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  Subjects -> HEALTH AND SAFETY (Total: 1290 journals)
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HEALTH AND SAFETY (520 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 5)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 11)
American Journal of Health Education     Hybrid Journal   (Followers: 26)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 9)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 184)
American Journal of Public Health Research     Open Access   (Followers: 26)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 9)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 6)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 5)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 7)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 12)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 1)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 9)
Evidence-based Medicine & Public Health     Open Access   (Followers: 5)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 5)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 8)
Global Journal of Public Health     Open Access   (Followers: 10)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 48)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 11)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 33)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 46)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 10)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 2)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 11)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 3)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 14)
International Journal of Health & Allied Sciences     Open Access   (Followers: 2)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)

        1 2 3 | Last

Journal Cover Gaceta Sanitaria
  [SJR: 0.397]   [H-I: 31]   [3 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0213-9111
   Published by Elsevier Homepage  [3043 journals]
  • Vigilancia en salud pública: una necesidad inaplazable

    • Authors: Isabel Noguer; Juan Pablo Alonso; José M. Arteagoitia; Jenaro Astray; Rosa Cano; Jesús de Pedro; Gonzalo Gutiérrez; Xurxo Hervada; Mario Margolles; Antonio Nicolau; Domingo Núñez; Marina Pollán; Julián Mauro Ramos; M. José Sierra; Hermelinda Vanoclocha
      Pages: 283 - 285
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Isabel Noguer, Juan Pablo Alonso, José M. Arteagoitia, Jenaro Astray, Rosa Cano, Jesús de Pedro, Gonzalo Gutiérrez, Xurxo Hervada, Mario Margolles, Antonio Nicolau, Domingo Núñez, Marina Pollán, Julián Mauro Ramos, M. José Sierra, Hermelinda Vanoclocha

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.11.002
  • Gasto de bolsillo en adultos mayores afiliados a un seguro público de
           salud en México

    • Authors: Patricia Pavón-León; Hortensia Reyes-Morales; Armando J. Martínez; Silvia María Méndez-Maín; María del Carmen Gogeascoechea-Trejo; María Sobeida L. Blázquez-Morales
      Pages: 286 - 291
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Patricia Pavón-León, Hortensia Reyes-Morales, Armando J. Martínez, Silvia María Méndez-Maín, María del Carmen Gogeascoechea-Trejo, María Sobeida L. Blázquez-Morales
      Objetivo Identificar la asociación de distintas variables sociodemográficas con el gasto de bolsillo en servicios de salud en adultos de 60 años y más afiliados al Seguro Popular (SP). Método Estudio transversal analítico. Se realizó una encuesta a través de una entrevista cara a cara a usuarios de la consulta externa de tres unidades médicas del estado de Veracruz: centro de salud (primer nivel), hospital regional (segundo nivel) y hospital de alta especialidad. El gasto de bolsillo en salud en el último año se analizó con el modelo lineal generalizado. Resultados La muestra fue de 1049 adultos de 60 años y más beneficiarios del SP y la tasa de respuesta fue del 97,7%. El gasto de bolsillo en salud mensual fue US$ 64,8 (intervalo de confianza del 95% [IC95%]: 59,9-69,8). El rubro con mayor gasto fueron los medicamentos incluidos en el SP (US$ 28,8; IC95%: 25,8-31,7) y los medicamentos que no cubre el SP (US$ 8; IC95%: 6,7-9,2). Conclusiones Los adultos de 60 años y más afiliados al SP pagan de su bolsillo para atender su salud, a pesar de contar con un seguro público de salud, lo que representa una inequidad en el acceso, principalmente para los más vulnerables, como son la población rural. Objective To identify the association between various sociodemographic variables and out-of-pocket expenditure on health by elderly people enrolled in Seguro Popular (SP). Method Analytical cross-sectional study. An in-person survey was administered to users of three outpatient clinics in the state of Veracruz: a health centre (first level), regional hospital (second level) and highly specialised hospital. The out-of-pocket expenditure on health was analysed using a generalised linear model. Results The sample consisted of 1,049 beneficiaries of SP over age 60 with a response rate of 97.7%. The monthly out-of-pocket expenditure on health was $64.80 (95% confidence interval [95% CI]: 59.90–69.80). The highest expense category was drugs that are included in the SP ($28.80; 95% CI: 25.80–31.70) and drugs that are not covered by the SP ($8.00; 95% CI: 6.70–9.20). Conclusions People over age 60 enrolled in SP pay out of their pocket to meet their health needs, despite having public health insurance. This represents an inequity in access, especially for the most vulnerable such as the rural population.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.12.015
  • Suicidal behaviours in male and female users of illicit drugs recruited in
           drug treatment facilities

    • Authors: Elisabet Arribas-Ibar; Josep Maria Suelves; Albert Sanchez-Niubò; Antònia Domingo-Salvany; M. T. Brugal
      Pages: 292 - 298
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Elisabet Arribas-Ibar, Josep Maria Suelves, Albert Sanchez-Niubò, Antònia Domingo-Salvany, M. T. Brugal
      Objective We assessed prevalence of suicidal ideation and plans among illicit drug users and their association with contextual factors, by gender. Methods Cross-sectional study. In a sample of 511 illicit drug users recruited during spring 2012 in drug treatment and prevention facilities in Catalonia (Spain), the prevalence of suicidal ideation/plans in the last 12 months was assessed. Poisson regression was used to examine associations between suicidal ideation/plans and various factors (socio-demographic, psychological, illegal drug market activities and marginal income generation activities, which included any reported sex work, stealing, peddling, begging or borrowing on credit from a dealer). Results The average age was 37.9 years (standard deviation: 8.62); 76.3% were men. Suicidal ideation/plans were reported by 30.8% of men and 38.8% of women, with no significant differences by age or gender. Recent aggression (male prevalence ratio [PR]=2.2; female PR=1.4), psychological treatment (male PR=1.2; female PR=1.3) and illegal/marginal income generation activities (male PR=1.5; female PR=1.1) were associated with suicidal ideation/plans. Men who trafficked were more likely to have suicidal ideation/plans (PR=1.3), while prison history was positive for women (PR=1.8) and negative for men (PR=0.7). Conclusions Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.11.011
  • Dificultades para ofrecer cuidados al final de la vida en las unidades de
           cuidados intensivos. La perspectiva de enfermería

    • Authors: Juan Francisco Velarde-García; Raquel Luengo-González; Raquel González-Hervías; Sergio González-Cervantes; Beatriz Álvarez-Embarba; Domingo Palacios-Ceña
      Pages: 299 - 304
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Juan Francisco Velarde-García, Raquel Luengo-González, Raquel González-Hervías, Sergio González-Cervantes, Beatriz Álvarez-Embarba, Domingo Palacios-Ceña
      Objetivo Describir las dificultades percibidas por el personal de enfermería para prestar cuidados al final de la vida al paciente grave dentro de la unidad de cuidados intensivos (UCI). Método Estudio cualitativo fenomenológico descriptivo. Se aplicó un muestreo por propósito y de bola de nieve. Las enfermeras debían tener una experiencia mínima de 1 año en UCI. Se incluyeron 22 participantes. Los datos se recopilaron mediante entrevistas en profundidad (no estructuradas y semiestructuradas) y notas de campo del investigador. El análisis se realizó mediante la propuesta de Giorgi. Resultados Se identificaron tres temas: dificultades académico-culturales, relacionadas con la orientación curativa de la UCI y la falta de formación en cuidados al final de la vida; dificultades estructurales-arquitectónicas, relacionadas con la falta de espacio e intimidad para el paciente y la familia en los últimos momentos; y dificultades psicoemocionales, relacionadas con el distanciamiento emocional como estrategia aplicada por el personal de enfermería. Conclusiones El personal de enfermería necesita formación sobre los cuidados al final de la vida mediante el uso de guías o protocolos y el desarrollo de estrategias de afrontamiento, junto a un cambio en la organización de la UCI orientado al cuidado terminal de los pacientes graves y a la atención de la familia. Objective To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). Method A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal. Results Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff. Conclusions Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.11.006
  • Indicadores de gobernanza en políticas y programas de salud mental en
           México: una perspectiva de actores clave

    • Authors: Lina Díaz-Castro; Armando Arredondo; Blanca Estela Pelcastre-Villafuerte; Marc Hufty
      Pages: 305 - 312
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Lina Díaz-Castro, Armando Arredondo, Blanca Estela Pelcastre-Villafuerte, Marc Hufty
      Objetivo Analizar el papel de la gobernanza en el sistema de salud mental en México, en el desarrollo de políticas y programas de salud mental, desde la perspectiva de sus propios actores. Métodos Se elaboró un mapeo para identificar a los actores en el sistema de salud mental en México. Se diseñó una guía para entrevistas en profundidad, las cuales fueron grabadas y organizadas en categorías para su análisis. Se utilizó el software Atlas-ti v.7 para la organización de los datos cualitativos y el Policy Maker v.4 para situar la posición y la influencia de los actores del sistema de salud. Resultados Los actores se identificaron de acuerdo con su nivel de influencia en políticas de salud mental, como alto, medio y bajo. Los actores con un nivel de influencia alto participan en políticas nacionales, los actores con un nivel de influencia medio lo hacen en políticas regionales o locales, y la participación de los actores con un nivel de influencia bajo es considerada marginal. Conclusiones Este estudio permitió comprender la gobernanza en salud mental. El nivel de influencia de los actores incide en el grado de alcance de los indicadores de gobernanza. Se obtuvieron datos relevantes para mejorar las políticas de atención de la salud mental. Objective To analyse the role of Mexico's mental health system governance in the development of mental health policies and programmes, from the perspective of its own actors. Methods A map was developed for identifying the actors in Mexico's mental health system. A guide was designed for in-depth interviews, which were recorded and arranged in categories for their analysis. The Atlas-ti v.7 software was used for the organisation of qualitative data and Policy Maker v.4 was used to determine the position and influence of actors within the health system. Results The actors were identified according to their level of influence in mental health policies: high, medium and low. Actors with a high level of influence participate in national policies, actors with medium influence are involved in regional or local policies and the participation of actors with a low level of influence is considered marginal. Conclusions This study facilitated understanding of governance in mental health. The level of influence of the actors directly affects the scope of governance indicators. Relevant data were obtained to improve policies in mental health care.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.08.001
  • Una evaluación crítica de la relación entre la industria alimentaria y
           la investigación en salud

    • Authors: Josep León Mengíbar; María Pastor-Valero; Ildefonso Hernández Aguado
      Pages: 320 - 323
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Josep León Mengíbar, María Pastor-Valero, Ildefonso Hernández Aguado
      Objetivo Describir la influencia de las corporaciones alimentarias en los resultados de la investigación en salud. Método Revisión sistemática en MedLine, Cochrane Library Plus y Scopus usando los MESH “Food Industry”, “Food-Processing Industry”, “Biomedical Research” y “Research Support as Topic”, y las palabras clave “Industry Sponsorship” y “Funding Source”. La calidad fue evaluada mediante las directrices PRISMA. Resultados Se revisaron 1506 artículos y se incluyeron 10, de los cuales dos analizaban la relación entre financiación y calidad respecto a resultados; seis, la relación entre financiación y resultados; y dos, la calidad metodológica. Seis mostraron efectos favorables a los productos de las industrias financiadoras. En cuanto a la calidad, no se observaron diferencias según la financiación, pero sí una peor calidad en aquellas que no la declaraban. Conclusión La financiación por parte de la industria alimentaria de investigaciones en salud se asocia a resultados favorables a sus productos, aunque no afecta a la calidad de los estudios. Objective To describe the influence of the food industry in health research, observing how funding influences health outcomes and the quality of the studies. Method We performed a systematic review in MEDLINE, Cochrane Library Plus and Scopus using the MESH “Food Industry”, “Food-Processing Industry”, “Biomedical Research”, “Research Support as Topic”, and the keywords “Industry Sponsorship” and “Funding Source”. The quality was assessed using the PRISMA guidelines. Results We revised 1,506 articles and 10 were included; two reviewed the relationship between funding-outcomes and quality-outcomes; six focused on the funding-outcomes relationship; and the other two focused on methodological quality. Six showed that funding from the food industry resulted in more favourable outcomes for their products. No differences in quality were found in relation to the funding source, but those which did not declare their funding had a worse quality. Conclusion Studies funded by the food industry showed favourable results for their products. However, this fact did not affect the quality of the studies.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.10.012
  • Evolución de la prevalencia de alto riesgo de trastornos mentales en
           población adulta española: 2006-2012

    • Authors: Virginia Basterra
      Pages: 324 - 326
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Virginia Basterra
      Objetivo Evaluar la prevalencia de alto riesgo de morbilidad psiquiátrica en población adulta española y su cambio entre 2006 y 2012. Métodos Se incluyeron 47.905 participantes de las Encuestas Nacionales de Salud de 2006 y 2012. El estado de salud mental se calculó con la puntuación del Cuestionario de salud general. Se calcularon regresiones logísticas ajustadas. Resultados La prevalencia de alto riesgo de morbilidad psiquiátrica fue del 20,5% en 2012 y del 21,3% en 2006. Usando 2006 como referencia, la odds ratio (OR) de estos problemas en 2012 fue de 0,84 (0,79-0,89) en las mujeres y de 1,10 (1,02-1,18) en los varones. En las mujeres descendió en todas las edades. En los varones, las OR fueron de 1,15 (1,04-1,27), 1,23 (1,08-1,40) y 0,81 (0,68-0,96), para los grupos de edad de 16-44, 45-64 y ≥65 años, respectivamente. Conclusiones La prevalencia de alto riesgo de morbilidad psiquiátrica disminuyó, salvo en los varones <65 años, que son más vulnerables a la crisis económica. Objective To evaluate the prevalence of high risk of psychiatric morbidity in the Spanish adult population and its changes between 2006 and 2012. Methods Data from 47,905 participants obtained from the National Health Surveys in 2006 and 2012 were used. Mental health status was assessed with the General Health Questionnaire score. Adjusted logistic regression models were fitted. Results The prevalence of high risk of psychiatric morbidity was 20.5% in 2012 and 21.3% in 2006. Using 2006 as the reference, the odds ratio (OR) for these problems in 2012 was 0.84 (0.79–0.89) in women and 1.10 (1.02–1.18) in men. In women, it decreased for all ages. In men, these ORs were 1.15 (1.04–1.27) in the aged 16–44 group, 1.23 (1.08–1.40) in the aged 45–64 group and 0.81 (0.68–0.96) in the aged ≥ 65 group. Conclusions The prevalence of high risk of psychiatric morbidity decreased except in males <65 years of age, who are more sensitive to the economic crisis.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2017.01.004
  • Características del uso inadecuado de medicamentos en pacientes
           pluripatológicos de edad avanzada

    • Authors: Paula Carlota Rivas-Cobas; Nieves Ramírez-Duque; Mercedes Gómez Hernández; Juana García; Antonia Agustí; Xavier Vidal; Francesc Formiga; Alfonso López-Soto; Olga H. Torres; Antonio San-José
      Pages: 327 - 331
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Paula Carlota Rivas-Cobas, Nieves Ramírez-Duque, Mercedes Gómez Hernández, Juana García, Antonia Agustí, Xavier Vidal, Francesc Formiga, Alfonso López-Soto, Olga H. Torres, Antonio San-José
      Objetivo Analizar el uso inadecuado de medicamentos en pacientes pluripatológicos de edad avanzada. Método Estudio multicéntrico, observacional y prospectivo. Se reclutaron 672 pacientes mayores de 75 años hospitalizados en Medicina Interna entre abril de 2011 y marzo de 2012. Se utilizaron los criterios Beers, STOPP-START y ACOVE para detectar el uso inadecuado de medicamentos, y los resultados se compararon entre pacientes pluripatológicos y no pluripatológicos. Resultados De 672 pacientes incluidos, 419 (62%) eran pluripatológicos y el 89,3% de ellos presentaban un uso inadecuado de medicamentos, frente al 79,4% de los no pluripatológicos (p <0,01). El 40,3% de los pacientes pluripatológicos cumplía criterios de Beers, el 62,8% criterios STOPP, el 62,3% criterios START y el 65,6% criterios ACOVE. El uso inadecuado de medicamentos fue mayor en los pacientes pluripatológicos con independencia de la herramienta utilizada. Conclusiones La alta prevalencia de uso inadecuado de medicamentos en pacientes pluripatológicos hace necesario desarrollar estrategias para mejorar la adecuación farmacológica. Objective To analyse potentially inappropriate prescribing (PIP) in elderly polypathological patients (PP). Method Multicentre observational, prospective study of 672 patients aged 75 years and older hospitalised in Internal Medicine between April 2011 and March 2012. The Beers, STOPP-START and ACOVE criteria were used to detect potentially inappropriate prescribing and the results of PP and non-PP patients were compared. Results Of the 672 patients included, 419 (62%) were polypathological, of which 89.3% met PIP criteria versus 79.4% of non-polypathological patients (p <0.01). 40.3% of polypathological patients met at least one Beers criteria, 62.8% at least one STOPP criteria, 62.3% at least one START criteria and 65.6% at least one ACOVE criteria. The rate of potentially inappropriate prescribing was higher in polypathological patients regardless of the tool used. Conclusions Given the high rate of potentially inappropriate prescribing in polypathological patients, strategies to improve prescribing adequacy must be developed.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.06.013
  • Multiple lifestyle risk behaviours and excess weight among adolescents in
           Barcelona, Spain

    • Authors: Xavier Continente; Anna Pérez; Albert Espelt; Carles Ariza; María José López
      Pages: 332 - 335
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Xavier Continente, Anna Pérez, Albert Espelt, Carles Ariza, María José López
      Objective We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain. Methods A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire. Results More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR=1.56; 95% confidence interval: 1.19-2.05). Conclusions These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2017.01.003
  • Imputación de valores ausentes en salud pública: conceptos generales y
           aplicación en variables dicotómicas

    • Authors: Gilma Hernández; David Moriña; Albert Navarro
      Pages: 342 - 345
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Gilma Hernández, David Moriña, Albert Navarro
      Que haya valores ausentes en variables registradas en encuestas de salud es habitual, pero no lo es imputarlos posteriormente cuando se realiza el análisis. Trabajar con datos imputados puede tener ventajas en términos de precisión de los estimadores y de identificación sin sesgos de la asociación entre variables. Probablemente, el proceso de imputación sigue siendo desconocido para muchos profesionales no estadísticos, que le atribuyen una alta complejidad y quizás un objetivo que no es exactamente el que persigue. Para aclarar estas cuestiones, esta nota pretende ofrecer una visión amena, no exhaustiva, del proceso de imputación, que permita conocer sus bondades para el trabajo de un salubrista. Todo ello en el marco de variables dicotómicas, habituales en salud pública. Para ilustrar los conceptos se usa un ejemplo en el cual se trabaja con datos con valores ausentes, imputados de forma simple y múltiple. The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2017.01.001
  • Intervenciones que incluyen webs y redes sociales: herramientas e
           indicadores para su evaluación

    • Authors: María José López; Xavier Continente; Esther Sánchez; Montse Bartroli
      Pages: 346 - 348
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): María José López, Xavier Continente, Esther Sánchez, Montse Bartroli
      En el ámbito de la salud, las tecnologías de la información y la comunicación (TIC) pueden generar un espacio que, sin depender del lugar o del tiempo, permite compartir y difundir información rápidamente. A los retos habituales de la evaluación de intervenciones en salud pública, en la evaluación de intervenciones con TIC se añaden otras dificultades, como la falta de estándares previos, el desconocimiento sobre la exposición individual o la falta de información sobre las características de las personas expuestas. El objetivo de esta nota es describir algunas herramientas e indicadores que pueden contribuir a evaluar el alcance, la utilización y algunos parámetros relacionados con el posicionamiento de las páginas web, así como de las redes sociales vinculadas. In the field of health, information and communication technology (ICT) can create a space that, regardless of place or time, enables information to be shared and disseminated quickly. In addition to the usual challenges of evaluating public health activities, other difficulties are present when evaluating activities using ICT, such as lack of previous standards, unknown individual exposure or lack of information on the characteristics of those exposed. The aim of this paper is to describe some tools and indicators that may help to assess the scope, use and parameters related to website positioning on search engines as well as the connected social networks.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.12.006
  • Priorización de intervenciones sanitarias. Revisión de criterios,
           enfoques y rol de las agencias de evaluación

    • Authors: Leonor Varela-Lema; Gerardo Atienza-Merino; Marisa López-García
      Pages: 349 - 357
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Leonor Varela-Lema, Gerardo Atienza-Merino, Marisa López-García
      Objetivo El presente trabajo surge con el propósito de desarrollar una metodología explícita para la selección de prioridades sanitarias que apoye la toma de decisiones sobre las tecnologías a evaluar de cara a su inclusión en la cartera de servicios del Sistema Nacional de Salud. El objetivo principal es identificar y analizar los criterios, procesos y marcos conceptuales empleados para la priorización de intervenciones sanitarias en el ámbito nacional e internacional. Método Se ha llevado a cabo una revisión exhaustiva de la literatura. Para ello, se ha buscado en las principales bases de datos biomédicas y se han revisado las páginas web de las principales agencias de evaluación, entre otras fuentes. Resultados En términos generales, se encontró que no existen criterios universales ni procedimientos estándar para la asignación de prioridades, aunque se han identificado algunos acuerdos y tendencias comunes respecto a aspectos fundamentales (criterios, modelos y estrategias, actores clave, etc.). Globalmente se identificaron ocho dominios críticos: 1) necesidad de la intervención; 2) resultados en salud; 3) tipo de beneficio de la intervención; 4) consecuencias económicas; 5) conocimiento existente sobre la intervención/calidad e incertidumbre de la evidencia; 6) implementación y complejidad de la intervención/factibilidad; 7) prioridad, justicia y ética; y 8) contexto global. Conclusiones La revisión proporciona un análisis detallado de los aspectos relevantes y ofrece recomendaciones clave para el desarrollo de un marco de priorización nacional. Se plantea que esta información podría ser útil para diferentes organizaciones públicas que pretendan establecer prioridades sanitarias. Objective This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. Method An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. Results In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. Conclusions The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities.

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.09.015
  • Másteres en economía de la salud en España. Una formación útil y bien

    • Authors: Manuel Correa; Manuel Ruiz-Adame Reina; Nuria García-Agua Soler
      Pages: 358 - 359
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Manuel Correa, Manuel Ruiz-Adame Reina, Nuria García-Agua Soler

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.12.019
  • The double burden of malnutrition: a threat for Peruvian childhood

    • Authors: J. Smith Torres-Roman; Diego Azañedo; Eloy F. Ruiz; José L. Avilez; Germán Málaga
      Pages: 359 - 360
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): J. Smith Torres-Roman, Diego Azañedo, Eloy F. Ruiz, José L. Avilez, Germán Málaga

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.09.011
  • Pasar de Quijote a Sancho y siempre pensar como Robin Hood. José María
           Mayoral (1956-2016): médico y epidemiólogo

    • Authors: Pere Godoy; Rosa Cano; María-José Sierra; Nuria Aragonés; Anxela Pousa; Ana Gandarillas; María-Antonia Galmés; Mauro Ramos; Eva Ardanaz; Francisco González
      Pages: 361 - 362
      Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4
      Author(s): Pere Godoy, Rosa Cano, María-José Sierra, Nuria Aragonés, Anxela Pousa, Ana Gandarillas, María-Antonia Galmés, Mauro Ramos, Eva Ardanaz, Francisco González

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.12.016
  • Exposición ambiental a dióxido de nitrógeno y salud respiratoria a los
           2 años en la Cohorte INMA-Valencia

    • Authors: Alejandra Gutiérrez Oyarce; Amparo Ferrero; Marisa Estarlich; Ana Esplugues; Carmen Iñiguez; Ferran Ballester
      Abstract: Publication date: Available online 26 July 2017
      Source:Gaceta Sanitaria
      Author(s): Alejandra Gutiérrez Oyarce, Amparo Ferrero, Marisa Estarlich, Ana Esplugues, Carmen Iñiguez, Ferran Ballester
      Objetivo Analizar la relación entre la exposición a dióxido de nitrógeno (NO2) en las etapas prenatal y posnatal y la incidencia de problemas respiratorios en niños/as hasta los 2 años de edad. Método La población consistió en 624 niños/as de la cohorte INMA-Valencia. Se estimó la exposición individual al NO2 en el exterior de la vivienda durante el periodo prenatal y hasta los 2 años de edad, a partir de la combinación de datos empíricos y el desarrollo de métodos geoestadísticos. Se aplicó un cuestionario para obtener la información sobre los síntomas respiratorios a los 2 años. La asociación entre la exposición al NO2 y los eventos respiratorios se realizó mediante regresión logística multivariante. Resultados La incidencia acumulada fue del 16,3% para tos persistente, del 34,9% para episodios de sibilancias y del 27,6% para las infecciones respiratorias de vías bajas. No se encontró asociación entre los síntomas respiratorios y la exposición al NO2 en el conjunto de los/las niños/as. Sin embargo, sí se encontró una asociación entre la exposición al NO2 y la tos persistente en el segundo año de vida en los/las niños/as con antecedentes familiares de alergias. Conclusión La exposición al NO2 ambiental contribuiría a la presencia de tos persistente en los/las niños/as con antecedentes familiares de alergias. Objective To analyze the association between exposure to nitrogen dioxide (NO2) during pregnancy and the postnatal period up to the age of 2 years old and the incidence of respiratory problems in children from the INMA-Valencia cohort. Methods The study population included 624 children from the INMA-Valencia cohort. Individual exposure to NO2 was estimated in different environments outside the home during pregnancy and up to the age of 2 using empirical measurement and data from geo-statistical methods. Respiratory symptoms were obtained from a questionnaire applied at the age of two. The association between NO2 exposure and respiratory symptoms was performed using multivariate logistic regression. Results The cumulative incidence was 16.3% for persistent cough, 34.9% for wheezing and 27.6% for lower respiratory tract infections. No association was found between respiratory symptoms and exposure to NO2 in any of the children. However an association between NO2 exposure and persistent cough was found at two years of life in the children with a parental history of allergy. Conclusion NO2 exposure would lead to persistent cough in children with a parental history of allergies.

      PubDate: 2017-08-03T01:58:21Z
      DOI: 10.1016/j.gaceta.2017.05.012
  • Exploring the role of social capital in urban citizens’ initiatives
           in the Netherlands

    • Authors: Carlijn Wentink; Lenneke Vaandrager; Rosalie van Dam; Jan Hassink; Irini Salverda
      Abstract: Publication date: Available online 25 July 2017
      Source:Gaceta Sanitaria
      Author(s): Carlijn Wentink, Lenneke Vaandrager, Rosalie van Dam, Jan Hassink, Irini Salverda
      Objective This research explores the role of social capital in urban citizens’ initiatives in the Netherlands, by using in-depth interviews. Method Social capital was operationalized as shared norms and values, connectedness, trust and reciprocity. Results The findings show that initiatives form around a shared idea or ambition (shared norms and values). An existing network of relationships (connectedness) is needed for an idea to emerge and take form. Connectedness can also increase as a result of an initiative. Some level of trust between people needs to be present from the start of the initiative. For the initiative to persist, strong in-group connections seem important, as well as a good balance between investments and returns. This reciprocity is mainly about intangible assets, such as energy and friendship. Conclusion This study concludes that social capital within citizens’ initiatives is both a prerequisite for the formation of initiatives and a result of the existence of initiatives.

      PubDate: 2017-08-03T01:58:21Z
      DOI: 10.1016/j.gaceta.2017.05.011
  • Publicaciones científicas de los directivos de investigación de las
           escuelas de medicina del Perú

    • Authors: Christian Ponce-Torres; Alejandro Zevallos-Morales; Luis G. Aguirre
      Abstract: Publication date: Available online 24 July 2017
      Source:Gaceta Sanitaria
      Author(s): Christian Ponce-Torres, Alejandro Zevallos-Morales, Luis G. Aguirre

      PubDate: 2017-08-03T01:58:21Z
      DOI: 10.1016/j.gaceta.2017.05.013
  • La prevención y el control de la iatrogenia requieren varios frentes y
           alianzas. SESPAS llama a la colaboración

    • Authors: Beatriz González López-Valcárcel; Carlos Campillo-Artero
      Abstract: Publication date: Available online 16 June 2017
      Source:Gaceta Sanitaria
      Author(s): Beatriz González López-Valcárcel, Carlos Campillo-Artero

      PubDate: 2017-08-03T01:58:21Z
      DOI: 10.1016/j.gaceta.2017.04.001
  • Getting to grips with context and complexity − the case for realist

    • Authors: Geoff Wong
      Abstract: Publication date: Available online 20 July 2017
      Source:Gaceta Sanitaria
      Author(s): Geoff Wong

      PubDate: 2017-07-24T03:17:59Z
      DOI: 10.1016/j.gaceta.2017.05.010
  • Contra la llamada gestación subrogada. Derechos humanos y justicia global
           versus bioética neoliberal

    • Authors: María José Guerra-Palmero
      Abstract: Publication date: Available online 13 July 2017
      Source:Gaceta Sanitaria
      Author(s): María José Guerra-Palmero

      PubDate: 2017-07-24T03:17:59Z
      DOI: 10.1016/j.gaceta.2017.05.009
  • Drivers for human papillomavirus vaccination in Valencia (Spain)

    • Authors: Pedro Navarro-Illana; Esther Navarro-Illana; Rafael Vila-Candel; Javier Díez-Domingo
      Abstract: Publication date: Available online 13 July 2017
      Source:Gaceta Sanitaria
      Author(s): Pedro Navarro-Illana, Esther Navarro-Illana, Rafael Vila-Candel, Javier Díez-Domingo
      Objective To describe the drivers associated with HPV vaccination in adolescent girls and their parent's opinion on the vaccine. Methods We conducted an observational and cross-sectional study on adolescent girls and their parents in Valencia (Spain), between September 2011 and June 2012. A consultation was made at a random sample of schools of the 14-year-old girls that should have received the vaccine in the free vaccination programme. We ran a personal survey on knowledge and attitudes regarding HPV infection and the vaccine. A binary logistic regression model was performed to determine which factors were most associated with vaccination. Results The survey was run on a binomial of 1,278 girls/mothers in 31 schools, to which 833 girls and their mothers responded (64.0%). The factors associated with vaccination were: country of origin of the families (adjusted OR [aOR]: 0.49; 95% confidence interval [95%CI]: 0.24-0.98), civil status of the parents (aOR: 0.33; 95%CI: 0.13-0.81), knowledge/beliefs about the vaccine when the source of information was the nurse (aOR: 1.83; 95%CI: 1.01-3.35), information source about the vaccine (aOR: 2.32; 95%CI: 1.37-3.92), preventive health centre visits (aOR: 2.1; 95%CI: 1.10-4.07), and nurse advice (aOR: 6.6; 95%CI: 3.19-13.56). Conclusions The main factor associated with HPV vaccination was the advice of health professionals. Therefore, the most effective interventions to improve vaccination coverage should focus on health professionals.

      PubDate: 2017-07-24T03:17:59Z
      DOI: 10.1016/j.gaceta.2017.05.008
  • Efectividad de una estrategia de apoyo individualizado al empleo para
           personas con trastornos mentales graves

    • Authors: Francisco Rodríguez Pulido; Nayra Caballero Estebaranz; Elena Tallo Aldana; Manuel E. Méndez Abad; M. Carmen Hernández Álvarez-Sotomayor; Susana López Reig; Patricia Inés Vílchez de León; Enrique González-Dávila
      Abstract: Publication date: Available online 13 July 2017
      Source:Gaceta Sanitaria
      Author(s): Francisco Rodríguez Pulido, Nayra Caballero Estebaranz, Elena Tallo Aldana, Manuel E. Méndez Abad, M. Carmen Hernández Álvarez-Sotomayor, Susana López Reig, Patricia Inés Vílchez de León, Enrique González-Dávila
      Objetivo Valorar la efectividad de una estrategia de apoyo individualizado al empleo (IPS) en personas con enfermedad mental grave en la isla de Tenerife (España). Método Pacientes de los Servicios de Salud Mental Comunitaria con trastornos mentales graves fueron asignados a dos grupos de forma aleatorizada. En uno de ellos se aplicó el método IPS (n=124) y en el grupo control (n=75) se asesoró en la manera habitual de búsqueda de empleo. Los pacientes fueron seguidos una media de 3,4 años y se analizó cuántos trabajaron al menos un día, el tiempo trabajado, los salarios, el número de contratos y el número de admisiones hospitalarias. Se usaron métodos estadísticos no paramétricos en la comparación de resultados (U de Mann-Whitney). Resultados Los pacientes asignados al grupo IPS trabajaron al menos un día el 99%, frente al 75% del grupo control; trabajaron de media 30,1 semanas/año vs. 7,4; el salario mensual fue de 777,9 euros vs. 599,9 euros; el número de contratos por persona fue de 3,89 vs. 4,85, y los ingresos hospitalarios fueron 0,19 vs. 2,1. Conclusión La estrategia IPS es efectiva en la integración laboral de personas con enfermedad mental grave, logrando que trabajen más tiempo, tengan mayor salario y menos ingresos hospitalarios, en un contexto social de alto desempleo. Objective To assess the effectiveness of an individual placement and support (IPS) strategy in people with severe mental disorders in Tenerife Island (Spain). Methods Patients of Community Mental Health Services with severe mental disorders were randomly assigned to two groups. One of them received IPS (n=124), and the control group (n=75) was advised in the usual job search. Patients were followed up for an average of 3.4 years and an analysis was made of how many patients worked at least one day, working hours, wages, the number of contracts and the number of hospital admissions. Non-parametric methods were used to compare the results (Mann-Whitney U test). Results The percentage of patients who worked at least one day was 99% in the IPS group compared with 75% in the control group; they worked on average 30.1 weeks per year vs 7.4; the monthly salary was € 777.9 vs € 599.9; the number of contracts per person was 3.89 vs 4.85, and hospital admissions were 0.19 vs 2.1. Conclusions The IPS strategy is effective for the labour integration of people with severe mental illness getting them to work longer, have higher wages and fewer hospital admissions.

      PubDate: 2017-07-24T03:17:59Z
      DOI: 10.1016/j.gaceta.2017.05.007
  • Salud Pública (también) para las personas migrantes y refugiadas
           en Europa

    • Authors: Ainhoa Rodríguez-García-de-Cortázar; Ainhoa Ruiz-Azarola; Olga Leralta-Piñán; Jaime Jiménez-Pernett; José Ignacio Oleaga-Usategui
      Abstract: Publication date: Available online 12 July 2017
      Source:Gaceta Sanitaria
      Author(s): Ainhoa Rodríguez-García-de-Cortázar, Ainhoa Ruiz-Azarola, Olga Leralta-Piñán, Jaime Jiménez-Pernett, José Ignacio Oleaga-Usategui

      PubDate: 2017-07-24T03:17:59Z
      DOI: 10.1016/j.gaceta.2017.05.005
  • Relevancia del contexto socioeconómico y sanitario en la
           satisfacción del paciente

    • Authors: Shirley Pérez-Romero; Juan J. Gascón-Cánovas; Diego Salmerón-Martínez; Pedro Parra-Hidalgo; Olga Monteagudo-Piqueras
      Abstract: Publication date: Available online 11 July 2017
      Source:Gaceta Sanitaria
      Author(s): Shirley Pérez-Romero, Juan J. Gascón-Cánovas, Diego Salmerón-Martínez, Pedro Parra-Hidalgo, Olga Monteagudo-Piqueras
      Objetivo Determinar qué factores de los contextos socioeconómico y sanitario influyen sobre la percepción de la satisfacción de la población con los servicios de salud. Método Los datos provienen de la Encuesta Europea de Salud de 2009. En los 22.188 sujetos encuestados se estudió la relación entre percepción de la satisfacción con los servicios sanitarios recibidos y las variables tanto individuales como contextuales, aplicando un análisis multinivel. Resultados Los factores de los contextos socioeconómico y sanitario que influyen sobre la satisfacción son las mayores tasas de población sin estudios, en la cual la percepción de excelencia es menos probable (odds ratio [OR]: 0,48-0,82) y la insatisfacción es más prevalente (OR: 1,46-1,63). Asimismo, la proporción de personas insatisfechas es menor cuando el gasto per cápita en servicios sanitarios es muy elevado (>1400 €) (OR: 0,49-0,87) y la ratio entre médicos de atención primaria de salud y habitantes es alta (>60) (OR: 0,50-0,85). Además, la prevalencia de insatisfacción describe una tendencia lineal positiva con la tasa de paro (OR: 1,12; p=0,0001) y la magnitud relativa del sector servicios (OR:1,03; p=0,001). Por el contrario, esta tendencia lineal es negativa conforme aumenta el índice de cobertura de la prestación sanitaria (OR: 0,88; p=0,04). Conclusiones Los factores individuales que determinan la satisfacción del paciente son el sexo, la edad, la salud mental y el país de nacimiento. Además, hay diferencias en la satisfacción del paciente entre las comunidades autónomas de acuerdo con determinantes socioeconómicos, como el producto interior bruto per cápita, las tasas de población sin estudios, las tasas de paro o la ratio número de habitantes/consultorios. Los estudios de satisfacción del usuario, además de ajustarse por variables individuales como el sexo, la edad o el nivel de salud, también deberían tomar en consideración características del entorno socioeconómico del área geográfica de residencia. Objective To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. Methods The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. Results The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio “primary health care physicians/inhabitants” is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04).
      PubDate: 2017-07-12T03:10:06Z
      DOI: 10.1016/j.gaceta.2017.05.003
  • Argumentos para la necesaria regulación de la gestación por

    • Authors: Eleonora Lamm
      Abstract: Publication date: Available online 11 July 2017
      Source:Gaceta Sanitaria
      Author(s): Eleonora Lamm

      PubDate: 2017-07-12T03:10:06Z
      DOI: 10.1016/j.gaceta.2017.04.009
  • Conocimientos tácito y explícito: análisis comparativo de la
           priorización de problemas de salud materna en México

    • Authors: Estephania Moreno Zegbe; Víctor Becerril Montekio; Jacqueline Alcalde Rabanal
      Abstract: Publication date: Available online 4 July 2017
      Source:Gaceta Sanitaria
      Author(s): Estephania Moreno Zegbe, Víctor Becerril Montekio, Jacqueline Alcalde Rabanal
      Objetivo Identificar coincidencias y diferencias en la identificación y la priorización de problemas de los servicios de salud materna en México, desde las perspectivas del conocimiento tácito y el conocimiento explícito, que ofrezcan evidencias que contribuyan a alcanzar los Objetivos de Desarrollo Sostenible. Método Estudio mixto, realizado en tres etapas: 1) sistematización de problemas de los servicios de atención a la salud materna identificados por el conocimiento tácito (derivado de la experiencia profesional); 2) identificación de problemas de los servicios de atención a la salud materna en América Latina abordados por el conocimiento explícito (publicaciones científicas); 3) comparación de problemas identificados por los conocimientos tácito y explícito. Resultados Los principales problemas identificados según el conocimiento tácito están vinculados con la mala calidad de la atención, mientras que aquellos mayormente abordados por el conocimiento explícito se refieren a barreras de acceso a la atención en los servicios de salud. Aproximadamente el 70% de los problemas identificados en el conocimiento tácito son señalados en el conocimiento explícito. Paralelamente, el 70% de los problemas identificados en la literatura también son considerados por el conocimiento tácito. No obstante, al comparar los problemas uno a uno no se encuentran similitudes estadísticamente significativas entre ambos enfoques. Conclusiones El estudio mostró que la identificación de problemas en los servicios de atención a la salud materna por el conocimiento tácito y por el conocimiento explícito es medianamente comparable, según el índice de comparabilidad utilizado, y subraya el interés de integrar ambos abordajes a fin de mejorar la priorización y la toma de decisiones hacia los Objetivos de Desarrollo Sostenible. Objective To identify coincidences and differences in the identification and prioritization of maternal healthcare service problems in Mexico based on the perspective of tacit knowledge and explicit knowledge that may offer evidence that can contribute to attaining the Sustainable Development Goals. Methods Mixed study performed in three stages: 1) systematization of maternal healthcare service problems identified by tacit knowledge (derived from professional experience); 2) identification of maternal healthcare service problems in Latin America addressed by explicit knowledge (scientific publications); 3) comparison between the problems identified by tacit and explicit knowledge. Results The main problems of maternal health services identified by tacit knowledge are related to poor quality of care, while the predominant problems studied in the scientific literature are related to access barriers to health services. Approximately, 70% of the problems identified by tacit knowledge are also mentioned in the explicit knowledge. Conversely, 70% of the problems identified in the literature are also considered by tacit knowledge. Nevertheless, when looking at the problems taken one by one, no statistically significant similarities were found. Conclusions The study discovered that the identification of maternal health service problems by tacit knowledge and explicit knowledge is fairly comparable, according to the comparability index used in the study, and high...
      PubDate: 2017-07-12T03:10:06Z
      DOI: 10.1016/j.gaceta.2017.04.006
  • La priorización comunitaria en el programa Barcelona Salut als Barris

    • Authors: Esther Sánchez-Ledesma; Anna Pérez; Noelia Vázquez; Irene García-Subirats; Ana Fernández; Ana M. Novoa; Ferran Daban
      Abstract: Publication date: Available online 29 June 2017
      Source:Gaceta Sanitaria
      Author(s): Esther Sánchez-Ledesma, Anna Pérez, Noelia Vázquez, Irene García-Subirats, Ana Fernández, Ana M. Novoa, Ferran Daban
      Priorizar es el proceso de selección y ordenación de las necesidades en salud identificadas tras el diagnóstico de necesidades y activos en salud de una comunidad. La valoración de las necesidades en salud se ha reforzado con la perspectiva comunitaria, lo que aporta múltiples beneficios: sensibiliza y empodera a la comunidad sobre su salud, fomenta el apoyo mutuo entre sus integrantes y promueve su protagonismo haciéndola corresponsable del proceso de mejora de su propia realidad. El objetivo de esta nota es describir el modelo de priorización de Barcelona Salut als Barris, estrategia de salud comunitaria liderada por la Agencia de Salud Pública de Barcelona para promover la equidad en salud en los barrios más desfavorecidos de la ciudad. Prioritizing corresponds to the process of selecting and managing health needs identified after diagnosing the community's health needs and assets. Recently, the health needs assessment has been reinforced with the community perspective, providing multiple benefits: it sensitizes and empowers the community about their health, encourages mutual support among its members and promotes their importance by making them responsible for the process of improving their own reality. The objective of this paper is to describe the prioritization of Barcelona Salut als Barris, a community health strategy led by the Barcelona Public Health Agency to promote equity in health in the most disadvantaged neighborhoods of the city.

      PubDate: 2017-07-03T13:21:40Z
      DOI: 10.1016/j.gaceta.2017.04.005
  • Citizens’ perceptions of the presence and health risks of synthetic
           chemicals in food: results of an online survey in Spain

    • Authors: José Pumarega; Cristina Larrea; Araceli Muñoz; Natàlia Pallarès; Magda Gasull; Giselle Rodriguez; Manel Jariod; Miquel Porta
      Abstract: Publication date: Available online 27 June 2017
      Source:Gaceta Sanitaria
      Author(s): José Pumarega, Cristina Larrea, Araceli Muñoz, Natàlia Pallarès, Magda Gasull, Giselle Rodriguez, Manel Jariod, Miquel Porta
      Objective To explore factors influencing perceptions and viewpoints on the responsibility for the presence of toxic substances in food, on enforcement of laws and regulations that control human exposure to toxic substances in food, and on the effectiveness of such regulations. Methods An online survey was completed by 740 individuals from several parts of Spain (median age, 47 years; 67% were women; 70% had completed university studies). Results Over 87% of respondents said that it was possible that throughout their lives they could have accumulated in their body toxic substances potentially dangerous to their health. The attribution of the responsibility for toxic substances in food to a larger number of social groups was more frequent among respondents who consulted information about the problem more often (odds ratio [OR]: 1.92), who correctly identified factors that increase the likelihood of toxic substances in food being harmful to human health (OR: 2.86), who better knew the health problems that may be caused by such substances (OR: 2.48), and who recognised more food groups that tend to have concentrations of toxic substances potentially harmful to health (OR: 2.92) (all p values <0.001). Women were 65% less likely than men to answer that regulations on toxic substances in food are effective (p<0.001); and so were participants who identified more food groups with potentially toxic concentrations. Conclusions Among study participants there was a widespread scepticism and distrust towards the enforcement and effectiveness of laws and regulations that in Spain aim to control human exposure to toxic substances in food.

      PubDate: 2017-07-03T13:21:40Z
      DOI: 10.1016/j.gaceta.2017.03.012
  • Assessing gender stereotypes and sexual risk practices in men who have sex
           with men

    • Authors: Ángel Gasch Gallén; Concepción Tomás Aznar; Encarnación Rubio Aranda
      Abstract: Publication date: Available online 23 June 2017
      Source:Gaceta Sanitaria
      Author(s): Ángel Gasch Gallén, Concepción Tomás Aznar, Encarnación Rubio Aranda
      Objective To analyze the construct validity and the internal consistency of the 12-item Bem Sex Role Inventory (BSRI-12) questionnaire and to study the association between gender stereotypes and sexual risk practices in men who have sex with men (MSM). Methods Cross-sectional study of 601 MSM who voluntarily and anonymously responded to an online survey on risk practices and gender stereotypes. The BSRI-12 was used to obtain gender stereotypes (masculine, feminine, undifferentiated and androgynous). For data analysis, exploratory factor analysis (EFA) of the BSRI-12 and logistic regression were performed. Results Two main factors (Cronbach alpha 0.95 and 0.81) were obtained from the EFA. Using the androgynous roles as the reference category, we found lower odds of engaging in unprotected anal intercourse (UAI) among those who endorse feminine roles (OR: 0.53; 95%CI: 0.29-0.95). Endorsing masculine roles with alcohol consumption (OR: 1.92; 95%CI: 1.15-3.20) or the undifferentiated when not knowing the partner's serological status (OR: 1.55; 95%CI: 1.02-2.35) were associated with higher odds of UAI compared to those endorsing the androgynous roles. Undifferentiated participants also perform receptive UAI using poppers (OR: 2.19; 95%CI: 1.24-3.87), and insertive UAI not knowing the serological status of the sexual partner (OR: 1.69; 95%CI: 1.04-2.76) compared to androgynous participants. Conclusion The BSRI is a valid and consistent instrument for identifying gender stereotypes in MSM. A greater proportion of participants within the undifferentiated and the masculine category engage in risk practices with the influence of substance consumption and unawareness of their sexual partner's serological status. The information obtained may be useful to define intervention and prevention programs.

      PubDate: 2017-07-03T13:21:40Z
      DOI: 10.1016/j.gaceta.2017.05.001
  • The theft of well-being: a comment on Zunzunegui et al

    • Authors: Usama Bilal; Jay S. Kaufman
      Abstract: Publication date: Available online 22 June 2017
      Source:Gaceta Sanitaria
      Author(s): Usama Bilal, Jay S. Kaufman

      PubDate: 2017-07-03T13:21:40Z
      DOI: 10.1016/j.gaceta.2017.04.004
  • Hombres que tienen sexo con hombres y detección del virus de la
           inmunodeficiencia humana en odontología

    • Authors: Jesús Eduardo Elizondo; Ana Cecilia Treviño; Deborah Violant; Ana María Rivas-Estilla; Mario Moisés Álvarez
      Abstract: Publication date: Available online 21 June 2017
      Source:Gaceta Sanitaria
      Author(s): Jesús Eduardo Elizondo, Ana Cecilia Treviño, Deborah Violant, Ana María Rivas-Estilla, Mario Moisés Álvarez
      Objetivo Determinar la percepción de hombres que tienen sexo con hombres (HSH) sobre la aplicación de la prueba rápida del virus de la inmunodeficiencia humana (VIH) 1/2 en el consultorio odontológico, y evaluar el estigma y la discriminación asociados a la orientación sexual percibidos en la consulta odontológica. Método Estudio transversal mediante cuestionario autoadministrado y estructurado de tipo analítico contestado anónimamente por 185 HSH en México. Además de las variables sociodemográficas, la percepción sobre los servicios y los prestadores de servicios odontológicos, y sobre la aplicación de la prueba rápida anti VIH-1/2, se diseñó y exploró mediante una escala psicométrica tipo Likert la percepción del estigma y la discriminación asociados a la orientación sexual. El análisis estadístico incluyó análisis factorial y análisis de clusters no jerárquico. Resultados El 86,5% se mostró a favor de la aplicación de la prueba del VIH-1/2 en la consulta odontológica. El 91,9% considera importante que el odontólogo esté capacitado y sensibilizado para realizar la prueba. El análisis factorial reveló dos factores: experiencias de estigma y discriminación en la consulta odontológica, y sentimientos de preocupación por la actitud del odontólogo o su personal hacia su orientación sexual. El análisis de clusters identificó tres grupos: usuarios que no han experimentado estigma ni discriminación (90,3%); usuarios que no han experimentado estigma ni discriminación, pero que sienten una ligera preocupación (8,1%); y usuarios que han experimentado algún tipo de estigma y discriminación, y sienten preocupación (1,6%). Conclusión La consulta odontológica podría representar una ubicación para realizar la prueba rápida del VIH-1/2, contribuyendo en el diagnóstico temprano de la infección. Objective To explore the attitudes of men who have sex with men (MSM) towards the implementation of rapid HIV-1/2 testing in the dental practice, and to evaluate MSM's perceptions of stigma and discrimination related to sexual orientation by dental care professionals. Methods Cross-sectional study using a self-administered, anonymous, structured analytical questionnaire answered by 185 MSM in Mexico. The survey included sociodemographic variables, MSM's perceptions towards public and private dental providers, and dental services, as well as their perception towards rapid HIV-1/2 testing in the dental practice. In addition, the perception of stigma and discrimination associated with their sexual orientation was explored by designing a psychometric Likert-type scale. The statistical analysis included factor analysis and non-hierarchical cluster analysis. Results 86.5% of the respondents expressed their willingness to take a rapid HIV-1/2 screening test during their dental visit. Nevertheless, 91.9% of them considered it important that dental professionals must be well-trained before administering any rapid HIV-1/2 tests. Factor analysis revealed two factors: experiences of sexual orientation stigma and discrimination in dental settings, and feelings of concern about the attitude of the dentist and dental staff towards their sexual orientation. Based on these factors and cluster analysis, three user profiles were identified: users who have not experienced stigma and discrimination (90.3%); users who have not experienced stigma and discrimination, but feel a slight concern (8.1%), and users who...
      PubDate: 2017-06-22T04:52:49Z
      DOI: 10.1016/j.gaceta.2017.04.008
  • Cribado in situ de la enfermedad de Chagas con una intervención
           comunitaria: ¿puede mejorar la accesibilidad al diagnóstico y al

    • Authors: Hakima Ouaarab Essadek; Isabel Claveria Guiu; Johanna Caro Mendivelso; Elena Sulleiro; Conxita Pastoret; Miriam Navarro; Irene Barrabeig; Jordi Gómez i Prat
      Abstract: Publication date: Available online 20 June 2017
      Source:Gaceta Sanitaria
      Author(s): Hakima Ouaarab Essadek, Isabel Claveria Guiu, Johanna Caro Mendivelso, Elena Sulleiro, Conxita Pastoret, Miriam Navarro, Irene Barrabeig, Jordi Gómez i Prat

      PubDate: 2017-06-22T04:52:49Z
      DOI: 10.1016/j.gaceta.2017.04.007
  • Línea de atención telefónica sobre virus Zika: experiencia de una
           unidad de medicina tropical y del viajero

    • Authors: Marta Díaz-Menéndez; Fernando de la Calle-Prieto; Marta Arsuaga; Elena Trigo; Concepción Ladrón de Guevara; Pablo Barreiro; Clara Crespillo; Mar Lago
      Abstract: Publication date: Available online 20 June 2017
      Source:Gaceta Sanitaria
      Author(s): Marta Díaz-Menéndez, Fernando de la Calle-Prieto, Marta Arsuaga, Elena Trigo, Concepción Ladrón de Guevara, Pablo Barreiro, Clara Crespillo, Mar Lago
      La actual epidemia por virus Zika ha generado gran alarma social, favorecida en parte por la falta de información de la población general. Para proporcionar información veraz y contrastada, la Unidad de Medicina Tropical y del Viajero del Hospital Carlos III-La Paz (Madrid) puso en marcha una línea de atención telefónica sobre la infección por el virus Zika. En este artículo se presentan los datos relativos a los primeros 6 meses de su funcionamiento. El perfil predominante de llamadas corresponde a mujeres solicitando información previa a la realización del viaje. Los destinos sobre los que más información se ha demandado han sido Brasil, Méjico y Colombia. La mayoría de las llamadas se resolvieron ofreciendo información exclusivamente. La implementación de dispositivos de atención telefónica que ofrezcan información contrastada y fiable en el contexto de enfermedades asociadas a gran alarma social es de gran interés sanitario, reduce el número de consultas innecesarias y ahorra costes. The current outbreak of Zika virus has caused great social alarm, generated in part by the lack of information in the general population. In order to provide accurate and verified information, the Tropical and Travel Medicine Unit of Hospital Carlos III-La Paz (Madrid, Spain) established a hotline for Zika virus infection. We present the data concerning the first 6 months of operation of the telephone hotline. The predominant call profile consisted of women seeking information about the risk of acquiring the disease before travelling. Brazil, Mexico and Colombia were the destinations for which the most information was requested. Most of the consultations were resolved by providing information only. The implementation of call devices that provide confirmed and reliable information on diseases associated with great alarm are of significant public health interest, as they reduce the number of unnecessary medical consultations and save on medical costs.

      PubDate: 2017-06-22T04:52:49Z
      DOI: 10.1016/j.gaceta.2017.04.003
  • Gaceta Sanitaria a Primera Vista

    • Abstract: Publication date: July–August 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 4

      PubDate: 2017-06-17T04:13:25Z
  • La financiación de la industria alimentaria y la investigación
           epidemiológica sobre nutrición y salud

    • Authors: Eva María Navarrete-Muñoz; Adonina Tardón; Dora Romaguera; Miguel Ángel Martínez-González; Jesús Vioque
      Abstract: Publication date: Available online 7 June 2017
      Source:Gaceta Sanitaria
      Author(s): Eva María Navarrete-Muñoz, Adonina Tardón, Dora Romaguera, Miguel Ángel Martínez-González, Jesús Vioque
      El interés de la industria alimentaria por financiar investigaciones en temas de nutrición y salud no se limita solo al avance científico. Algunas revisiones sistemáticas han puesto de manifiesto un sesgo en las conclusiones de los estudios que habían recibido financiación de la industria alimentaria, particularmente cuando comunicaban los efectos de las bebidas azucaradas. En este contexto, coincidiendo con la XXXIV Reunión Científica de la Sociedad Española de Epidemiología, el Grupo de Nutrición de esta sociedad organizó una mesa temática titulada Industria alimentaria e investigación epidemiológica para abordar el tema de la conveniencia o no de que la industria alimentaria financie directamente proyectos de investigación, y los posibles conflictos de intereses que pueden derivarse de esta financiación. Todos/as los/las participantes coincidieron en la necesidad de garantizar el rigor y la calidad necesarios en los estudios, y su realización de forma independiente de la financiación recibida, para evitar sesgos que lleven a una pérdida de credibilidad de los resultados de las investigaciones por los posibles conflictos de intereses. El Dr. Pérez-Farinós y la Dra. Romaguera coincidieron en que una forma de evitar conflictos de intereses era impedir que la industria financiara proyectos de investigación; la Dra. Marcos y el Prof. Martínez-González indicaron la conveniencia de establecer mecanismos para evitar que la financiación de la industria influya tanto en la distribución de fondos entre grupos e instituciones como en el análisis y los resultados de las investigaciones, para garantizar al máximo la independencia de los investigadores, así como su ética profesional. The interests of the food industry to fund nutrition and health research are not limited to promoting scientific advances. Recently, several systematic reviews conducted about the effect of sugar-sweetened beverages and health outcomes have shown some biased conclusions in studies that acknowledge industry sponsorship. In this context, the Nutrition Working Group of the Spanish Epidemiology Society presented a scientific session entitled Food industry and epidemiologic research at its annual meeting. In a round table, four experts in nutrition research presented their points of view about whether the food industry should fund nutrition-related research and the related potential conflicts of interest of the food industry. All the experts agreed not only on defending independence in nutritional epidemiology regarding the design, interpretation and conclusion of their studies but also on the crucial need for guaranteed scientific rigor, scientific quality of the results and measures to protect studies against potential biases related to the conflicts of interest of funding by the food industry. Drs Pérez-Farinós and Romaguera believe that the most effective way to prevent conflicts of interest would be not to allow the food industry to fund nutrition research; Drs Marcos and Martínez-González suggested the need to establish mechanisms and strategies to prevent the potential influences of the food industry in selecting researchers or institutional sponsorship and in the analysis and results of the studies, to ensure maximum independence for researchers, as well as their professional ethics.

      PubDate: 2017-06-12T03:12:40Z
      DOI: 10.1016/j.gaceta.2017.04.002
  • El asbesto, una epidemia todavía por controlar

    • Authors: Roberto Alfonso Accinelli; Lidia Marianella López
      Abstract: Publication date: Available online 7 June 2017
      Source:Gaceta Sanitaria
      Author(s): Roberto Alfonso Accinelli, Lidia Marianella López

      PubDate: 2017-06-12T03:12:40Z
      DOI: 10.1016/j.gaceta.2017.02.011
  • Uso de paneles de consumidores en estudios observacionales de salud

    • Authors: Nuria Matilla-Santander; Marcela Fu; Montse Ballbè; Cristina Lidón-Moyano; Juan Carlos Martín-Sánchez; Esteve Fernández; Jose M. Martínez-Sánchez
      Abstract: Publication date: Available online 7 June 2017
      Source:Gaceta Sanitaria
      Author(s): Nuria Matilla-Santander, Marcela Fu, Montse Ballbè, Cristina Lidón-Moyano, Juan Carlos Martín-Sánchez, Esteve Fernández, Jose M. Martínez-Sánchez
      Los paneles de consumidores son una técnica de investigación de mercados de gran utilidad para obtener información sobre clientes poco frecuentes o de difícil acceso. El objetivo de esta nota de campo es exponer nuestra experiencia usando esta técnica para un estudio transversal de salud pública sobre el uso de cigarrillos electrónicos. Después de valorar diferentes técnicas de muestreo no probabilístico para obtener una muestra elevada de usuarios de cigarrillos electrónicos (n=600), se ha optado por el uso del panel de consumidores debido al tiempo relativamente corto para obtener el gran tamaño muestral requerido para el estudio y una buena representatividad de la muestra. Consumer panels are a market research method useful for gathering information about low-frequency or difficult-access customers. The objective of this field-note is to explain our experience using this method in a cross-sectional public health study on the use of electronic cigarettes. After taking into account other non-probabilistic sampling techniques to obtain a huge sample of electronic-cigarette users (n=600), in the end we decided to use consumer panels (recruiters) because of the relative short duration of the field work and the high representativeness of the sample.

      PubDate: 2017-06-12T03:12:40Z
      DOI: 10.1016/j.gaceta.2017.03.011
  • Inequities in visual health and health services use in a rural region in

    • Authors: Sergio Latorre-Arteaga; José Fernández-Sáez; Diana Gil-González
      Abstract: Publication date: Available online 7 June 2017
      Source:Gaceta Sanitaria
      Author(s): Sergio Latorre-Arteaga, José Fernández-Sáez, Diana Gil-González
      Objective To analyse perceived visual health and health services use in a rural population in relation to socioeconomic characteristics and compared with the general population in Spain. Method Cross-sectional study in a rural population using a structured questionnaire including questions comparable to the Spanish National Health Survey (2012). A descriptive analysis was carried out through the calculation of frequencies and prevalence, the χ2 test for independent variables, contrasts of proportions and logistic regression to obtain associations between the rural and general populations and socioeconomic variables. Results For the rural population studied, the prevalence of poor perceptions of visual health is 40.8% in men and 39.4% in women, and is strongly associated with age, employment situation, income and presence of chronic diseases (p ˂0.001). Compared with the general population, the rural population has a higher risk of presenting with serious difficulties related to farsightedness (OR: 2.56; 95% CI: 1.32-4.95) and make less use of optical correction (OR: 0.57; 95%CI: 0.44-0.74). The use of health services is not sufficient for adequate prevention, particularly in diabetics. For those affected by poor vision, the distance to travel to receive an eye exam, the belief that eyesight problems come with age and the cost of glasses are the principal reasons used to explain why eyesight problems are not resolved. Conclusions The rural population presents worse visual health that is influenced by social and economic factors. Improving accessibility and reducing barriers is essential to tackle avoidable visual disability and reduce health inequities.

      PubDate: 2017-06-12T03:12:40Z
      DOI: 10.1016/j.gaceta.2017.03.009
  • Has the quality of health care for the immigrant population changed during
           the economic crisis in Catalonia (Spain)? Opinions of health professionals
           and immigrant users

    • Authors: Victoria Porthé; Ingrid Vargas; Elena Ronda; Davide Malmusi; Lola Bosch; M. Luisa Vázquez
      Abstract: Publication date: Available online 3 June 2017
      Source:Gaceta Sanitaria
      Author(s): Victoria Porthé, Ingrid Vargas, Elena Ronda, Davide Malmusi, Lola Bosch, M. Luisa Vázquez
      Objective To analyse changes in health professionals’ and immigrant users’ perceptions of the quality of care provided to the immigrant population during the crisis. Methods A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. Results Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals’ working conditions and users’ attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. Conclusion The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants.

      PubDate: 2017-06-07T01:42:46Z
      DOI: 10.1016/j.gaceta.2017.03.010
  • Seizing the opportunity – a salutogenic approach to public health

    • Authors: Bengt Lindstrom
      Abstract: Publication date: Available online 31 May 2017
      Source:Gaceta Sanitaria
      Author(s): Bengt Lindstrom

      PubDate: 2017-06-02T00:42:55Z
      DOI: 10.1016/j.gaceta.2017.03.005
  • Problemas de conducta infantil y competencias parentales en madres en
           contextos de violencia de género

    • Authors: Ana Rosser Limiñana; Raquel Suriá Martínez; Miguel Ángel Mateo Pérez
      Abstract: Publication date: Available online 24 May 2017
      Source:Gaceta Sanitaria
      Author(s): Ana Rosser Limiñana, Raquel Suriá Martínez, Miguel Ángel Mateo Pérez
      Objetivo Evaluar la problemática comportamental de los/las menores que han estado expuestos/as junto a sus madres a situaciones de violencia de género, y el efecto moderador de las pautas de crianza materna. Método Se analiza, mediante la Child Behavior Checklist, la problemática conductual de 46 menores de entre 6 y 16 años de edad, y la posible relación entre los problemas detectados y las competencias parentales mostradas en la interacción madre-hijo/a en los centros de acogida. Resultados Se detecta una mayor problemática conductual en los/las menores, en comparación con la población normativa. Las dificultades en la crianza y la interacción madre-hijo/a se relacionan especialmente con la manifestación de problemas externalizantes. Conclusiones Vivir en contextos de violencia de género afecta al ajuste psicosocial de los/las menores y deteriora las competencias parentales de las víctimas. En consecuencia, la intervención de los/las profesionales del ámbito sociosanitario con las víctimas debería prestar mayor atención a las dificultades de los/las menores y a restablecer las competencias de crianza de las madres en aras de paliar las repercusiones de la violencia de género en sus hijos/as. Objective To assess the behavioural problems of children who have been exposed to intimate partner violence situations, and the moderating effect of mother parenting. Method We analysed, using the Child Behavior CheckList, behavioural problems of 46 children between 6 and 16 years, and the relationship between the detected problems and parenting skills shown in the mother-child interaction in shelters. Results Increased behavioural problems were detected in children, compared with normative population. Difficulties in parenting skills in mother-child interaction especially connect with the manifestation of externalizing problems in children. Conclusions Living in a gender violence environment affects children's psychosocial adjustment and it damages the victim's parental competence. Consequently, the intervention of socio-health professionals with Intimate partner violence victims should pay more attention to detect the difficulties of children and restore the parenting skills of the mothers in order to alleviate the repercussions of gender violence on their children.

      PubDate: 2017-05-27T23:34:58Z
      DOI: 10.1016/j.gaceta.2017.02.004
  • Ingesta de flúor a través del consumo de agua de abastecimiento público
           en la cohorte INMA-Gipuzkoa

    • Authors: Ana Jiménez-Zabala; Loreto Santa-Marina; Mónica Otazua; Mikel Ayerdi; Ane Galarza; Mara Gallastegi; Enrique Ulibarrena; Amaia Molinuevo; Asier Anabitarte; Jesús Ibarluzea
      Abstract: Publication date: Available online 22 May 2017
      Source:Gaceta Sanitaria
      Author(s): Ana Jiménez-Zabala, Loreto Santa-Marina, Mónica Otazua, Mikel Ayerdi, Ane Galarza, Mara Gallastegi, Enrique Ulibarrena, Amaia Molinuevo, Asier Anabitarte, Jesús Ibarluzea
      Objetivo Estimar la ingesta de flúor en mujeres embarazadas y sus hijos/as de la cohorte INMA-Gipuzkoa a través del consumo de agua de la red municipal y comparar estas ingestas con los valores recomendados. En Euskadi, la fluoración del agua de consumo es obligatoria en abastecimientos de más de 30.000 habitantes. Método Se han incluido 575 mujeres embarazadas (reclutamiento en 2006-2008) y 424 niños/as de 4 años (seguimiento en 2010-2012). Las concentraciones de fluoruros en el agua se obtuvieron del sistema de información de aguas de consumo de Euskadi (EKUIS). Los hábitos de consumo de agua y las variables socioeconómicas se obtuvieron mediante cuestionario. Resultados El 74,9% de las mujeres y el 87,7% de los/las niños/as consumían agua de red municipal. En agua fluorada, el valor medio de fluoruro fue de 0,805mg/l (desviación estándar [DE]: 0,194) durante el periodo de reclutamiento, y de 0,843mg/l (DE: 0,080) durante el seguimiento de los/las niños/as. La ingesta media de flúor y el percentil 95 en las zonas fluoradas fueron de 0,015 y 0,026mg/kg al día en las mujeres y de 0,033 y 0,059mg/kg al día en los/las niños/as. Considerando solo el flúor aportado por el agua, el 8,71% de los/las niños/as residentes en zonas con fluoración superaban la ingesta de 0,05mg/kg al día recomendada por la European Food Safety Authority. Conclusión Los resultados obtenidos muestran que las ingestas de flúor a través del agua de consumo pueden superar lo recomendado en población infantil, y propician futuros estudios que aporten evidencias que puedan ayudar en las políticas de fluoración de las aguas de consumo público. Objective To estimate fluoride intake through consumption of water from the municipal network in pregnant women and their children from the INMA-Gipuzkoa cohort and to compare these intakes with recommended levels. In Euskadi (Spain), fluoridation of drinking water is compulsory in water supplies for more than 30,000 inhabitants. Method 575 pregnant women (recruitment, 2006-2008) and 424 4-year-old children (follow-up, 2010-2012) have been included. Fluoride levels in drinking water were obtained from the water consumption information system of the Basque Country (EKUIS). Water consumption habits and socioeconomic variables were obtained by questionnaire. Results 74.9% and 87.7% of women and children consumed water from the municipal network. Average fluoride levels in fluoridated water were 0.805 (SD: 0.194) mg/L during baseline recruitment and 0.843 (SD: 0.080) mg/L during follow up, at 4 years old of the children. Average and 95th percentile of fluoride intake were 0.015 and 0.026mg/kg per day in women and 0.033 and 0.059mg/kg per day in children. Considering only fluoride provided by drinking water, 8.71% of children living in fluoridated areas exceeded intake level recommended by the European Food Safety Authority, consisting in 0.05mg/kg per day. Conclusion The results show that ingested levels of fluoride through consumption of municipal water can exceed the recommended levels in children and encourages further studies that will help in ...
      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.02.008
  • Factores asociados a la respuesta a la violencia del compañero íntimo en
           atención primaria de salud en España

    • Authors: Pilar Murillo; Miguel San Sebastián; Carmen Vives-Cases; Isabel Goicolea
      Abstract: Publication date: Available online 22 May 2017
      Source:Gaceta Sanitaria
      Author(s): Pilar Murillo, Miguel San Sebastián, Carmen Vives-Cases, Isabel Goicolea
      Objetivo Analizar la capacidad de respuesta a la violencia del compañero íntimo (VCI) de profesionales sanitarios/as españoles/as en atención primaria e identificar posibles determinantes que puedan favorecer una mejor respuesta. Método Estudio transversal con muestreo no probabilístico y por conveniencia en profesionales sanitarios/as de 15 centros de atención primaria españoles. El instrumento Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), en su versión validada y traducida al español, permitió recolectar información sobre conocimientos, opiniones y prácticas sobre VCI. Se realizaron análisis estadísticos descriptivo y de regresión lineal bivariada y multivariada. Resultados Se recibieron 265 cuestionarios diligenciados, con una tasa de respuesta del 80,3%. Se observó un efecto exposición-respuesta, en el que a más horas de formación, mayor puntuación en las escalas del cuestionario (p <0,05). La edad, el tipo de profesión, los años de experiencia en atención primaria, las horas de formación en VCI y la lectura del protocolo mostraron asociación positiva con conocimientos (preparación percibida, conocimiento percibido, conocimiento real), opiniones (preparación del equipo, requerimientos legales, autoeficacia, disponibilidad de recursos en el lugar de trabajo, barreras, entendimiento de la víctima) y prácticas del personal sanitario. Conclusiones Leer el protocolo de actuación regional/nacional y recibir formación en VCI fueron las intervenciones más importantes asociadas a una mejor capacidad de respuesta a la VCI de los/las profesionales sanitarios/as en atención primaria. Objective To analyse the Spanish primary care professionals’ readiness to respond to intimate partner violence (IPV) in primary care and identify possible determinants that could facilitate a better response. Method A cross-sectional study with a non-probabilistic sampling by convenience was performed among healthcare professionals working in 15 primary care centres in Spain. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), the version validated and translated into Spanish, was the instrument used to collect information about knowledge, opinions and practices regarding intimate partner violence. Descriptive analysis and, simple and multiple linear regression analysis were performed. Results A total of 265 completed questionnaires were received, with a response rate of 80.3%. An exposure-response effect was observed, where at higher hours of training a higher score was obtained on the questionnaire sections (p <0.05). Age, type of profession, years of experience in primary care, hours of IPV training and reading the protocol showed positive association with knowledge (perceived preparation, perceived knowledge, actual knowledge), opinions (staff preparation, legal requirements, self-efficacy, workplace issues, constraints, understanding of the victim) and practice of healthcare professionals. Conclusions Reading the regional/national protocol for action and receiving training in IPV were the most important interventions associated to a better primary care professionals’ readiness to respond to IPV in Spanish primary care settings.
      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.03.003
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