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  Subjects -> HEALTH AND SAFETY (Total: 1292 journals)
    - CIVIL DEFENSE (18 journals)
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HEALTH AND SAFETY (521 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 180)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
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  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
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: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
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: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 7)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
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: 9)
Health and Social Work     Hybrid Journal   (Followers: 47)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 33)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
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: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Services Insights     Open Access   (Followers: 2)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 11)
Health, Risk & Society     Hybrid Journal   (Followers: 10)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
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: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)

        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  [3042 journals]
  • Vigilancia en salud pública: una necesidad inaplazable

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

      PubDate: 2017-06-17T04:13:25Z
      DOI: 10.1016/j.gaceta.2016.12.016
  • Hacia una salud pública con orgullo: equidad en la salud en las personas
           lesbianas, gais, bisexuales y trans en España

    • Authors: Christian Carlo Gil-Borrelli; César Velasco; Carlos Iniesta; Paula de Beltrán; Javier Curto; Pello Latasa
      Pages: 175 - 177
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Christian Carlo Gil-Borrelli, César Velasco, Carlos Iniesta, Paula de Beltrán, Javier Curto, Pello Latasa

      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2016.09.013
  • Gaceta Sanitaria se suma a la iniciativa REWARD para mejorar la
           investigación biomédica y reducir el desperdicio en ciencia

    • Authors: Clara Bermúdez-Tamayo; Julia Bolívar Muñoz; Erica Briones Vozmediano; Mercedes Elcira Carrasco Portiño; María Victoria Zunzunegui Pastor; Miguel Ángel Negrín; Laura Inés González Zapata; Leila Posenato García; Carlos Álvarez-Dardet Díaz
      Pages: 178 - 179
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Clara Bermúdez-Tamayo, Julia Bolívar Muñoz, Erica Briones Vozmediano, Mercedes Elcira Carrasco Portiño, María Victoria Zunzunegui Pastor, Miguel Ángel Negrín, Laura Inés González Zapata, Leila Posenato García, Carlos Álvarez-Dardet Díaz

      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2017.03.002
  • Primary health care attributes and responses to intimate partner violence
           in Spain

    • Authors: Isabel Goicolea; Paola Mosquera; Erica Briones-Vozmediano; Laura Otero-García; Marta García-Quinto; Carmen Vives-Cases
      Pages: 187 - 193
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Isabel Goicolea, Paola Mosquera, Erica Briones-Vozmediano, Laura Otero-García, Marta García-Quinto, Carmen Vives-Cases
      Objective This study provides an overview of the perceptions of primary care professionals on how the current primary health care (PHC) attributes in Spain could influence health-related responses to intimate partner violence (IPV). Methods A qualitative study was conducted using semi-structured interviews with 160 health professionals working in 16 PHC centres in Spain. Data were analysed using a qualitative content analysis. Results Four categories emerged from the interview analysis: those committed to the PHC approach, but with difficulties implementing it; community work relying on voluntarism; multidisciplinary team work or professionals who work together?; and continuity of care hindered by heavy work load. Participants felt that person-centred care as well as other attributes of the PHC approach facilitated detecting IPV and a better response to the problem. However, they also pointed out that the current management of the health system (workload, weak supervision and little feedback, misdistribution of human and material resources, etc.) does not facilitate the sustainability of such an approach. Conclusion There is a gap between the theoretical attributes of PHC and the “reality” of how these attributes are managed in everyday work, and how this influences IPV care.

      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2016.11.012
  • Indicadores contextuales para evaluar los determinantes sociales de la
           salud y la crisis económica española

    • Authors: Andrés Cabrera-León; Antonio Daponte Codina; Inmaculada Mateo; Elena Arroyo-Borrell; Xavier Bartoll; María José Bravo; María Felicitas Domínguez-Berjón; Gemma Renart; Carlos Álvarez-Dardet; Marc Marí-Dell’Olmo; Julia Bolívar Muñoz; Marc Saez; Vicenta Escribà-Agüir; Laia Palència; María José López; Carme Saurina; Vanessa Puig; Unai Martín; Mercè Gotsens; Carme Borrell; Laura Serra Saurina; Luis Sordo; Amaia Bacigalupe; Maica Rodríguez-Sanz; Glòria Pérez; Albert Espelt; Miguel Ruiz; Mariola Bernal
      Pages: 194 - 203
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Andrés Cabrera-León, Antonio Daponte Codina, Inmaculada Mateo, Elena Arroyo-Borrell, Xavier Bartoll, María José Bravo, María Felicitas Domínguez-Berjón, Gemma Renart, Carlos Álvarez-Dardet, Marc Marí-Dell’Olmo, Julia Bolívar Muñoz, Marc Saez, Vicenta Escribà-Agüir, Laia Palència, María José López, Carme Saurina, Vanessa Puig, Unai Martín, Mercè Gotsens, Carme Borrell, Laura Serra Saurina, Luis Sordo, Amaia Bacigalupe, Maica Rodríguez-Sanz, Glòria Pérez, Albert Espelt, Miguel Ruiz, Mariola Bernal
      Objetivo Proporcionar indicadores para evaluar, en España y en sus comunidades autónomas, el impacto sobre la salud, sus determinantes sociales y las desigualdades en salud del contexto social y de la crisis económica más reciente. Métodos Basándonos en el marco conceptual de los determinantes de las desigualdades sociales en salud en España, identificamos indicadores secuencialmente a partir de documentos clave, Web of Science y organismos con estadísticas oficiales. La información recopilada dio lugar a un directorio amplio de indicadores que fue revisado por un panel de expertos. Posteriormente seleccionamos un conjunto de esos indicadores según un criterio geográfico y otro temporal: disponibilidad de datos según comunidades autónomas y al menos desde 2006 hasta 2012. Resultados Identificamos 203 indicadores contextuales sobre determinantes sociales de la salud y seleccionamos 96 (47%) según los criterios anteriores. De los indicadores identificados, el 16% no cumplieron el criterio geográfico y el 35% no cumplieron el criterio temporal. Se excluyó al menos un 80% de los indicadores relacionados con la dependencia y los servicios de salud. Los indicadores finalmente seleccionados cubrieron todas las áreas de los determinantes sociales de la salud. El 62% de estos no estuvieron disponibles en Internet. Alrededor del 40% de los indicadores se extrajeron de fuentes relacionadas con el Instituto Nacional de Estadística. Conclusiones Proporcionamos un amplio directorio de indicadores contextuales sobre determinantes sociales de la salud y una base de datos que facilitarán la evaluación, en España y sus comunidades autónomas, del impacto de la crisis económica sobre la salud y las desigualdades en salud. Objective To provide indicators to assess the impact on health, its social determinants and health inequalities from a social context and the recent economic recession in Spain and its autonomous regions. Methods Based on the Spanish conceptual framework for determinants of social inequalities in health, we identified indicators sequentially from key documents, Web of Science, and organisations with official statistics. The information collected resulted in a large directory of indicators which was reviewed by an expert panel. We then selected a set of these indicators according to geographical (availability of data according to autonomous regions) and temporal (from at least 2006 to 2012) criteria. Results We identified 203 contextual indicators related to social determinants of health and selected 96 (47%) based on the above criteria; 16% of the identified indicators did not satisfy the geographical criteria and 35% did not satisfy the temporal criteria. At least 80% of the indicators related to dependence and healthcare services were excluded. The final selection of indicators covered all areas for social determinants of health, and 62% of these were not available on the Internet. Around 40% of the indicators were extracted from sources related to the Spanish Statistics Institute.
      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2016.06.014
  • Impacto del abuso sexual durante la infancia-adolescencia en las
           relaciones sexuales y afectivas de mujeres adultas

    • Authors: Sílvia López; Concepció Faro; Lourdes Lopetegui; Enriqueta Pujol-Ribera; Mònica Monteagudo; Jesús Cobo; María Isabel Fernández
      Pages: 210 - 219
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Sílvia López, Concepció Faro, Lourdes Lopetegui, Enriqueta Pujol-Ribera, Mònica Monteagudo, Jesús Cobo, María Isabel Fernández
      Objetivo Analizar la satisfacción sexual percibida, las disfunciones sexuales, la satisfacción con las relaciones afectivas, la confianza y la comunicación con la pareja actual, en función del antecedente de abuso sexual en la infancia y la adolescencia, y el tipo padecido, en mujeres atendidas dentro del Programa de Atención a la Salud Sexual y Reproductiva de Catalunya (PASSIR). Método Estudio multicéntrico, descriptivo y transversal. Participaron 1013 mujeres mayores de 18 años, atendidas en visita psicológica en los 24 Centros del PASSIR. Se utilizó un cuestionario estructurado autoadministrado y anónimo adaptado del Cuestionario de abuso sexual en la infancia y adolescencia de Wyatt (1985) y Dubé et al. (2005), y el Female Sexual Function Index de Rosen (2000). Análisis estadístico descriptivo, bivariado y multivariado. Resultados Todas las disfunciones sexuales resultaron significativamente más frecuentes en las mujeres que padecieron abuso sexual en la infancia y la adolescencia, y la satisfacción sexual percibida fue menor. Las situaciones de abuso sexual con intento de penetración o penetración se asociaron a más dificultades de excitación y mayor rechazo. Las mujeres que sufrieron abuso sexual en la infancia y la adolescencia manifestaron menos confianza y más dificultades de comunicación con la pareja. Conclusiones Es necesario identificar un posible abuso sexual en la infancia y la adolescencia en las mujeres que consultan por problemas con sus parejas, y continuar investigando sobre factores protectores e intervenciones terapéuticas tendentes a paliar las consecuencias de dicho abuso al llegar a la vida adulta. Objective To analyse perceived sexual satisfaction, sexual dysfunction, satisfaction with affective relationships and confidence and communication in existing relationships, related to a past history of childhood sexual abuse (CSA) and type suffered, among women treated as part of the Catalonian Sexual and Reproductive Health Care Programme (PASSIR). Method Multicentric, descriptive, cross-sectional study. A total of 1,013 women over the age of 18 years, who underwent psychological therapy at any of the 24 PASSIR centres, were enrolled. A structured, anonymised, self-administered Sex History Questionnaire adapted from Wyatt (1985) & Dubé et al. (2005), and the Female Sexual Function Index (Rosen, 2000), were used. Statistical analysis was descriptive, bivariate and multivariate. Results Women who suffered childhood sexual abuse had a significantly higher prevalence of sexual dysfunction, with lower perceived sexual satisfaction. CSA with penetration or attempted penetration was associated with greater arousal difficulties and greater rejection. Women who experienced CSA were less confident and experienced greater communication difficulties with their partner. Conclusions It is necessary to identify potential childhood sexual abuse among women who seek therapy due to relationship problems. It is also necessary to continue research into protective factors and therapeutic interventions to alleviate the consequences of CSA in adult life.

      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2016.05.010
  • La validez del Conjunto Mínimo Básico de Datos como fuente de
           identificación de las anomalías congénitas en la Comunitat Valenciana

    • Authors: Clara Cavero-Carbonell; Silvia Gimeno-Martos; Óscar Zurriaga; María José Rabanaque-Hernández; Carmen Martos-Jiménez
      Pages: 220 - 226
      Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3
      Author(s): Clara Cavero-Carbonell, Silvia Gimeno-Martos, Óscar Zurriaga, María José Rabanaque-Hernández, Carmen Martos-Jiménez
      Objetivo Evaluar la validez del Conjunto Mínimo Básico de Datos (CMBD) para identificar anomalías congénitas mayores en la Comunitat Valenciana. Métodos Se realizó un estudio epidemiológico retrospectivo. Del CMBD se seleccionaron las altas en menores de un año nacidos en 2007, residentes en la Comunitat Valenciana con código de anomalía congénita (740-759 CIE9-MC) y una muestra aleatoria de menores de un año sin altas con estos códigos. Tras revisar la documentación clínica, se clasificaron como verdaderos positivos y negativos y falsos positivos y negativos. Se calcularon el valor predictivo positivo y negativo y la sensibilidad. Se analizaron la concordancia de los diagnósticos entre el CMBD y la documentación clínica utilizando la prueba kappa. Resultados Se identificaron 2305 altas de 1651 pacientes. En los 544 pacientes de la muestra, 4 tenían alguna anomalía congénita mayor. El valor predictivo positivo fue del 56,4% (intervalo de confianza del 95% [IC95%]: 53,9-58,8) y el negativo fue del 99,3% (IC95%: 98,6-100,0). La sensibilidad del CMBD fue del 68,6% (IC95%: 66,1-71,1). Los códigos más frecuentes en los verdaderos positivos fueron: 745.5 (Comunicación interauricular), 745.4 (Comunicación interventricular) y 747.0 (Ductus arterioso persistente), y en los falsos positivos: 747.0, 745.5 y 752.51 (Criptorquidia). El 25,5% de los diagnósticos con anomalía congénita del CMBD no estaban en la historia clínica. Considerando todos los diagnósticos codificados en el CMBD, la concordancia fue de 0,70 (IC95%: 0,68-0,72). Conclusiones El CMBD es la principal fuente de información para la identificación de casos para el Registro Poblacional de Anomalías Congénitas de la Comunitat Valenciana, pero su principal limitación es el elevado número de casos falsos positivos que detecta. Objective To assess the validity of the Spanish Minimum Basic Data Set (MBDS) for identifying major congenital anomalies in the Valencian Community. Methods A retrospective epidemiological study was carried out. Children under the age of one year, born in 2007 and residing in the Valencian Community with congenital anomalies code 740-759 CIE9-MC, were selected from the MBDS, in addition to a random sample of children under the age of 1 year without these discharge codes. Having reviewed the clinical documentation, the cases were classified as true positives and negatives and false positives and negatives. Positive and negative predictive value and sensitivity were calculated. The kappa test was applied to analyse diagnostic consistency between the MBDS and the clinical documentation. Results A total of 2305 discharges of 1651 patients were identified. 4 out of the 5434 patients sampled had a major congenital abnormality. The positive predictive value was 56.4% (95% confidence interval [95%CI]: 53.9-58.8) and the negative predictive value was 99.3% (95%CI: 98.6-100.0). MBDS sensitivity was 68.6% (95%CI: 66.1-71.1). The most common codes in the true positives were: 745.5 (atrial septal defect), 745.4 (ventricular septal defect) and 747.0 (patent ductus arteriosus) and in the false positives: 747.0, 745.5 and 752.51 (cryptorchidism). 25.5% of diagnoses with congenital anomaly from the MBDS were not in the clinical documentation. Considering all diagnoses coded in the MBDS, the correlation was 0.70 (95%CI: 0.68-0.72)
      PubDate: 2017-04-25T14:14:58Z
      DOI: 10.1016/j.gaceta.2016.09.014
  • Hombres que tienen sexo con hombres y detección del virus de la
           inmunodeficiencia humana en odontología

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    • Authors: Pilar Murillo; Miguel San Sebastián; Carmen Vives-Cases; Isabel Goicolea
      Abstract: Publication date: Available online 22 May 2017
      Source:Gaceta Sanitaria
      Author(s): Pilar Murillo, Miguel San Sebastián, Carmen Vives-Cases, Isabel Goicolea
      Objetivo Analizar la capacidad de respuesta a la violencia del compañero íntimo (VCI) de profesionales sanitarios/as españoles/as en atención primaria e identificar posibles determinantes que puedan favorecer una mejor respuesta. Método Estudio transversal con muestreo no probabilístico y por conveniencia en profesionales sanitarios/as de 15 centros de atención primaria españoles. El instrumento Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), en su versión validada y traducida al español, permitió recolectar información sobre conocimientos, opiniones y prácticas sobre VCI. Se realizaron análisis estadísticos descriptivo y de regresión lineal bivariada y multivariada. Resultados Se recibieron 265 cuestionarios diligenciados, con una tasa de respuesta del 80,3%. Se observó un efecto exposición-respuesta, en el que a más horas de formación, mayor puntuación en las escalas del cuestionario (p <0,05). La edad, el tipo de profesión, los años de experiencia en atención primaria, las horas de formación en VCI y la lectura del protocolo mostraron asociación positiva con conocimientos (preparación percibida, conocimiento percibido, conocimiento real), opiniones (preparación del equipo, requerimientos legales, autoeficacia, disponibilidad de recursos en el lugar de trabajo, barreras, entendimiento de la víctima) y prácticas del personal sanitario. Conclusiones Leer el protocolo de actuación regional/nacional y recibir formación en VCI fueron las intervenciones más importantes asociadas a una mejor capacidad de respuesta a la VCI de los/las profesionales sanitarios/as en atención primaria. Objective To analyse the Spanish primary care professionals’ readiness to respond to intimate partner violence (IPV) in primary care and identify possible determinants that could facilitate a better response. Method A cross-sectional study with a non-probabilistic sampling by convenience was performed among healthcare professionals working in 15 primary care centres in Spain. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), the version validated and translated into Spanish, was the instrument used to collect information about knowledge, opinions and practices regarding intimate partner violence. Descriptive analysis and, simple and multiple linear regression analysis were performed. Results A total of 265 completed questionnaires were received, with a response rate of 80.3%. An exposure-response effect was observed, where at higher hours of training a higher score was obtained on the questionnaire sections (p <0.05). Age, type of profession, years of experience in primary care, hours of IPV training and reading the protocol showed positive association with knowledge (perceived preparation, perceived knowledge, actual knowledge), opinions (staff preparation, legal requirements, self-efficacy, workplace issues, constraints, understanding of the victim) and practice of healthcare professionals. Conclusions Reading the regional/national protocol for action and receiving training in IPV were the most important interventions associated to a better primary care professionals’ readiness to respond to IPV in Spanish primary care settings.
      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.03.003
  • 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
      Abstract: Publication date: Available online 22 May 2017
      Source:Gaceta Sanitaria
      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: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.01.014
  • Cambios en las diferencias por sexo en la esperanza de vida en España
           (1980-2012): descomposición por edad y causa

    • Authors: Juan Manuel García González; Rafael Grande
      Abstract: Publication date: Available online 19 May 2017
      Source:Gaceta Sanitaria
      Author(s): Juan Manuel García González, Rafael Grande
      Objetivo Calcular y analizar las contribuciones de los cambios de la mortalidad por grupos de edad y causas de muerte seleccionadas a la diferencia por sexo en la esperanza de vida al nacimiento en España, de 1980 a 2012. Métodos Estudio transversal con tres momentos temporales (1980, 1995 y 2012). Datos de Human Cause-of-Death Database y de Human Mortality Database. Se utiliza la técnica de descomposición de las diferencias en la esperanza de vida a partir de los cambios en la mortalidad por edad quinquenal y las causas de muerte entre mujeres y hombres. Resultados De 1980 a 1995, el incremento se sustentó en las contribuciones generadas por la menor mortalidad de las mujeres desde los 25 años de edad y en la diferencia en mortalidad por virus de la inmunodeficiencia humana (VIH)/sida, cáncer de pulmón y enfermedades pulmonares obstructivas crónicas. De 1995 a 2012, el recorte se generó por la mayor mejora en la mortalidad de los hombres hasta los 74 años de edad, y por la mejora en la mortalidad masculina por VIH/sida, infarto agudo de miocardio y accidentes de tráfico. Conclusiones La diferencia en la esperanza de vida entre hombres y mujeres ha disminuido desde 1995, debido a la mejora en la mortalidad por causas de muerte asociadas a conductas y hábitos de riesgo de la población masculina en edad activa. Objective To calculate and analyse the contributions of changes in mortality by age groups and selected causes of death to sex differences in life expectancy at birth in Spain from 1980 to 2012. Methods Cross-sectional study with three time points (1980, 1995, and 2012). We used data from Human Cause-of-Death Database and Human Mortality Database. We use a decomposition method of the differences in life expectancy and gender differences in life expectancy from changes in mortality by 5-year age groups and causes of death between women and men. Results From 1980 to 1995, the lower mortality of women from 25 years old, and the differences in mortality by HIV/AIDS, lung cancer, and chronic obstructive pulmonary diseases contributed to the gap increase. From 1995 to 2012, greatest improvement in mortality of males under 74 years of age, and in improving male mortality from HIV/AIDS, acute myocardial infarction and traffic accidents contributed to the narrowing. Conclusions The difference in life expectancy at birth between men and women has decreased since 1995 due to a greater improvement in mortality from causes of death associated with risky behaviours and habits of the working age male population.

      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.03.004
  • The value of comparative research in major day surgery

    • Authors: Alba Llop-Gironés; Montse Vergara-Duarte; Josep Anton Sánchez; Gemma Tarafa; Joan Benach
      Abstract: Publication date: Available online 19 May 2017
      Source:Gaceta Sanitaria
      Author(s): Alba Llop-Gironés, Montse Vergara-Duarte, Josep Anton Sánchez, Gemma Tarafa, Joan Benach
      Objective To measure time trends in major day surgery rates according to hospital ownership and other hospital characteristics among the providers of the public healthcare network of Catalonia, Spain. Method Data from the Statistics of Health Establishments providing Inpatient Care. A generalized linear mixed model with Gaussian response and random intercept and random slopes. Results The greatest growth in the rate of major day surgery was observed among private for-profit hospitals: 42.9 (SD: 22.5) in 2009 versus 2.7 (SD: 6.7) in 1996. These hospitals exhibited a significant increase in major day surgery compared to public hospitals (coefficient 2; p-value <0.01) Conclusions The comparative evaluation of hospital performance is a decisive tool to ensure that public resources are used as rationally and efficiently as possible.

      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.02.005
  • López S, Pi-Sunyer MT. Morir cuando la vida empieza. Conocer y despedir
           al hijo al mismo tiempo. Pamplona: Editorial Círculo Rojo; 2015. ISBN:
           978-84-9095-759-2. 187 p

    • Authors: Ernesto
      Abstract: Publication date: Available online 19 May 2017
      Source:Gaceta Sanitaria
      Author(s): Ernesto Magallón-Neri

      PubDate: 2017-05-23T14:35:39Z
  • Differences in the economic valuation and determining factors of informal
           care over time: the case of blood cancer

    • Authors: Marta Ortega-Ortega; Roberto Montero-Granados; Juan de Dios Jiménez-Aguilera
      Abstract: Publication date: Available online 19 May 2017
      Source:Gaceta Sanitaria
      Author(s): Marta Ortega-Ortega, Roberto Montero-Granados, Juan de Dios Jiménez-Aguilera
      Objective To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. Methods 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant). Economic value of informal care was estimated using proxy good and opportunity cost methods. Ordered and binary logistic models were performed to identify factors associated with informal care. Results 123 patients reported having received informal care. A progressive reduction of the number of hours of care was observed between phases. Monetary value per patient ranged from 1,288 to 3,409; 1,045 to 2,786; and 336 to 854 €/month in the short, medium and long term, respectively. Patients with acute leukaemia and those who received an unrelated allogeneic transplantation were 22% (short-term) and 33.5% (medium-term) more likely to receive more than 8hours/day of care respect to patients diagnosed with lymphoma and autologous transplantation. In the long term, patients with multiple myeloma were more likely to receive more care. Better health status and higher educational level were associated with fewer daily hours of care. Conclusions Informal care varies greatly between stages of the treatment depending on the clinical and sociodemographic factors. Significant caring time and societal costs are associated with such care in blood cancer patients.

      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.02.006
  • ¿Cómo ven los residentes y los estudiantes de medicina los conflictos de
           intereses en la clínica?

    • Authors: Carme Agra Tuñas; Susana Rujido Freire; Antonio Rodríguez Núñez
      Abstract: Publication date: Available online 19 May 2017
      Source:Gaceta Sanitaria
      Author(s): Carme Agra Tuñas, Susana Rujido Freire, Antonio Rodríguez Núñez

      PubDate: 2017-05-23T14:35:39Z
      DOI: 10.1016/j.gaceta.2017.01.015
  • Gaceta Sanitaria a primera vista

    • Abstract: Publication date: May–June 2017
      Source:Gaceta Sanitaria, Volume 31, Issue 3

      PubDate: 2017-04-25T14:14:58Z
  • Análisis de contenido de la publicidad de productos alimenticios
           dirigidos a la población infantil

    • Authors: José Antonio Ponce-Blandón; Manuel Pabón-Carrasco; María de las Mercedes Lomas-Campos
      Abstract: Publication date: Available online 3 March 2017
      Source:Gaceta Sanitaria
      Author(s): José Antonio Ponce-Blandón, Manuel Pabón-Carrasco, María de las Mercedes Lomas-Campos
      Objetivo Conocer los contenidos y los mecanismos de persuasión utilizados en los anuncios de productos alimenticios procesados dirigidos al público infantil en Andalucía, comparándolos con los dirigidos al público adulto. Métodos Estudio basado en la técnica de análisis del contenido publicitario, con dos fases: una de diseño descriptivo y otra de diseño analítico observacional. Se procedió a seleccionar una muestra de anuncios procedentes de 60 horas de programación de los dos canales de televisión de mayor audiencia en Andalucía. Resultados Se obtuvieron 416 anuncios de productos alimenticios procesados y bebidas no alcohólicas, de los que se identificaron 91 productos distintos. El 42,9% (n=39) estaba dirigido al público infantil y el 53,8% (n=49) correspondía a productos clasificados como «no saludables». Estos últimos eran más frecuentes en los anuncios para niños (p <0,001). Se observaron diferencias significativas entre los anuncios dirigidos al público adulto y los dirigidos al público infantil, de modo que se utilizan, con más frecuencia en estos últimos, recursos persuasivos emotivos e irracionales, tales como la fantasía (p <0,001), los dibujos animados (p <0,001) o la entrega de obsequios con la compra del producto (p=0,003). Conclusiones La publicidad de productos alimenticios dirigidos al público infantil en Andalucía se basa fundamentalmente en la oferta de productos de escaso valor nutricional y en el empleo de recursos persuasivos basados en la fantasía o en la oferta de regalos, centrando el mensaje más en el incentivo que en el alimento. Deben ponerse en marcha medidas más eficaces que los actuales sistemas de autorregulación para contrarrestar estas informaciones publicitarias distorsionadas. Objective To determine the contents and persuasive techniques used in processed food adverts aimed at children in Andalusia, comparing them with those aimed at adults. Methods Study based on advert content analysis with two phases: a descriptive design phase and an analytical observational design phase. A sample of adverts from 60hours of broadcasting from the two most watched television channels in Andalusia. Results A total of 416 food and non-alcoholic beverage adverts were obtained, for 91 different products. Approximately 42.9% (n=39) was aimed at children and 53.8% (n=49) were products classified as “unhealthy”. Unhealthy foods were more common in adverts for children (p <0.001). Significant differences were found between the ads aimed at adults and those aimed at children. Emotional and irrational persuasive resources such as fantasy (p <0.001), cartoons (p <0.001) or offering gifts with the purchase of the product (p=0.003) were observed more frequently in adverts for children. Conclusions Food advertising aimed at children in Andalusia is mainly based on offering products with a low nutritional value and using persuasive resources based on fantasy or gifts. The message is focused on the incentive and not the food. More effective measures than the current self-regulatory systems must be put in pl...
      PubDate: 2017-03-09T12:35:44Z
      DOI: 10.1016/j.gaceta.2016.12.008
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