the following domains – Political, Economic, Sociological, Technological, Ecological, Legislative, and wider Industry (the PESTELI framework). Participants were then asked to explain their responses using free text. Descriptive and thematic analysis was followed by triangulation with the literature and expert validation to develop the assessment tool, which was then compared with four existing pandemic planning frameworks.Results 928 respondents from 66 countries (57% healthcare professionals) participated. Political and economic influences were consistently perceived as powerful negative forces and technology as a facilitator across high- and low-income countries. The 103-item tool developed for guiding rapid situational assessment for pandemic planning is comprehensive when compared to existing tools and highlights the interconnectedness of the 7 domains. Conclusions The tool developed and proposed addresses the problems associated with decision making in disciplinary silos and offers a means to refine future use of epidemic modelling.

Journal article

Ashiru-Oredope D, Hopkins S, Vasandani S, Umoh E, Oloyede O, Nilsson A, Kinsman J, Elsert L, Monnet DL, ECDCAntibioticSurvey Project Advisory Groupet al., 2021, Healthcare workers' knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/EEA countries in 2019., Euro Surveillance, Vol: 26, Pages: 1-10, ISSN: 1560-7917

BackgroundWhile several studies have assessed knowledge, attitudes and behaviours of the public, physicians and medical students in a number of EU/EEA countries with respect to antibiotic use and antibiotic resistance, there is a paucity of literature for other healthcare workers. This survey aimed to fill this gap.MethodsA 43-item online questionnaire was developed, validated and pilot-tested through a modified Delphi consensus process involving 87 Project Advisory Group (PAG) members, including national representatives and members of European health professional groups. The survey was distributed by the PAG and via social media to healthcare workers in 30 EU/EEA countries.ResultsRespondents (n = 18,365) from 30 EU/EEA countries participated. Knowledge of antibiotics and antibiotic use was higher (97%) than knowledge of development and spread of antibiotic resistance (75%). Sixty percent of respondents stated they had received information on avoiding unnecessary prescribing, administering or dispensing of antibiotics. Among respondents who prescribed, administered or dispensed antibiotics, 55% had provided advice on prudent antibiotic use or management of infections to patients, but only 17% had given resources (leaflets or pamphlets). For community and hospital prescribers, fear of patient deterioration or complications was the most frequent reason (43%) for prescribing antibiotics that were considered unnecessary. Community prescribers were almost twice as likely as hospital prescribers to prescribe antibiotics due to time constraints or to maintain patient relationships.ConclusionIt is important to move from raising awareness about prudent antibiotic use and antibiotic resistance among healthcare workers to designing antimicrobial stewardship interventions aimed at changing relevant behaviours.

Journal article

Castro-Sanchez E, Russell AM, Dolman L, Wells Met al., 2021, What place does nurse-led research have in the COVID-19 pandemic?, INTERNATIONAL NURSING REVIEW, Vol: 68, Pages: 214-218, ISSN: 0020-8132

Journal article

Martischang R, Tartari E, Kilpatrick C, Mackenzie G, Carter V, Castro-Sanchez E, Marquez-Villarreal H, Otter JA, Perencevich E, Silber D, Storr J, Tetro J, Voss A, Pittet Det al., 2021, Enhancing engagement beyond the conference walls: analysis of Twitter use at #ICPIC2019 infection prevention and control conference, Antimicrobial Resistance and Infection Control, Vol: 10, Pages: 1-10, ISSN: 2047-2994

BackgroundSocial media may provide a tool, when coupled with a patient-included™ conference, to enhance the engagement among the general public. We describe authors and potential readers of Twitter content surrounding a patient-included™ scientific congress, the International Consortium for Prevention and Infection Control (ICPIC) 2019.MethodsRetrospective observational analysis of Twitter users posting with the #ICPIC2019 hashtag during the conference. Tweet authors, overall followers, and active followers were categorized according to their Twitter biographies using unsupervised learning. Diversity of professional backgrounds of Tweet authors and their followers was explored. Network analysis explored connectedness between the reach of authors.ResultsIn total, 1264 participants attended ICPIC 2019, of which 28 were patients. From September 7 to 16, 2019, we were able to categorize 235′620 (41%) followers linked to 474 (76%) authors. Among authors and followers, respectively 34% and 14% were healthcare workers, 11% and 15% were from industry representatives, 8% and 7% were academic researchers. On average, 23% (range 9–39%) followers belonged to the same categories as authors. Among all followers categorized, only 582/235 620 (0.25%) interacted with original messages, including healthcare workers (37%), global and public health (12%), academic research (11%) and those from industry (11%). Though the similarity between Tweet authors and followers was supported by network analysis, we also observed that non-healthcare workers (including patients) appeared to have more diverse followers.ConclusionsWe observed the participation of numerous Tweet authors and followers from diverse professional backgrounds potentially supporting the benefit of including patients in conferences to reach a more general, non-specialized public.

Journal article

Charani E, Holmes A, Bonaconsa C, Mbamalu O, Mendelson M, Surendran S, Singh S, Nampoothiri V, Boutall A, Tarrant C, Dhar P, Pennel T, Leather A, Hampton Met al., 2021, Investigating infection management and antimicrobial stewardship in surgery: a qualitative study from India and South Africa, Clinical Microbiology and Infection, ISSN: 1198-743X

Objectives To investigate the drivers for infection management and antimicrobial stewardship (AMS) across high infection risk surgical pathways. Methods An qualitative study, ethnographic observation of clinical practices, patient case studies, and face-to-face interviews with healthcare professionals (HCP) and patients was conducted across cardiovascular and thoracic and gastrointestinal surgical pathways in South Africa (SA) and India. Aided by Nvivo 11 software, data were coded and analysed until saturation was reached. The multiple modes of enquiry enabled cross-validation and triangulation of findings.Results Between July 2018–August 2019 data were gathered from 190 hours of non-participant observations (138 India, 72 SA); interviews with HCPs (44 India, 61 SA); patients (6 India, 8 SA), and, case studies (4 India, 2 SA). Across the surgical pathway, multiple barriers impede effective infection management and AMS. The existing, implicit roles of HCPs (including nurses, and senior surgeons) are overlooked as interventions target junior doctors, bypassing the opportunity for integrating infection-related care across the surgical team. Critically, the ownership of decisions remains with the operating surgeons and entrenched hierarchies restrict the inclusion of other HCPs in decision-making. The structural foundations to enable staff to change their behaviours and participate in infection-related surgical care is lacking.ConclusionsIdentifying the implicit existing HCPs roles in infection management is critical and will facilitate the development of effective and transparent processes across the surgical team for optimised care. Applying a framework approach that includes nurse leadership, empowering pharmacists and engaging surgical leads is essential for integrated AMS and infection-related care. Keywords: antibiotic prescribing, infection control, ethnography, low- and middle-income country, surgery

Journal article

Castro-Sanchez E, Alexander CM, Atchison C, Patel D, Leung W, Calamita ME, Garcia DM, Cimpeanu C, Mumbwatasai JM, Ramid D, Doherty K, Grewal HS, Otter JA, Wells EMet al., 2020, Evaluation of a personal protective equipment (PPE) support programme ('PPE Helpers') for staff during the COVID-19 pandemic in London, Journal of Hospital Infection, Vol: 109, Pages: 68-7, ISSN: 0195-6701

BackgroundThe COVID-19 pandemic has presented one of the biggest challenges to healthcare providers worldwide. The appropriate use of Personal Protective Equipment (PPE) has been essential to ensuring staff and patient safety. To counteract sub-optimal PPE practice, a PPE helper programme was developed at a large London hospital group. Based on a behaviour change model of Capability, Opportunity and Motivation (COM-B), the programme provided PPE support, advice and education to ward staff.AimEvaluation of the PPE Helper Programme.MethodsClinical and non-clinical ward staff completed a questionnaire informed by the Theoretical Domains Framework and COM-B. The questionnaire was available in paper and electronic versions. Quantitative responses were analysed using descriptive and non-parametric statistics, free-text responses were analysed thematically.FindingsOver a six-week period, PPE helpers made 268 ward visits. Overall, 261 questionnaires were available for analysis. Across the Trust, 68% of respondents reported having had contact with a PPE helper. Staff who had encountered a PPE helper responded significantly more positively to a range of statements about using PPE than those who had not. Black and Minority Ethnic (BAME) staff were significantly more anxious in relation to the adequacy of PPE. Non-clinical and redeployed staff (e.g. domestic staff) were most positive about the impact of PPE helpers. Free-text comments showed that staff found the programme supportive and would have liked it earlier in the pandemic.ConclusionA PPE Helper programme is a feasible and beneficial intervention for providing support, advice and education to ward staff during infectious disease outbreaks.

Journal article

Tsioutis C, Birgand G, Bathoorn E, Deptula A, ten Horn L, Castro-Sánchez E, Săndulescu O, Widmer AF, Tsakris A, Pieve G, Tacconelli E, Mutters NTet al., 2020, Education and training programmes for infection prevention and control professionals: mapping the current opportunities and local needs in European countries, Antimicrobial Resistance and Infection Control, Vol: 9, Pages: 1-12, ISSN: 2047-2994

BackgroundStudies have repeatedly highlighted the need for homogenisation of training content and opportunities in infection prevention and control (IPC) across European countries.ObjectivesTo map current training opportunities for IPC professionals, define local needs and highlight differences, across 11 European countries (Cyprus, France, England, Germany, Greece, Italy, Netherlands, Poland, Romania, Spain, Switzerland).SourcesFrom July 2018 to February 2019, IPC experts directly involved in IPC training and education in their countries and/or internationally were invited to complete a prespecified set of questions in order to provide a detailed description of IPC training opportunities and needs in their country.ConclusionsIPC training among nurses and doctors varies greatly across countries, with differences in content and type of training (e.g., standardised curriculum, educational programme, clinical experience) duration, as well as in assessment and recognition/accreditation. The observed heterogeneity in IPC training between European countries can be eliminated through establishment of interdisciplinary region-wide training programmes, with common learning objectives, shared know-how and supported by national and international professional bodies.

Journal article

Naylor N, Yamashita K, Iwami M, Kunisawa S, Mizuno S, Castro-Sánchez E, Imanaka Y, Ahmad R, Holmes Aet al., 2020, Code-sharing in cost-of-illness calculations: an application to antibiotic-resistant bloodstream infections, Frontiers in Public Health, Vol: 8, ISSN: 2296-2565

Background: More data-driven evidence is needed on the cost of antibiotic resistance. Both Japan and England have large surveillance and administrative datasets. Code sharing of costing models enables reduced duplication of effort in research.Objective: To estimate the burden of antibiotic-resistant Staphylococcus aureus bloodstream infections (BSIs) in Japan, utilizing code that was written to estimate the hospital burden of antibiotic-resistant Escherichia coli BSIs in England. Additionally, the process in which the code-sharing and application was performed is detailed, to aid future such use of code-sharing in health economics.Methods: National administrative data sources were linked with voluntary surveillance data within the Japan case study. R software code, which created multistate models to estimate the excess length of stay associated with different exposures of interest, was adapted from previous use and run on this dataset. Unit costs were applied to estimate healthcare system burden in 2017 international dollars (I$).Results: Clear supporting documentation alongside open-access code, licensing, and formal communication channels, helped the re-application of costing code from the English setting within the Japanese setting. From the Japanese healthcare system perspective, it was estimated that there was an excess cost of I$6,392 per S. aureus BSI, whilst oxacillin resistance was associated with an additional I$8,155.Conclusions: S. aureus resistance profiles other than methicillin may substantially impact hospital costs. The sharing of costing models within the field of antibiotic resistance is a feasible way to increase burden evidence efficiently, allowing for decision makers (with appropriate data available) to gain rapid cost-of-illness estimates.

Journal article

Vila-Candel R, Soriano-Vidal FJ, Mena-Tudela D, Quesada JA, Castro-Sanchez Eet al., 2020, Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study, JOURNAL OF ADVANCED NURSING, Vol: 77, Pages: 703-714, ISSN: 0309-2402

Journal article

Charani E, Singh S, Mendelson M, Veepanattu P, Nampoothiri V, Edathadatil F, Surendran S, Bonaconsa C, Mbamalu O, Ahuja S, Sevdalis N, Tarrant C, Birgand G, Castro-SAnchez E, Ahmad R, Holmes Aet al., 2020, Building resilient and responsive research collaborations to tackle antimicrobial resistance – lessons learnt from India, South Africa and UK, International Journal of Infectious Diseases, Vol: 100, Pages: 278-282, ISSN: 1201-9712

Research, collaboration and knowledge exchange are critical to global efforts to tackle antimicrobial resistance (AMR). Different healthcare economies are faced with different challenges in implementing effective strategies to address AMR. Building effective capacity for research to inform AMR related strategies and policies AMR is recognised as an important contributor to success. Interdisciplinary, inter-sector, as well as inter-country collaboration is needed to span AMR efforts from the global to local. Developing reciprocal, long-term, partnerships between collaborators in high-income and low- and middle-income countries (LMICs) needs to be built on principles of capacity building. Using case-studies spanning local to international research collaborations to co-design, implement and evaluate strategies to tackle AMR, we evaluate and build upon the ESSENCE criteria for capacity building in LMICs. The first case-study describes the local co-design and implementation of antimicrobial stewardship in the state of Kerala in India. The second case-study describes an international research collaboration investigating AMR across surgical pathways in India, UK and South Africa. We describe the steps undertaken to develop robust, agile, and flexible antimicrobial stewardship research and implementation teams. Notably, investing in capacity building ensured that the programmes described in these case-studies were sustained through the current severe acute respiratory syndrome corona virus pandemic. Describing the strategies adopted by a local and an international collaboration to tackle AMR, we provide a model for capacity building in LMICs that can support sustainable and agile antimicrobial stewardship programmes.

Journal article

Cortes R, Bennasar-Veny M, Castro-Sanchez E, Fresneda S, de Pedro-Gomez J, Yanez Aet al., 2020, Nutrition screening tools for risk of malnutrition among hospitalized patients A protocol for systematic review and meta analysis, MEDICINE, Vol: 99, ISSN: 0025-7974

Journal article

Blanco-Mavillard I, Parra-Garcia G, Fernandez-Fernandez I, Rodriguez-Calero MA, Personat-Labrador C, Castro-Sanchez Eet al., 2020, Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines, PLOS ONE, Vol: 15, ISSN: 1932-6203

Journal article

Vila-Candel R, Martinez-Arnau FM, de la Camara-de las Heras JM, Castro-Sanchez E, Perez-Ros Pet al., 2020, Interventions to Improve Health among Reproductive-Age Women of Low Health Literacy: A Systematic Review, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 17

Journal article

Santillan-Garcia A, Zaforteza-Lallemand C, Castro-Sanchez E, 2020, Nurses as political knowledge brokers, opportunities for growth in the Spanish context, INTERNATIONAL JOURNAL OF NURSING STUDIES, Vol: 110, ISSN: 0020-7489

Journal article

Pouwels KB, Roope LSJ, Buchanan J, Morrell L, Tonkin-Crine S, Peters M, Jones LF, Castro-Sanchez E, Crook DW, Peto T, Butler CC, Robotham JV, Walker AS, Wordsworth Set al., 2020, Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys, ANTIBIOTICS-BASEL, Vol: 9, ISSN: 2079-6382

Journal article

Courtenay M, Burnett E, Castro-Sanchez E, Du Toit B, Figueiredo RM, Gallagher R, Gotterson F, Kennedy H, Manias E, McEwen J, Ness V, Olans R, Padoveze MCet al., 2020, Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardship programmes, JOURNAL OF HOSPITAL INFECTION, Vol: 106, Pages: 176-178, ISSN: 0195-6701

Journal article

Castro-Sanchez E, Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel Ret al., 2020, Health literacy: A crucial determinant of vaccination decision-making, INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, Vol: 97, Pages: 202-203, ISSN: 1201-9712

Journal article

Rosser E, Westcott L, Ali PA, Bosanquet J, Castro-Sanchez E, Dewing J, McCormack B, Merrell J, Witham Get al., 2020, The Need for Visible Nursing Leadership During COVID-19, JOURNAL OF NURSING SCHOLARSHIP, Vol: 52, Pages: 459-461, ISSN: 1527-6546

Journal article

Rawson TM, Moore L, Castro Sanchez E, Charani E, Davies F, Satta G, Ellington M, Holmes Aet al., 2020, COVID-19 and the potential long term impact on antimicrobial resistance, Journal of Antimicrobial Chemotherapy, Vol: 75, Pages: 1681-1684, ISSN: 0305-7453

The emergence of the SARS-CoV-2 respiratory virus has required an unprecedented response to control the spread of the infection and protect the most vulnerable within society. Whilst the pandemic has focused society on the threat of emerging infections and hand hygiene, certain infection control and antimicrobial stewardship policies may have to be relaxed. It is unclear whether the unintended consequences of these changes will have a net-positive or -negative impact on rates of antimicrobial resistance. Whilst the urgent focus must be on allaying this pandemic, sustained efforts to address the longer-term global threat of antimicrobial resistance should not be overlooked.

Journal article

Castro Sanchez E, Santillan-Garcia A, 2020, Smart lobbying for minimum nurse staffing ratios in Spain: not just numbers, Policy Politics and Nursing Practice, Vol: 21, Pages: 60-61, ISSN: 1527-1544

Journal article

Macduff C, Rafferty AM, Prendiville A, Currie K, Castro Sanchez E, King C, Carvalho F, Iedema Ret al., 2020, Fostering nursing innovation to prevent and control antimicrobial resistance using approaches from the arts and humanities, Journal of Research in Nursing, Vol: 25, Pages: 189-207, ISSN: 1361-4096

BackgroundEfforts to address the complex global problem of antimicrobial resistance (AMR) highlight the need for imagination and innovation. However, nursing has not yet leveraged its potential to innovate to prevent AMR advancing. AimThis paper focuses on the initial phase of an ongoing research and development study that seeks to foster nursing imagination and innovation by enhancing the meaningfulness of AMR for practicing nurses and by facilitating their creative ideas.MethodsThis aim is addressed through application of arts and humanities approaches, in particular the use of visualisation, co-design and historical methods, underpinned by the Design Council Double Diamond process model. The first phase with twenty UK participants explored how hospital and community based nurses understand and respond to the priorities and consequences of antimicrobial resistance (AMR) within their everyday working lives.FindingsNurses varied in their conceptualisations of AMR and in their depictions and explanations of its meaning and priority within everyday practices. Some saw IPC and AMR as bound up together whereas others differentiated in the context of specific work activities. Insights into related reasoning and practice tactics were also generated.ConclusionThe initial project phase provides a basis for fostering nursing innovation in this important field.

Journal article

Rodriguez-Calero MA, Blanco-Mavillard I, Morales-Asencio JM, Fernandez-Fernandez I, Castro Sanchez E, de Pedro Gomez Jet al., 2020, Defining risk factors associated with difficult peripheral venous cannulation: a systematic review and meta-analysis, Heart Lung and Circulation, Vol: 49, Pages: 273-286, ISSN: 1443-9506

Peripheral venous catheterization is a common technique in hospitals which is not always successful, resulting in multiple punctures and degradation of the vessels. This scenario, which we have termed ‘difficult peripheral venous access’, is associated to delays in care, obtention of samples or diagnosis, as well as a higher use of central catheters.This study intends to identify risk factors associated to the incidence of ‘difficult peripheral venous access’ in adults at hospital.We designed a systematic review of published studies (protocol PROSPERO 2018 CRD42018089160). We conducted structured electronic searches using key words and specific vocabulary, as well as directed searches in several databases. After validity analysis, we selected 7 studies with observational methodology.We found great variability in the definition of ‘difficult peripheral venous access’ and in the variables proposed as risk factors. Statistically significant factors through studies include demographic and anthropometric variables (gender, Body Mass Index), as well as medical and health conditions (diabetes, renal insufficiency, parenteral drug abuse, cancer chemotherapy), together with variables related to the vein or vascular access (vein visibility and palpability, vessel diameter, previous history of difficulty). Some studies have also considered variables related to the professional performing the technique.Meta-analyses were carried out for gender and obesity as potential risk factors. Only obesity appeared as a statistically significant risk factor with OR of 1.48; 95% CI (1.03 to 1.93; p = 0.016). Methodological heterogeneity prevented the development of further meta-analyses.It is essential to design future studies with diverse hospital populations, in which a wide selection of potential risk factors can be studied in a unique analysis. Our work identifies the most relevant variables that should be included in those studies.

Journal article

Vila-Candel R, Navarro-Illana E, Mena-Tudela D, Pérez-Ros P, Castro-Sánchez E, Soriano-Vidal FJ, Quesada JAet al., 2020, Influence of puerperal health literacy on tobacco use during pregnancy among Spanish women: a transversal study, International Journal of Environmental Research and Public Health, Vol: 17, ISSN: 1660-4601

Background: Despite the fact that tobacco use during pregnancy produces adverse perinatal effects, some women continue to smoke. Health literacy (HL) is essential for health outcomes in adults. However, little is known about HL in pregnant women or postpartum women. The study aimed to analyse the relationship between the degree of HL of women during the early puerperium and tobacco use during pregnancy. Methods: A multicentre, descriptive, cross-sectional study was carried out with women in the early puerperium in a region of eastern Spain, between November 2017 and May 2018. Their HL level was obtained using the Newest Vital Sign (NVS) tool. Multivariate logistic models were adjusted to estimate the magnitude of association with tobacco use in pregnancy. Odds ratios (OR) were estimated with a 95% confidence interval. Results: 193 were included in the total. 29.5% (57) of pregnant women smoked tobacco during pregnancy, with a smoking cessation rate of 70.1% (40) while pregnant. 42.0% (81) of pregnant women had inadequate or limited HL. A low level of HL was strongly associated with tobacco use, adjusted by catchment area and age of first pregnancy (LRT p &lt; 0.001; ROC curve = 0.71, 95% CI: 0.64–0.79). Conclusion: A low HL is associated with tobacco consumption during pregnancy. Whether low HL reflects the wide constellation of already-known socioeconomic, political and commercial determinants of tobacco use, or whether incorporating HL support interventions strengthens tobacco cessation activities in pregnancy, warrants further research. Still, it should be considered as essential to understanding the health disparities related to its consumption.</jats:p>

Journal article

Roope L, Tonkin-Crine S, Herd N, Michie S, Pouwels KB, Castro Sanchez E, Sallis Sallis A, Hopkins S, Robotham J, Crook D, Peto T, Peters M, Butler CC, Walker S, Wordsworth Set al., 2020, Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear based messages about antimicrobial resistance., BMC Medicine, ISSN: 1741-7015

Journal article

Cabellos-Garcia A, Castro Sanchez E, Martinez-Sabater A, Diaz-Herrera MA, Ocaña-Ortiz A, Juarez-Vela R, Gea-Caballero Vet al., 2020, Relationship between determinants of health, equity, and dimensions of health literacy in patients with cardiovascular disease, International Journal of Environmental Research and Public Health, Vol: 17, ISSN: 1660-4601

Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. The Health Literacy Questionnaire was used. Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions. Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account.

Journal article

Vila-Candel R, Martin A, Escuriet R, Castro Sanchez E, Soriano-Vidal Fet al., 2020, Analysis of caesarean section rates using the Robson classification system at a university hospital in Spain, International Journal of Environmental Research and Public Health, Vol: 17, ISSN: 1660-4601

Background: The WHO recommends the use of the Robson ten-group classification system (RTGCS) as an effective monitoring and analysis tool to assess the use of caesarean sections (CS). The present study aimed to conduct an analysis of births using the RTGCS in La Ribera University Hospital over nine years and to assess the levels and trends of CS births. Methods: Retrospective study between January 1, 2010, and December 31, 2018. All eligible women were allocated in RTGCS to determine the absolute and relative contribution made by each group to the overall CS rate; linear regression and weighted least squares regression analysis were used to analyze trends over time. The risk of CS of women with induced versus spontaneous onset of labor was calculated with an odds ratio (OR) with a 95% CI. Results: 16,506 women gave birth during the study period, 19% of them by CS. Overall, 20.4% of women were in group 1 (nulliparous, singleton cephalic, term, spontaneous labor), 29.4% in group 2 (nulliparous, singleton cephalic, term, induced labor or caesarean before labor), and 12.8% in group 4 (multiparous, singleton cephalic, term, induced or caesarean delivery before labor) made the most significant contributions to the overall rate of CS; Conclusions: In our study, Robson Groups 1, 2, and 4, were identified as the main contributors to the hospital’s overall CS rate. The RTGCS provides an easy way of collecting information about the CS rate, is a valuable clinical method that allows standardized comparison of data, and time point, and identifies the groups driving changes in CS rates.

Journal article

Castro Sanchez E, Black CA, Whitehouse C, Hare N, Tinkler L, Maxton F, Valentine J, Grieve S, on behalf of the 20192022 NIHR 7070 Senior Nurse and Midwife Research Leaderset al., 2020, The NIHR 70@70 programme: transforming research, British Journal of Nursing, Vol: 29, Pages: 240-241, ISSN: 0142-0372

Journal article

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