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PUBLIC ADMINISTRATION (179 journals)                  1 2 | Last

Academy of Management Annals, The     Full-text available via subscription   (Followers: 35)
Accounting and the Public Interest     Full-text available via subscription  
Acta Universitatis Danubius. Administratio     Open Access   (Followers: 1)
Administração Pública e Gestão Social     Open Access  
Administration : Journal of the Institute of Public Administration of Ireland     Open Access   (Followers: 1)
Administrative Sciences     Open Access   (Followers: 3)
Administrative Theory & Praxis     Full-text available via subscription   (Followers: 3)
African Journal of Governance and Development     Full-text available via subscription  
American Review of Public Administration     Hybrid Journal   (Followers: 12)
AQ - Australian Quarterly     Full-text available via subscription   (Followers: 1)
Australian Social Work     Hybrid Journal   (Followers: 7)
BAR. Brazilian Administration Review     Open Access   (Followers: 1)
Cadernos EBAPE.BR     Open Access  
Cadernos Gestão Pública e Cidadania     Open Access  
Canadian Public Administration/Administration Publique Du Canada     Hybrid Journal   (Followers: 8)
Cities     Hybrid Journal   (Followers: 12)
Citizenship Studies     Hybrid Journal   (Followers: 5)
Clinical Social Work Journal     Hybrid Journal   (Followers: 19)
COEPTUM     Open Access  
Commonwealth Journal of Local Governance     Open Access   (Followers: 4)
Congress & the Presidency: A Journal of Capital Studies     Hybrid Journal   (Followers: 3)
Criterio Libre     Open Access  
Critical Policy Studies     Hybrid Journal   (Followers: 7)
Cuadernos de Administración     Open Access  
Cuadernos de Relaciones Laborales     Open Access  
Der Staat     Full-text available via subscription   (Followers: 10)
Die Verwaltung     Full-text available via subscription   (Followers: 8)
Économie publique/Public economics     Open Access   (Followers: 2)
eJournal of eDemocracy and Open Government     Open Access   (Followers: 6)
eJournal of Public Affairs     Open Access  
Electronic Government, an International Journal     Hybrid Journal   (Followers: 15)
Electronic Journal of e-Government     Full-text available via subscription   (Followers: 4)
Éthique publique     Open Access  
Études rurales     Open Access   (Followers: 2)
EURE (Santiago) - Revista Latinoamericana de Estudios Urbano Regionales     Open Access  
European Journal of Government and Economics     Open Access   (Followers: 2)
European Journal of Social Work     Hybrid Journal   (Followers: 21)
Evaluation     Hybrid Journal   (Followers: 11)
Federal Governance     Open Access   (Followers: 1)
FOR Rivista per la formazione     Full-text available via subscription  
Frontiers in Public Health Services and Systems Research     Open Access   (Followers: 2)
Future Studies Research Journal : Trends and Strategies     Open Access   (Followers: 1)
Gaceta Sanitaria     Open Access   (Followers: 3)
Georgia Journal of Public Policy     Open Access   (Followers: 1)
Gestión y Política Pública     Open Access   (Followers: 1)
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 12)
Governance     Hybrid Journal   (Followers: 56)
Government and Opposition     Full-text available via subscription   (Followers: 16)
Government Information Quarterly     Hybrid Journal   (Followers: 18)
Government News     Full-text available via subscription   (Followers: 2)
Growth and Change     Hybrid Journal   (Followers: 5)
Headmark     Full-text available via subscription   (Followers: 1)
HR Highway     Full-text available via subscription   (Followers: 1)
Human Resource Development Quarterly     Hybrid Journal   (Followers: 13)
Human Service Organizations Management, Leadership and Governance     Hybrid Journal   (Followers: 22)
Ids Working Papers     Hybrid Journal   (Followers: 2)
IMIESA     Full-text available via subscription  
In Vestigium Ire     Open Access  
International Affairs and Global Strategy     Open Access   (Followers: 7)
International Journal of Electronic Government Research     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Policy and Decision Making     Hybrid Journal   (Followers: 8)
International Journal of Information Systems for Crisis Response and Management     Full-text available via subscription   (Followers: 4)
International Journal of Leadership in Public Services     Hybrid Journal   (Followers: 5)
International Journal of Public Administration     Hybrid Journal   (Followers: 12)
International Journal of Public Sector Performance Management     Hybrid Journal   (Followers: 6)
International NGO Journal     Open Access   (Followers: 2)
International Review of Public Administration     Hybrid Journal   (Followers: 3)
International Tax and Public Finance     Hybrid Journal   (Followers: 5)
Journal of Asian Public Policy     Hybrid Journal   (Followers: 1)
Journal of Community Practice     Hybrid Journal   (Followers: 7)
Journal of Comparative Policy Analysis : Research and Practice     Hybrid Journal   (Followers: 8)
Journal of Developing Areas     Full-text available via subscription   (Followers: 5)
Journal of Development and Administrative Studies     Open Access  
Journal of Economic and Administrative Sciences     Hybrid Journal   (Followers: 3)
Journal of Economics, Finance and Administrative Science     Open Access  
Journal of Entrepreneurship and Public Policy     Hybrid Journal   (Followers: 9)
Journal of European Public Policy     Hybrid Journal   (Followers: 36)
Journal of Higher Education Outreach and Engagement     Open Access   (Followers: 10)
Journal of Management & Organization     Full-text available via subscription   (Followers: 367)
Journal of Nursing Management     Hybrid Journal   (Followers: 19)
Journal of Organisational Transformation & Social Change     Hybrid Journal   (Followers: 6)
Journal of Park and Recreation Administration     Full-text available via subscription   (Followers: 3)
Journal of Public Administration     Full-text available via subscription   (Followers: 18)
Journal of Public Administration and Governance     Open Access   (Followers: 15)
Journal of Public Administration Research and Theory     Hybrid Journal   (Followers: 20)
Journal of Science and Sustainable Development     Full-text available via subscription  
Journal of Social and Administrative Sciences     Open Access  
Journal of Social Work Education     Hybrid Journal   (Followers: 4)
Just Policy: A Journal of Australian Social Policy     Full-text available via subscription   (Followers: 7)
Law and Administration in Post-Soviet Europe : The Journal of Kolegium Jagiellonskie Torunska Szkola Wyzsza     Open Access  
Law, Democracy & Development     Open Access   (Followers: 4)
Law, Innovation and Technology     Hybrid Journal   (Followers: 10)
Liinc em Revista     Open Access  
Local Government Bulletin     Full-text available via subscription   (Followers: 1)
Local Government Studies     Hybrid Journal   (Followers: 6)
Macramè. Trame e ritagli dell’urbanistica     Open Access  
Middle East Law and Governance     Hybrid Journal   (Followers: 6)
National Civic Review     Hybrid Journal  
National Journal     Full-text available via subscription   (Followers: 3)
NISPAcee Journal of Public Administration and Policy     Open Access   (Followers: 3)

        1 2 | Last

Journal Cover Gaceta Sanitaria
  [SJR: 0.434]   [H-I: 27]   [3 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0213-9111
   Published by Elsevier Homepage  [2805 journals]
  • Austeridad y privatización sanitaria en época de crisis:
           ¿existen diferencias entre las comunidades autónomas?

    • Abstract: Publication date: Available online 23 April 2016
      Source:Gaceta Sanitaria
      Author(s): Amaia Bacigalupe, Unai Martín, Raquel Font, Yolanda González-Rábago, Noemi Bergantiños

      PubDate: 2016-04-25T01:08:56Z
  • Enfermedades transmitidas por vectores. Un nuevo reto para los sistemas de
           vigilancia y la salud pública

    • Abstract: Publication date: Available online 19 April 2016
      Source:Gaceta Sanitaria
      Author(s): Carmen Amela Heras, María José Sierra Moros

      PubDate: 2016-04-20T21:34:30Z
  • Inequalities in mental health in the working population of Spain: a
           National Health Survey-based study

    • Abstract: Publication date: Available online 5 April 2016
      Source:Gaceta Sanitaria
      Author(s): Jorge Arias-de la Torre, Lucía Artazcoz, Antonio José Molina, Tania Fernández-Villa, Vicente Martín
      Objective In the working population, poor mental health is a significant problem whose prevalence rates and associated factors could differ by gender, especially in a period of socioeconomic changes. The aims of this study were: a) to determine the prevalence of poor mental health in the working population of Spain in 2011; b) to identify the association of this prevalence with socioeconomic and work-related variables for men and women separately; c) to determine if the patterns differ by gender. Methods A cross-sectional study was conducted with data from the National Health Survey of Spain (2011). Of the 21,007 participants in the survey, we selected 7396 whose employment status was described as “working” The General Health Questionnaire (GHQ-12) was used as a screening tool to detect poor mental health. Prevalences were calculated and bivariate and multivariate logistic regression models were fitted to verify the association between variables. Results The prevalence of poor mental health was higher among women (19.9%) than men (13.9%), the overall prevalence being 16.8%. The variables associated with a higher prevalence were type of contract and work-related variables in men, and age and socioeconomic variables in women. Conclusions This study shows that, in the working population of Spain, the prevalence of poor mental health and its related factors differ by gender. Poor mental health is mainly related to socioeconomic variables in women but is mostly associated with work-related variables in men.

      PubDate: 2016-04-10T18:21:03Z
  • Demanda asistencial en atención primaria y especializada según
           la salud mental de población adulta española

    • Abstract: Publication date: Available online 6 April 2016
      Source:Gaceta Sanitaria
      Author(s): Virginia Basterra

      PubDate: 2016-04-10T18:21:03Z
  • Prevalence and profile of alcohol consumption among university students in

    • Abstract: Publication date: Available online 5 April 2016
      Source:Gaceta Sanitaria
      Author(s): Pablo Ruisoto, Raúl Cacho, José J. López-Goñi, Silvia Vaca, Marco Jiménez
      Objective Alcohol consumption is one of the main health and social problems in Ecuador. The aim of this study was to explore gender differences in the prevalence and psychosocial profile of problematic consumers among university students. Method We surveyed 3,232 students by using the AUDIT and psychosocial scales. To discriminate the explanatory value of each variable, a CHAID segmentation analysis was used. Results The prevalence of alcohol consumption was 92.24% in men and 82.86% in women. In total, 49.73% of men and 23.80% of women reported problematic consumption. In men, the profile of problematic consumption was defined by higher scores in anxiety and depression, especially if they showed higher levels of psychological stress and lower life engagement. In women, problematic consumption showed a tendency towards psychological inflexibility, especially in those with lower life engagement. Conclusion There is a need to prioritise attention to alcohol consumption in university students and to design different interventions for men and women.

      PubDate: 2016-04-10T18:21:03Z
  • El enfoque de sostenibilidad en los planes de salud de las comunidades
           autónomas: el desarrollo sostenible como oportunidad

    • Abstract: Publication date: Available online 30 March 2016
      Source:Gaceta Sanitaria
      Author(s): Miguel A. Moyano-Santiago, Juana M. Rivera-Lirio
      Objetivo Determinar el grado de orientación de los planes de salud de las comunidades autónomas a las tres dimensiones habituales de sostenibilidad: económica, social y medioambiental; tanto en el nivel discursivo general como en las diferentes áreas de intervención. Método Investigación cualitativa mediante análisis de contenido de una amplia muestra de documentos. La metodología específica es el análisis de sensibilidad simbólica y operativa realizado a una muestra de once planes de salud de España. Resultados Los aspectos sociales, tales como los determinantes o los grupos más vulnerables, reciben cada vez más atención por parte del planificador sanitario, si bien hay espacio para fortalecer la atención a las cuestiones medioambientales y dotar de forma específica a las actuaciones en términos económicos. Conclusiones el análisis evidencia el estado incipiente en el que se encuentran los planes de salud como documentos de planificación estratégica que integren aspectos económicos, sociales y ambientales con los cuales contribuir a la sostenibilidad de los diferentes sistemas sanitarios del país. Objective To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. Method A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Results Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. Conclusions The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country.

      PubDate: 2016-03-31T16:16:58Z
  • Efecto de la crisis económica sobre el consumo de psicofármacos
           en Asturias

    • Abstract: Publication date: Available online 24 March 2016
      Source:Gaceta Sanitaria
      Author(s): María Luisa Nicieza-García, Julio C. Alonso-Lorenzo, Patricio Suárez-Gil, Natalia Rilla-Villar
      Objetivo Evaluar si la crisis económica de 2008ha comportado cambios en la evolución del consumo de ansiolíticos, hipnótico-sedantes y antidepresivos en Asturias. Método Estudio descriptivo y de utilización de medicamentos durante 2003-2013. Se calcularon las dosis diarias definidas por 1000 habitantes/día (DHD) de ansiolíticos, hipnótico-sedantes y antidepresivos. Se obtuvieron coeficientes de regresión lineal (b) de las DHD de la etapa precrisis (2003-2008) y de la etapa de crisis (2009-2013). Resultados El consumo de ansiolíticos creció un 40,25%, el de hipnóticos un 88,11% y el de antidepresivos un 80,93%. Para los ansiolíticos: b-(2003-2008)=4,38 DHD/año y b-(2009-2013)=1,08 DHD/año. Para los hipnótico-sedantes: b-(2003-2008)=2,30 DHD/año y b-(2009-2013)=0,40 DHD/año. Para los antidepresivos: b-(2003-2008)=5,79 DHD/año y b-(2009-2013)=2,83 DHD/año. Conclusiones El incremento del consumo para los tres subgrupos en la época de crisis fue menor que en la época precrisis. No se confirma que la crisis económica haya influido aumentando el consumo de estos medicamentos. Objective To assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain). Method We conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013). Results The consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year. Conclusions The rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs.

      PubDate: 2016-03-26T18:49:24Z
  • La desigualdad en el acceso a las prestaciones sanitarias. Propuestas para
           lograr la equidad

    • Abstract: Publication date: Available online 20 March 2016
      Source:Gaceta Sanitaria
      Author(s): Rosa Urbanos-Garrido
      El artículo pone de manifiesto la presencia de desigualdades en el acceso a las prestaciones sanitarias, que pueden calificarse de indeseables y evitables. Entre ellas, las relacionadas con la cobertura de necesidades, la dificultad para completar tratamientos médicos como consecuencia de dificultades económicas, o las desigualdades en los tiempos de espera y en el uso de servicios a igual necesidad. Una parte importante de las desigualdades parece haberse incrementado como consecuencia de las medidas adoptadas frente a la crisis. Las propuestas para lograr la equidad afectan a distintos ejes del Sistema Nacional de Salud: entre otros, la definición del aseguramiento, el reparto de costes entre aseguradores y asegurados, la distribución de competencias entre atención primaria y especializada, la gestión clínica y la producción y la difusión de información para favorecer la toma de decisiones de autoridades sanitarias, profesionales y ciudadanía. Además, se recomienda prestar especial atención a colectivos específicos particularmente vulnerables. This article reveals the presence of inequalities in access to health care that may be considered unfair and avoidable. These inequalities are related to coverage of clinical needs, to the financial problems faced by families in completing medical treatments, or to disparities in waiting times and the use of services for equal need. A substantial proportion of inequalities appears to have increased as a result of the measures adopted to face the economic crisis. The recommendations aimed at improving equity affect different pillars of the taxpayer-funded health system, including, among others, the definition of the right to public health care coverage, the formulas of cost-sharing, the distribution of powers between primary and specialty care, the reforms of clinical management, and the production and dissemination of information to facilitate the decision-making processes of health authorities, professionals and citizens. Moreover, it is recommended to focus on particularly vulnerable population groups.

      PubDate: 2016-03-21T18:04:22Z
  • Problemas en el proceso de adaptación a los cambios en personas
           cuidadoras familiares de mayores con demencia

    • Abstract: Publication date: Available online 14 March 2016
      Source:Gaceta Sanitaria
      Author(s): Sara Moreno-Cámara, Pedro Ángel Palomino-Moral, Lourdes Moral-Fernández, Antonio Frías-Osuna, Rafael del-Pino-Casado
      Objetivo Identificar y analizar los problemas que surgen en el proceso de adaptación de la persona cuidadora a los cambios durante el cuidado familiar a una persona afectada por demencia. Método Estudio cualitativo basado en la metodología de la teoría fundamentada constructivista de Charmaz. Se realizaron siete grupos focales en diferentes centros de atención primaria de salud en la provincia de Jaén (España). Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Se llevó a cabo una triangulación del análisis para favorecer la validez interna del estudio. Resultados Se obtuvieron tres categorías centrales, que fueron «Cuidados cambiantes», «Problemas en el proceso de adaptación a los cambios» y «Factores facilitadores del proceso de adaptación a los cambios». La persona cuidadora desempeña su rol en una realidad caracterizada por el cambio, tanto personal como de la persona a la que cuida y su contexto social y cultural. El reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora a las nuevas situaciones de cuidado y los factores que facilitan su labor cuidadora. Conclusiones La escasez de apoyo formal y el infradiagnóstico de la demencia dificultan la adaptación de la persona cuidadora al cuidado de una persona afectada por demencia. El proceso de adaptación podría mejorar reforzando el apoyo formal en las primeras fases del cuidado para reducir el estrés del proceso de aprendizaje autodidacta de las familias cuidadoras, así como adaptando las intervenciones a cada fase de la evolución del rol cuidador. Objective To identify and analyse problems in adapting to change among the family caregivers of relatives with dementia. Method Qualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity. Results We obtained three main categories: ‘Changing Care’, ‘Problems in the process of adapting to change’ and ‘Facilitators of the process of adapting to change’. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role. Conclusions The adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role.

      PubDate: 2016-03-16T17:07:18Z
  • Percepciones de médicas y médicos de atención primaria de
           Madrid sobre las medidas de ajuste en el sistema público de salud

    • Abstract: Publication date: Available online 14 March 2016
      Source:Gaceta Sanitaria
      Author(s): Julio Heras-Mosteiro, Laura Otero-García, Belén Sanz-Barbero, Jesús María Aranaz-Andrés
      Objetivo Para hacer frente a la actual crisis económica, las administraciones han impulsado medidas de ajuste que han afectado al sistema público de salud. Presentamos la percepción que de esas medidas tienen los/las médicos/as de atención primaria de dos centros de salud de Madrid. Método Se desarrolló un estudio cualitativo en dos centros de salud del distrito de Fuencarral-El Pardo (Madrid), que tiene tasas de paro y de población inmigrante superiores a la media de la ciudad. Se realizaron 12 entrevistas semiestructuradas a médicos/as de dichos centros. El análisis de la información se basó en el análisis del contenido clásico. Resultados Se identifican dos categorías: valoración de medidas de ajuste y valoración de la toma de decisiones en dicho proceso. Las personas entrevistadas manifiestan la necesidad de impulsar medidas que mejoren el sistema público de salud, pero expresan su desacuerdo con las implementadas. Consideran que no están basadas en la evidencia y que obedecen a una necesidad de ahorro a corto plazo. Creen que ha habido una mala comunicación de las medidas, sin la participación de profesionales sanitarios/as asistenciales en su priorización, elección e implementación. Consideran imprescindible esta participación porque son quienes conocen de forma práctica las disfunciones del sistema, teniendo más presente la centralidad del paciente. Conclusiones Se hace imprescindible que los poderes públicos incorporen activamente a profesionales sanitarios/as asistenciales en la toma de decisiones para garantizar la implementación de medidas basadas en la evidencia, con un alto respaldo profesional, manteniendo así la calidad asistencial. Objective To address the current economic crisis, governments have promoted austerity measures that have affected the taxpayer-funded health system. We report the findings of a study exploring the perceptions of primary care physicians in Madrid (Spain) on measures implemented in the Spanish health system. Methods We carried out a qualitative study in two primary health care centres located in two neighbourhoods with unemployment and migrant population rates above the average of those in Madrid. Interviews were conducted with 12 primary health care physicians. Interview data were analysed by using thematic analysis and by adopting some elements of the grounded theory approach. Results Two categories were identified: evaluation of austerity measures and evaluation of decision-making in this process. Respondents believed there was a need to promote measures to improve the taxpayer-funded health system, but expressed their disagreement with the measures implemented. They considered that the measures were not evidence-based and responded to the need to decrease public health care expenditure in the short term. Respondents believed that they had not been properly informed about the measures and that there was adequate professional participation in the prioritization, selection and implementation of measures. They considered physician participation to be essential in the decision-making process because physicians have a more patient-centred view and have first-hand knowledge of areas requiring improvement in the system. Conclusions It is essential that public authorities actively involve health care professionals in d...
      PubDate: 2016-03-16T17:07:18Z
  • Diferencias entre comunidades autónomas en austeridad y
           privatización sanitaria en época de crisis

    • Abstract: Publication date: Available online 11 March 2016
      Source:Gaceta Sanitaria
      Author(s): Luis Rajmil, María José Fernández de Sanmamed

      PubDate: 2016-03-16T17:07:18Z
  • Conflictos entre la ética enfermera y la legislación sanitaria
           en España

    • Abstract: Publication date: Available online 14 March 2016
      Source:Gaceta Sanitaria
      Author(s): Montserrat Gea-Sánchez, Lourdes Terés-Vidal, Erica Briones-Vozmediano, Fidel Molina, Denise Gastaldo, Laura Otero-García
      Objetivo Evidenciar los conflictos éticos que pueden surgir entre los discursos legal y ético, a través de explorar el contenido del Real Decreto-Ley 16/2012 que modifica la ley sanitaria en España y los códigos éticos. Método Revisión y análisis crítico del discurso de cinco códigos éticos de Enfermería de Barcelona, Cataluña, España, Europa e Internacional, y del discurso de la legislación sanitaria vigente en España en 2013, en los que se identificaron y compararon estructuras lingüísticas referentes a cinco principios y valores éticos del marco teórico de la ética de los cuidados: equidad, derechos humanos, derecho a la salud, accesibilidad y continuidad de los cuidados. Resultados Mientras que el discurso ético define la función enfermera en función de la equidad, el reconocimiento de los derechos humanos, el derecho a la salud, la accesibilidad y la continuidad de los cuidados de la persona, el discurso legal se vertebra sobre el concepto de beneficiario o asegurado. Conclusiones La divergencia entre el discurso ético y legal puede producir conflictos éticos que afecten negativamente a la práctica de la profesión enfermera. La aplicación del RDL 16/2012 promueve un marco de acción que impide que los profesionales enfermeros presten sus cuidados a colectivos no asegurados, lo que atenta contra los derechos humanos y los principios de la ética de los cuidados. Objective To identify the ethical conflicts that may arise between the nursing codes of ethics and the Royal Decree-law 16/2012 modifying Spanish health regulations. Method We conducted a review and critical analysis of the discourse of five nursing codes of ethics from Barcelona, Catalonia, Spain, Europe and International, and of the discourse of the Spanish legislation in force in 2013. Language structures referring to five different concepts of the theoretical framework of care were identified in the texts: equity, human rights, right to healthcare, access to care, and continuity of care. Results Codes of ethics define the function of nursing according to equity, acknowledgement of human rights, right to healthcare, access to care and continuity of care, while legal discourse hinges on the concept of beneficiary or being insured. Conclusions The divergence between the code of ethics and the legal discourse may produce ethical conflicts that negatively affect nursing practice. The application of RDL 16/2012 promotes a framework of action that prevents nursing professionals from providing care to uninsured collectives, which violates human rights and the principles of care ethics.

      PubDate: 2016-03-16T17:07:18Z
  • Infecciones de transmisión sexual en hombres internos en
           prisión: riesgo de desarrollo de nuevas infecciones

    • Abstract: Publication date: Available online 15 March 2016
      Source:Gaceta Sanitaria
      Author(s): Raquel Sánchez Recio, Juan Pablo Alonso Pérez de Ágreda, Javier Santabárbara Serrano
      Objetivo Medir la incidencia y determinar los factores de riesgo de las infecciones de transmisión sexual (ITS) en la población del Centro Penitenciario de Daroca (Zaragoza). Método Estudio de cohortes retrospectivo (2005-2013) para medir la incidencia de ITS y estudio transversal para estudiar los factores de riesgo. Resultados De los 203 internos, 79 desarrollaron una ITS, 37 tenían ITS previas, el 55,2% conocimientos y el 28,9% comportamientos no favorables a la prevención de ITS. La incidencia fue de 6,5 ITS por cada 1000 internos-año. Las de mayor incidencia fueron la hepatitis B (39,7%), la infección por Ureaplasma urealyticum (19,1%), el herpes simple (16,2%) y la infección por el virus de la inmunodeficiencia humana (8,8%). El riesgo (hazard ratio [HR]) de adquirir una nueva ITS fue significativamente mayor en los internos con antecedentes de ITS previa (HR=2,61; intervalo de confianza del 95% [IC95%]: 1,01-6,69), y en el límite de la significación para los comportamientos no preventivos (HR=2,10; IC95%: 0,98-4,53), pero no en los conocimientos frente a ITS (HR=1,33; IC95%: 0,58-3,07). Conclusión Los factores de riesgo más relevantes en prisión son los comportamientos y los antecedentes de ITS. Otros factores son ser reincidente, el consumo de drogas inyectadas o estar en un programa de metadona. Los/las profesionales sanitarios y la educación por pares pueden facilitar la prevención y el control. Objective To measure incidence and main risk factors related to sexually transmitted infections (STIs) in Daroca Prison (Zaragoza, Spain). Method A retrospective cohort study (2005-2013) to measure the incidence of STI and a cross-sectional study to measure risk factors. Results Of the 203 inmates, 79 developed an STI, 37 had a previous STI, 55.2% lacked knowledge on STI prevention, and 28.9% showed behaviours unfavourable for STI prevention. The incidence rate was 6.5 STIs per 1,000 inmates-year. The most frequent STIs were hepatitis B (39.7%), Ureaplasma urealyticum (19.1%), herpes simplex (16.2%) and HIV (8.8%). The risk (hazard ratio, HR) of acquiring a new STI was significantly higher in inmates with a history of previous STI (HR=2.61; 95%CI: 1.01 to 6.69), and was at the limit of significance for non-preventive behaviour (HR=2.10; 95%CI: 0.98 to 4.53), but not in knowledge related to STIs (HR=1.33; 95%CI: 0.58 to 3.07). Conclusion The most important risk factors in prison are behaviours related to STIs and previous history of STIs. Other factors are being a repeat offender, injecting drug use, or being in a methadone programme. Health personnel and peer education can facilitate prevention and control.

      PubDate: 2016-03-16T17:07:18Z
  • García Gómez M, Cárcoba A, Menéndez-Navarro A,
           Morón R, Vogel L. Qué hacemos con el deterioro de la salud
           laboral y cómo avanzar en la igualdad y los derechos de los
           trabajadores en tiempos de crisis. Madrid: Ediciones Akal; 2015. ISBN:
           978-84-460-4199-3. 77 p.

    • Abstract: Publication date: March–April 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 2
      Author(s): Carlos Ruiz-Frutos

      PubDate: 2016-03-06T14:25:07Z
  • Efectividad de un programa de juego basado en realidad virtual para la
           mejora cognitiva en la esquizofrenia

    • Abstract: Publication date: March–April 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 2
      Author(s): Olga López-Martín, Antonio Segura Fragoso, Marta Rodríguez Hernández, Iris Dimbwadyo Terrer, Begoña Polonio-López
      Objetivo Evaluar la efectividad de un programa de juego basado en la realidad virtual para la mejora de los dominios cognitivos en pacientes con esquizofrenia. Método Ensayo clínico aleatorizado con 40 pacientes con esquizofrenia, 20 en el grupo experimental y 20 en el grupo control. El grupo experimental recibió 10 sesiones con Nintendo Wii® durante 5 semanas, 50 minutos/sesión, 2 días/semana, además del tratamiento convencional. El grupo control sólo recibió tratamiento convencional. Resultados Se encontraron diferencias estadísticamente significativas de las puntuaciones T-Score entre la preevaluación y la postevaluación en el grupo experimental en cinco de los seis dominios cognitivos evaluados: velocidad de procesamiento (F=12,04, p=0,001), atención/vigilancia (F=12,75, p=0,001), memoria de trabajo (F=18,86, p <0,01), aprendizaje verbal (F=7,6, p=0,009), y razonamiento y resolución de problemas (F=11,08, p=0,002). Conclusiones La participación en intervenciones de realidad virtual dirigidas al entrenamiento cognitivo ofrece un gran potencial de ganancias significativas en los diferentes dominios cognitivos evaluados en pacientes con esquizofrenia. Objective To evaluate the effectiveness of a programme based on a virtual reality game to improve cognitive domains in patients with schizophrenia. Method A randomized controlled trial was conducted in 40 patients with schizophrenia, 20 in the experimental group and 20 in the control group. The experimental group received 10 sessions with Nintendo Wii® for 5 weeks, 50minutes/session, 2 days/week in addition to conventional treatment. The control group received conventional treatment only. Results Statistically significant differences in the T-Score were found in 5 of the 6 cognitive domains assessed: processing speed (F=12.04, p=0.001), attention/vigilance (F=12.75, p=0.001), working memory (F=18.86, p <0.01), verbal learning (F=7.6, p=0.009), visual learning (F=3.6, p=0.064), and reasoning and problem solving (F=11.08, p=0.002). Conclusions Participation in virtual reality interventions aimed at cognitive training have great potential for significant gains in different cognitive domains assessed in patients with schizophrenia.

      PubDate: 2016-03-06T14:25:07Z
  • Evaluación de la eficiencia técnica de la atención primaria
           pública en el País Vasco, 2010-2013

    • Abstract: Publication date: March–April 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 2
      Author(s): José Manuel Cordero, Roberto Nuño-Solinís, Juan F. Orueta, Cristina Polo, Mario del Río-Cámara, Edurne Alonso-Morán
      Objetivo Evaluar la eficiencia técnica de las unidades de provisión de atención primaria del Servicio Vasco de Salud (Osakidetza) en el periodo 2010-2013 correspondiente al inicio del despliegue de la integración vertical en la sanidad pública vasca. Métodos El estudio comprende 11 de las 12 unidades de provisión de atención primaria de Osakidetza en 2010-2013. La metodología empleada para la medición de la eficiencia técnica es el análisis envolvente de datos (DEA). Se utiliza la extensión DEA Windows, que permite analizar todas las unidades como si fuera un único periodo, y un modelo condicionado para incorporar el efecto de las características de la población atendida. Se utilizan las siguientes variables: como outputs, el índice de calidad basado en el cumplimiento de la oferta preferente y las tasas de hospitalizaciones evitables (output indeseable); como inputs, el número de profesionales de medicina, el número de profesionales de enfermería y el gasto en prescripciones; finalmente, como variable exógena, el índice de morbilidad. Resultados Se observa una mejora generalizada de la eficiencia media de todas las unidades en el periodo analizado, que no es mayor en las unidades constituidas como organizaciones sanitarias integradas. Discusión El estudio muestra la mejora de la eficiencia en atención primaria en un contexto de transformación del modelo de prestación sanitaria en el País Vasco, pero no se aprecia un mayor efecto en las unidades integradas verticalmente durante el periodo. Objective To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. Methods This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. Results The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. Discussion In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers.

      PubDate: 2016-03-06T14:25:07Z
  • Gaceta Sanitaria a primera vista (marzo-abril 2016)

    • Abstract: Publication date: March–April 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 2

      PubDate: 2016-03-06T14:25:07Z
  • Gaceta Sanitaria en 2015

    • Abstract: Publication date: March–April 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 2
      Author(s): Carme Borrell, Mª Felicitas Domínguez-Berjón, Carlos Álvarez-Dardet, Clara Bermúdez-Tamayo, Pere Godoy, María José López, Miguel Angel Negrín, Glòria Pérez, Napoleón Pérez-Farinós, Alberto Ruano, Carmen Vives Cases, Rosana Peiró, Iñaki Galán

      PubDate: 2016-03-06T14:25:07Z
  • Impact of a community-based exercise programme on physical fitness in
           middle-aged and older patients with type 2 diabetes

    • Abstract: Publication date: Available online 18 February 2016
      Source:Gaceta Sanitaria
      Author(s): Romeu Mendes, Nelson Sousa, José Themudo-Barata, Victor Reis
      Objectives Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. Methods This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months’ duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Results Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. Conclusions A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.

      PubDate: 2016-02-24T12:27:49Z
  • Plaguicidas organofosforados y efecto neuropsicológico y motor en la
           Región del Maule, Chile

    • Abstract: Publication date: Available online 19 February 2016
      Source:Gaceta Sanitaria
      Author(s): María Teresa Muñoz-Quezada, Boris Lucero, Verónica Iglesias, María Pía Muñoz, Eduardo Achú, Claudia Cornejo, Carlos Concha, Angela Grillo, Ana María Brito
      Objetivo Evaluar la exposición a plaguicidas organofosforados y el desempeño neuropsicológico y motor de trabajadores/as agrícolas y no agrícolas de la Región del Maule, Chile. Método Estudio transversal analítico con 93 trabajadores/as agrícolas expuestos/as a plaguicidas organofosforados y 84 trabajadores/as no agrícolas no expuestos/as. Se administró una batería de cuatro pruebas neuropsicológicas junto con un examen físico neuromotor. Resultados Los/las trabajadores/as agrícolas expuestos/as tuvieron un menor desempeño en la escala de inteligencia de Wechsler para Adultos (WAIS-IV) en comprensión verbal (β=−3,2; p=0,034), en velocidad de procesamiento (β=−4,4; p=0,036) y en la escala total (β=−4; p=0,016); sensibilidad discriminativa (β=1, p=0,009) ajustada por años de educación o edad en comparación con los controles. Conclusiones Se sugiere el desarrollo de políticas en materia de control, venta y uso de plaguicidas organofosforados, y de intervenciones con la población expuesta respecto a medidas de seguridad. Objective To evaluate organophosphate pesticide exposure and neuropsychological and motor performance in agricultural and non-agricultural workers in the Maule Region in Chile. Method Analytic cross-sectional study in 93 exposed farm workers and 84 unexposed non-agricultural workers. A battery of four neuropsychological tests was administered together with a neuro-motor physical examination. Results On the Weschler adult intelligence scale (WAIS-IV), exposed agricultural workers exhibited poorer performance than non-agricultural workers in verbal comprehension (β=−3.2; p=0.034) and processing speed (β=−4.4; p=0.036) and in the full scale (β=−4; p=0.016), as well as in discrimination sensitivity (β=1, p=0,009), adjusted by years of schooling and/or age. Conclusions We suggest the development of policies and regulations for the control, sale and use of organophosphate pesticides and intervention strategies on safety measures aimed at the exposed population.

      PubDate: 2016-02-24T12:27:49Z
  • Desnutrición y desarrollo cognitivo en infantes de zonas rurales
           marginadas de México

    • Abstract: Publication date: Available online 22 February 2016
      Source:Gaceta Sanitaria
      Author(s): María del Refugio Carrasco Quintero, Luis Ortiz Hernández, José Antonio Roldán Amaro, Adolfo Chávez Villasana
      Objetivo Analizar la relación entre el estado nutricional medido por antropometría y el desarrollo mental, psicomotor y del lenguaje en infantes de zonas rurales marginadas de México. Método Estudio transversal con 576 infantes de 7 a 26 meses de edad de cuatro localidades rurales. Las variables fueron antropométricas y de desarrollo cognitivo. Resultados Los infantes con baja estatura tuvieron un menor índice de desarrollo del lenguaje, mientras que el peso al nacer se relacionó marginalmente con el desarrollo psicomotor. Conclusión Aunque la desnutrición aguda (identificada por el peso) ya no es un problema en las zonas rurales de México, la desnutrición crónica (expresada como baja estatura) sigue siendo frecuente y se relaciona con alteraciones en el desarrollo mental de la población infantil. Objective To analyze the relationship between nutritional status measured by anthropometry and the mental, psychomotor and language development of infants in marginalized rural areas of Mexico. Method Cross-sectional study with 576 infants aged from 7 to 26 months in four rural locations. Variables consisted of measures of anthropometric and cognitive development. Results Infants with short stature had a lower rate of language development, while birth weight was marginally associated with psychomotor development. Conclusion Although acute malnutrition (identified by underweight) is no longer a problem in rural areas of Mexico, chronic malnutrition (expressed as stunting) is still common and is associated with alterations in mental development in the child population.

      PubDate: 2016-02-24T12:27:49Z
  • Uso de customer relationship management para mejorar la atención
           sanitaria de la ciudadanía. Servicio Salud Andalucía 24 horas.
           Salud Responde

    • Abstract: Publication date: Available online 18 February 2016
      Source:Gaceta Sanitaria
      Author(s): Manuel Quero, María Belén Ramos, Wilfredo López, Juan José Cubillas, José María González, José Luis Castillo
      Salud Responde es un centro de información y servicios de salud del Sistema Sanitario Público de Andalucía, que ofrece, entre otros, un servicio telefónico de atención sanitaria denominado Salud Andalucía 24 horas. El objetivo principal es informar y asesorar a la ciudadanía en materia de salud y sobre los recursos existentes de los servicios sanitarios. El servicio se basa en un customer relationship management que organiza la información en varios niveles de especialización y dependiendo de la dificultad de la consulta del ciudadano es atendida por diferentes perfiles de profesionales, ofreciendo una respuesta consensuada con profesionales de Salud Responde o con otros niveles de atención sanitaria. Salud Andalucía 24 horas ha dado respuesta a 457.168 pacientes desde finales de 2008 hasta el 1 de diciembre de 2015. Sus operadores han resuelto un 9,4% de las consultas y un 84,1% han sido resueltas por personal sanitario. Un 6,5% fueron derivados al servicio de urgencias. El 88,8% de quienes usaron el servicio no necesitaron ir a su médico de su centro de salud en menos de 24 horas, evitando así desplazamientos innecesarios. Salud Responde (in English: Healthline) is a Health Service and Information Centre of the taxpayer-funded Andalusian Health System (AHS) that offers a Telephone Health Advisory Service called SA24h, among other services. The main objective of SA24h is to inform and advise citizens on health issues and the available health resources of the AHS. SA24h has a Customer Relationship Management information technology tool that organises information at various levels of specialization. Depending on the difficulty of the query, the citizen is attended by professionals with distinct profiles, providing a consensual response within the professionals working within Salud Responde or within other healthcare levels of the AHS. SA24h provided responses to 757,168 patient queries from late 2008 to the end of 01/12/2015. A total of 9.38% of the consultations were resolved by the non-health professionals working at Salud Responde. The remaining 84.07% were resolved by health staff. A total of 6.5% of users were referred to accident and emergency facilities while 88.77% did not need to attend their general practitioner within the next 24hours, thus avoiding unnecessary visits to health care facilities.

      PubDate: 2016-02-24T12:27:49Z
  • ¿Tenemos presente en las instituciones sanitarias el consumo indebido
           de medicamentos con fines de dopaje?

    • Abstract: Publication date: Available online 20 February 2016
      Source:Gaceta Sanitaria
      Author(s): Raquel Vázquez Mourelle, Arantzazu López Pérez, Estrella López-Pardo Pardo, Sinda Blanco Lobeiras

      PubDate: 2016-02-24T12:27:49Z
  • Tiempo de estancia prolongado en los pacientes ingresados por
           insuficiencia cardiaca aguda

    • Abstract: Publication date: Available online 19 February 2016
      Source:Gaceta Sanitaria
      Author(s): Francisco Javier Martín-Sánchez, Virginia Carbajosa, Pere Llorens, Pablo Herrero, Javier Jacob, Òscar Miró, Cristina Fernández, Héctor Bueno, Elpidio Calvo, José Manuel Ribera Casado
      Objetivo Identificar los factores asociados al tiempo de estancia hospitalaria prolongado en pacientes ingresados/as por insuficiencia cardiaca aguda. Método Estudio observacional de cohorte multipropósito que incluyó pacientes del registro EAHFE (Epidemiology Acute Heart Failure in Emergency) ingresados/as por insuficiencia cardiaca aguda en 25 hospitales españoles. Se recogieron variables demográficas y clínicas, el día y el lugar del ingreso. La variable resultado principal fue el tiempo de estancia hospitalaria mayor que la mediana. Resultados Se incluyeron 2400 pacientes con una edad media de 79,5 (±9,9) años, de los cuales 1334 (55,6%) eran mujeres. Quinientos noventa (24,6%) ingresaron en la unidad de corta estancia (UCE), 606 (25,2%) en cardiología y 1204 (50,2%) en medicina interna o geriatría. La mediana del tiempo de estancia hospitalaria fue de 7,0 (intervalo intercuartílico: 4-11 días). Cincuenta y ocho (2,4%) pacientes fallecieron y 562 (23,9%) sufrieron un reingreso a los 30 días tras el alta. Los factores independientes asociados a un tiempo de estancia hospitalaria prolongado fueron la enfermedad pulmonar obstructiva crónica, ser portador de un dispositivo, tener un factor precipitante desconocido o no común, la presencia en urgencias de insuficiencia renal, hiponatremia y anemia, no ingresar en una UCE o no disponer de dicha unidad e ingresar un lunes, martes o miércoles; y los asociados a un tiempo de estancia hospitalaria ≤7 días fueron la hipertensión arterial y tener como factor precipitante una crisis hipertensiva o la falta de adherencia al tratamiento. El área bajo la curva del modelo mixto ajustado al centro fue de 0,78 (intervalo de confianza del 95%: 0,76-0,80; p <0,001). Conclusiones Hay una serie de factores asociados con un tiempo de estancia hospitalaria prolongado que deben ser considerados para la gestión del proceso de la insuficiencia cardiaca aguda. Objective To identify the factors associated with prolonged length of hospital stay in patients admitted for acute heart failure. Methods Multipurpose observational cohort study including patients from the EAHFE registry admitted for acute heart failure in 25 Spanish hospitals. Data were collected on demographic and clinical variables and on the day and place of admission. The primary outcome was length of hospital stay longer than the median. Results We included 2,400 patients with a mean age of 79.5 (9.9) years; of these, 1,334 (55.6%) were women. Five hundred and ninety (24.6%) were admitted to the short stay unit (SSU), 606 (25.2%) to cardiology, and 1,204 (50.2%) to internal medicine or gerontology. The mean length of hospital stay was 7.0 (RIC 4-11) days. Fifty-eight (2.4%) patients died and 562 (23.9%) were readmitted within 30 days after discharge. The factors associated with prolonged length of hospital stay were chronic pulmonary disease; being a device carrier; having an unknown or uncommon triggering factor; the presence of renal insufficiency, hyponatremia and anaemia in the emergency department; not being admitted to an SSU or the lack of this facility in the hospital; and being admitted on Monday, Tuesday or Wednesday. The factors associated with length of hospital stay≤7days were hypertension, having a hypertensive episode, or a lack of treatment adherence. The area under the curve of the mixed model adjusted to the center was 0.78 (95% CI: 0.76-0.80; p<0.001).
      PubDate: 2016-02-24T12:27:49Z
  • Cómo evaluar y reducir desigualdades sociales en los programas de
           cribado de cáncer

    • Abstract: Publication date: Available online 23 February 2016
      Source:Gaceta Sanitaria
      Author(s): Gemma Binefa, Montse García, Rosana Peiró, Ana Molina-Barceló, Raquel Ibáñez
      Esta nota de campo presenta las conclusiones y recomendaciones elaboradas en el encuentro «¿Cómo reducir las desigualdades sociales en los programas de cribado de cáncer», celebrado en la XXVI Escuela de Salud Pública de Mahón (Menorca). Los participantes elaboraron recomendaciones a partir de las experiencias de los programas de cribado poblacionales de cáncer de mama y colorrectal, y del cribado oportunista de cáncer de cuello uterino. Las conclusiones y recomendaciones se centraron en cuatro grandes áreas (sistemas de información, evaluación y calidad, investigación e intervenciones): incorporar variables sociales individuales en los sistemas de información sanitarios; establecer unos estándares mínimos de recogida de información que permitan conocer las desigualdades en el acceso a los servicios preventivos; realizar acciones en población vulnerable; y promover el intercambio de experiencias y buenas prácticas a través de la Red de Programas de Cribado de Cáncer y de grupos de trabajo de sociedades científicas. This field note presents the conclusions and recommendations made at the meeting ‘How to reduce social inequalities in cancer screening programmes?’ held at the XXVI School of Public Health of Mahon (Menorca, Spain). Participants developed recommendations based on experiences of population-based screening programmes (breast and colorectal) and opportunistic screening (cervical). The conclusions and recommendations focused on four main areas (information systems, evaluation and quality, research, and interventions): the inclusion of social variables at an individual level in health information systems; the establishment of minimum standards for gathering information regarding inequalities in access to preventive services; the performance of actions in vulnerable populations; and the promotion of the exchange of experiences and best practices through the Cancer Screening Programmes Network and working groups of the scientific societies.

      PubDate: 2016-02-24T12:27:49Z
  • The use of clinical practice guidelines in primary care: professional
           mindlines and control mechanisms

    • Abstract: Publication date: Available online 16 February 2016
      Source:Gaceta Sanitaria
      Author(s): Joan Gené-Badia, Pedro Gallo, Jordi Caïs, Emília Sánchez, Carme Carrion, Liliana Arroyo, Marta Aymerich
      Objective To identify the relevant barriers and enablers perceived by primary care professionals in implementing the recommendations of clinical practice guidelines (CPG). Methods Two focus groups were conducted with primary care physicians and nurses in Catalonia (Spain) between October and December 2012. Thirty-nine health professionals were selected based on their knowledge and daily use of CPG. Finally, eight general practitioners and eight nurses were included in the discussion groups. Participants were asked to share their views and beliefs on the accessibility of CPG, their knowledge and use of these documents, the content and format of CPG, dissemination strategy, training, professional-patient relationship, and the use of CPG by the management structure. We recorded and transcribed the content verbatim and analysed the data using qualitative analysis techniques. Results Physicians believed that, overall, CPG were of little practical use and frequently referred to them as a largely bureaucratic management control instrument that threatened their professional autonomy. In contrast, nurses believed that CPG were rather helpful tools in their day-to-day practice, although they would like them to be more sensitive to the current role of nurses. Both groups believed that CPG did not provide a response to most of the decisions they faced in the primary care setting. Conclusions Compliance with CPG recommendations would be improved if these documents were brief, non-compulsory, not cost-containment oriented, more based on nursing care models, sensitive to the specific needs of primary care patients, and integrated into the computer workstation.

      PubDate: 2016-02-17T11:40:05Z
  • Nutrition and health claims in products directed at children via
           television in Spain in 2012

    • Abstract: Publication date: Available online 11 February 2016
      Source:Gaceta Sanitaria
      Author(s): Miguel Ángel Royo-Bordonada, María José Bosqued-Estefanía, Javier Damián, Lázaro López-Jurado, María Ángeles Moya-Geromini
      Objective To describe the use of nutrition and health claims in products directed at children via television in Spain and to analyse their nutrient profile. Methods A cross-sectional study of television food advertisements over 7 days in five Spanish television channels popular among children. The products were classified as core, non-core or miscellaneous, and as either healthy or less healthy, according to the United Kingdom Nutrient Profile Model. We registered all claims contained on the product (packaging and labelling) and its advertisement. We calculated the frequency distributions of health and nutrition claims. Results During the 420hours of broadcasting, 169 food products were identified, 28.5% in the dairy group and 60.9% in the non-core category. A total of 53.3% of products contained nutrition claims and 26.6% contained health claims; 62.2% of the products with claims were less healthy. Low-fat dairy products were the food category containing the highest percentage of health and nutrition claims. Conclusion Over half of all food products marketed to children via television in Spain made some type of nutrition or health claim. Most of these products were less healthy, which could mislead Spanish consumers.

      PubDate: 2016-02-13T04:48:41Z
  • Acceso a medicamentos de alto precio en Brasil: la perspectiva de
           médicos, farmacéuticos y usuarios

    • Abstract: Publication date: Available online 3 February 2016
      Source:Gaceta Sanitaria
      Author(s): Marina Raijche Mattozo Rover, Claudia Marcela Vargas-Pelaez, Mareni Rocha Farias, Silvana Nair Leite
      Objetivo Explorar las percepciones sobre el acceso a los medicamentos del Componente Especializado de la Asistencia Farmacéutica (CEAF) del Sistema Único de Salud brasileño (que incluye los medicamentos de alto costo), por parte de los actores involucrados en el ámbito asistencial del CEAF. Métodos Estudio cualitativo descriptivo. Para la recolección de los datos se realizaron un grupo focal con siete usuarios/as y 11 entrevistas semiestructuradas a profesionales de la salud (medicina y farmacia) del estado de Santa Catarina. Resultados Según los/las participantes, el acceso a medicamentos del CEAF ha mejorado. Se encontraron también dos percepciones sobre los Protocolos Clínicos y Directrices de Tratamiento del CEAF: las exigencias son burocracia que limita el acceso y los requisitos aumentan la demanda de exámenes y especialistas, superando la capacidad de la red de servicios de salud. A partir de estas percepciones se generan vías alternativas de acceso que evidencian una concepción frágil del derecho a la salud, desinformación y dependencia por parte de los usuarios, las cuales pueden tener consecuencias en la salud de las personas y en el sistema de salud. Según los/las participantes, debido a las dificultades en el acceso de los servicios de salud en general, el pleno acceso a los medicamentos aún es un objetivo por alcanzar. Conclusión De acuerdo con las percepciones encontradas, aunque el acceso a los medicamentos del CEAF ha mejorado, persisten dificultades para garantizar su oportunidad y su integralidad. Objective To explore perceptions on access to medication supplied by the Specialized Component of Pharmaceutical Assistance (CEAF) within the Brazilian Unified Health System (which includes high-cost drugs) by the actors involved in the healthcare services of this component. Method A descriptive, qualitative study was carried out by using a focal group with 7 users and 11 semi-structured interviews with health professionals (physicians and pharmacist) in the state of Santa Catarina. Results According to the participants, access to medicines had improved. Two main perceptions of the CEAF Clinical Guidelines were identified: the requirements constitute a bureaucracy that limits access, and the requisites increase the demand for tests and specialized healthcare services, exceeding the capacity of the healthcare services network. These assumptions generated the search for other means of access that revealed a lack of information and understanding of the right to health among the users. In addition, according to the participants, because of the difficulties of accessing services as a whole, full access to CEAF medicines is a goal that remains to be achieved. Conclusion Although access to CEAF medicines has improved, there are still some difficulties in guaranteeing treatment access and comprehensiveness.

      PubDate: 2016-02-09T04:12:09Z
  • Diferencia de género en investigadores peruanos según Google
           Académico, 2015

    • Abstract: Publication date: Available online 29 January 2016
      Source:Gaceta Sanitaria
      Author(s): J. Jhonnel Alarco, Esmilsinia V. Álvarez-Andrade, Hugo Arroyo-Hernández

      PubDate: 2016-02-09T04:12:09Z
  • Anticoncepción de urgencia y objeción de conciencia: un debate
           sin cerrar

    • Abstract: Publication date: Available online 29 January 2016
      Source:Gaceta Sanitaria
      Author(s): María del Mar García-Calvente, Vicente Lomas-Hernández

      PubDate: 2016-02-09T04:12:09Z
  • La opinión de las personas egresadas sobre la utilidad de la
           formación en gerontología

    • Abstract: Publication date: Available online 29 January 2016
      Source:Gaceta Sanitaria
      Author(s): Manuel Ruiz-Adame Reina

      PubDate: 2016-02-09T04:12:09Z
  • La hospitalización terapéutica obligatoria en el control de la

    • Abstract: Publication date: Available online 29 January 2016
      Source:Gaceta Sanitaria
      Author(s): Joan R. Villalbí, Mònica Rodríguez-Campos, Àngels Orcau, M. Àngels Espachs, Marta Salamero, José Maldonado, Joan A. Caylà
      Este trabajo describe las acciones de los servicios de salud pública de la ciudad de Barcelona para evitar la transmisión de la tuberculosis por pacientes bacilíferos incumplidores utilizando las posibilidades de la Ley 3/1986. Se basan en la resolución de la autoridad sanitaria de la necesidad de su localización y hospitalización terapéutica obligatoria para administrar el tratamiento, movilizando la colaboración policial, comunicándolo a la persona afectada y pidiendo al Juzgado de lo Contencioso Administrativo su ratificación. Se describen el proceso y las características de los casos. Desde julio de 2006 hasta junio de 2015, a lo largo de 9 años, se ha activado sólo en 12 ocasiones. Se valora que se ha usado con prudencia y proporcionalidad, y que ha permitido tratar a pacientes que comportaban riesgo en su entorno, reduciendo así la transmisión de la infección. This article describes the actions of public health services of the city of Barcelona to prevent tuberculosis transmission by noncompliant smear-positive patients by using the possibilities of Spanish Law 3/1986. The actions were based on a resolution of the health authorities on the need to locate such patients and to detain them in hospitals to provide treatment. This involved police cooperation, informing noncompliant patients, and requesting ratification from the Administrative Court. The article describes the process and the characteristics of the cases involved. Over nine years, from July 2006 to June 2015, the law was used in only twelve cases. The authors conclude that the criteria of prudence and proportionality were used in the application of the law, which resulted in the treatment of patients who posed a risk to their environment, reducing the transmission of infection.

      PubDate: 2016-02-09T04:12:09Z
  • Las enfermedades crónicas como prioridad de la vigilancia de la salud
           pública en España

    • Abstract: Publication date: Available online 29 January 2016
      Source:Gaceta Sanitaria
      Author(s): José María Mayoral Cortes, Nuria Aragonés Sanz, Pere Godoy, María José Sierra Moros, Rosa Cano Portero, Francisco González Moran, Ánxela Pousa Ortega
      En la actualidad, la vigilancia epidemiológica sigue centrada, en España, en las enfermedades transmisibles incluidas en la lista de enfermedades de declaración obligatoria. Sin embargo, el patrón epidemiológico que dominó hasta las últimas décadas del siglo xx ha cambiado. Las enfermedades infecciosas, que eran las principales causas de morbimortalidad, han dado paso a un predominio de las enfermedades crónicas. En este sentido, se ha avanzado en la redacción y la aprobación de normativa específica sobre vigilancia de la salud pública. No obstante, tenemos pendiente el desarrollo de esta normativa que, entre otros puntos, recoge el mandato de organizar la vigilancia de las enfermedades no transmisibles en España. El objetivo de este trabajo es describir algunas características a tener en cuenta para desarrollar un sistema nacional de vigilancia de la salud pública vinculado a las estrategias ya existentes para la prevención y el control de las enfermedades crónicas. At present, epidemiological surveillance in Spain remains focused on the communicable diseases included in the list of notifiable diseases. However, there has been a change in epidemiological pattern that predominated until the last few decades of the twentieth century. Infectious diseases, which used to be the leading causes of morbidity and mortality, have given way to a predominance of chronic diseases. In this regard, progress has been made in the drafting and adoption of specific legal regulations on public health monitoring. However, Spain has yet to develop this legislation which, among other elements, includes the mandate to organize the surveillance of non-communicable diseases in Spain. This article aims to describe some points that should be considered in the development of a national surveillance system linked to existing strategies for the prevention and control of chronic diseases.

      PubDate: 2016-02-09T04:12:09Z
  • Cómo los equipos de dirección usan los sistemas de
           información y control en la gestión hospitalaria

    • Abstract: Publication date: Available online 4 February 2016
      Source:Gaceta Sanitaria
      Author(s): David Naranjo-Gil
      Objetivo Analizar la relación entre las características de los equipos de dirección y el uso diferenciado de los sistemas de información y control de la gestión (SICG), así como el efecto de tales sistemas en la cooperación y la coordinación de actividades en los hospitales públicos. Métodos Los datos se recogieron mediante un cuestionario enviado individualmente a los miembros del equipo de dirección de 231 hospitales públicos españoles (director/a gerente, director/a médico, director/a de enfermería y director/a de asuntos sociales y económicos). Se recibieron 457 respuestas válidas, con las cuales se formaron 86 equipos de dirección completos (37,23%). Resultados Un equipo de dirección con diversidad de características está relacionado positivamente con un uso interactivo de los SICG. Los equipos directivos más jóvenes y de mayor antigüedad usaron interactivamente los SICG. Los equipos de dirección con formación y experiencia clínica también usaron los SICG interactivamente; sin embargo, los equipos con formación y experiencia predominantemente administrativas usaron los SICG de forma diagnóstica. Los resultados también muestran que la cooperación y la coordinación en los hospitales se relacionan positivamente con un uso interactivo de los SICG y negativamente con un uso diagnóstico de los SICG. Conclusión El uso interactivo de los SICG es un mediador importante de la relación entre la diversidad del equipo de dirección y el fomento de políticas de cooperación y coordinación en los hospitales. Los equipos con diversidad de características (p. ej., edad, antigüedad, educación y experiencia) tienden a usar los sistemas de información de la gestión de forma interactiva para mejorar la coordinación de actividades y la asignación de recursos en los hospitales. Objective To analyze the relationship between the characteristics of top management teams and the different use of management information and control systems (MICS) to implement policies that encourage cooperation and activity coordination in public hospitals. Methods Data were collected through a questionnaire sent to each member of the top management teams of 231 Spanish public hospitals (chief executive director, medical director, nursing director and director for financial and social issues). A total of 457 valid questionnaires were returned, composing 86 full top management teams (37.23%). Results Top management team diversity was positively related to the interactive use of MICS. Management teams composed of younger members and members with longer service used MICS interactively. Top management teams with a predominantly clinical education and experience used MICS interactively, while top teams with a predominantly administrative education and experience used MICS diagnostically. The results also showed that cooperation and coordination in hospitals were positively related to the interactive use of MICS and were negatively related to the diagnostic use of MICS. Conclusions The interactive use of MICS is an important mediator in the relationship between top team diversity and policies focused on hospital decentralization. Top management teams with diverse characteristics (e.g. age, length of service, education and experience) use management information interactively to enhance activity coordination and resourc...
      PubDate: 2016-02-09T04:12:09Z
  • Impacto poblacional de un programa de salud escolar podológica

    • Abstract: Publication date: Available online 4 January 2016
      Source:Gaceta Sanitaria
      Author(s): José Ramos-Galván, Verónica Álvarez-Ruiz, Natalia Tovaruela-Carrión, Ramón Mahillo-Durán, Fernando Gago-Reyes
      Este trabajo presenta un resumen de lo realizado en los últimos 12 años de colaboración entre la comunidad escolar de varios centros de enseñanza primaria y secundaria y los/las responsables de las prácticas de la asignatura Podología Preventiva y Comunitaria del Grado en Podología, que se imparte en la Universidad de Sevilla. Se muestran diferentes estrategias llevadas a cabo desde las líneas de investigación Salud Podológica para Todos y Podología Preventiva y Comunitaria, integradas en el Grupo de Investigación Hermes (CTS-601), dirigidas a promocionar la salud podológica en general. Se ha explorado un total de 4630 escolares y se han confirmado alteraciones podológicas en 677. También se han beneficiado 7145 miembros de la comunidad escolar a quienes se ha llegado a través de actividades educativas sobre el cuidado de los pies. Su desarrollo trata de impedir que se generen lesiones, en la edad adulta, que perjudiquen la calidad de vida. This article presents an overview of the work done over the past 12 years in a collaboration between the school communities at various primary and secondary schools and the practical experience managers working in the Preventive and Community Podiatry area of the Podiatry degree at the University of Seville (Spain). The article presents several strategies, which were carried out in the fields of Foot Health for All and Preventive and Community Podiatry as part of the Hermes Research Group (CTS-601) aimed at promoting general foot health. Foot examinations were conducted in a total of 4,630 school pupils, with foot problems being confirmed in 677 of them. Some 7,145 members of the school community were also helped, with these people being reached through educational activities around foot care. The aim of the initiative was to prevent foot damage among children, which could have a harmful impact on their quality of life as adults.

      PubDate: 2016-01-06T20:31:08Z
  • Utilización del conocimiento tácito por proveedores de

    • Abstract: Publication date: Available online 23 December 2015
      Source:Gaceta Sanitaria
      Author(s): Emmanuel Calderón Espinosa, Víctor Becerril Montekio, Jacqueline Alcalde Rabanal, Luis García Bello
      Introducción La búsqueda de respuestas eficaces para fortalecer la atención a la salud materna ha incluido diversas fuentes de evidencia para apoyar la toma de decisiones. En este trabajo presentamos un mapeo sistemático de la utilización del conocimiento tácito de los actores involucrados en la atención de la salud materna reportada en la literatura científica. Método Mapeo sistemático de artículos científicos publicados en inglés y español entre 1971 y 2014 siguiendo las recomendaciones de Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Resultados Treinta de 793 artículos cumplen los criterios de inclusión. El 60% procede de países de ingresos altos y la población más estudiada fue el personal de salud (66,7%). Encontramos un predominio (62%) de metodologías cualitativas. Se generaron cuatro categorías sobre el uso del conocimiento tácito: propuestas para mejorar la organización del sistema de atención a la salud materna (30%), y la atención que se les brinda a lo largo del continuo de embarazo, parto y puerperio (26,7%); determinación de la percepción y el nivel de competencias profesionales del personal de salud (26.7%); e interacciones del conocimiento tácito y el conocimiento explícito en la toma de decisiones clínicas (16,7%). Conclusiones Este mapeo muestra que el conocimiento tácito es un enfoque de investigación emergente, innovador y versátil, con mayores avances en los países de ingresos altos, y que encierra interesantes posibilidades de utilización como evidencia para mejorar las intervenciones en salud materna, especialmente en los países de ingresos medios y bajos, donde se requiere fortalecerlo. Introduction The search for efficient answers to strengthen maternal health care has included various sources of evidence for decision making. In this article, we present a systematic mapping of the scientific literature on the use of tacit knowledge in relation to maternal healthcare. Methods A systematic mapping was conducted of scientific articles published in Spanish and English between 1971 and 2014 following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results Of 793 articles, 30 met the inclusion criteria; 60% were from high-income countries and 66.7% were focused on health professionals. We identified a predominance of qualitative methodologies (62%). Four categories regarding the use of tacit knowledge were generated: proposals to improve the organization of the maternal care system (30%) and to improve the care provided to women during the continuum of pregnancy, childbirth and postpartum (26.7%), determination of health workers’ perception and skill levels (26.7%) and the interactions between tacit and explicit knowledge in clinical decision making (16.7%). Conclusions This mapping shows that tacit knowledge is an emerging, innovative and versatile research approach used primarily in high-income countries and that includes interesting possibilities for its use as evidence to improve maternal healthcare, particularly in middle- and low-income countries, where it needs to be strengthened.

      PubDate: 2015-12-27T17:06:38Z
  • Análisis de las barreras y oportunidades legales-éticas de la
           comunicación y disculpa de errores asistenciales en España

    • Abstract: Publication date: Available online 23 December 2015
      Source:Gaceta Sanitaria
      Author(s): Priscila Giraldo, Josep Corbella, Carmen Rodrigo, Mercè Comas, Maria Sala, Xavier Castells
      Objetivo Identificar las oportunidades y las barreras legales-éticas sobre la comunicación y disculpa del error médico en España. Método Estudio transversal a 46 expertos/as en derecho sanitario-bioética. Resultados 39 (84,7%) respondieron que siempre deberían comunicarse los eventos y 38 (82,6%) se mostraron a favor de una disculpa. Treinta expertos/as (65,2%) declararon que si se realizaba una comunicación de errores, esta no devengaría responsabilidad profesional. Se identificó como oportunidad la mejora de la confianza médico/a-paciente, y como barrera principal, el miedo a las consecuencias de la comunicación. Discusión existe un consenso sobre la falta de responsabilidad derivada de una comunicación-disculpa y la necesidad de iniciar un programa de comunicación a través del soporte a los/las médicos/as. Objective To identify opportunities for disclosing information on medical errors in Spain and issuing an apology, as well as legal-ethical barriers. Method A cross-sectional study was conducted through a questionnaire sent to health law and bioethics experts (n=46). Results A total of 39 experts (84.7%) responded that health providers should always disclose adverse events and 38 experts (82.6%) were in favour of issuing an apology. Thirty experts (65.2%) reported that disclosure of errors would not lead to professional liability. The main opportunity for increasing disclosure was by enhancing trust in the physician-patient relationship and the main barrier was fear of the outcomes of disclosing medical errors. Conclusions There is a broad agreement on the lack of liability following disclosure/apology on adverse events and the need to develop a strategy for disclosure among support for physicians.

      PubDate: 2015-12-27T17:06:38Z
  • Un ejemplo innovador en políticas de salud

    • Abstract: Publication date: Available online 24 December 2015
      Source:Gaceta Sanitaria
      Author(s): Raúl Pesquera-Cabezas, Luis Mariano López-López

      PubDate: 2015-12-27T17:06:38Z
  • Demographic, psychological and smoking characteristics of users of an
           on-line smoking cessation programme in the Spanish language

    • Abstract: Publication date: January–February 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 1
      Author(s): Guillermo Mañanes, Miguel A. Vallejo, Laura Vallejo-Slocker
      Objective To determine the characteristics of users of a smoking cessation programme run by the Open University of Spain (Universidad Nacional de Educación a Distancia [UNED]). Methods We examined the demographic, psychological and smoking characteristics of 23,763 smokers who participated in the on-line smoking cessation program of the UNED. The programme was open to any smoker, free of charge, and was fully automated and with direct access. Results A total of 93.5% of the users were Spaniards, with an equal percentage of participation among men and women. The mean age was 39 years. Somewhat less than half were married and had a university education. The participants smoked a mean of 19.3 cigarettes per day, showing a mid-range level of nicotine dependence according to the Heaviness of Smoking Index. The results of the Anxiety and Depression subscales of the Symptom Checklist-90-Revised (SCL-90-R) and Perceived Stress Scale were not clinically significant. In a secondary analysis of the data, we found gender differences in all the variables measured. Conclusions The results of this study confirm the digital divide, with lower participation among people with a lower educational level. No association was observed between stress, anxiety or depression and cigarette consumption.

      PubDate: 2015-12-23T00:26:40Z
  • Gaceta Sanitaria a Primera Vista

    • Abstract: Publication date: January–February 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 1

      PubDate: 2015-12-23T00:26:40Z
  • El patrón de consumo de alcohol en adultos desde la perspectiva de
           los adolescentes

    • Abstract: Publication date: January–February 2016
      Source:Gaceta Sanitaria, Volume 30, Issue 1
      Author(s): Cristian Suárez, Gonzalo Del Moral, Belén Martínez, Bev John, Gonzalo Musitu
      Objetivo Conocer la opinión de un grupo de adolescentes acerca del patrón de consumo de alcohol que muestran los/las adultos/as de su entorno social. Métodos Investigación cualitativa fundamentada en Grounded Theory (Glaser y Strauss, 1967) con información obtenida mediante cinco grupos de discusión. Los/las participantes fueron seleccionados/as mediante muestreo teórico en la fase inicial y emergente del estudio, aplicando criterios maestros de selección fundamentados en la literatura previa. Se utilizaron criterios de heterogeneidad-homogeneidad en la composición de los grupos. Participaron 40 adolescentes de ambos sexos, entre 15 y 20 años de edad, pertenecientes a cuatro centros educativos de Sevilla. Resultados Según los/las adolescentes entrevistados/as, el consumo de alcohol está normalizado entre las personas adultas, se vincula a actos de celebración, se orienta hacia la diversión e incluye el consumo abusivo e intensivo y la presencia de destilados. Los datos de los estudios recientes contradicen en parte la opinión de los/las adolescentes, pues muestran un patrón de consumo en las personas adultas asociado fundamentalmente al componente gastronómico y social de la bebida, con ingestas moderadas de cerveza y vino. Conclusiones Se sugiere la posible existencia de una percepción distorsionada en algunos/as adolescentes acerca de la realidad del consumo en los/las adultos/as. Como explicación, se plantea la hipótesis de una relación entre esta percepción y la información contradictoria que reciben los/las jóvenes en materia de alcohol, la idea de ser normativos y el deseo de satisfacer sus propias necesidades hedónicas y de socialización. Objective To identify the views of a sample of adolescents on the pattern of alcohol consumption shown by adults in their social environment. Method A qualitative study was conducted using the method proposed by grounded theory (Glaser & Strauss, 1967). Data were collected through five discussion groups. Participants were selected by theoretical sampling in the initial and emerging phases of the study by applying criteria based on previous research. Heterogeneity-homogeneity criteria were used in the composition of the groups. The final sample consisted on 40 adolescents of both sexes between 15 and 20 years from four educational centres in Seville (Spain). Results According to the adolescents interviewed, alcohol use was normal among adults, geared towards fun, and was linked to social gatherings and to abusive and intensive consumption including drinking spirits. Data from recent studies partly contradict adolescents’ perceptions, showing a pattern of consumption in adults associated mostly with the gastronomic and social component of drink and with moderate intake of beer and wine. Conclusions The results of this study suggest that adolescents may have a distorted view of the reality of adult patterns of alcohol use. As an explanation, we hypothesize that, faced with conflicting information, adolescents prioritize the information that best fits their view of what is socially acceptable and what meets their own hedonistic and social needs

      PubDate: 2015-12-23T00:26:40Z
  • Competencias y contenidos comunes de salud pública del Grado en
           Medicina en las universidades españolas

    • Abstract: Publication date: Available online 17 December 2015
      Source:Gaceta Sanitaria
      Author(s): Mª Carmen Davó-Blanes, Carmen Vives-Cases, José Luis Barrio-Fernández, Miquel Porta, Fernando G. Benavides, Ángel Gil de Miguel
      Objetivo Consensuar las competencias profesionales de salud pública que deben adquirir los estudiantes en el Grado en Medicina y los contenidos fundamentales que debe incluir la materia de salud pública según el criterio de un grupo de docentes de salud pública del Grado en Medicina de distintas universidades españolas. Métodos Se organizó una 2ª Reunión del Foro de Profesorado Universitario de Salud Pública en la Universidad Rey Juan Carlos (Madrid, 11-12 de diciembre de 2014), en la que participaron 24 docentes de 19 universidades españolas con Grado en Medicina que fueron distribuidos en tres grupos durante tres sesiones de trabajo. En la primera sesión, se identificaron y clasificaron las competencias propias del Grado; en la segunda, se propusieron contenidos de salud pública para las competencias identificadas; en la tercera, se organizaron los contenidos en bloques temáticos. Los resultados se discutieron hasta alcanzar acuerdos, en distintas sesiones plenarias. Resultados El mayor número de competencias identificadas corresponde a actividades de las funciones «Valorar las necesidades de salud de la población» y «Desarrollar políticas de salud». El programa final incluye contenidos básicos organizados en cinco bloques: Concepto de salud, salud pública y sus condicionantes; Epidemiología e investigación en salud; Condicionantes y problemas de salud; Estrategias, intervenciones y políticas; y Sistemas de salud, gestión clínica y sanitaria. Conclusiones Las competencias y los contenidos comunes consensuados en este Foro constituyen una base para actualizar y mejorar la formación en salud pública de los futuros profesionales de la medicina. Objective To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees. Methods The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions. Results The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management. Conclusions The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training program...
      PubDate: 2015-12-18T23:16:40Z
  • Corrigendum a: A corazón abierto: vivencias de madres y padres de
           menores con anomalías congénitas cardiacas

    • Abstract: Publication date: Available online 7 December 2015
      Source:Gaceta Sanitaria
      Author(s): Lucía Páramo-Rodríguez, Rosa Mas Pons, Clara Cavero-Carbonell, Carmen Martos-Jiménez, Óscar Zurriaga, Carmen Barona Vilar

      PubDate: 2015-12-08T20:58:18Z
  • Icart Isern MT, Donaghy K. Films in health sciences education. Learning
           through moving images. Barcelona: Ediciones Universitat de Barcelona;
           2012. 164 p. ISBN: 978-84-475-3583-5.

    • Abstract: Publication date: Available online 4 December 2015
      Source:Gaceta Sanitaria
      Author(s): Fèlix Bosch, Esteve Fernández

      PubDate: 2015-12-08T20:58:18Z
  • Herramienta de retorno de la inversión en control del tabaquismo:
           ¿qué opinan aquellos que toman decisiones?

    • Abstract: Publication date: Available online 3 December 2015
      Source:Gaceta Sanitaria
      Author(s): Celia Muñoz, Marta Trapero-Bertran, Kei Long Cheung, Silvia Evers, Mickaël Hiligsmann, Hein de Vries, Ángel López-Nicolás
      Introducción El Proyecto Europeo EQUIPT pretende adaptar una herramienta de retorno de la inversión en tabaco para varios países, con el fin de proporcionar información sobre el retorno de invertir en estrategias y justificar la toma de decisiones. El objetivo de este estudio es identificar las necesidades de los usuarios en España para documentar la transferibilidad de la herramienta. Métodos Entrevistas telefónicas con actores relevantes sobre la implementación de la Herramienta EQUIPT, intención de uso y estrategias de control del tabaco. Resultados La herramienta puede añadir valor a la información utilizada al tomar decisiones y abogar por políticas coste-efectivas. Como inconvenientes, conocer cómo funcionará la herramienta, así como la formación y el tiempo que requerirá la consistencia y los cálculos internos. Conclusión Se recogen conocimientos e ideas de los potenciales usuarios para ayudar a adaptar la Herramienta EQUIPT, de modo que proporcione ayuda en la toma de decisiones eficientes. Introduction The European EQUIPT study will co-create a return on investment tool in several countries, aiming to provide decision makers with information and justification on the returns that can be generated by investing in tobacco control. This study aimed to identify the needs of potential users in Spain in order to provide information on the transferability of the tool. Methods Telephone interviews with stakeholders were conducted including questions about the implementation of the tool, intended use and tobacco control interventions. Results Implementing the tool could provide added value to the information used in decision-making to advocate for cost-effective policies. The main drawback would be the training and time needed to learn how the tool works and for internal calculations. Conclusion Knowledge and ideas from potential users collected in this study could inform the EQUIPT Tool adaptation. Thus, stakeholders could have an instrument that assists them on making healthcare decisions.

      PubDate: 2015-12-08T20:58:18Z
  • ¿Es ética la promoción farmacéutica en el

    • Abstract: Publication date: Available online 8 December 2015
      Source:Gaceta Sanitaria
      Author(s): Rafael Florián Castro

      PubDate: 2015-12-08T20:58:18Z
  • R-ALERGO. Rutas alergosaludables en Valencia

    • Abstract: Publication date: Available online 7 December 2015
      Source:Gaceta Sanitaria
      Author(s): Rafael R. Temes Cordovez, Alfonso Moya Fuero, Jaume Martí Garrido, Carolina Perales Chordá, Miguel Díaz Palacios, Dolores Hernández Fernández de Rojas
      El proyecto R-ALERGO, desarrollado entre la Universitat Politècnica de València y el Hospital Universitario La Fe, tiene como objetivo crear una aplicación móvil (App) que permita a los/las usuarios/as seleccionar, dentro de la ciudad de Valencia, las rutas más favorables para las personas alérgicas. En el desarrollo de la aplicación se ha seleccionado un conjunto de nueve variables ambientales presentes en la ciudad, que pueden influir en la aparición de manifestaciones clínicas en las personas alérgicas. Mediante el uso de un método de análisis espacial apoyado en tecnología de redes y sistemas de información geográfica se ha desarrollado la versión 01 de la App que se audita a través del Distintivo AppSaludable. El paso siguiente en este desarrollo es diseñar un proceso de validación clínica con el fin de comprobar su utilidad para las personas alérgicas. R-ALERGO is a project developed by researchers from the Universitat Politècnica de València and the Hospital Universitario La Fe (Valencia, Spain). The main objective of the project is to create a mobile application identifying, within the city of Valencia, the most favorable routes for allergic individuals. The application is developed using nine environmental variables with a potential effect on the development of clinical manifestations in allergic individuals. The application combines the use of spatial analysis based on network technology and implemented with a geographic information system software. The first 01 version is under evaluation for a Healthy app hallmark. The next step in this project is to design a clinical validation process to test its usefulness in allergic individuals.

      PubDate: 2015-12-08T20:58:18Z
  • Alcohol consumption and Mediterranean Diet adherence among health science
           students in Spain: the DiSA-UMH Study

    • Abstract: Publication date: Available online 3 December 2015
      Source:Gaceta Sanitaria
      Author(s): Alexander Scholz, Eva Maria Navarrete-Muñoz, Manuela Garcia de la Hera, Daniel Gimenez-Monzo, Sandra Gonzalez-Palacios, Desirée Valera-Gran, Laura Torres-Collado, Jesus Vioque
      Objective To describe the association between consumption of different alcoholic beverages and adherence to the Mediterranean diet. Methods A cross-sectional analysis was conducted of the baseline data of the DiSA-UMH study, an ongoing cohort study with Spanish health science students (n=1098) aged 17-35 years. Dietary information was collected by a validated 84-item food frequency questionnaire. Participants were grouped into non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages. Mediterranean diet adherence was determined by using a modification of the relative Mediterranean Diet Score (rMED; score range: 0-16) according to consumption of 8 dietary components. We performed multiple linear and multinomial regression analyses. Results The mean alcohol consumption was 4.3g/day (SD: 6.1). A total of 19.5%, 18.9% and 61.6% of the participants were non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages, respectively. Participants who consumed beer and/or wine exclusively had higher rMED scores than non-drinkers (β: 0.76, 95%CI: 0.25-1.27). Drinkers of all types of alcoholic beverages had similar rMED scores to non-drinkers. Non-drinkers consumed less fish and more meat, whereas drinkers of all types of alcoholic beverages consumed fewer fruits, vegetables and more meat than exclusive beer and/or wine drinkers. Conclusions The overall alcohol consumption among the students in our study was low-to-moderate. Exclusive beer and/or wine drinkers differed regarding the Mediterranean diet pattern from non-drinkers and drinkers of all types of alcohol. These results show the need to properly adjust for diet in studies of the effects of alcohol consumption.

      PubDate: 2015-12-03T18:57:04Z
  • Controversias sobre vacunas en España, una oportunidad para la
           vacunología social

    • Abstract: Publication date: Available online 21 November 2015
      Source:Gaceta Sanitaria
      Author(s): José Tuells

      PubDate: 2015-11-23T15:36:41Z
  • La salud de las personas adultas afectadas por un proceso de desahucio

    • Abstract: Publication date: Available online 6 November 2015
      Source:Gaceta Sanitaria
      Author(s): Julia Bolívar Muñoz, Mariola Bernal Solano, Inmaculada Mateo Rodríguez, Antonio Daponte Codina, Cecilia Escudero Espinosa, Carmen Sánchez Cantalejo, Isis González Usera, Humbelina Robles Ortega, José Luis Mata Martín, M. Carmen Fernández Santaella, Jaime Vila Castellar
      Objetivo Analizar el estado de salud percibida, y otros indicadores relacionados con la salud, en personas adultas de Granada que se encuentran en un proceso de desahucio de su vivienda habitual, de alquiler o en propiedad, en comparación con la salud de la población general andaluza. Métodos Estudio transversal mediante encuesta administrada por personal entrenado que incluye instrumentos de la Encuesta Andaluza de Salud 2011 para la medición de variables de salud física y mental, y de hábitos relacionados con la salud. Se han comparado los resultados con los obtenidos sobre la población general andaluza mediante la Encuesta Andaluza de Salud. Se ha realizado un análisis bivariado utilizando la prueba de ji al cuadrado, y un análisis multivariado mediante regresión logística. Resultados Se ha obtenido una muestra total de 205 personas en proceso de desahucio. El 59,5% (122) son mujeres y el 40,5% (83) hombres. Presentan una mayor probabilidad de tener una salud deficiente (odds ratio [OR]: 12,63; intervalo de confianza del 95% [IC95%]: 8,74-18,27), enfermedad cardiovascular (OR: 3,08; IC95%:1,54-6,16) o consumir tabaco (OR: 1,68; IC95%: 1,21-2,33), en comparación con la población general andaluza. La mayoría de los indicadores analizados muestran un peor resultado para las mujeres que experimentan un proceso de desahucio. Conclusiones Nuestros resultados indican que las personas afectadas por un proceso de desahucio en Granada y su área metropolitana, en el actual contexto de crisis, expresan una peor salud en relación a la población general andaluza. Es necesario seguir investigando sobre la salud y los desahucios, desde diferentes aproximaciones metodológicas, para una mejor comprensión de este problema. Objective To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. Methods A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. Results We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. Conclusions Our results suggest that, in the curren...
      PubDate: 2015-11-09T18:15:48Z
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