Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated.

Cancer is one of the main causes of morbidity and mortality. Environmental factors along with lifestyle: tobacco and alcohol consumption, unhealthy diet and sedentary lifestyle and lack of physical activity, are some of the risk factors that have caused an increase in cancer. This article updates the evidence and recommendations for cancer prevention strategies through screening in asymptomatic patients, as well as early detection of signs and symptoms in medium-risk and high-risk populations.

Introduction Uncomplicated lower urinary tract infections (uLUTI) are a common problem in primary care. Current local guidelines recommend the use of a single 3 g dose of fosfomycin. However, most general practitioners (GP) prefer short-course therapies to single-dose therapy. No study has compared head-to-head short-course antimicrobial agents for uLUTIs. Therefore, the aim of this randomised clinical trial is to compare three different short-course antibiotic therapies with a single-dose of fosfomycin for these infections. Methods and analysis This will be a pragmatic, multicentre, parallel group, open trial. Women aged 18 or older and with symptoms of uLUTI and a positive urine dipstick analysis will be randomised to one of the following four groups: a single dose of 3 g of fosfomycin, 2 days of 3 g of fosfomycin o.d., 3 days of pivmecillinam 400 mg three times per day (t.i.d) or 5 days of nitrofurantoin 100 mg t.i.d. A total sample of 1120 patients was calculated. The primary endpoint is clinical effectiveness at day 7, defined as cure of symptoms reported by the patients in a diary including four symptoms: dysuria, urgency, frequency and suprapubic pain, which will be scored on a 4-point severity scale (not present/mild/moderate/severe). Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed. If positive, antibiograms for the three antibiotics studied will be performed. Bacterial eradication will be measured at days 14 and 28. Ethics and dissemination The study was approved by the Ethical Board of IDIAP Jordi Gol (reference number: 21/173-AC) and Spanish Agency of Medicines and Medical Devices. The findings of this trial will be disseminated through research conferences and peer-review journals. Trial registration number NCT04959331; EudraCT Number: 2021-001332-26. Time schedule January 2022 to April 2023.

Background: A method of determining the initial symptoms and main prognostic identifiers for COVID-19 can be a key tool for physicians, especially primary care physicians. Therefore, the objective of this study was to examine the prognosis of patients with COVID-19 from two different demographic regions according to baseline and main symptoms, age, and sex.Methods: All individuals selected from both urban and rural health centers were over 18 years of age, had COVID-19 before 2 March 2021, and were followed up with a primary care physician. All patients included in this study were recruited in terms of sex, age at the time of infection, type of contact, baseline symptoms, primary and secondary symptomatology, emergency assistance, hospitalization, intensive care unit (ICU) admission, and death.Results: A total of 219 and 214 subjects were recruited from rural and urban health centers, respectively. Subjects with COVID-19 from rural areas were significantly older in age, with a higher proportion of men, and had significantly lower baseline and main symptoms than those from urban areas. In addition, the presence of both fever and dyspnea as the initial or main symptom is significantly associated with emergency assistance, hospitalization, and death, regardless of sex, age, and demographic area. This type of illness was reported to be significantly less frequent in the rural population than in the urban population.Conclusion: The presence of both fever and dyspnea as both initial and main symptoms is a poor prognostic factor for COVID-19, regardless of age, sex, and demographic areas. In addition, women reported lower levels of fever and dyspnea, requiring minimal emergency assistance and fewer hospitalization, and a lower rate of mortality than men. During a COVID-19 infection follow-up, subjects in rural areas seem to have less access to medical care than those in urban areas.

Healthcare workers, especially medical and nursing residents, are exposed to situations that can lead to burnout. The main factors are organizational. However, it is more feasible for professionals to act on personal factors. There is a growing interest in interventions to prevent and reduce burnout. To examine the association between organizational and personal characteristics and burnout in Family and Community Medicine and Nursing residents, using baseline data from a non-randomised comparative study. This study is a secondary cross-sectional analysis of baseline data from a pragmatic non-randomised trial. We analysed sociodemographic, occupational, and psychological variables in relation to burnout. Medical and nursing residents enrolled in 2018–2021 at the teaching units of Vigo, Zaragoza, and Mallorca.” Variables: Sociodemographic, professional, burnout, empathy, resilience, social support, sense of coherence, anxiety and depression, personality, locus of control. Descriptive statistics and bivariate analyses (chi-square and Mann–Whitney U) were performed, and Pearson correlations with 95% confidence intervals were estimated to assess associations between burnout and organizational/personal variables (R 4.1.3). Registered in Clinical Trials with ID: NCT04625582 (November 10, 2020) A total of 147 residents were included at baseline (71% medicine, 29% nursing; 80% women; mean age 27.6 years). Mean burnout scores were 44.1 (SD 18.1) for personal burnout, 47.8 (SD 16.8) for work-related burnout, and 38.2 (SD 16.3) for patient-related burnout. Burnout correlated positively with weekly hours worked (r = 0.32, 95% CI 0.17–0.46), number of patients/day (r = 0.41, 95% CI 0.27–0.54) and monthly on-call shifts (r = 0.29, 95% CI 0.14–0.43), and with anxiety (r = 0.47, 95% CI 0.33–0.60) and depression (r = 0.36, 95% CI 0.21–0.50). Negative correlations were found with resilience (r = –0.38, 95% CI –0.52 to –0.23), social support (r = –0.24, 95% CI –0.39 to –0.08), and sense of coherence (r = –0.52, 95% CI –0.62 to –0.40) (all p < 0.05). Burnout in Family and Community Medicine and Nursing residents is associated with both organizational factors (workload, on-call duties, patient volume) and personal resources (resilience, empathy, sense of coherence). These findings underscore the importance of addressing structural workload while simultaneously enhancing coping resources to prevent burnout during residency training.