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HEALTH AND SAFETY (526 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: 23)
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: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
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: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Sciences     Open Access   (Followers: 6)
American Journal of Health Studies     Full-text available via subscription   (Followers: 10)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 25)
American Journal of Public Health     Full-text available via subscription   (Followers: 202)
American Journal of Public Health Research     Open Access   (Followers: 29)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
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: 2)
Archive of Community Health     Open Access  
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: 3)
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: 5)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 8)
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: 20)
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: 17)
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: 12)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 20)
Case Reports in Women's Health     Open Access   (Followers: 3)
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: 10)
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: 2)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 1)
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: 15)
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: 4)
Education for Health     Open Access   (Followers: 5)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 4)
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   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 2)
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: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
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: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 11)
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: 9)
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: 16)
Global Journal of Health Science     Open Access   (Followers: 9)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 1)
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: 51)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 14)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 15)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 36)
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: 48)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 12)
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: 3)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 13)
Health, Risk & Society     Hybrid Journal   (Followers: 12)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthy-Mu Journal     Open Access  
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: 11)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
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: 5)
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: 34)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
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: 16)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 10)

        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  [3089 journals]
  • Repensar la Carta de Ottawa 30 años después

    • Authors: Luis Andrés López-Fernández; Orielle Solar Hormazábal
      Pages: 443 - 445
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Luis Andrés López-Fernández, Orielle Solar Hormazábal

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.12.013
  • Rendimiento y optimización de la herramienta trigger en la detección de
           eventos adversos en pacientes adultos hospitalizados

    • Authors: Óscar Guzmán Ruiz; Juan José Pérez Lázaro; Pedro Ruiz López
      Pages: 453 - 458
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Óscar Guzmán Ruiz, Juan José Pérez Lázaro, Pedro Ruiz López
      Objetivo Caracterizar el rendimiento de los triggers utilizados en la detección de eventos adversos (EA) de pacientes adultos hospitalizados y definir un panel de triggers simplificado suficientemente sensible y específico, para la detección de EA. Método Estudio transversal de altas de pacientes de un servicio de medicina interna para la detección de EA mediante revisión sistemática de la historia clínica y la identificación de 41 triggers (evento clínico relacionado frecuentemente con EA), determinando si hubo EA según el contexto en que apareció el trigger. Una vez identificado el EA, se procedió a la caracterización de los triggers que lo detectaron. Se aplicó regresión logística para la selección de los triggers con mayor capacidad de detección de EA. Resultados Se revisaron 291 historias clínicas y se detectaron 562 triggers en 103 pacientes, de los cuales 163 estuvieron implicados en la detección de un EA. Los triggers que detectaron más EA fueron «A.1. Úlcera por presión» (9,82%), «B.5. Laxante o enema» (8,59%), «A.8. Agitación» (8,59%), «A.9. Sobresedación» (7,98%), «A.7. Hemorragia» (6,75%) y «B.4. Antipsicótico» (6,75%). Se obtuvo un modelo simplificado de triggers que incluyó la variable «Número de fármacos» y los triggers «Sobresedación», «Sondaje», «Reingreso en 30 días», «Laxante o enema» y «Cese brusco de la medicación». Este modelo obtuvo una probabilidad del 81% de clasificar correctamente las historias con EA y sin EA (p <0,001; intervalo de confianza del 95%: 0,763-0,871). Conclusiones Un número elevado de triggers estuvieron asociados a EA. El modelo resumido permite detectar una gran cantidad de EA con un mínimo de elementos. Objective To characterise the performance of the triggers used in the detection of adverse events (AE) of hospitalised adult patients and to define a simplified panel of triggers to facilitate the detection of AE. Method Cross-sectional study of charts of patients from a service of internal medicine to detect EA through systematic review of the charts and identification of triggers (clinical event often related to AE), determining if there was AE as the context in which it appeared the trigger. Once the EA was detected, we proceeded to the characterization of the triggers that detected it. Logistic regression was applied to select the triggers with greater AE detection capability. Results A total of 291 charts were reviewed, with a total of 562 triggers in 103 patients, of which 163 were involved in detecting an AE. The triggers that detected the most AE were “A.1. Pressure ulcer” (9.82%), “B.5. Laxative or enema” (8.59%), “A.8. Agitation” (8.59%), “A.9. Over-sedation” (7.98%), “A.7. Haemorrhage” (6.75%) and “B.4. Antipsychotic” (6.75%). A simplified model was obtained using logistic regression, and included the variable “Number of drugs” and the triggers “Over-sedation”, “Urinary catheterisation”, “Readmission in 30 days”, “Laxative or enema” and “Abrupt medication stop”. This model showed a probability of 81% to correctly classify charts with EA or without EA (p <0.001; 95% confidence interval: 0.763-0.871).
      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.01.014
  • Condiciones de trabajo en consultorios adyacentes a farmacias privadas en
           Ciudad de México: perspectiva del personal médico

    • Authors: Sandra P. Díaz-Portillo; Hortensia Reyes-Morales; Silvia Magali Cuadra-Hernández; Álvaro J. Idrovo; Gustavo Nigenda; Anahí Dreser
      Pages: 459 - 465
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Sandra P. Díaz-Portillo, Hortensia Reyes-Morales, Silvia Magali Cuadra-Hernández, Álvaro J. Idrovo, Gustavo Nigenda, Anahí Dreser
      Objetivo Analizar, desde la perspectiva del personal médico, las condiciones laborales de los consultorios adyacentes a farmacias privadas (CAF), así como sus elementos organizativos. Método Estudio cualitativo exploratorio consistente en entrevistas semiestructuradas a 32 médicos/as de los CAF en Ciudad de México. Se utilizó la técnica de análisis de contenido dirigido basado en códigos previamente construidos y emergentes, relacionados con la experiencia vivida de los sujetos en su campo laboral. Resultados El personal médico percibió que trabajar en los CAF no cumple con sus expectativas profesionales por la baja remuneración, la informalidad en la contratación y la ausencia de garantías laborales establecidas en la ley. Esto les impide disfrutar de los beneficios asociados con el empleo formal y sustenta el deseo de laborar en los CAF solo de manera temporal. Consideraron que los incentivos económicos por número de consultas, procedimientos y ventas alcanzadas por la farmacia les permiten aumentar su ingreso sin influir en su conducta prescriptiva. Señalaron que los sistemas de supervisión y presión en los CAF buscan afectar su autonomía para activar la venta de medicamentos en la farmacia. Conclusiones El personal médico que labora en CAF enfrenta una difícil situación laboral. Los elementos gerenciales usados para inducir la prescripción y activar las ventas de las farmacias conforman un entorno laboral que genera retos en materia de regulación, y subraya la necesidad de monitorear la calidad de los servicios brindados en estos consultorios y los posibles riesgos a los usuarios. Objective To analyse the working conditions of physicians in outpatient clinics adjacent to pharmacies (CAFs) and their organizational elements from their own perspective. Methods We carried out an exploratory qualitative study. Semi-structured interviews were conducted with 32 CAF physicians in Mexico City. A directed content analysis technique was used based on previously built and emerging codes which were related to the experience of the subjects in their work. Results Respondents perceive that work in CAFs does not meet professional expectations due to low pay, informality in the recruitment process and the absence of minimum labour guarantees. This prevents them from enjoying the benefits associated with formal employment, and sustains their desire to work in CAF only temporarily. They believe that economic incentives related to number of consultations, procedures and sales attained by the pharmacy allow them to increase their income without influencing their prescriptive behaviour. They express that the monitoring systems and pressure exerted on CAFs seek to affect their autonomy, pushing them to enhance the sales of medicines in the pharmacy. Conclusions Physicians working in CAFs face a difficult employment situation. The managerial elements used to induce prescription and enhance pharmacy sales create a work environment that generates challenges for regulation and underlines the need to monitor the services provided at these clinics and the possible risk for users.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.10.016
  • Alimentos de producción local en los comedores escolares de

    • Authors: Panmela Soares; Maria Asunción Martínez-Mián; Pablo Caballero; Carmen Vives-Cases; Mari Carmen Davó-Blanes
      Pages: 466 - 471
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Panmela Soares, Maria Asunción Martínez-Mián, Pablo Caballero, Carmen Vives-Cases, Mari Carmen Davó-Blanes
      Objetivo Identificar y caracterizar las iniciativas que fomentan la compra local de alimentos para el suministro de los comedores escolares en España y los centros escolares que las llevan a cabo. Método Estudio exploratorio y descriptivo, basado en la consulta de fuentes secundarias e informantes clave. Se buscaron iniciativas gubernamentales y no gubernamentales de ámbito autonómico. Las gubernamentales se localizaron a través de los programas de comedores escolares de las comunidades autónomas y sus guías alimentarias, y de representantes de las consejerías de educación y agricultura. Las no gubernamentales se localizaron en páginas web y mediante la técnica de bola de nieve. Dichas iniciativas se analizaron en función de su distribución geográfica, ámbito del organismo promotor (gubernamental o no), número de centros escolares que las desarrollan, forma de gestión de los centros y compra de alimentos ecológicos. Se realizó un análisis descriptivo de los datos. Resultados Se localizaron 12 iniciativas desarrolladas en 318 centros escolares (un 2,16% del total de centros con servicio de comedor en España). De ellas, seis son gubernamentales, con 274 centros vinculados (1,86%), y seis no son gubernamentales, con 44 centros (0,30%). La mayoría de estos centros son de gestión pública (n=284). Todas las iniciativas contemplan la compra de alimentos ecológicos. Conclusión Las iniciativas de compra local de alimentos en España tienen un alcance limitado en los centros escolares. No obstante, la existencia de una directriz estatal podría apoyar y fortalecer su desarrollo, dado que la adhesión de los centros es mayor cuando se impulsa desde el sector público. Objective To identify and characterize initiatives that promote the purchase of locally-sourced foods to supply schools and the school centres carrying out the initiatives. Method Exploratory, descriptive study based on secondary data and key informant reports. A search of governmental and non-governmental initiatives was carried out at the autonomous community level. Government initiatives were located through school feeding programmes in the different autonomous communities, their nutritional guides and representatives of the councils for education and agriculture. Non-governmental initiatives were found through their own websites and the snowball technique. Initiatives were analysed by their geographic distribution, organizational area (government vs. non-government), number of school centres carrying out the initiatives, management style and organic food purchase. A descriptive analysis of the data was carried out. Results 12 initiatives carried out by 318 schools (2.16% of all the schools with food service in Spain) were identified. Among these, 6 are governmental initiatives with a scope of 274 schools (1.86%), and 6 are non-governmental initiatives with a scope of 44 schools (0.30%). Most of these schools have a public management system in place (n=284). All the initiatives provide for the purchase of organic food. Conclusion Local food purchase initiatives in Spain have a limited reach. However, the existence of a state directive could support and strengthen the developmen...
      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.10.015
  • Mejora de la calidad de la dieta y del estado nutricional en población
           infantil mediante un programa innovador de educación nutricional:

    • Authors: Maria del Mar Bibiloni; Jordi Fernández-Blanco; Noemí Pujol-Plana; Núria Martín-Galindo; Maria Mercè Fernández-Vallejo; Mariona Roca-Domingo; Juan Chamorro-Medina; Josep A. Tur
      Pages: 472 - 477
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Maria del Mar Bibiloni, Jordi Fernández-Blanco, Noemí Pujol-Plana, Núria Martín-Galindo, Maria Mercè Fernández-Vallejo, Mariona Roca-Domingo, Juan Chamorro-Medina, Josep A. Tur
      Objetivo Evaluar los resultados de un programa de educación nutricional desarrollado con recursos locales para mejorar la calidad de la dieta y reducir la prevalencia de sobrepeso y obesidad en la población infantil. Método Estudio longitudinal de intervención por educación nutricional (INFADIMED) en población infantil (3-7 años) de Vilafranca del Penedès (Barcelona) reclutada en centros de educación infantil y primaria, con grupo de intervención o INFADIMED (n=319; 50,2% niñas) y grupo control (n=880; 49,8% niñas). En ambos grupos se determinaron el peso, la talla y el índice de masa corporal al inicio y al final del programa. También se evaluó la adherencia al patrón dietético mediterráneo mediante el test KIDMED. Resultados INFADIMED incrementó el porcentaje de sujetos que consumían fruta o zumos, vegetales, yogures o queso, pasta o arroz, y frutos secos; disminuyó el porcentaje de quienes no desayunaban o consumían bollería para desayunar, así como el consumo de dulces o caramelos varias veces al día. INFADIMED cambió, de inicio a final, los porcentajes de adherencia a la dieta mediterránea: alta (39,2% a 70,5%), aceptable (49,2% a 28,2%) y baja (11,6% a 1,3%). Los/las participantes que al inicio del estudio presentaron sobrepeso u obesidad y evolucionaron a normopeso fueron un 2,6% en el grupo control y un 11,3% en INFADIMED (odds ratio: 4,08; intervalo de confianza del 95%: 2,37-7,04). Conclusiones INFADIMED es un programa de educación nutricional con incidencia positiva sobre la calidad de la dieta y la prevalencia de sobrepeso y obesidad en la población infantil. Objective To assess the results of a nutritional education programme developed by using available local resources to improve diet quality and decrease overweight and obesity prevalence among children. Method A longitudinal intervention study by means of nutritional education (INFADIMED) in children (aged 3-7 years) from Vilafranca del Penedès (Barcelona, Spain), recruited from preschool centres and primary schools, with an intervention or INFADIMED group (n=319; 50.2% female) and a control group (n=880; 49.8% female). Weight, height and body mass index were measured in both groups at the beginning and at the end of the programme. Adherence to the Mediterranean diet was also assessed using the KIDMED test. Results Consumption of fruit or juices, vegetables, yogurt and/or cheese, pasta or rice, and nuts increased, while skipping breakfast, consumption of bakery products for breakfast, and/or consumption of sweets several times per day decreased in the INFADIMED group. INFADIMED also changed, from the beginning to the end of the study, the adherence to a Mediterranean diet: high (39.2% to 70.5%), acceptable (49.2% to 28.2%), and low (11.6% to 1.3%). Approximately 2.6% of the participants in the control group and 11.3% of the participants in the INFADIMED group who were overweight and obese changed to normal weight (odds ratio: 4.08; 95% confidence interval: 2.37-7.04). Conclusions INFADIMED is a nutritional education programme with...
      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.10.013
  • Adaptación de una encuesta bioconductual para la vigilancia del VIH en
           mujeres trabajadoras sexuales chilenas

    • Authors: Bielka Carvajal; Valeria Stuardo; José Manuel Manríquez; Julieta Belmar; Cinta Folch
      Pages: 478 - 484
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Bielka Carvajal, Valeria Stuardo, José Manuel Manríquez, Julieta Belmar, Cinta Folch
      Objetivo Adaptar un cuestionario conductual para la vigilancia de segunda generación del VIH/sida en mujeres trabajadoras sexuales (MTS) de la Región Metropolitana, Chile. Métodos Estudio cualitativo de validación de instrumento. Se validó un cuestionario español adaptado en Cataluña (España) mediante traducción y retrotraducción del instrumento original. La validación de contenido se realizó a través de un grupo Delphi modificado, constituido por expertos en MTS y VIH, representantes de los ámbitos comunitario, político e institucional. Se evaluaron aspectos relacionados con la aplicabilidad del instrumento en terreno, encuestando a MTS de la Región Metropolitana. Resultados El cuestionario, escrito en español de España, fue satisfactoriamente adaptado al español de Chile. En el proceso de validación de contenido se logró definir las secciones que abordan el VIH en la población MTS. El cuestionario adaptado tiene un tiempo de aplicación de menos de 15 minutos, por lo que es utilizable en terreno. Las 61 mujeres encuestadas presentan características diversas, tanto en país de origen (todas eran latinoamericanas) como en nivel de estudios, lo que permitió captar potenciales problemas en su aplicación. Discusión El cuestionario adaptado para Chile contiene todos los indicadores para MTS recomendados por ONUSIDA, así como los recomendados por el Familly Health International para la vigilancia bioconductual. El instrumento definitivo emerge como una herramienta para la vigilancia de segunda generación del VIH y otras infecciones de transmisión sexual en Chile, y como un aporte al abordaje de políticas preventivas en la población de MTS. Objective To adapt a behavioural questionnaire for second-generation HIV/AIDS surveillance in female sex workers (FSWs) in the Metropolitan Region, Chile. Methods Qualitative study of instruments validation. A Spanish instrument adapted in Catalonia was validated through a translation and back-translation of the original version. The content validity was determined through a modified Delphi method, via FSW and HIV experts representing community, political and institutional levels. Applicability aspects were determined by the application of the questionnaire to FSW in the Metropolitan Region. Results The questionnaire, drafted in Spain, was successfully adapted to Chilean Spanish. The content validity process enabled sections to be created that address HIV in FSWs. The adapted questionnaire takes less than 15minutes to complete, which makes it usable in fieldwork. The 61 women surveyed came from different countries (all were Latin Americans) and had different educational levels; all this enabled potential applicability problems to be detected. Discussion The adapted questionnaire for Chile contains all the UNAIDS indicators for FSWs, as well as the recommended indicators of Family Health International for bio-behavioural surveillance. Said questionnaire serves as a tool for second-generation HIV/other STD surveillance and further contributes to preventive policies in Chilean FSWs.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.10.010
  • Patterns of physical activity and associated factors among teenagers from
           Barcelona (Spain) in 2012

    • Authors: Alicia Ruiz-Trasserra; Anna Pérez; Xavier Continente; Kerry O’Brien; Montse Bartroli; Ester Teixidó-Compaño; Albert Espelt
      Pages: 485 - 491
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Alicia Ruiz-Trasserra, Anna Pérez, Xavier Continente, Kerry O’Brien, Montse Bartroli, Ester Teixidó-Compaño, Albert Espelt
      Objective To estimate the prevalence of moderate and vigorous physical activity (MVPA), as defined by the World Health Organisation (WHO), and associated factors among teenagers from Barcelona in 2012. Methods Cross-sectional survey to assess risk factors in a representative sample of secondary school students (aged 13–16 years, International Standard Classification of Education [ISCED] 2, n=2,162; and 17–18 years, ISCED 3, n=1016) in Barcelona. We estimated MVPA prevalence overall, and for each independent variable and each gender. Poisson regression models with robust variance were fit to examine the factors associated with high-level MVPA, and obtained prevalence ratios (PR) and 95% confidence intervals (95%CI). Results Only 13% of ISCED 2 and 10% of ISCED 3 students met the WHO physical activity recommendations. This percentage was lower among girls at both academic levels. MVPA was lower among ISCED 3 compared to ISCED 2 students, and among students with a lower socioeconomic status. Physical activity was associated with positive self-perception of the health status (e.g., positive self-perception of health status among ISCED 2 compared to ISCED 3 students: PR=1.31 [95%CI: 1.22–1.41] and 1.61 [95%CI: 1.44–1.81] for boys and girls, respectively]. Conclusions The percentage of teenagers who met WHO MVPA recommendations was low. Strategies are needed to increase MVPA levels, particularly in older girls, and students from low socioeconomic backgrounds.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.10.004
  • Desarrollo y estudio piloto de un cuestionario para evaluar la
           satisfacción con la estancia hospitalaria en población infanto-juvenil

    • Authors: Montserrat Gómez de Terreros Guardiola; José Francisco Lozano Oyola; Isabel Avilés Carvajal; Rafael Jesús Martínez Cervantes
      Pages: 492 - 498
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Montserrat Gómez de Terreros Guardiola, José Francisco Lozano Oyola, Isabel Avilés Carvajal, Rafael Jesús Martínez Cervantes
      Objetivo Elaborar un instrumento para evaluar la satisfacción de niños, niñas y adolescentes con su estancia hospitalaria. Métodos Análisis cualitativo de las dimensiones de la satisfacción hospitalaria a partir de narrativas de menores hospitalizados; validación de contenido mediante juicio de expertos de los ítems generados para las distintas dimensiones de satisfacción; y estudio piloto para valorar el funcionamiento del cuestionario con 84 niños, niñas y adolescentes ingresados en hospitales andaluces. Resultados Tras sucesivas depuraciones se obtuvo un cuestionario breve, cuya aplicación dura entre 5 y 15 minutos. Todos los ítems presentaron correlaciones ítem-total positivas (r>0,18). El cuestionario mostró un índice de consistencia interna de 0,779 (alfa de Cronbach) y contrastes de rangos significativos (U de Mann-Whitney; p<0,001), con tamaños de efectos medianos (η2 >0,151) en tres dimensiones de satisfacción comparadas entre hospitales. Discusión Se ha obtenido un cuestionario breve, de fácil aplicación, fiable en cuanto a su consistencia interna y sensible para detectar diferencias en las dimensiones de satisfacción hospitalaria. Una vez terminada su validación, servirá para evaluar la satisfacción de los menores con su estancia hospitalaria, además de ser un potencial indicador de calidad asistencial. Objective To develop an instrument to assess the satisfaction of children and teenagers with their stay in hospital. Methods A qualitative analysis of hospitalisation satisfaction dimensions based on the feedback of hospitalised children and teenagers; a content validation study by a group of experts of the items generated for the different satisfaction dimensions; and a pilot study to assess the usefulness of the questionnaire with a sample of 84 children and teenagers hospitalised in Andalusia. Results After successive refinements, a short questionnaire was obtained which took between 5 and 15minutes to complete. All items presented positive item-total correlations (r>0.18). The questionnaire showed an internal consistency index of 0.779 (Cronbach's alpha) and significant rank differences (Mann-Whitney U test; p<0.001) with medium size effects (η2 >0.151) in three satisfaction dimensions compared between hospitals. Discussion A short, easy-to-answer questionnaire was developed that is reliable regarding its internal consistency and sensitive to differences in hospital satisfaction dimensions. Once validated, it will be used to assess the satisfaction of children and teenagers with their hospital stay, in addition to being a potential indicator of quality of care.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.09.009
  • Relationship between caries, body mass index and social class in Spanish

    • Authors: Teresa Almerich-Torres; José María Montiel-Company; Carlos Bellot-Arcís; José Manuel Almerich-Silla
      Pages: 499 - 504
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Teresa Almerich-Torres, José María Montiel-Company, Carlos Bellot-Arcís, José Manuel Almerich-Silla
      Objective To determine the association between caries, body mass index (BMI) and social class in child population of the Valencia region (Spain) at 6, 12 and 15 years, and study. Methods In a cross sectional study of 1326 children aged 6 (n=488), 12 (n=409) and 15 years (n=433) who took part in the 2010 Oral Health Survey of the Valencia region, the ICDAS II criteria were employed for diagnosing and coding all the teeth examined. The quantitative BMI values on a continuous scale were grouped into 3 categories (normal weight, overweight, obese) based on a table adjusted for age and gender. The highest-ranking occupation of the parents was taken to indicate the social class of the child. Results The mean BMI was 17.21 at 6 years, 21.39 at 12 years and 22.38 at 15 years. No significant differences in caries indexes (DMFT or dft) by degree of obesity stratified by social class were found in any of the age groups studied. There was no significant correlation between BMI and DMFT-dft in any of the age groups. Conclusions Obesity is not associated with dental caries in schoolchildren of this population

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.09.005
  • Estudio MESGI50: descripción de una cohorte sobre la madurez y el
           envejecimiento satisfactorio

    • Authors: Josep María Corominas Barnadas; Secundino López-Pousa; Joan Vilalta-Franch; Laia Calvó-Perxas; Dolors Juvinyà Canal; Josep Garre-Olmo
      Pages: 511 - 517
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Josep María Corominas Barnadas, Secundino López-Pousa, Joan Vilalta-Franch, Laia Calvó-Perxas, Dolors Juvinyà Canal, Josep Garre-Olmo
      Objetivo Describir las principales características demográficas, de salud y socioeconómicas de los participantes en el Estudio sobre la Madurez y el Envejecimiento Satisfactorio en Girona (estudio MESGI50). Métodos Estudio epidemiológico poblacional vinculado a la Survey of Health, Ageing, and Retirement in Europe (SHARE). La población de referencia fueron los habitantes de la provincia de Girona de 50 y más años de edad. Se utilizó un muestreo probabilístico por conglomerados bietápico estratificado según el número de habitantes y el grado de envejecimiento de la población. Resultados Se seleccionaron aleatoriamente 28 municipios según su tipo (demográficamente envejecidos o jóvenes) y estratificados según el número de habitantes. La tasa de respuesta fue del 65%, con una media de 1,7 sujetos elegibles por hogar y una muestra final de 2065 hogares y 3331 participantes. El efecto del diseño fue de 1,27. El 52,9% eran mujeres y la media de edad era de 66,9 años (desviación estándar: 11,5). La salud autorreferida, la fuerza de agarre manual, la limitación en las actividades de la vida diaria y la sintomatología depresiva aumentaron con la edad y de forma más acusada en las mujeres. Se observaron diferencias en el consumo de alcohol y en los patrones de alimentación según el ámbito de residencia. Conclusiones Las características demográficas, de salud y socioeconómicas durante el proceso de envejecimiento son distintas según los grupos de edad, el sexo y el ámbito de residencia. Objective To describe the demographic, health and socio-economic characteristics of the participants in the Study on Maturity and Satisfactory Ageing in Girona (MESGI50 study). Methods Population-based Study linked to the Survey of Health, Ageing, and Retirement in Europe (SHARE). The reference population was the inhabitants of the province of Girona (Spain) aged 50 and over. A probabilistic two-stage stratified cluster sampling according to the number of inhabitants and the degree of ageing of the population was used. Results Twenty-eight municipalities were randomly selected according to their type (demographically aged or young), and then stratified by the population size. The response rate was 65% with a mean of 1.7 eligible individuals per household and a final sample of 2,065 households and 3,331 participants. The design effect was 1.27. 52.9% were women and the mean age was 66.9 years (SD=11.5). The self-rated health status, hand grip strength, restriction in daily life activities and depressive symptomatology increased with age and more markedly in women. There were differences in alcohol consumption and eating patterns depending on the area of residence. Conclusions The demographic, health and socio-economic characteristics during the ageing process differ depending on age group, gender, and area of residence.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.07.017
  • Aplicación del modelo Balance of Care en la toma de decisiones acerca del
           mejor cuidado para las personas con demencia

    • Authors: Ester Risco; Adelaida Zabalegui; Susana Miguel; Marta Farré; Carme Alvira; Esther Cabrera
      Pages: 518 - 523
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Ester Risco, Adelaida Zabalegui, Susana Miguel, Marta Farré, Carme Alvira, Esther Cabrera
      Objetivo Describir la aplicación del modelo Balance of Care en la toma de decisiones acerca del mejor cuidado para las personas con demencia en el contexto español. Métodos Se utilizó el modelo Balance of Care, que consistió en 1) la descripción del perfil de los casos más habituales de personas con demencia y sus cuidadores, 2) la identificación del emplazamiento más adecuado (domiciliario o centro sociosanitario) para cada caso, 3) el diseño de planes de cuidados específicos para cada caso, y 4) la evaluación del coste de los planes de cuidados. Resultados En el diseño de los casos participaron 1641 personas con demencia y sus cuidadores de ocho países europeos. La evaluación de los casos la realizaron 20 profesionales expertos en demencia de distintos ámbitos asistenciales. En España, los resultados indican que inicialmente el lugar más idóneo para cuidar de las personas con demencia es el domicilio, pero en los casos con mayor dependencia para las actividades de la vida diaria el centro sociosanitario era el emplazamiento con mejor prestación de cuidados. Los recursos escogidos en el plan de cuidados fueron ayuda profesional para realizar las actividades de la vida diaria e instrumentales, centro de día, equipo de atención domiciliaria, apoyo económico, enfermera de enlace y trabajador/a social. Discusión El modelo Balance of Care permite evaluar de manera sistemática, objetiva y mediante un equipo multidisciplinario el emplazamiento más adecuado para las personas con demencia. Se deberían incluir otras intervenciones coste-eficientes para mejorar la situación domiciliaria de estas personas. Objective To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. Methods The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans. Results A total of 1,641 people with dementia and their caregivers from eight European countries were used in the case design. The evaluation of cases was conducted by 20 experts in different medical fields of dementia. In Spain, the results indicated that initially the most suitable placement to take care of people with dementia was the home, however in cases with higher dependency in activities of daily living, the long-term care setting was the best option. For the best care plan, the following resources were chosen: professional help to perform basic activities; day center; multidisciplinary home care team; financial support; community nurse; and social worker. Discussion The Balance of Care method allows us to assess the most appropriate place of care for people with dementia systematically, objectively and with a multidisciplinary team. Other cost-effective interventions should be integrated in patients with dementia care in order to improve home care.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.07.006
  • Actividad asistencial y costes en los últimos 3 meses de vida de
           pacientes fallecidos con cáncer en Euskadi

    • Authors: Roberto Nuño-Solinís; Emilio Herrera Molina; Silvia Librada Flores; Juan F. Orueta Mendía; Andrés Cabrera-León
      Pages: 524 - 530
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Roberto Nuño-Solinís, Emilio Herrera Molina, Silvia Librada Flores, Juan F. Orueta Mendía, Andrés Cabrera-León
      Objetivo Analizar el consumo de recursos sanitarios y su coste en los últimos meses de vida de la población fallecida por neoplasia maligna en la Comunidad Autónoma del País Vasco. Método Estudio retrospectivo observacional sobre una población con diagnóstico de neoplasia maligna fallecida en el País Vasco (2010 y 2011). Fuente de datos: Conjunto Mínimo Básico de Datos y Registro de Mortalidad. Variables: sexo, edad, lugar de defunción, localización del tumor, actividad asistencial y costes en los últimos 3 meses de vida. Análisis descriptivo de la actividad asistencial y costes. Regresiones lineales multivariadas para obtener los costes medios ajustados según sexo, edad y lugar de defunción. Resultados Se identificaron 9333 fallecidos/as por neoplasia maligna durante 2010 y 2011. El 65,4% eran hombres, el 61,5% tenían 70 o más años de edad, la edad media era de 72,9 años y el 71,1% falleció en el hospital. Las personas fallecidas en el hospital tuvieron un coste medio de casi el doble con respecto a las fallecidas en el domicilio (14.794 € y 7.491 €, respectivamente; p <0,001), y un 31,3% superior al de la residencia (11.269 €; p <0,001). Conclusiones Es necesaria una mayor capacidad de intervención al final de la vida en el nivel comunitario, reforzando la capacidad de atención desde la atención primaria, tanto desde su capacitación como desde el soporte de equipos expertos con el fin de cambiar el perfil actual de atención hacia una mayor atención extrahospitalaria que permita un menor consumo de recursos y una mayor atención en el domicilio. Objective To analyse the use of health resources and its budget in the last months of life of the population who died from malignant neoplasm in the Basque Autonomous Country (Spain). Method Retrospective observational study of a population with a diagnosis of malignancy deceased in the Basque Country (2010 and 2011). Data source: MDS and Mortality Register. Variables: gender, age, place of death, tumour location, clinical activity data and costs in the last three months of life. We performed a descriptive analysis of clinical activity and costs, and lineal multivariate regressions to obtain the adjusted mean costs by gender, age and place of death. Results 9,333 deaths from malignancy were identified in 2010 and 2011. 65.4% were men, 61.5% aged 70 or over, mean age 72.9 years, 71.1% died in hospital. People who died in the hospital had an average cost of about double that of the people who died at home (€14,794 and €7,491, respectively; p <0.001) and 31.3% higher than in the nursing home (€11,269; p <0.001). Conclusions Greater interventions at the end of life at the community level are necessary, strengthening the care capacity of primary health care, both from training and support from expert teams in order to change the current care profile to a more outpatient care that allows a lower consumption of resources and greater care at home.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.06.005
  • 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
      Pages: 531 - 534
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      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: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.04.003
  • Contra la llamada gestación subrogada. Derechos humanos y justicia global
           versus bioética neoliberal

    • Authors: María José Guerra-Palmero
      Pages: 535 - 538
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): María José Guerra-Palmero

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.05.009
  • Argumentos para la necesaria regulación de la gestación por

    • Authors: Eleonora Lamm
      Pages: 539 - 540
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Eleonora Lamm

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.04.009
  • Financiamiento de la investigación en pregrado en las facultades de
           medicina peruanas

    • Authors: Carlos J. Toro-Huamanchumo; Laura R. Arce-Villalobos; Jorge Gonzales-Martínez; Alejandro Melgarejo-Castillo; Álvaro Taype-Rondán
      Pages: 541 - 542
      Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6
      Author(s): Carlos J. Toro-Huamanchumo, Laura R. Arce-Villalobos, Jorge Gonzales-Martínez, Alejandro Melgarejo-Castillo, Álvaro Taype-Rondán

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2016.06.009
  • El asbesto, una epidemia todavía por controlar

    • Authors: Roberto Alfonso Accinelli; Lidia Marianella López
      Pages: 365 - 367
      Abstract: Publication date: September–October 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 5
      Author(s): Roberto Alfonso Accinelli, Lidia Marianella López

      PubDate: 2017-09-09T05:36:03Z
      DOI: 10.1016/j.gaceta.2017.02.011
  • Lobo F. La economía, la innovación y el futuro del Sistema Nacional de
           Salud. Madrid: FUNCAS; 2017. ISBN: 978-84 15722-67-0. 345 páginas

    • Authors: Guillem López Casasnovas
      Abstract: Publication date: Available online 4 November 2017
      Source:Gaceta Sanitaria
      Author(s): Guillem López Casasnovas

      PubDate: 2017-11-10T02:13:33Z
      DOI: 10.1016/j.gaceta.2017.08.005
  • Validity of self-reported intensity of exposure to second-hand smoke at
           home against environmental and personal markers

    • Authors: José M. Martínez-Sánchez; Adrián González-Marrón; Juan Carlos Martín-Sánchez; Xisca Sureda; Marcela Fu; Raúl Pérez-Ortuño; Cristina Lidón-Moyano; Iñaki Galán; José Antonio Pascual; Esteve Fernández
      Abstract: Publication date: Available online 2 November 2017
      Source:Gaceta Sanitaria
      Author(s): José M. Martínez-Sánchez, Adrián González-Marrón, Juan Carlos Martín-Sánchez, Xisca Sureda, Marcela Fu, Raúl Pérez-Ortuño, Cristina Lidón-Moyano, Iñaki Galán, José Antonio Pascual, Esteve Fernández
      The objective of this study was to assess the validity of two questions about the perception of intensity of exposure to secondhand smoke (SHS) at home using as a reference environmental markers (airborne nicotine and benzene) and biomarkers of exposure (cotinine in saliva and urine). This was a cross-sectional study in a convenience sample of 49 non-smoking volunteers. We found a high correlation between self-reported SHS exposure and airborne nicotine (rsp =0.806, p<0.05), salivary cotinine (rsp =0.752, p<0.05), and urinary cotinine (rsp =0.626, p<0.05). We did not find differences between the score question and the conventional ones (p >0.05). In conclusion, the significant correlation of the two questions proposed with environmental markers and personal markers indicates their potential validity to assess exposure to SHS at home.

      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.08.002
  • Gaceta Sanitaria A PRIMERA VISTA

    • Abstract: Publication date: November–December 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 6

      PubDate: 2017-11-03T01:39:33Z
  • Grado de conocimiento y actitudes de los profesionales sanitarios sobre el
           documento de voluntades anticipadas

    • Authors: Juan Miguel Aguilar-Sánchez; María José Cabañero-Martínez; Francisca Puerta Fernández; Mireia Ladios-Martín; José Fernández-de-Maya; Julio Cabrero-García
      Abstract: Publication date: Available online 28 October 2017
      Source:Gaceta Sanitaria
      Author(s): Juan Miguel Aguilar-Sánchez, María José Cabañero-Martínez, Francisca Puerta Fernández, Mireia Ladios-Martín, José Fernández-de-Maya, Julio Cabrero-García
      Objetivo Evaluar el grado de conocimiento y las actitudes sobre el documento de voluntades anticipadas (DVA) del personal médico y de enfermería de dos departamentos sanitarios, así como examinar su asociación con variables sociodemográficas y laborales de los profesionales. Método Se realizó una encuesta transversal a 329 profesionales a través de Internet y mediante un procedimiento estandarizado. Se examinaron los conocimientos y las actitudes hacia el DVA utilizando dos cuestionarios validados de 17 y 12 ítems, respectivamente. Se recogieron datos sociodemográficos y profesionales. Resultados El 45% fueron médicos/as, con una media de 13,1 (desviación típica [DT]: 8,3) años de experiencia profesional. El 67,5% fueron mujeres, con una edad media de 38,9 (DT: 9,2) años. Tuvieron actitudes muy positivas hacia el documento (media: 75,37; DT: 11,97; R=0-90), a pesar de que su nivel de conocimientos fue medio-bajo (media: 9,31; DT: 2,73; R=0-18). Tanto el nivel de conocimientos como su autopercepción se asociaron a la formación previa en cuidados paliativos, a la experiencia en el manejo del documento, su lectura o la demanda de información. La suscripción del documento se relacionó con la autopercepción de los conocimientos. Las actitudes se asociaron con la experiencia en el manejo y la actitud positiva hacia la formación. Conclusiones Los/las profesionales mostraron actitudes positivas hacia el DVA, pero escasos conocimientos sobre el mismo. La experiencia con el DVA fue la única variable que se asoció tanto a los conocimientos como a las actitudes de los profesionales. Objective To evaluate the degree of knowledge and attitudes of medical and nursing professionals in two health departments to advance directives, as well as to examine their association with the sociodemographic and occupational variables of the professionals. Methods A cross-sectional survey on 329 health professionals was carried out through the internet and a standardised procedure. The knowledge and attitudes of the professionals about advance directives were examined using two validated questionnaires of 17 and 12 items, respectively. Sociodemographic and professional data were also collected from the participants. Results 45% of the professionals were physicians, with X ¯ = 13,1 (SD: 8.3) years of professional experience. Sixty-seven point five percent were women and the mean age was 38.9 (SD: 9.2) years. Professionals had very positive attitudes towards the advance directives document ( X ¯ = 75.37 ;SD: 11.97;R=0-90), although their level of knowledge about them was medium-low ( X ¯ = 9.31 ;SD: 2.73;R=0-18). Both the level of knowledge and self-perception were associated with previous training in palliative care, experience with document management, reading, or the demand for information. Completing the document related to self-perception of knowledge. Attitudes towards the document related to experience in its use and a positive attitude t...
      PubDate: 2017-11-03T01:39:33Z
      DOI: 10.1016/j.gaceta.2017.08.006
  • Differences in the prevalence of diagnosis of overweight-obesity in
           Spanish children according to the diagnostic criteria set used

    • Authors: María Julia Ajejas Bazán; María Isab Jiménez Trujillo; Julia Wärnberg; Silvia Domínguez Fernández; Ana López de Andrés; Napoleón Pérez Farinós
      Abstract: Publication date: Available online 29 September 2017
      Source:Gaceta Sanitaria
      Author(s): María Julia Ajejas Bazán, María Isab Jiménez Trujillo, Julia Wärnberg, Silvia Domínguez Fernández, Ana López de Andrés, Napoleón Pérez Farinós
      Objective To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher.

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.07.014
  • Adecuación de las intervenciones selectivas en eventos

    • Authors: Ángel Gasch Gallén; Blanca Obón Azuara; Concepción Tomás Aznar
      Abstract: Publication date: Available online 29 September 2017
      Source:Gaceta Sanitaria
      Author(s): Ángel Gasch Gallén, Blanca Obón Azuara, Concepción Tomás Aznar

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.07.017
  • Alfabetización para la salud, más que información

    • Authors: Dolors Juvinyà-Canal; Carme Bertran-Noguer; Rosa Suñer-Soler
      Abstract: Publication date: Available online 28 September 2017
      Source:Gaceta Sanitaria
      Author(s): Dolors Juvinyà-Canal, Carme Bertran-Noguer, Rosa Suñer-Soler

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.07.005
  • Implementación de estrategias y herramientas de coordinación
           sociosanitaria en un departamento de salud

    • Authors: Pilar Botija; Mercedes Botija; Jorge Navarro
      Abstract: Publication date: Available online 27 September 2017
      Source:Gaceta Sanitaria
      Author(s): Pilar Botija, Mercedes Botija, Jorge Navarro
      Es objetivo de este artículo mostrar una experiencia de práctica novedosa implementada por la dirección de un departamento de salud. Se expone un modelo organizativo de coordinación sociosanitaria entre los diferentes niveles asistenciales y sectores, estableciendo sinergias de los recursos sociales y sanitarios comunes del Departamento de Salud Clínico-Malvarrosa (Valencia). Tras un año, se han constituido cinco consejos de salud de zona básica en atención primaria y una comisión de coordinación sociosanitaria integrada por tres subcomisiones: 1) de atención asistencial social y sanitaria, 2) de asociacionismo y voluntariado hospitalario, y 3) de acción comunitaria y participación ciudadana. La estructura organizativa propuesta se ha consolidado y las acciones realizadas se han valorado de manera positiva por las diferentes personas implicadas. Se ha generado una red de comunicación social y sanitaria: interdepartamental, extradepartamental y extrahospitalaria. The objective of this article is to show an experience of new practice as implemented by the management of a Department of Health. An organisational model is shown of sociosanitary coordination between the different levels of care and sectors, establishing synergies of the common social and health resources of the Clínico-Malvarrosa Department of Health (Valencia, Spain). After one year, five basic health councils have been set up in Primary Care and a Sociosanitary Coordination Commission composed of three subcommittees: 1) socio and health care, 2) associationism and hospital volunteering, and 3) community action and citizen participation. The proposed organisational structure has been consolidated, the actions carried out have been valued positively by the different agents involved. It has generated a network of social and health communication: interdepartmental, extra-departmental and out-of-hospital.

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.07.008
  • Explaining differences in perceived health-related quality of life: a
           study within the Spanish population

    • Authors: Jesús Martín-Fernández; Gloria Ariza-Cardiel; Elena Polentinos-Castro; Teresa Sanz-Cuesta; Antonio Sarria-Santamera; Isabel del Cura-González
      Abstract: Publication date: Available online 27 September 2017
      Source:Gaceta Sanitaria
      Author(s): Jesús Martín-Fernández, Gloria Ariza-Cardiel, Elena Polentinos-Castro, Teresa Sanz-Cuesta, Antonio Sarria-Santamera, Isabel del Cura-González
      Objective To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions. Method Cross-sectional study. Data were obtained from the Spanish National Health Survey (2012), and HRQOL was measured using the EQ-5D-5L questionnaire (utility and visual analogue scale –VAS– scores). Demographic variables, physical health condition, social variables, mental health status, and lifestyle were also analysed. Tobit regression models were employed to study the relationships between expressed HRQOL and personal characteristics. Results A total of 20,979 surveys were obtained. Of them, 62.4% expressed a utility score of 1, corresponding to perfect health (95%CI: 61.8%–63.2%), and 54.2% showed VAS scores ≥80 (95%CI: 53.5%–54.9%). HRQOL was mainly described as a function of age, chronic limitation in daily activities, and mental health status. Belonging to a higher-class strata and physical activity were related to better self-perceived HRQOL. Ageing worsened perceived HRQOL, but did not influence its determinants, and differences in HRQOL by regions were also not significant after model adjustment. Conclusion HRQOL perception in the Spanish population varied slightly depending on the measure used (utilities index or VAS). Age, chronic limitations in daily life, and mental health status best explained the variability in perception, and no meaningful differences in HRQOL perception among regions were found after adjustment.

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.05.016
  • Estado del bienestar y salud pública, una relación que debe ser

    • Authors: Fernando G. Benavides; Jordi Delclós; Consol Serra
      Abstract: Publication date: Available online 27 September 2017
      Source:Gaceta Sanitaria
      Author(s): Fernando G. Benavides, Jordi Delclós, Consol Serra
      La salud de las personas ha mejorado a lo largo del siglo xx, al mismo tiempo que se consolidaba el Estado del bienestar. Este trabajo explora la relación actual del Estado del bienestar y la salud pública. Las funciones esenciales de la salud pública se ejercen como parte del Estado, y su principal reto en la actualidad es conseguir que la salud sea protegida y promocionada en las diferentes políticas públicas, entre otras las de empleo. Los resultados de los estudios que valoran el efecto sobre la salud de los distintos tipos de Estado del bienestar son contradictorios, pero cuando se valora el impacto de políticas concretas, como por ejemplo el subsidio de desempleo, los resultados son positivos y consistentes. Sin embargo, la actual crisis del Estado del bienestar dificulta su continuidad, en gran medida por los cambios en el mercado de trabajo, con empleos más flexibles e inseguros. Human health has improved throughout the 20th century, at the same time that the Welfare State was consolidated. This paper explores the current relationship between the welfare state and public health. The essential functions of public health are exercised as part of the State, and currently the main challenge is to ensure that health is protected and promoted through different public policies, including employment. Studies assessing the health effect of different types of welfare state are contradictory, but when the impact of specific policies, such as unemployment benefits, is considered, the results are positive and consistent. However, the current crisis of the Welfare State hampers its continuity, largely due to changes in the labour market, with more flexible and insecure jobs.

      PubDate: 2017-10-03T15:06:27Z
      DOI: 10.1016/j.gaceta.2017.07.006
  • Los ingresos ectópicos y su relación con la aparición de complicaciones
           y estancias prolongadas

    • Authors: Enrique Cabrera Torres; María Aránzazu García Iglesias; María Teresa Santos Jiménez; Miguel González Hierro; María Luisa Diego Domínguez
      Abstract: Publication date: Available online 22 September 2017
      Source:Gaceta Sanitaria
      Author(s): Enrique Cabrera Torres, María Aránzazu García Iglesias, María Teresa Santos Jiménez, Miguel González Hierro, María Luisa Diego Domínguez
      Objetivo Analizar la relación entre el tipo de ingreso (ectópico y no ectópico) y la aparición de complicaciones clínicas y la estancia media. Métodos Mediante un estudio epidemiológico retrospectivo de cohorte de pacientes ingresados durante un periodo de 6 meses en el Hospital Complejo Asistencial Universitario de Salamanca se identificaron los pacientes ectópicos y no ectópicos. Se utilizaron las bases de datos del servicio de admisión, el conjunto mínimo básico de datos de hospitalización, el agrupador de pacientes por grupos relacionados por el diagnóstico (GRD) y el analizador estadístico clínico-asistencial ALCOR. El análisis se amplió detallando los resultados para los cinco GRD más frecuentes en el periodo. Resultados De un total de 11.842 ingresos, el 8,4% fueron ingresos ectópicos. En el estudio global, la estancia media fue mayor en los ectópicos (8,11 días) que en los no ectópicos (7,15 días). La mortalidad también fue superior en los ectópicos, pero aparecieron menos complicaciones (7,6% en ectópicos frente a 8,4% en no ectópicos). El análisis por GRD mantuvo estos resultados en tres de los cinco grupos analizados, con mayor estancia media, pero menos complicaciones, en los casos ectópicos. Conclusiones Un determinado porcentaje de pacientes ingresaron ectópicos. Fueron más frecuentes los pacientes de especialidades médicas ubicados en plantas quirúrgicas. Estos pacientes ectópicos presentaron una estancia media mayor respecto a los no ectópicos. No hubo diferencias significativas en la aparición de complicaciones. Objective To analyze the relationship between the type of hospital admission (outlier and non-outlier admissions) and the appearance of clinical complications and the average stay. Methods From a retrospective epidemiological study of a cohort of patients admitted to the Hospital Complejo Asistencial Universitario de Salamanca (Salamanca, Spain) over a six-month period, outlier and non-outlier patients were identified. This project had access to the admissions department database, the hospital's CMBD (in Spanish, Conjunto Mínimo Básico de Datos) for hospitalisation, the AP-DRG (All Patient-Diagnosis Related Groups) and ALCOR (a clinical-statistics analytics tool). It then proceeded to break down the results by DRG, looking at the five most common DRGs in that period. Results 8.4% of the total 11,842 admissions were medical outliers. In the overall study, the average stay was longer for outlier patients (8. 11 days) than for other patients (7.15 days). The mortality rate was, likewise, higher for outlier patients, although there was a reduced incidence of complications (7.6% for outlier patients as opposed to 8.4% for others). The analysis by DRG corroborated these results in three of the five cases investigated, showing longer average stays but fewer clinical complications in the case of outlier patients. Conclusions On admission to hospital, a significant proportion of patients were allocated beds on inappropriate wards (outlier patients). It was more common to find medical patients placed on surgical wards than vice versa. The average stay of outlier patients was longer than that of patients admitte...
      PubDate: 2017-09-27T13:27:37Z
      DOI: 10.1016/j.gaceta.2017.07.012
  • Facilitadores de la participación e implementación de la subcohorte
           PELFI de familias inmigrantes

    • Authors: Cristina Hernando Rovirola; Florianne Gaillardin; Laia Ferrer Serret; Ana Cayuela Mateo; Elena Ronda Pérez; Jordi Casabona Barbarà
      Abstract: Publication date: Available online 22 September 2017
      Source:Gaceta Sanitaria
      Author(s): Cristina Hernando Rovirola, Florianne Gaillardin, Laia Ferrer Serret, Ana Cayuela Mateo, Elena Ronda Pérez, Jordi Casabona Barbarà
      Objetivo PELFI es un estudio multicéntrico de cohortes de familias inmigradas en España. Los objetivos de este manuscrito son: 1) describir el reclutamiento, la recogida de información y las características sociodemográficas según origen y sexo de los participantes de las familias; y 2) valorar las estrategias de reclutamiento y recogida de información que facilitaron la participación en la subcohorte PELFI Badalona/SC. Método Estudio descriptivo con una muestra de conveniencia de familias inmigrantes y autóctonas residentes en Badalona y Santa Coloma de Gramanet. Se encuestaron los padres, madres e hijos >16 años, y se realizaron exámenes médicos. Resultados Participaron 115 familias. Entre las estrategias de reclutamiento, la bola de nieve logró el 69% de cooperación. La tasa de cooperación del estudio fue del 57,5% y de los exámenes médicos del 66,6%. La cooperación de las familias chinas fue del 38,5% y no se reclutaron hijos >16 años. El 28% de las encuestas se realizaron en fin de semana o por la noche. Las familias tenían un tiempo medio de residencia de 12,2 años. El 71,2% de los hijos >16 años tenían estudios secundarios finalizados. Los inmigrantes tenían una clase social más baja que los autóctonos (p<0,05) y las mujeres inmigradas menor nivel de estudios (p<0,05). Conclusiones Interaccionar frecuentemente con la comunidad, utilizar simultáneamente distintas estrategias de reclutamiento, incorporar investigadores del mismo origen geográfico que los participantes, minimizar las barreras idiomáticas y ofrecer flexibilidad de tiempo y lugar facilitó la participación. Las familias chinas presentaron mayores dificultades. Las conclusiones facilitarán la implementación de futuras cohortes de características similares. Objective PELFI is a multicentre cohort study of migrant families in Spain. The objectives of this manuscript were: 1) to describe the recruitment strategies, data collection and the main socio-demographic characteristics according to geographical origin and sex of participants of the families; and 2) to assess the recruitment and data collection strategies that facilitated participation in the basal assessment of the Badalona and Santa Coloma de Gramanet cohort. Method Descriptive study on a convenience sample of migrant and native families residing in Badalona and Santa Coloma de Gramanet. Health interviews were conducted on fathers, mothers and children>16 years; and medical examinations were performed. Results There were 115 participating families. Within the recruitment strategies, snow ball achieved 69% cooperation. The cooperation rate of the study was 57.5% and that of the clinical sub-sample was 66.6%. Cooperation rate of the Chinese families was 38.5% and Chinese children >16 years old were not recruited. Twenty-eight percent of the interviews were conducted at weekends or during the evening. Families had a mean of 12.2 years of residence. Seventy-one point two percent of the children >16 years had completed secondary studies. The migrants had lower social class than natives (p < 0.05) and the migrant women had lower levels of education (p < 0.05). Conclusions Interacting frequently with the community, using different recruitment strateg...
      PubDate: 2017-09-27T13:27:37Z
      DOI: 10.1016/j.gaceta.2017.07.010
  • Estado de bienestar y salud pública: el papel de la salud laboral

    • Authors: Fernando G. Benavides; Jordi Delclós; Consol Serra
      Abstract: Publication date: Available online 21 September 2017
      Source:Gaceta Sanitaria
      Author(s): Fernando G. Benavides, Jordi Delclós, Consol Serra
      En el contexto de la actual crisis del Estado de bienestar, la salud laboral puede contribuir significativamente a su sostenibilidad, facilitando un trabajo decente y saludable a lo largo de la vida laboral de las personas que trabajan. Para ello, la salud laboral debe afrontar el reto de la promoción de la salud, la prevención y la asistencia de lesiones, enfermedades y, sobre todo, incapacidades, basándose en una mejor coordinación de los servicios de prevención, las mutuas colaboradoras con la seguridad social y el sistema de salud, así como potenciando el liderazgo en prevención de las empresas y la participación activa de las personas que trabajan. In the context of the current crisis of the Welfare State, occupational health can contribute significantly to its sustainability by facilitating decent and healthy employment throughout the working life. To this end, occupational health must take on the challenge of promoting health, preventing and managing injuries, illnesses and disability, based on better coordination of prevention services, mutual insurance companies, and health services, as well as by empowering the leadership in prevention of companies and the active participation of those who work.

      PubDate: 2017-09-27T13:27:37Z
      DOI: 10.1016/j.gaceta.2017.07.007
  • Monitoring sedentary patterns in office employees: validity of an m-health
           tool (Walk@Work-App) for occupational health

    • Authors: Judit Bort-Roig; Anna Puig-Ribera; Ruth S. Contreras; Emilia Chirveches-Pérez; Joan C. Martori; Nicholas D. Gilson; Jim McKenna
      Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): Judit Bort-Roig, Anna Puig-Ribera, Ruth S. Contreras, Emilia Chirveches-Pérez, Joan C. Martori, Nicholas D. Gilson, Jim McKenna
      Objective This study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping. Methods The W@W-App was installed on the smartphones of office-based employees (n=17; 10 women; 26±3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker). Results During the protocol, agreement between self-paced walking (ICC=0.85) and active working tasks step counts (ICC=0.80) was good. The smallest median difference was for sitting time (1.5seconds). During free-living conditions, sitting time (ICC=0.99) and stepping (ICC=0.92) showed excellent agreement, with a difference of 0.5minutes and 18 steps respectively. Conclusions The W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness.

      PubDate: 2017-09-20T07:21:18Z
      DOI: 10.1016/j.gaceta.2017.05.004
  • Tabaco en adolescentes escolares brasileños: asociación con salud mental
           y contexto familiar

    • Authors: Camila Zander Neves; Claudine Devicari Bueno; Giovana Pires Felden; Mariane Costa Irigaray; María Fernanda Rivadeneira; Nágila Oenning; Bárbara Niegia Garcia de Goulart
      Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): Camila Zander Neves, Claudine Devicari Bueno, Giovana Pires Felden, Mariane Costa Irigaray, María Fernanda Rivadeneira, Nágila Oenning, Bárbara Niegia Garcia de Goulart
      Objetivo Estudiar la asociación entre aspectos de la salud mental y el contexto familiar con la experimentación y el consumo de tabaco en jóvenes escolares brasileños. Método Estudio transversal utilizando datos de la Encuesta Nacional de Salud Escolar de Brasil, que incluyó 109.104 escolares del noveno año de formación fundamental, turno diurno, de escuelas públicas y privadas de los 26 Estados y el Distrito Federal. Se realizó un análisis descriptivo de las variables, análisis bivariado y multivariado, con obtención de odds ratio (OR) e intervalo de confianza del 95% (IC95%). Resultados El 20,9% de los escolares experimentaron el tabaco por lo menos una vez en la vida. Los adolescentes que presentaban sentimientos de soledad más frecuentemente (OR: 2,07; IC95%: 1,98-2,16), dificultad para dormir (OR: 2,37; IC95%: 2,52-2,48) y menor interacción social (OR: 1,27; IC95%: 1,26-1,32) se asociaron más frecuentemente con consumo de tabaco, con independencia del tipo de escuela, el sexo y el color de piel. Los escolares de padres o responsables poco comprensivos (OR: 2,39; IC95%: 2,29-2,49), o que no saben lo que los hijos hacen en su tiempo libre (OR: 1,52; IC95%: 1,46-1,59), se asociaron con consumo frecuente de cigarrillos. Conclusión Se evidenció una asociación entre la salud mental y el contexto familiar con la experimentación y el uso de tabaco en adolescentes escolarizados brasileños, independientemente del tipo de escuela, sexo y color de piel. Es importante que programas destinados a prevenir y retardar la experimentación y el uso de tabaco en la adolescencia enfaticen en estos hallazgos y se planteen estrategias en ámbitos de salud mental y familiar. Objective To study the association between aspects of mental health and the family context with tobacco experimentation and consumption among Brazilian schoolchildren. Method A cross-sectional study using data from the National Survey of Schoolchildren's Health in Brazil conducted on 109,104 schoolchildren from the ninth year of elementary school, day scholars in public and private schools in all Brazilian state capitals and the Federal District. Descriptive analysis of variables, bivariate and multivariate analyses were performed with logistic regression estimates, adjusted for socioeconomic variables, obtaining the odds ratio (OR) and 95% confidence interval (95%CI). Results Among the participants, 52.2% were female. Twenty point nine percent of the students reported having experimented with cigarettes at least once. Adolescents who experienced more often feelings of loneliness (OR: 2.07; 95%CI: 1.98-2.16), difficulty sleeping (OR: 2.37; 95%CI: 2.52-2.48) and lower social interaction (OR: 1.27; 95%CI: 1.26-1.32), were more likely to smoke, regardless of socioeconomic status. The schoolchildren of parents or caregivers (OR: 2.39; 95%CI: 2.29-2.49) who did not know what their children did in their free time (OR: 1.52; 95%CI: 1.46-1.59) were associated with more frequent cigarette smoking. Conclusion An association was seen between aspects of mental health and the family context with the experimentation and consumption of tobacco in adolescents enrolled in the study in Brazil. These associations are independent of schoo...
      PubDate: 2017-09-20T07:21:18Z
      DOI: 10.1016/j.gaceta.2017.07.003
  • Conducta sexual y realización de la prueba del virus de la
           inmunodeficiencia humana en jóvenes que estudian en la universidad en
           Cuzco (Perú)

    • Authors: M. Paz Bermúdez; M. Teresa Ramiro; Inmaculada Teva; Tamara Ramiro-Sánchez; Gualberto Buela-Casal
      Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): M. Paz Bermúdez, M. Teresa Ramiro, Inmaculada Teva, Tamara Ramiro-Sánchez, Gualberto Buela-Casal
      Objetivo El objetivo era analizar la conducta sexual, la realización de la prueba del virus de la inmunodeficiencia humana (VIH), las intenciones para hacérsela y los motivos para no realizársela en jóvenes estudiantes en la universidad en Cuzco (Perú). Métodos Participaron 1377 estudiantes universitarios/as de diversas instituciones de educación superior de Cuzco (Perú). El rango de edad era de 16 a 30 años. Se aplicó un cuestionario sobre conducta sexual y realización de la prueba del VIH. El tamaño de la muestra se estableció considerando un nivel de confianza del 97% y un error de estimación del 3%. El cuestionario se cumplimentó en las aulas durante las horas lectivas. Resultados Un mayor porcentaje de varones que de mujeres ha tenido sexo vaginal, anal y oral, un mayor número de parejas sexuales y un inicio a una edad más temprana en el sexo vaginal y oral. Un mayor porcentaje de mujeres que de varones no utilizó el preservativo en la primera relación sexual anal y tenía un mayor índice de riesgo anal. La mayoría de los/las jóvenes no se había realizado nunca la prueba del VIH. El principal motivo para no hacérsela era la seguridad de no estar infectados/as. Conclusiones Parece existir una baja percepción de riesgo frente al VIH en los/las jóvenes a pesar de implicarse en conductas sexuales de riesgo. Es necesaria la realización de campañas de prevención dirigidas tanto a la población general como a las poblaciones clave, y considerar especialmente a la juventud. Objective To analyse sexual behaviour, HIV testing, HIV testing intentions and reasons for not testing for HIV in university students from Cuzco (Peru). Methods The sample comprised 1,377 university students from several institutions from Cuzco (Peru). The size of the sample was set according to a maximum 3% error estimation and a 97% confidence interval. Ages ranged from 16 to 30 years old. The data were collected through a self-administered, anonymous and voluntary questionnaire regarding sexual behaviour and HIV testing. The data were collected in classrooms during teaching hours. Results A higher percentage of males than females reported having had vaginal, anal and oral sex, a higher number of sexual partners and an earlier age at first vaginal and oral sex. A higher percentage of females than males did not use condoms when they first had anal sex and had a higher anal sex-risk index. Most of the participants had never been HIV tested. The main reason was that they were sure that they were not HIV infected. Conclusions It seems that there was a low HIV risk perception in these participants despite the fact that they had been involved in sexual risk behaviours. Prevention campaigns focused on the general population as well as the at-risk populations and young people are needed.

      PubDate: 2017-09-20T07:21:18Z
      DOI: 10.1016/j.gaceta.2017.07.002
  • Recortes en los presupuestos sanitarios y listas de espera

    • Authors: Marciano Sánchez-Bayle; Luis Palomo
      Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): Marciano Sánchez-Bayle, Luis Palomo

      PubDate: 2017-09-20T07:21:18Z
      DOI: 10.1016/j.gaceta.2017.07.013
  • Sarampión en Europa: necesidad de acción global y local para su

    • Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): Adrián González-Marrón, José M. Martínez-Sánchez

      PubDate: 2017-09-20T07:21:18Z
  • Reticencia vacunal: análisis del discurso de madres y padres con rechazo
           total o parcial a las vacunas

    • Authors: Maite Cruz Piqueras; Ainhoa Rodríguez García de Cortazar; Joaquín Hortal Carmona; Javier Padilla Bernáldez
      Abstract: Publication date: Available online 18 September 2017
      Source:Gaceta Sanitaria
      Author(s): Maite Cruz Piqueras, Ainhoa Rodríguez García de Cortazar, Joaquín Hortal Carmona, Javier Padilla Bernáldez
      Objetivo Analizar y comprender los discursos reticentes a la vacunación, particularmente los de las personas que han decidido no vacunar a sus hijos/as. Métodos Estudio cualitativo con cinco entrevistas individuales y dos grupos focales con personas que optaron por no vacunar a su hijos/as en la provincia de Granada. Resultados Padres y madres manifiestan un sistema de creencias en salud diferente al paradigma biomédico. Desde el punto de vista ético, justifican su posición a partir del derecho a la autonomía y la responsabilidad de sus decisiones. Como argumentos concretos, dudan de la administración de varias vacunas simultáneamente en edades muy tempranas de manera sistemática y sin individualizar cada caso, temen efectos adversos y no entienden la variabilidad en el calendario vacunal. Conclusiones Los discursos reticentes responden al conflicto de individualidad vs. colectividad: padres y madres, en defensa de su derecho a una crianza sin interferencias del Estado, centran su responsabilidad en el bienestar individual de sus hijos/as independientemente de las consecuencias que su acción u omisión conlleve a la colectividad. En su gestión de los riesgos, elevan los derivados de vacunar por encima de las consecuencias individuales y colectivas de no hacerlo. Las vacunas que más dudas generan son aquellas con mayor controversia en el ámbito científico. La transparencia en la comunicación de efectos adversos, el respeto de las autoridades a otros conceptos de salud/enfermedad, el destierro del término «antivacunas» del lenguaje mediático y científico, y el desarrollo de espacios de diálogo son puentes por construir. Objective To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters. Methods Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain). Results Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule. Conclusions These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term R...
      PubDate: 2017-09-20T07:21:18Z
      DOI: 10.1016/j.gaceta.2017.07.004
  • Gaceta Sanitaria A PRIMERA VISTA

    • Abstract: Publication date: September–October 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 5

      PubDate: 2017-09-09T05:36:03Z
  • Compra de alimentos de proximidad en los comedores escolares de
           Andalucía, Canarias y Principado de Asturias

    • Authors: Panmela Soares; Pablo Caballero; Mari Carmen Davó-Blanes
      Abstract: Publication date: Available online 24 August 2017
      Source:Gaceta Sanitaria
      Author(s): Panmela Soares, Pablo Caballero, Mari Carmen Davó-Blanes
      Objetivo Explorar y comparar las características de los centros de educación primaria (CEP) de Andalucía, Canarias y Principado de Asturias en función de si compran o no alimentos de proximidad para los comedores escolares, así como la opinión de los/las responsables del comedor sobre los beneficios y las dificultades para incorporarla. Método Mediante un cuestionario electrónico se recogió información de las características de 186 CEP y la opinión de los/las responsables del comedor sobre los beneficios/dificultades de la compra de alimentos de proximidad. Los datos se estratificaron según la forma de adquisición de los alimentos (compra de alimentos de proximidad: sí/no) y se aplicó el test de ji al cuadrado. Resultados El 38,2% de los CEP estudiados compra alimentos de proximidad. Es más frecuente en centros de zonas rurales (51,0%), con comedores autogestionados (80,0%) y con cocina propia (65,5%). Dichos centros cuentan con menús más económicos que sus homólogos (69,8%), participan con mayor frecuencia en programas de alimentación saludable (81,5%) y compran más alimentos ecológicos (65,8%). Según la mayoría de los/las participantes cuyos centros compran alimentos de proximidad, sus beneficios son el fomento de la economía local (97,2%), la oferta de alimentos frescos (97,2%) y la sostenibilidad ambiental (93%), y sus dificultades son la capacidad productiva de la región (50,7%), la variación estacional de la producción (71,8%) y la falta de apoyo (42,3%) y de información de la Administración (46,5%). Conclusión La ubicación de los centros, la gestión del comedor y la disponibilidad de cocina pueden condicionar el desarrollo de la compra de alimentos de proximidad en las escuelas. El apoyo institucional podría ayudar a integrarla en los CEP, mejorando la alimentación escolar con menor coste económico y ambiental. Objective To explore and compare the characteristics of Primary Education Centres (PEC) in Andalusia, the Canary Islands and the Principality of Asturias depending on whether or not they make local food purchases (LFP) for school meals and to explore the opinion of cafeteria managers about the benefits and challenges of this type of purchase. Method Information on the characteristics of 186 PECs and opinions of cafeteria managers about the benefits/challenges of LFP was collected through an electronic questionnaire. Data were stratified according to how the products were purchased (LFP: yes/no), and the chi square test was applied. Results 38.2% of the PECs studied make LFP. This is more frequent in rural areas (51.0 with self-managed cafeterias (80.0%), and their own kitchen (65.5%). These centres have less expensive menus than their peers (69.8%), participate more frequently in healthy eating programmes (81.5%) and purchase more organic food products (65.8%). According to the majority of the participants whose centres engage in LFP, the benefits include: supporting the local economy (97.2%), the offer of fresh foods (97.2%) and environmental sustainability (93.0%). The challenges include: productive capacity of the region (50.7%), the seasonal variation in food production (71.8%), and the lack of support (42.3%) and information from the government (46.5%). Conclusion The location of the centres, the management of the cafeteria and the availability of ...
      PubDate: 2017-09-03T04:06:57Z
      DOI: 10.1016/j.gaceta.2017.05.015
  • 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
  • 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
  • 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
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