Salmerón Martínez, Diego

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Salmerón Martínez, Diego

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Salmerón Martínez, Diego

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Universidad de Murcia. Departamento de Ciencias Sociosanitarias

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Open Access
Características sociales y de género en el ámbito de contagio de COVID-19 en una región mediterránea
(Ministerio de Sanidad y Consumo, 2022-12-19) Soriano López, Jesús; Salmerón Martínez, Diego; García Pina, Rocío; Humberto Gómez, Jesús; Sánchez Rodríguez, Inés; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias; Facultad de Enfermería
BACKGROUND // Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin,occupational social class and gender, which is essential in order to designing public health strategies. METHODS // A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables. RESULTS // The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%). CONCLUSIONS // The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.
Open Access
Childhood adversities and suicidal behavior in the general population. The cross-sectional PEGASUS-Murcia Project
(Elsevier, 2024) Navarro Mateu, Fernando; Salmerón Martínez, Diego; Vilagut, Gemma; Husky, Mathilde; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Huerta, José María; Martínez, Salvador J.; Navarro, Carmen A.; Alonso Caballero, Jordi; Nock, Matthew; Kessler, Ronald C.; Ciencias Sociosanitarias
Introduction The aim of the present study is to estimate the lifetime prevalence of suicidal ideation, plans, and attempts in a regional representative sample and the association of these outcomes with sociodemographic factors, prior mental disorders, and childhood adversities. Material and methods The PEGASUS-Murcia project is a cross-sectional survey of a representative sample of adults in Murcia that is part of the WHO World Mental Health Survey Initiative. The Composite International Diagnostic Interview (CIDI 3.0) was administered face-to-face to 2621 participants (67.4% response rate). The main outcomes were suicidal ideation, plans, and attempts. Lifetime prevalence, age of onset, and risk factors (sociodemographic variables, mental disorders, and childhood adversities) were examined using multiple discrete-time survival models. Results Lifetime prevalence of suicidal ideation, plans and attempts were 8.0% (standard error, SE: 1.1), 2.1% (SE: 0.3), and 1.2% (SE: 1.1), respectively. Prevalence of any childhood adversities was 22.1% (SE: 1.3) in the total sample and, even higher, among those with suicide related outcomes (ranging between 36.8% and 53.7%). Female sex, younger age, prior (to onset of the outcome) lifetime prevalence of mood disorders, number of mental disorders, and exposure to childhood adversity were associated with significantly increased odds of suicidal ideation and plans. Conclusions Lifetime prevalence estimates of suicidality are similar to those in community epidemiological surveys. Childhood adversities and mental disorders, especially mood disorders, are important risk factors for suicidality. Early detection of these adversities and disorders should be targeted in suicide prevention programs.
Open Access
Control epidémico y necesidad de un certificado médico de defunción con recuento rápido de causas de muerte
(Elsevier, 2026) Cirera, Lluís; Salmerón Martínez, Diego; Xifró, Alexandre; Bañón, Rafael María; Barbería, Eneko; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Medicina
Open Access
Influence of operator’s professional experience in the postoperative course after surgical extrac-tion of the impacted lower third molar: a pilot study
(Medicina Oral S. L., 2020-09-01) Ruiz Roca, Juan Antonio; Donoso Martínez, Benjamín; Ameneiros Serantes, Susana; Martínez Beneyto, Yolanda; Salmerón Martínez, Diego; Gay Escoda, Cosme; Dermatología, Estomatología, Radiología y Medicina Física
Background: Third molars are present in 96.6% of humans, although they do not always erupt completely. Between 9.5% and 73% of them remain impacted. Surgical removal of impacted third molars is the most common practice in oral and maxillofacial surgery. This procedure results in traumatism and, consequently, the postoperative phase will involve symptomatology. It is uncommon to find studies that directly relate postoperative symptomatology and the operator’s experience. The aim of this study was to determine the differences regarding postoperative symp-tomatology in patients undergoing the bilateral extraction of lower impacted third molars and according to the operator’s experience. Material and Methods: A prospective cohort double-blind study was conducted in 50 healthy patients (100 molar extractions) to whom both lower third molars were removed by two dentists with different degree of professional experience. The extractions were randomly assigned with a split–mouth design. If an operator extracted the lower third molar on one side, the other operator extracted the contralateral one. The variables studied after four days of postoperative period were Pain (EVA scale), Inflammation and Trismus, in addition to intraoperative time and local anesthesia administered. Results: Statistically significant differences were detected in the time of intervention and in trismus, since the most experienced operator always needed less time and caused higher degree of trismus. However, this does not entail more inflammation or pain in patients, so there are no relevant differences between operators with more or less experience (p>0.05). Conclusions: The postoperative period is more favorable for the most experienced operator, although the results do not vary in a relevant manner between them.
Open Access
Obesity rise plateaus in developed nations and accelerates in developing nations
(Nature Research, 2026-05-13) Salmerón Martínez, Diego; NCD Risk Factor Collaboration (NCD-RisC); Bin Zhou, Bin et al.; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Medicina
Global reporting of obesity is commonly based on comparisons over multiple decades1 and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3–4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small decline in obesity in children and adolescents in some high-income western countries (for example, Italy, Portugal and France) since the 2000s. Similar trends were seen in some countries in Central and Eastern Europe. In adults, the rise in obesity slowed down in high-income western countries about a decade after children, followed by a plateau or possibly a small reversal of the rise in some countries (for example, Spain). In most low-income and middle-income countries, the annual absolute change in prevalence has remained stable or increased over time, even though prevalence has surpassed that of high-income countries. These highly varied dynamics suggest that the social, economic and technological trends that influence the availability, affordability and use of different foods may have helped control the rise in obesity in high-income countries, but require policy interventions in low-income and middle-income countries.
Open Access
Trends in socioeconomic inequalities in mortality in small areas of 33 Spanish cities
(BioMed Central, 2016-07-29) Marí-Dell’Olmo, Marc; Gotsens, Mercè; Palència, Laia; Rodríguez Sanz, Maica; Martínez Beneito, A.; Ballesta Ruiz, Mónica; Calvo, Montse; Cirera, Lluís; Daponte, Antonio; Domínguez Berjón, Felicitas; Gandarillas, Ana; Izco Goñi, Natividad; Martos, Carmen; Moreno Iribas, Conchi; Nolasco, Andreu; Salmerón Martínez, Diego; Borrell, Carme; Taracido, Margarita; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
Background In Spain, several ecological studies have analyzed trends in socioeconomic inequalities in mortality from all causes in urban areas over time. However, the results of these studies are quite heterogeneous finding, in general, that inequalities decreased, or remained stable. Therefore, the objectives of this study are: (1) to identify trends in geographical inequalities in all-cause mortality in the census tracts of 33 Spanish cities between the two periods 1996–1998 and 2005–2007; (2) to analyse trends in the relationship between these geographical inequalities and socioeconomic deprivation; and (3) to obtain an overall measure which summarises the relationship found in each one of the cities and to analyse its variation over time. Methods Ecological study of trends with 2 cross-sectional cuts, corresponding to two periods of analysis: 1996–1998 and 2005–2007. Units of analysis were census tracts of the 33 Spanish cities. A deprivation index calculated for each census tracts in all cities was included as a covariate. A Bayesian hierarchical model was used to estimate smoothed Standardized Mortality Ratios (sSMR) by each census tract and period. The geographical distribution of these sSMR was represented using maps of septiles. In addition, two different Bayesian hierarchical models were used to measure the association between all-cause mortality and the deprivation index in each city and period, and by sex: (1) including the association as a fixed effect for each city; (2) including the association as random effects. In both models the data spatial structure can be controlled within each city. The association in each city was measured using relative risks (RR) and their 95 % credible intervals (95 % CI). Results For most cities and in both sexes, mortality rates decline over time. For women, the mortality and deprivation patterns are similar in the first period, while in the second they are different for most cities. For men, RRs remain stable over time in 29 cities, in 3 diminish and in 1 increase. For women, in 30 cities, a non-significant change over time in RR is observed. However, in 4 cities RR diminishes. In overall terms, inequalities decrease (with a probability of 0.9) in both men (RR = 1.13, 95 % CI = 1.12–1.15 in the 1st period; RR = 1.11, 95 % CI = 1.09–1.13 in the 2nd period) and women (RR = 1.07, 95 % CI = 1.05–1.08 in the 1st period; RR = 1.04, 95 % CI = 1.02–1.06 in the 2nd period). Conclusions In the future, it is important to conduct further trend studies, allowing to monitoring trends in socioeconomic inequalities in mortality and to identify (among other things) temporal factors that may influence these inequalities.
Open Access
On integral priors for multiple comparison in Bayesian model selection
(Wiley, 2026-02-16) Salmerón Martínez, Diego; Cano, Juan Antonio; Robert, Christian P.; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Medicina
Noninformative priors constructed for estimation purposes are usually not appropriate for model selection and testing. The methodology of integral priors was developed to get prior distributions for Bayesian model selection when comparing two models, modifying initial improper reference priors. We propose a generalisation of this methodology to more than two models. Our approach adds an artificial copy of each model under comparison by compactifying the parametric space and creating an ergodic Markov chain across all models that returns the integral priors as marginals of the stationary distribution. Besides the guarantee of their existence and the lack of paradoxes attached to estimation reference priors, an additional advantage of this methodology is that the simulation of this Markov chain is straightforward as it only requires simulations of imaginary training samples for all models and from the corresponding posterior distributions. We present some examples, including situations where other methodologies need specific adjustments or do not produce a satisfactory answer.
Open Access
Mortality attributable to modifiable lifestyle factors in the Spanish cohort of the European prospective investigation into cancer and nutrition (EPIC) study
(BioMed Central, 2025-11-26) Cirera, Lluis; Huerta, José María; Moreno-Iribas, Conchi; Jiménez, Ana; Mokoroa, Olatz; Guevara, Marcela; Andueza, Naroa; Sánchez, María José; Petrova, Dafina; Luján-Barroso, Leila; Salmerón Martínez, Diego; Chirlaque López, María Dolores; Ciencias Sociosanitarias
Background There is consistent evidence on the relationship of unhealthy habits with mortality risk. The population attributable fraction (PAF) is a useful quantifier of the number of new disease cases attributable to modifiable risk factors. Our objective was to obtain the hazard ratios (HRs) and the PAFs for the major individual lifestyle factors of mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods Prospective study which included 40 307 EPIC-Spain participants (62.5% women). A total of 7 262 cases of all-cause mortality (53.9% were men) occurred during an average follow-up of 25.1 years. We calculated PAFs separately for men and women, using adjusted HRs of mortality (and 95% CI) from multivariate Cox regression models for binary categories of smoking, high alcohol consumption, obesity markers, poor Mediterranean diet adherence, and low physical activity. Results Most lifestyle factors studied were significantly associated with mortality in the study cohort. In final multivariate analyses, smoking registered the largest PAFs in men (21.0%, 95%CI 19.1–22.7%), while general obesity (BMI) accounted for the largest PAF in women (10.8%, 7.5–13.8%). Attributable fractions were similar in both sexes for poor adherence to the Mediterranean diet, whereas the lowest PAFs were estimated for physical activity. High alcohol consumption and central obesity did not pose a risk in women. Conclusions Shifting from any risk factor to a healthier lifestyle would reduce mortality in both sexes. However, in women, alcohol consumption did not influence mortality risk and only BMI was associated with mortality risk attributable body adiposity. Key messages What is already known on this topic: modifiable lifestyle risk factors affect the occurrence of chronic disease incidence and mortality, but most studies provide relative measures of risk. What this study adds: this study quantifies the proportion of overall deaths attributable to a combination of major lifestyle risk factors in a large population sample from the EPIC-Spain study. How the study might affect research, practice or policy: the results would assist public health professionals and policy makers in identifying priorities and setting goals for intervention at the population level in order to prevent avoidable premature mortality in the population.
Open Access
Optimal nap timing and body mass index: beyond duration
(BioMed Central, 2026-04-01) Longo-Silva, Giovana; Rodríguez Martín, María; Salmerón Martínez, Diego; Scheer, Frank A. J. L.; Garaulet Aza, Marta; Ciencias Sociosanitarias; Facultad de Medicina
Background: Overweight and obesity continue to rise globally, and sleep has emerged as an important behavioral determinant of body weight. While nighttime sleep has been widely studied, the role of daytime napping—especially nap timing—remains unclear. Existing research relies on clock time, which may not reflect individual rhythms. This study investigates whether nap timing referenced to daily events is associated with BMI in two adult populations of habitual nappers (Spain and Brazil). Secondary aims included the association of nap duration and weekend–weekday differences in nap timing and duration with BMI. Methods: Habitual nappers (n = 3550) aged 18–65 years were studied. Nap timing was calculated relative to wake time and lunch time. As secondary analyses, nap duration and weekend–weekday differences in nap timing (nap jet lag) and in nap duration were evaluated. Linear regression and restricted cubic spline models were applied. Results: BMI and excess weight prevalence were similar between countries. Compared with Spaniards, Brazilians showed earlier naps (by >2 h), longer weekend naps (by 13 min), and greater nap jet lag (by 23 min) (all p < 0.001). Despite these differences, no significant interactions by country were observed in nap–BMI associations, and data were pooled. Nap timing relative to wake and lunch displayed L-shaped associations with BMI: the highest BMI corresponded to early naps (~3h after waking and ~2h before lunch), whereas the lowest BMI (i.e. the inflection points) occurred when naps were 7h18min after wake (β = −0.48 kg/m2 per hour before the inflection point, p = 0.001) and 1h15min after lunch (β = −0.53 kg/m2 per hour before the inflection point, p = 0.031). Shorter and more consistent nap duration across the week was associated with lower BMI (p < 0.05). Conclusions: Findings highlight nap timing as a novel behavioral factor associated with BMI, warranting further longitudinal research to explore its potential causal role.
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Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
(Elsevier, 2020-12) Cirera, Lluís; Márquez Calderón, S.; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Sáez, Marc; Salmerón Martínez, Diego; Mortality working group of the Spanish Epidemiological Association; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
Objectives The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975–2016 in Spain. Study design A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975–2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results HIV/AIDS shaped the increasing trend period of infectious diseases in 1989–1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995–1999 and 1999–2016. Lung cancer fell gradually from 1994 in men (−0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980–2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.