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  Subjects -> PUBLIC ADMINISTRATION (Total: 196 journals)
    - MUNICIPAL GOVERNMENT (6 journals)
    - PUBLIC ADMINISTRATION (171 journals)
    - SECURITY (19 journals)

PUBLIC ADMINISTRATION (171 journals)                  1 2 | Last

Academy of Management Annals, The     Full-text available via subscription   (Followers: 25)
Accounting and the Public Interest     Full-text available via subscription   (Followers: 1)
Acta Universitatis Danubius. Administratio     Open Access  
Administração Pública e Gestão Social     Open Access   (Followers: 1)
Administrative Sciences     Open Access   (Followers: 2)
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: 8)
AQ - Australian Quarterly     Full-text available via subscription   (Followers: 1)
ATA Journal of Legal Tax Research     Full-text available via subscription   (Followers: 3)
Australian Social Work     Hybrid Journal   (Followers: 10)
BAR. Brazilian Administration Review     Open Access  
Cadernos EBAPE.BR     Open Access   (Followers: 1)
Canadian Public Administration/Administration Publique Du Canada     Hybrid Journal   (Followers: 10)
Cities     Hybrid Journal   (Followers: 11)
Citizenship Studies     Hybrid Journal   (Followers: 3)
Clinical Social Work Journal     Hybrid Journal   (Followers: 14)
COEPTUM     Open Access  
Commonwealth Journal of Local Governance     Open Access   (Followers: 5)
Congress & the Presidency: A Journal of Capital Studies     Hybrid Journal   (Followers: 3)
Criterio Libre     Open Access  
Critical Policy Studies     Hybrid Journal   (Followers: 4)
Cuadernos de Administración     Open Access  
Cuadernos de Relaciones Laborales     Open Access  
Der Staat     Full-text available via subscription   (Followers: 11)
Die Verwaltung     Full-text available via subscription   (Followers: 8)
Documentos y Aportes en Administración Pública y Gestión Estatal     Open Access  
Économie publique/Public economics     Open Access   (Followers: 1)
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: 3)
EURE (Santiago) - Revista Latinoamericana de Estudios Urbano Regionales     Open Access  
European Journal of Government and Economics     Open Access   (Followers: 1)
European Journal of Social Work     Hybrid Journal   (Followers: 18)
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: 1)
Future Studies Research Journal : Trends and Strategies     Open Access   (Followers: 1)
Gaceta Sanitaria     Open Access   (Followers: 2)
Georgia Journal of Public Policy     Open Access   (Followers: 1)
Gestión y Política Pública     Open Access   (Followers: 1)
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 4)
Governance     Hybrid Journal   (Followers: 289)
Government and Opposition     Full-text available via subscription   (Followers: 16)
Government Information Quarterly     Hybrid Journal   (Followers: 16)
Government News     Full-text available via subscription   (Followers: 2)
Growth and Change     Hybrid Journal   (Followers: 5)
Headmark     Full-text available via subscription   (Followers: 2)
HR Highway     Full-text available via subscription   (Followers: 1)
Human Resource Development Quarterly     Hybrid Journal   (Followers: 12)
Human Service Organizations Management, Leadership and Governance     Hybrid Journal   (Followers: 21)
Ids Working Papers     Hybrid Journal   (Followers: 3)
IMIESA     Full-text available via subscription  
International Affairs and Global Strategy     Open Access   (Followers: 5)
International Journal of Electronic Government Research     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Policy and Decision Making     Hybrid Journal   (Followers: 10)
International Journal of Information Systems for Crisis Response and Management     Full-text available via subscription   (Followers: 2)
International Journal of Leadership in Public Services     Hybrid Journal   (Followers: 6)
International Journal of Public Administration     Hybrid Journal   (Followers: 12)
International Journal of Public Sector Performance Management     Hybrid Journal   (Followers: 5)
International NGO Journal     Open Access   (Followers: 1)
International Review of Public Administration     Hybrid Journal  
Journal of Asian Public Policy     Hybrid Journal   (Followers: 1)
Journal of Community Practice     Hybrid Journal   (Followers: 6)
Journal of Comparative Policy Analysis : Research and Practice     Hybrid Journal   (Followers: 8)
Journal of Developing Areas     Full-text available via subscription   (Followers: 4)
Journal of E-Governance     Hybrid Journal   (Followers: 3)
Journal of Economic and Administrative Sciences     Hybrid Journal   (Followers: 4)
Journal of Entrepreneurship and Public Policy     Hybrid Journal   (Followers: 7)
Journal of European Public Policy     Hybrid Journal   (Followers: 25)
Journal of Higher Education Outreach and Engagement     Open Access   (Followers: 12)
Journal of Management & Organization     Full-text available via subscription   (Followers: 15)
Journal of Nursing Management     Hybrid Journal   (Followers: 19)
Journal of Park and Recreation Administration     Full-text available via subscription   (Followers: 3)
Journal of Public Administration     Full-text available via subscription   (Followers: 17)
Journal of Public Administration and Governance     Open Access   (Followers: 10)
Journal of Public Administration Research and Theory     Hybrid Journal   (Followers: 17)
Journal of Science and Sustainable Development     Full-text available via subscription  
Journal of Social Work Education     Hybrid Journal   (Followers: 3)
Just Policy: A Journal of Australian Social Policy     Full-text available via subscription   (Followers: 6)
Law, Democracy & Development     Open Access   (Followers: 6)
Law, Innovation and Technology     Full-text available via subscription   (Followers: 9)
Liinc em Revista     Open Access  
Local Government Bulletin     Full-text available via subscription   (Followers: 1)
Local Government Studies     Hybrid Journal   (Followers: 8)
Macramè. Trame e ritagli dell’urbanistica     Open Access   (Followers: 1)
Middle East Law and Governance     Hybrid Journal   (Followers: 7)
National Civic Review     Hybrid Journal  
National Journal     Full-text available via subscription   (Followers: 3)
NISPAcee Journal of Public Administration and Policy     Open Access   (Followers: 2)
Organisational Transformation and Social Change     Hybrid Journal   (Followers: 6)
Organizações & Sociedade     Open Access  
Orientación y Sociedad : Revista Internacional e Interdisciplinaria de Orientación Vocacional Ocupacional     Open Access  
P3T : Journal of Public Policies and Territory     Open Access   (Followers: 1)
Parliaments, Estates and Representation     Hybrid Journal   (Followers: 3)
People Management     Full-text available via subscription   (Followers: 8)

        1 2 | Last

Journal Cover   Gaceta Sanitaria
  [SJR: 0.434]   [H-I: 27]   [4 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0213-9111
   Published by Elsevier Homepage  [2665 journals]
  • Factores asociados al empoderamiento en personas con lesión medular
           tras un accidente de tráfico

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Raquel Suriá Martínez
      Objetivo Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edad en la cual adquirieron la lesión. Métodos Participaron 94 personas con lesión medular (42 tetrapléjicos y 52 parapléjicos), que contestaron la versión española adaptada de la Escala de Rogers, Chamberlin, Ellison y Crean (1997), diseñada para medir el empoderamiento. Resultados Los análisis indicaron niveles más altos de esta capacidad en las mujeres. Asimismo, las personas con tetraplejia que tuvieron el accidente hace más años indicaron más empoderamiento. Conclusión El estudio sugiere que esta capacidad puede variar y evolucionar. Por lo tanto, es importante fomentarla en programas de intervención-acción. Objetivo Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. Methods Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. Results The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. Conclusion This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs.


      PubDate: 2015-05-01T04:36:26Z
       
  • GACETA SANITARIA A PRIMERA VISTA

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3




      PubDate: 2015-05-01T04:36:26Z
       
  • Las desigualdades de género en la ciencia: Gaceta Sanitaria da un
           paso adelante

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Carme Borrell , Carmen Vives-Cases , Mª Felicitas Domínguez-Berjón , Carlos Álvarez-Dardet



      PubDate: 2015-05-01T04:36:26Z
       
  • Interrupción voluntaria del embarazo y uso de métodos
           anticonceptivos en mujeres que ejercen la prostitución en
           Almería

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): María Jesús Cabrerizo Egea , María Pilar Barroso García , Rafael Rodríguez-Contreras Pelayo
      Objetivo Analizar la realización de interrupciones voluntarias del embarazo (IVE) en mujeres que ejercen la prostitución en Almería y su relación con la utilización de métodos anticonceptivos. Métodos Estudio transversal, con 110 mujeres. Se realizó un análisis bivariado utilizando el test de ji al cuadrado o el test de Fisher (nivel de significación <0,05), y se calculó la odds ratio con un intervalo de confianza del 95%. Resultados Del 52,7% de mujeres que se habían sometido a alguna IVE, todas utilizaban preservativo y un 35,5% además otro método anticonceptivo. No se encontró asociación estadísticamente significativa entre presentar rotura del preservativo y realizar alguna IVE, ni con la utilización de otros métodos anticonceptivos. Conclusiones Este grupo de mujeres presenta un alto porcentaje de IVE, a pesar de que el uso del preservativo está muy extendido. Sin embargo, se ha encontrado un alto porcentaje de rotura de este y un bajo porcentaje de uso de píldora poscoital tras la relación de riesgo. Objective To analyze the performance of induced abortion (IA) in prostitutes in Almería (Spain) and its association with the use of contraceptive methods. Methods A cross-sectional study was conducted in 110 women. A bivariate analyses using either the χ2 test or Fisher's exact test was carried out (significance level <0.05), with calculation of odds ratios and 95% confidence intervals. Results A total of 52.7% of women had undergone at least one IA. All of these women used condoms and 35.5% of them also used another contraceptive method. No statistically significant association was found between condom breakage and the performance of IA or in the use of other contraceptive methods. Conclusions A high percentage of this group of women had undergone IA, despite widespread condom use. However, there was a high percentage of condom breakage and a low percentage of use of emergency contraceptive pills after risky sexual relationships.


      PubDate: 2015-05-01T04:36:26Z
       
  • Representatividad de las mujeres en las sociedades científicas
           españolas del ámbito de la salud en 2014

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Rosa Casado-Mejía , Alicia Botello-Hermosa
      Objetivo Describir la presencia de las mujeres en las estructuras directivas de las sociedades científicas de salud en España actualmente. Métodos Se identificó el sexo de presidencia, cargos ejecutivos y junta directiva de sociedades estatales, recopiladas por el Ministerio de Sanidad, Servicios Sociales e Igualdad, y Fisterra, visitando su web. Se analizó el porcentaje de mujeres global, y según profesión y ámbito de atención. Resultados De 173 sociedades científicas en julio de 2014, 41 tienen presidentas (22,53%). Las mujeres ocupan un 32,41% de puestos ejecutivos y un 36,24% del total de juntas directivas. Las sociedades médicas y enfermeras tienen presidenta en un 16,07% y un 76,92%, respectivamente. Las de primaria tienen más mujeres en cargos ejecutivos (54,55%) que las transversales (35,74%) y las hospitalarias (27,93%). Conclusión No existe paridad en el conjunto. La presencia femenina es mayor en las sociedades de enfermería y de primaria que en las médicas y las hospitalarias. Disminuye con el nivel de responsabilidad. Objective To describe the presence of women in the governance of health-related scientific societies in Spain today. Methods Spanish scientific societies were identified by vising the websites of the Ministry of Health, Social Services and Equality, and Fisterra. The sex of the president, executive officers and the board of directors was identified. Data were analyzed according to the overall percentage of women and by profession and setting. Results Of 173 scientific societies in July 2014, 41 had a female president (22.53%). Women held 35.45% of executive positions and accounted for 36.32% of the boards of directors. Only 16.07% of medical societies had a female president compared with 76.92% of nursing societies. Primary care societies had more women in executive positions (54.55%) than societies in which the professional activity of members involved both primary and secondary care (35.74%) and societies related to hospital care (27.93%). Conclusion There is a lack of parity, which is greater in nursing and primary care societies than in medical and hospital-related societies. Parity decreases as the level of responsibility rises.


      PubDate: 2015-05-01T04:36:26Z
       
  • Dos décadas de actividades puente entre la farmacología, la
           epidemiología y la salud pública en España

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Pol Morales , Laura García , Fèlix Bosch
      No debería sorprender que disciplinas como la epidemiología, la salud pública y la farmacología tengan a menudo puntos de confluencia. Es por ello que tanto los profesionales de estas áreas como sus instituciones han compartido diversas actividades. Este artículo recopila dos décadas de iniciativas compartidas entre dichas disciplinas, coordinadas por la Fundación Dr. Antonio Esteve. Se detallan 20 colaboraciones, entre actividades presenciales y publicaciones. En ellas han participado diversas instituciones y casi un millar de profesionales. Destacan las actividades orientadas a la formación en redacción y edición científica, en particular las 32 ediciones del curso sobre cómo redactar un artículo científico, entre 2004 y 2014. Se concluye que la colaboración entre instituciones y profesionales ha actuado, y se espera que lo siga haciendo, como puente entre disciplinas, con el fin de potenciar sus actividades y contribuir al avance científico desde una perspectiva multidisciplinaria. Unsurprisingly, disciplines such as epidemiology, public health and pharmacology have points of confluence. Consequently, in Spain, both professionals and organizations from these disciplines have collaborated on many different activities altogether. This article compiles two decades of shared initiatives among these fields, coordinated by the Esteve Foundation. We discuss 20 collaborations, including face-to-face activities and joint publications. These activities involved numerous institutions and over 1,000 professionals. Among other activities, we would like to stress the training activities in scientific writing and editing. In particular, we highlight the 32 editions of a training workshop on how to write a scientific article, which has been running since 2004 to the present day. We conclude that collaborations between different institutions and professionals have acted and will continue to act as a bridge between disciplines and to contribute to scientific progress from a multidisciplinary perspective


      PubDate: 2015-05-01T04:36:26Z
       
  • El registro de los estudios observacionales: es el momento de cumplir el
           requerimiento de la Declaración de Helsinki

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Rafael Dal-Ré , Miguel Delgado , Francisco Bolumar
      El sesgo de publicación es una grave deficiencia del actual sistema de comunicación de los resultados de estudios de investigación en seres humanos. Los investigadores clínicos saben que, desde el punto de vista ético, deben inscribir los ensayos clínicos antes de su inicio en un registro público. Se entiende que este hecho ayudará a reducir el sesgo de publicación. Sin embargo, la mayor parte de los estudios en seres humanos son de tipo observacional y no de tipo experimental. Se estima que se han registrado menos del 2% de los 2 millones de estudios observacionales concluidos o en curso. La revisión de 2013 de la Declaración de Helsinki exige el registro de todo estudio de investigación en seres humanos, sus muestras o datos identificables. Se propone que los agentes financiadores, como el Fondo de Investigaciones Sanitarias, requieran el registro de los estudios observacionales para proveer la financiación. Las empresas deberían hacer lo propio. Así mismo, se propone que los comités de ética de la investigación, que cumpliendo la regulación española utilizan desde 1990 la Declaración como marco de referencia para evaluar los aspectos éticos de los ensayos clínicos con medicamentos, hagan lo mismo con los estudios observacionales del ámbito sanitario; deberían, por tanto, exigir el registro del estudio antes de otorgar su aprobación definitiva. Esto permitiría educar a los investigadores de estudios observacionales en el cumplimiento de un requisito ético de reciente introducción en el código ético de mayor relevancia en la realización de investigaciones en seres humanos. Publication bias is a serious deficiency in the current system of disseminating the results of human research studies. Clinical investigators know that, from an ethical standpoint, they should prospectively register clinical trials in a public registry before starting them. In addition, it is believed that this approach will help to reduce publication bias. However, most studies conducted in humans are observational rather than experimental. It is estimated that less than 2% out of 2 million concluded or ongoing observational studies have been registered. The 2013 revision of the Declaration of Helsinki requires registration of any type of research study involving humans or identifiable samples or data. It is proposed that funding agencies, such as the Fondo de Investigaciones Sanitarias, as well as private companies, require preregistration of observational studies before providing funding. It is also proposed that Research Ethics Committees which, following Spanish regulation, have been using the Declaration as the framework for assessing the ethics of clinical trials with medicines since 1990, should follow the same provisions for the assessment of health-related observational studies: therefore, they should require prospective registration of studies before granting their final approval. This would allow observational study investigators to be educated in complying with an ethical requirement recently introduced in the most important ethical code for research involving humans.


      PubDate: 2015-05-01T04:36:26Z
       
  • Cuando el radón es beneficioso para la salud

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Francisco Maraver , Ana Isabel Martín-Megías , Iluminada Corvillo , Francisco Armijo



      PubDate: 2015-05-01T04:36:26Z
       
  • ¿Puede ser saludable un carcinógeno humano reconocido como el
           radón?

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Alberto Ruano-Raviña , Luis Quindós-Poncela , Carlos Sainz Fernández , Juan M. Barros-Dios



      PubDate: 2015-05-01T04:36:26Z
       
  • Estado vacunal de pacientes inmunocomprometidos atendidos en atención
           primaria

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Francisca Rivera Casares , Rahalf Pineda Coronel , Sebastián García de León Chocano , Silvia López , Silvana Montagud , Pilar Lorente



      PubDate: 2015-05-01T04:36:26Z
       
  • Fe de errores: Uso equitativo de tests en ciencias de la salud

    • Abstract: Publication date: May–June 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 3
      Author(s): Albert Espelt , Carme Viladrich , Eduardo Doval , Joan Aliaga , Rebeca García-Rueda , Salomé Tárrega



      PubDate: 2015-05-01T04:36:26Z
       
  • Las llaves del acceso abierto

    • Abstract: Publication date: Available online 14 April 2015
      Source:Gaceta Sanitaria
      Author(s): Ricard Meneu , Vicente Ortún



      PubDate: 2015-04-21T03:29:57Z
       
  • Tendencias en el consumo de alcohol en los adolescentes escolarizados
           españoles a lo largo de la primera década del siglo xxi

    • Abstract: Publication date: Available online 11 April 2015
      Source:Gaceta Sanitaria
      Author(s): Inmaculada Sánchez-Queija , Carmen Moreno , Francisco Rivera , Pilar Ramos
      Objetivo Conocer la tendencia en el consumo de cerveza, vino y licores destilados de los adolescentes españoles en 2002, 2006 y 2010, así como la tendencia de haber experimentado episodios de embriaguez durante este mismo periodo de tiempo. Método La muestra está conformada por 23.169 adolescentes de 15 a 18 años de edad: 7103 en 2002, 10.443 en 2006 y 5623 en 2010. En las tres ediciones del estudio, los datos son representativos de los escolares de esas edades en España. Se utilizó el cuestionario de consumo de alcohol consensuado por el equipo internacional del estudio Health Behaviour in School-aged Children (HBSC). Se estimaron las odds ratio y los intervalos de confianza del 95% mediante regresiones logísticas. Resultados Los resultados principales muestran un descenso del consumo frecuente de vino y licores destilados de 2002 a 2010, que se mantiene cuando se controla la variabilidad debida al sexo y a la edad de los participantes. Sin embargo, se encontró una tendencia al alza de los episodios de embriaguez en las diferentes cohortes de adolescentes estudiadas. Conclusiones Se obtienen resultados de especial importancia para el análisis de las consecuencias de las políticas de salud pública implementadas durante los años que abarca el estudio. Se encuentran cambios en los patrones de consumo de las diferentes bebidas alcohólicas, lo que puede constituir una información clave para el diseño de nuevas políticas de salud pública. Objective To determine trends in beer, wine, and liquor consumption among Spanish adolescents in 2002, 2006, and 2010, as well as drunkenness trends during the same period. Method The study sample was composed of 23,169 adolescents aged 15 to 18 years old: 7,103 in 2002, 10,443 in 2006 and 5,623 in 2010. In the three time points of the study, the data were representative of Spanish adolescent students. We used the alcohol consumption questionnaire designed by the international team of the Health Behavior in School-aged Children (HBSC) study. We estimated odds ratios and 95% confidence intervals through logistic regressions. Results The main results showed a decrease in frequent consumption of wine and liquor from 2002 to 2010. This decrease was maintained after controlling for the variability due to the participants’ gender and age. However, an increasing trend was found in drunkenness episodes in the different cohorts of the adolescents under study. Conclusions The results of this study are of particular importance in the analysis of the effects of the public health policies implemented during this time period. We also found changes in consumption patterns of the various alcoholic drinks, which may constitute key information in the design of new public health policies.

      PubDate: 2015-04-12T12:32:59Z
       
  • Productivity loss due to premature mortality caused by blood cancer: a
           study based on patients undergoing stem cell transplantation

    • Abstract: Publication date: Available online 11 April 2015
      Source:Gaceta Sanitaria
      Author(s): Marta Ortega-Ortega , Juan Oliva-Moreno , Juan de Dios Jiménez-Aguilera , Antonio Romero-Aguilar , Ildefonso Espigado-Tocino
      Introduction Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. Methods We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. Results Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. Conclusions Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses.


      PubDate: 2015-04-12T12:32:59Z
       
  • Eficiencia técnica de los hospitales públicos y de las empresas
           públicas hospitalarias de Andalucía

    • Abstract: Publication date: Available online 11 April 2015
      Source:Gaceta Sanitaria
      Author(s): Luis Herrero Tabanera , José Jesús Martín Martín , Ma del Puerto López del Amo González
      Objetivo Evaluar la eficiencia técnica de los hospitales públicos tradicionales sin personalidad jurídica específica y sujetos al derecho administrativo, y de las empresas públicas hospitalarias, sujetos de derecho y regidas parcialmente por el derecho privado del Sistema Sanitario Público de Andalucía, durante el periodo 2005-2008. Métodos El estudio comprende los 32 hospitales públicos de Andalucía durante el periodo 2005-2008. La metodología consta de dos etapas. Primero se calcularon los índices de eficiencia técnica de los hospitales mediante análisis envolvente de datos, y la evolución de la eficiencia con el índice de Malmquist. Los resultados se compararon por calidad percibida, y se realizó un análisis de sensibilidad mediante un modelo auxiliar y bootstrapping. En la segunda etapa se realizó un análisis bivariado entre la eficiencia de los hospitales y su tipo de organización. Resultados Las empresas públicas fueron más eficientes que los hospitales tradicionales en todos los años del estudio (más de un 10% de media). Sin embargo, se observa un proceso de convergencia entre ambos tipos de organizaciones, ya que mientras que los hospitales tradicionales aumentaron ligeramente su eficiencia en el periodo, un 0,50%, las empresas públicas sufrieron una disminución en su eficiencia de más de un 2%. Discusión La principal causa de la superior eficiencia de las empresas públicas puede radicar en su mayor flexibilidad laboral y presupuestaria. El proceso de convergencia observado apunta, no obstante, a un proceso de aprendizaje mutuo no necesariamente eficiente. Objective To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008. Methods The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type. Results Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%.
      PubDate: 2015-04-12T12:32:59Z
       
  • Explicaciones de las prácticas sexuales de riesgo en hombres que
           tienen sexo con hombres

    • Abstract: Publication date: Available online 11 April 2015
      Source:Gaceta Sanitaria
      Author(s): Constanza Jacques Aviñó , Patricia García de Olalla , Elia Díez , Silvia Martín , Joan A. Caylà
      Objetivo Conocer las explicaciones sobre prácticas sexuales de riesgo, la percepción del virus de la inmunodeficiencia humana (VIH) y propuestas de intervención para prevenir infecciones por VIH en un grupo de hombres que tienen sexo con hombres. Métodos Estudio cualitativo con una muestra de 13 hombres que tenían sexo con hombres, participantes de una cohorte de VIH seronegativos contactados en saunas gay de Barcelona. Se realizaron entrevistas en profundidad semiestructuradas y un posterior análisis de contenido temático. Resultados Las prácticas sexuales de riesgo se atribuyeron a una masculinidad asociada a una alta necesidad sexual, a determinados lugares de intercambio sexual (como saunas, fiestas privadas y clubs), al consumo de drogas y al deseo de experimentar con el riesgo y la propia sexualidad. La infección por VIH se percibía como una enfermedad normalizada, aunque contraerla se asociaba a vergüenza y culpa. Entre las propuestas de intervención se encontraban: concienciar sobre lo que significa vivir con el VIH, generar más alarma social, incorporar las nuevas tecnologías en la prevención y aumentar las acciones en lugares de encuentro gay. Conclusiones El concepto de la masculinidad desempeña un papel fundamental en las prácticas sexuales entre los hombres que tienen sexo con hombres. Se sugiere innovar en los programas preventivos e incorporar la percepción de riesgo y la infección por el VIH desde una perspectiva de género. Objective To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men. Methods We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis. Results Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues. Conclusions The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspe...
      PubDate: 2015-04-12T12:32:59Z
       
  • Twenty years trends and socio-demographic characteristics of HIV
           prevalence in women giving birth in Catalonia (Spain)

    • Abstract: Publication date: Available online 23 March 2015
      Source:Gaceta Sanitaria
      Author(s): Dolors Carnicer-Pont , Alexandra Montoliu , Jose Luis Marin , Jesus Almeda , Victoria Gonzalez , Rafael Muñoz , Carmen Martinez , Mireia Jane , Jordi Casabona
      Background Studies of the prevalence of HIV in sentinel populations are one of the key strategies to monitor the HIV epidemic. We describe HIV prevalence trends and identify differences across time in the sociodemographic characteristics of HIV-infected women giving birth in Catalonia. Methods We used dried blood specimens, residual to newborn screening, which have been collected in Catalonia every 2 months since 1994. The total number of samples obtained until 2009 and in 2013 represented half of yearly newborns. From 2010 to 2012, the total number of samples obtained represented a quarter of yearly newborns. We studied the prevalence by year and place of current residence (Barcelona-city, cities>200,000 inhabitants and cities ≤ 200,000 inhabitants) and by the mother's birth country. A total of 624,912 infants were tested for HIV antibodies from January 1994 to December 2013. Results HIV prevalence trends among women giving birth in Catalonia decreased until 2007. Thereafter, there was a change to a steady trend until 2013. However, among foreign women giving birth and living in cities ≤ 200,000 inhabitants, the prevalence of HIV increased from 2007 to 2013. Conclusion To ensure early identification and treatment of HIV-infected mothers, it is essential to maintain HIV surveillance programs and pre- and post-natal screening programs, both in Barcelona and in cities with 200,000 inhabitants or less, especially in immigrant women.


      PubDate: 2015-04-04T18:45:06Z
       
  • Enfermedad por virus Ébola y seguridad de las/los estudiantes de
           enfermería: experiencia de cooperación institucional en una
           práctica formativa de simulación

    • Abstract: Publication date: Available online 25 March 2015
      Source:Gaceta Sanitaria
      Author(s): M. Flores Vizcaya-Moreno , M. Mercedes Núñez del Castillo , Rosa M. Pérez-Cañaveras , Antonio Hernández Ortuño , José Luis Jurado Moyano



      PubDate: 2015-04-04T18:45:06Z
       
  • Hospital costs associated with nosocomial infections in a pediatric
           intensive care unit

    • Abstract: Publication date: Available online 25 March 2015
      Source:Gaceta Sanitaria
      Author(s): Áurea Morillo-García , Josefa M. Aldana-Espinal , Antonio Olry de Labry-Lima , Raquel Valencia-Martín , Reyes López-Márquez , Mercedes Loscertales-Abril , Manuel Conde-Herrera
      Objective To estimate the additional cost attributable to nosocomial infection (NI) in a pediatric intensive care unit (PICU) and related factors. Methods A prospective cohort study was conducted in all children admitted to the PICU of a tertiary-care pediatric hospital between 2008 and 2009. Descriptive and bivariate analyses were conducted of total direct costs due to PICU stay and medical procedures in patients with and without NI. A log-linear regression model was performed to determine the factors associated with higher total cost. Results A total of 443 patients were studied and the prevalence of NI was 11.3%. The difference in the median total cost was €30,791.4 per patient between groups with and without NI. The median cost of PICU length of stay in patients with NI was almost eight times higher than the median cost of patients without NI. In patients with NI, the highest costs related to medical procedures were associated with antibiotics, enteral and parenteral feeding, and imaging tests. In the multivariate model, the factors associated with higher cost were infection, the performance of cardiovascular surgery, urgent admission, a higher pediatric risk mortality score, and the presence of immunosuppression. By contrast, older children and those with surgical admission generated lower cost. Conclusions NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems.


      PubDate: 2015-04-04T18:45:06Z
       
  • Oliva J, Ruiz-Giménez JL, Segura J. Qué hacemos contra recortes
           y privatizaciones por un modelo universal y equitativo de la sanidad
           pública. Madrid: Akal; 2014. 85 p. ISBN: 978-84-460-4155-9.

    • Abstract: Publication date: Available online 29 March 2015
      Source:Gaceta Sanitaria
      Author(s): Andreu Segura



      PubDate: 2015-04-04T18:45:06Z
       
  • Malaria in Europe: a rare disease?

    • Abstract: Publication date: Available online 26 March 2015
      Source:Gaceta Sanitaria
      Author(s): Aitor Olaso , Miguel de Górgolas , José M. Ramos



      PubDate: 2015-04-04T18:45:06Z
       
  • The Effect of The European Traditional Use Dnirective on The Register of
           Herbal Medicinal Products in Spain

    • Abstract: Publication date: Available online 30 March 2015
      Source:Gaceta Sanitaria
      Author(s): Noelia Tejedor-García , Coral García-Pastor , Estefanía Navalmoral-Arenas , Javier Blas-Espada , Antonio Madrigal-Martínez , Francisco Javier de Lucio-Cazaña
      Background Directive 2004/24/EC, which came into force in 2011, created new regulatory requirements for traditional herbal medicines (THM). This study compared the Spanish THM registry before and after the Directive came fully into force in 2011. Methods We consulted the herbal medicinal plant and drug catalogues (General Council of the Official Colleges of Pharmacists), the website of the European Medicines Agency (EMA), and retail web sites. Results Of 315 THM (from 39 companies) licensed in Spain in 2010, only 48 (10 companies) remained licensed in 2013, mainly due to their withdrawal: the EMA had received just 123 applications from Spain and at least 34% formerly licensed THM had shifted to the less strictly regulated food sector, while up to 54% might have disappeared from the market. However, there is still a significant presence of retail websites making illegal health claims. Conclusion In Spain, the public health benefits of the Directive 2004/24/EC might be less than expected.


      PubDate: 2015-04-04T18:45:06Z
       
  • Análisis de la intervención de precios de los medicamentos en
           España y Europa Lobo F. La intervención de precios de los
           medicamentos en España: panorama de la regulación y los estudios
           empíricos. Madrid: Springer Healthcare Ibérica S.L.; 2014. 159
           p. ISBN: 978-84-940-3468-8. Lobo F. Políticas actuales de precios de
           medicamentos en Europa: panorama general. Madrid: Springer Healthcare
           Ibérica S.L.; 2015. 181 p. ISBN: 978-84-940-3469-5.

    • Abstract: Publication date: Available online 20 March 2015
      Source:Gaceta Sanitaria
      Author(s): Juan Oliva



      PubDate: 2015-03-20T19:54:29Z
       
  • Alfredo Morabia. Enigmas of health and disease. New York: Columbia
           University Press; 2014. ISBN: 978-0-231-16885-4. 296 p.

    • Abstract: Publication date: Available online 7 February 2015
      Source:Gaceta Sanitaria
      Author(s): Josep M. Borràs , Esteve Fernández



      PubDate: 2015-03-16T15:24:51Z
       
  • Contenido en nitratos de aguas de consumo público españolas

    • Abstract: Publication date: Available online 7 February 2015
      Source:Gaceta Sanitaria
      Author(s): Isidro Vitoria , Francisco Maraver , Félix Sánchez-Valverde , Francisco Armijo
      Objetivo Analizar el contenido en nitratos de aguas de consumo público de una muestra de ciudades españolas. Material y métodos Se determinaron los nitratos por cromatografía iónica en aguas de consumo público recogidas entre enero y abril de 2012 en 108 municipios españoles de más de 50.000 habitantes, donde viven 21.290.707 personas. El número total de muestras analizadas fue de 324. Resultados La concentración mediana de nitratos es 3,47mg/l (rango: 0,38-66,76; rango intercuartílico: 4,51). El agua del 94% de los municipios estudiados contiene menos de 15mg/l. Solo en tres municipios la concentración es de más de 25mg/l y en uno es superior a 50mg/l. Conclusiones El nivel de nitratos de la mayoría de las aguas de consumo público que abastecen los municipios donde habita casi la mitad de la población española tiene niveles inferiores a 15mg/l. Objective To determine nitrate concentrations in drinking water in a sample of Spanish cities. Material and methods We used ion chromatography to analyze the nitrate concentrations of public drinking water in 108 Spanish municipalities with more than 50,000 inhabitants (supplying 21,290,707 potential individuals). The samples were collected between January and April 2012. The total number of samples tested was 324. Results The median nitrate concentration was 3.47mg/L (range: 0.38-66.76; interquartile range: 4.51). The water from 94% of the municipalities contained less than 15mg/L. The concentration was higher than 25mg/L in only 3 municipalities and was greater than 50mg/L in one. Conclusions Nitrate levels in most public drinking water supplies in municipalities inhabited by almost half of the Spanish population are below 15mg/L.


      PubDate: 2015-03-16T15:24:51Z
       
  • Navarro V, Muntaner C, editores. The financial and economic crises and
           their impact on health and social well-being. Amityville, New York:
           Baywood Publishing Company, Inc.; 2014. ISBN: 978-0-89503-879-1. 510
           páginas

    • Abstract: Publication date: Available online 20 February 2015
      Source:Gaceta Sanitaria
      Author(s): Rosa Urbanos



      PubDate: 2015-03-16T15:24:51Z
       
  • Carta respuesta al artículo Aspectos a señalar de la
           formación en salud pública

    • Abstract: Publication date: Available online 25 February 2015
      Source:Gaceta Sanitaria
      Author(s): Juan Atenza Fernández , Mar Blasco Blasco



      PubDate: 2015-03-16T15:24:51Z
       
  • Use of new technologies to notify possible contagion of
           sexually-transmitted infections among men

    • Abstract: Publication date: Available online 21 February 2015
      Source:Gaceta Sanitaria
      Author(s): Dolors Carnicer-Pont , Maria Jesus Barbera-Gracia , Percy Fernández-Dávila , Patricia Garcia de Olalla , Rafael Muñoz , Constanza Jacques-Aviñó , Maria Pilar Saladié-Martí , Mercè Gosch-Elcoso , Encarna Arellano Muñoz , Jordi Casabona
      Background Among men who have sex with men (MSM), the association between searching for sexual partners’ on the Internet and increased risk of sexually transmitted infections (STIs)/HIV infection, together with current low levels of partner notification (PN), justifies a study to explore the intention to use new communication technologies for PN in Spain. Methods Two cross-sectional surveys were performed: the first was administered online to visitors to web pages where the survey was advertised; the second was administered on paper to patients attending an STI Unit and centres similar to Community-Based Voluntary Counselling and Testing centres. Results The study population comprised 1578 Spanish residents (median age, 34 years [range: 18 to 74]); 84% lived in urban areas, and 69% reported searching for sexual partners on the Internet. Thirty-seven per cent would be willing to use a website for PN, 26% did not know if they would use one, and 37% would not want to use one. The main reasons for not intending to notify STI/HIV were “shame or fear” (stable partner) and “not knowing how to contact them” (casual partner). The preferred method of notification was face to face (73%) for both stable and casual partners, although using new technologies (Short Messaging System, e-mail, web page, phone applications) was widely accepted for notifying casual partners. Conclusions Fighting stigma and promoting alternative methods of PN among MSM and health professionals through new technologies could increase the frequency of PN. This approach will improve early detection and reduce transmission in Spain.


      PubDate: 2015-03-16T15:24:51Z
       
  • Epidemiología de la enfermedad de Lyme en un área sanitaria del
           noroeste de España

    • Abstract: Publication date: Available online 25 February 2015
      Source:Gaceta Sanitaria
      Author(s): María Esther Vázquez-López , Robustiano Pego-Reigosa , Carolina Díez-Morrondo , Manuel Castro-Gago , Pablo Díaz , Gonzalo Fernández , Patrocinio Morrondo
      Objetivo Valorar la influencia de algunos factores de riesgo sobre la tasa de incidencia de la enfermedad Lyme y describir las principales manifestaciones clínicas de esta. Métodos Se realizó un estudio retrospectivo sobre esta enfermedad (2006-2013), en una zona del noroeste de España, incluyendo solo los pacientes que cumplían los criterios de vigilancia epidemiológica de los Centers for Disease Control and Prevention de los Estados Unidos. Resultados La tasa de incidencia varió entre 2,64 y 11,61 por 100.000 habitantes y año. Hubo diferencias significativas respecto al hábitat, la edad y la zona de residencia. Los pacientes presentaron manifestaciones neurológicas (67,59%), dermatológicas (47,22%), reumatológicas (15,74%) o cardiacas (13,88%), solas o combinadas. Conclusiones El incremento de esta enfermedad en el noroeste de España y las diferencias observadas entre las distintas zonas de una misma área sanitaria hacen necesario plantear estudios epidemiológicos que permitan aumentar el índice de sospecha diagnóstica e implementar medidas de prevención eficaces. Objective To evaluate the influence of some risk factors on the incidence rate of Lyme disease and the main clinical manifestations. Methods A retrospective study of Lyme disease (2006-2013) was performed in north-west Spain; we included only patients who fulfilled the epidemiological surveillance criteria defined by the Centers for Disease Control and Prevention. Results The incidence rate varied between 2.64 and 11.61/100,000 inhabitants/year. Significant differences were found in relation to habitat, age and area of residence. Patients showed neurological (67.59%), dermatological (47.22%), rheumatological (15.74%) and cardiac (13.88%) manifestations, alone or combined. Conclusions Due to the increase of the disease in north-west Spain and the differences observed between the different areas, epidemiological studies are needed that increase the index of diagnostic suspicion and lead to the implementation of effective prevention measures.


      PubDate: 2015-03-16T15:24:51Z
       
  • Salud y conductas relacionadas con la salud según la atracción y
           la conducta sexual

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2
      Author(s): Glòria Pérez , Marc Martí-Pastor , Mercè Gotsens , Xavier Bartoll , Elia Diez , Carme Borrell
      Objetivo Describir la salud percibida, la salud mental y algunas conductas relacionadas con la salud según la atracción y la conducta sexual en los residentes en Barcelona en 2011. Métodos Se analizó la salud percibida y mental, los trastornos crónicos y las conductas relacionadas con la salud, en 2675 personas de 15 a 64 años de edad teniendo en cuenta la atracción y la conducta sexual en el marco de la Encuesta de Salud de Barcelona 2011. Se ajustaron modelos multivariados de regresión de Poisson robusta para obtener razones de prevalencia. Resultados Las personas atraídas por el mismo sexo presentaron mayor prevalencia de mala salud percibida y mental. Estas personas y las que habían tenido relaciones con personas del mismo sexo declararon más frecuentemente conductas perjudiciales para la salud. Conclusiones La población lesbiana, gay, transexual y bisexual puede presentar problemas de salud que deben ser explorados en profundidad, prevenidos y atendidos. Objective to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Methods Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. Results People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Conclusions Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended.


      PubDate: 2015-03-16T15:24:51Z
       
  • Inactividad física en Galicia: tendencia e impacto de cambios en la
           definición

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2
      Author(s): Mónica Pérez-Ríos , María I. Santiago-Pérez , Elena Rodríguez-Camacho , Alberto Malvar , Jorge Suanzes , Xurxo Hervada
      Objetivo El objetivo de este trabajo fue estimar la prevalencia de la inactividad física en Galicia en el tiempo libre en 2007-2011, así como el impacto que supone en ella el considerar otras actividades cotidianas. Métodos Estudios transversales en mayores de 15 años (n=19235). La actividad física se caracterizó mediante el cuestionario Minnesota. En el año 2011 se estimó la inactividad física considerando otras actividades cotidianas. Resultados Entre 2007 y 2011, la prevalencia de inactividad física en el tiempo libre en Galicia fue estable (p=0,249), próxima al 50%, y más alta en las mujeres y en la población que trabaja o estudia. La inactividad física disminuyó (47% a 16%) cuando se tuvieron en cuenta las actividades cotidianas. Conclusiones La prevalencia de inactividad física fue alta y estable en los años estudiados. Tener en cuenta otras actividades de la vida cotidiana hizo disminuir de forma importante esta prevalencia. Objective To estimate the prevalence of physical inactivity during leisure time in Galicia (Spain) between 2007 and 2011 and to assess the impact of including non-leisure time activities in the definition of physical inactivity. Methods A cross-sectional study was conducted in the population aged 16 years and older (n=19,235). Physical activity was assessed by the Minnesota Questionnaire. In 2011, inactivity was estimated by including daily activities. Results Between 2007 and 2011, the prevalence of inactivity in Galicia remained stable (p=0.249) and close to 50%. This prevalence was higher among women and those who worked or were in education. Inactivity decreased from 47% to 16% when non-leisure time activities were included in the definition. Conclusions Between 2007 and 2011 in Galicia, the prevalence of inactivity remained high and stable. This prevalence was significantly decreased when non-leisure time activities were included in the definition.


      PubDate: 2015-03-16T15:24:51Z
       
  • Gaceta Sanitaria en 2014

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2
      Author(s): Carme Borrell , M. Felicitas Domínguez-Berjón , Carlos Álvarez-Dardet , Clara Bermúdez-Tamayo , Pere Godoy , María José López , Miguel Ángel Negrín , Glòria Pérez , Napoleón Pérez-Farinós , Alberto Ruano , Carmen Vives Cases , Ana M. García



      PubDate: 2015-03-16T15:24:51Z
       
  • Predictors of having heard about human papillomavirus vaccination:
           Critical aspects for cervical cancer prevention among Colombian women

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2
      Author(s): Silvia Bermedo-Carrasco , Cindy Xin Feng , Juan Nicolás Peña-Sánchez , Rein Lepnurm
      Objectives To determine whether the probability of having heard about human papillomavirus (HPV) vaccination differs by socio-demographic characteristics among Colombian women; and whether the effect of predictors of having heard about HPV vaccination varies by educational levels and rural/urban area of residence. Methods Data of 53,521 women aged 13–49 years were drawn from the 2010 Colombian National Demographic and Health Survey. Women were asked about aspects of their health and their socio-demographic characteristics. A logistic regression model was used to identify factors associated with having heard about HPV vaccination. Educational level and rural/urban area of residence of the women were tested as modifier effects of predictors. Results 26.8% of the women had heard about HPV vaccination. The odds of having heard about HPV vaccination were lower among women: in low wealth quintiles, without health insurance, with subsidized health insurance, and those who had children (p <0.001). Although women in older age groups and with better education had higher probabilities of having heard about HPV vaccination, differences in these probabilities by age group were more evident among educated women compared to non-educated ones. Probability gaps between non-educated and highly educated women were wider in the Eastern region. Living in rural areas decreased the probability of having heard about HPV vaccination, although narrower rural/urban gaps were observed in the Atlantic and Amazon-Orinoquía regions. Conclusions Almost three quarters of the Colombian women had not heard about HPV vaccination, with variations by socio-demographic characteristics. Women in disadvantaged groups were less likely to have heard about HPV vaccination.


      PubDate: 2015-03-16T15:24:51Z
       
  • GACETA SANITARIA A PRIMERA VISTA

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2




      PubDate: 2015-03-16T15:24:51Z
       
  • Ampliando la profesionalización de la salud pública: la
           formación especializada multiprofesional

    • Abstract: Publication date: March–April 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 2
      Author(s): Mar Blasco Blasco , Juan Atenza Fernández



      PubDate: 2015-03-16T15:24:51Z
       
  • Carga de la mortalidad por diabetes mellitus en América Latina
           2000-2011: los casos de Argentina, Chile, Colombia y México

    • Abstract: Publication date: Available online 5 March 2015
      Source:Gaceta Sanitaria
      Author(s): Marcela Agudelo-Botero , Claudio Alberto Dávila-Cervantes
      Objetivo Analizar la evolución de la mortalidad por diabetes mellitus en Argentina, Chile, Colombia y México, entre 2000 y 2011, por sexo y grupos quinquenales de edad (entre los 20 y los 79 años). Material y método se emplearon estadísticas vitales de mortalidad y datos de población de los censos o proyecciones de cada país. Se calcularon tasas estandarizadas de mortalidad y los años de vida perdidos. Resultados México sobresalió por presentar la tasa de mortalidad más alta y por perder más años de vida por diabetes que el resto de los países analizados. Para el periodo 2000-2011, los mexicanos perdieron en promedio 1,13 años de vida por diabetes, muy por encima de los años que descontaron Colombia (0,24), Argentina (0,21) y Chile (0,18). En general, la mortalidad por esta causa fue mayor en los hombres que en las mujeres, excepto para Colombia. Cerca del 80% de los años de vida perdidos por diabetes ocurrieron entre los 50 y los 74 años de edad en los cuatro países. Discusión La diabetes representa un reto para los países de América Latina, especialmente para México, donde la mortalidad por esta causa aumenta de manera acelerada. Si bien en Argentina, Chile y Colombia la diabetes no alcanza la misma proporción que en México, esta enfermedad destaca entre las principales causas de muerte en dichos países. Objective To analyze trends in mortality in Argentina, Chile, Colombia and Mexico, between 2000 and 2011, by sex and 5-year age groups (between 20 and 79 years of age). Material and methods Mortality vital statistics and census data or projected population estimates were used for each country. Age-specific mortality rates and the years of life lost were calculated. Results Among the countries analyzed, Mexico had the highest mortality rate and lost the most years of life due to diabetes. Between 2000 and 2011, Mexicans lost an average of 1.13 years of life, while Colombia (0.24), Argentina (0.21) and Chile (0.18) lost considerably fewer life years. In general, deaths from diabetes were higher in men than in women except in Colombia. Nearly 80% of years of life lost due to diabetes occurred between 50 and 74 years of age in the four countries. Discussion Diabetes is a huge challenge for Latin America, especially in Mexico where mortality due to diabetes is accelerating. Even though the proportion of deaths due to diabetes in Argentina, Chile and Colombia is smaller, this disease figures among the main causes of death in these countries.


      PubDate: 2015-03-16T15:24:51Z
       
  • Conocimiento y percepción de la nocividad del cigarrillo
           electrónico en población adulta de Barcelona

    • Abstract: Publication date: Available online 7 March 2015
      Source:Gaceta Sanitaria
      Author(s): Jose M. Martínez-Sánchez , Marcela Fu , Montse Ballbè , Juan Carlos Martín-Sánchez , Esteve Saltó , Esteve Fernández
      Objetivo Describir el conocimiento y la percepción de nocividad de los cigarrillos electrónicos (e-cigarrillos) en la población de Barcelona en 2013-2014. Métodos Se utilizaron los datos del seguimiento (n=736) de un estudio de cohortes de una muestra representativa de la población adulta de la ciudad de Barcelona. Resultados El 79,2% de los participantes manifestó conocer el e-cigarrillo. El grado de conocimiento medio fue de 4,4 puntos sobre 10, con diferencias estadísticamente significativas según edad, nivel de estudios, consumo de tabaco y dependencia de la nicotina. La mayoría de los participantes conocieron los e-cigarrillos por los medios de comunicación clásicos (57,8%). El 47,2% de los participantes opinaba que los e-cigarrillos son menos nocivos que los cigarrillos convencionales. Conclusión La publicidad de los e-cigarrillos en los medios de comunicación debería regularse debido a la escasa evidencia científica sobre su utilidad y sus potenciales efectos adversos. Objective To describe knowledge of electronic cigarettes (e-cigarettes) and their perceived harmfulness in the population of Barcelona in 2013-2014. Methods We used participants from a longitudinal study of a representative sample of the adult population in the city of Barcelona (n=736). The field work was conducted between May 2013 and February 2014. Results Awareness of e-cigarette was 79.2%. The average level of knowledge was 4.4 points out of 10; there were statistically significant differences according to age, educational level, tobacco consumption, and nicotine dependence. Most participants had learned about e-cigarettes through traditional media (57.8%). Nearly half (47.2%) of the participants believed that e-cigarettes are less harmful than conventional cigarettes. Conclusion Advertising of e-cigarettes in the media should be regulated because there is still scarce scientific evidence about the usefulness and harmful effects of these devices.


      PubDate: 2015-03-16T15:24:51Z
       
  • Aborto farmacológico dispensado a través de un servicio de
           telemedicina a mujeres de América Latina: complicaciones y su
           tratamiento

    • Abstract: Publication date: Available online 12 March 2015
      Source:Gaceta Sanitaria
      Author(s): Sara Larrea , Laia Palència , Glòria Perez
      Objetivo Analizar las complicaciones y los tratamientos declarados después de un aborto farmacológico con mifepristona y misoprostol dispensado a través de un servicio de telemedicina a mujeres que viven en América Latina. Métodos Estudio observacional basado en el registro de consultas médicas de un servicio de telemedicina. Participaron 872 mujeres que usaron el servicio entre 2010 y 2011. Variables dependientes: total de complicaciones, hemorragia, aborto incompleto, total de tratamientos, evacuación quirúrgica y antibióticos. Variables independientes: edad, zona de residencia, privación socioeconómica, tener hijos/as, embarazos y abortos previos, y semana gestacional. Se ajustaron modelos de Poisson con estimación de la varianza robusta para estimar razones de incidencia (RI) y sus intervalos de confianza del 95% (IC95%). Resultados El 14,6% de las participantes declaró complicaciones (6,2% hemorragia y 6,8% aborto incompleto). El 19,0% tuvo tratamiento postaborto (10,9% evacuación quirúrgica y 9,3% antibióticos). La privación socioeconómica aumentó en un 64% el riesgo de complicaciones (IC95%: 15%-132%), y dentro de estas un 82% el de aborto incompleto (IC95%: 8%-206%) y un 62% el riesgo de intervención quirúrgica (IC95%: 7%-144%). Los embarazos previos aumentaron el riesgo de hemorragia (RI=2,29; IC95%: 1,33-3,95%). Las mujeres con un embarazo de 12 semanas o más tuvieron un riesgo 2,45 veces mayor de tener tratamiento médico y 2,94 veces mayor de tomar antibióticos, comparado con embarazos de 7 semanas o menos. Conclusión El aborto farmacológico proveído por telemedicina puede ser una opción segura y efectiva para la interrupción voluntaria del embarazo en contextos donde está legalmente restringido. Objective To analyze reported complications and their treatment after a medical abortion with mifepristone and misoprostol provided by a telemedicine service to women living in Latin America. Methods Observational study based on the registry of consultations in a telemedicine service. A total of 872 women who used the service in 2010 and 2011 participated in the study. The dependent variables were overall complications, hemorrhage, incomplete abortion, overall treatments, surgical evacuation, and antibiotics. Independent variables were age, area of residence, socioeconomic deprivation, previous children, pregnancies and abortions, and week of pregnancy. We fitted Poisson regression models with robust variance to estimate incidence ratios and 95% confidence intervals (95%CI). Results Complications were reported by 14.6% of the participants: 6.2% reported hemorrhage and 6.8% incomplete abortion. Nearly one-fifth (19.0%) received postabortion treatment: 10.9% had a surgical evacuation and 9.3% took antibiotics. Socioeconomic deprivation increased the risk of complications by 64% (95%CI: 15%-132%), and, among these, the risk of incomplete abortion by 82% (95%CI: 8%-206%) and the risk of surgical intervention by 62% (95%CI: 7%-144%). Previous pregnancies increased the risk of complications and, specifically, the risk of hemorrhage by 2.29 times (95%CI: ...
      PubDate: 2015-03-16T15:24:51Z
       
  • Exceso de mortalidad relacionado con la gripe en España en el
           invierno de 2012

    • Abstract: Publication date: Available online 12 March 2015
      Source:Gaceta Sanitaria
      Author(s): Inmaculada León-Gómez , Concepción Delgado-Sanz , Silvia Jiménez-Jorge , Víctor Flores , Fernando Simón , Diana Gómez-Barroso , Amparo Larrauri , Salvador de Mateo Ontañón
      Objetivo El sistema de monitorización de la mortalidad diaria en España y el programa European monitoring of excess mortality for public health action detectaron un exceso de mortalidad en España en febrero y marzo de 2012. El objetivo de este trabajo es estudiar el papel que puede atribuirse a la gripe como factor de sobremortalidad en ese periodo. Métodos Se estudiaron los excesos de mortalidad por todas las causas en el periodo 2006-2012 utilizando series temporales en el sistema de vigilancia de la mortalidad diaria español y mediante regresión de Poisson en el sistema de vigilancia de la mortalidad europeo y en un modelo que estima la mortalidad atribuible a la gripe. Los excesos de mortalidad por gripe y neumonía atribuibles a la gripe se estudiaron con un modelo Serfling modificado. Para detectar los periodos de exceso se comparó la mortalidad observada con la esperada. Resultados En febrero y marzo de 2012, en los sistemas de monitorización de mortalidad español y europeo se detectó un exceso de mortalidad de 8110 y 10.872 defunciones (razón de mortalidad: 1,22, intervalo de confianza del 95% [IC95%]: 1,21-1,23, y 1,32, IC95%: 1,29-1,31, respectivamente). El modelo que estima la mortalidad atribuible a la gripe identificó en la temporada 2011-2012 el máximo porcentaje (97%) de defunciones atribuibles a la gripe en mayores de 64 años con respecto al total de la mortalidad asociada a la gripe (13.822 defunciones). La tasa de excesos de defunciones por gripe y neumonía y causas respiratorias en mayores de 64 años, obtenida con el modelo Serfling, fue máxima en la temporada 2011-2012: 18,07 y 77,20 defunciones por 100.000 habitantes, respectivamente. Conclusiones Uno de los principales incrementos significativos de la mortalidad acontecidos en España en los inviernos de los últimos años, en mayores de 64 años, fue detectado por los sistemas de monitorización de mortalidad español y europeo en la temporada 2011-2012, coincidiendo en el tiempo con una tardía temporada gripal, con predominio de virus A(H3N2), y una ola de bajas temperaturas. Este estudio muestra que la gripe pudo ser uno de los principales factores contribuyentes al exceso de mortalidad observado en el invierno de 2012 en España. Objective An excess of mortality was detected in Spain in February and March 2012 by the Spanish daily mortality surveillance system and the «European monitoring of excess mortality for public health action» program. The objective of this article was to determine whether this excess could be attributed to influenza in this period. Methods Excess mortality from all causes from 2006 to 2012 were studied using time series in the Spanish daily mortality surveillance system, and Poisson regression in the European mortality surveillance system, as well as the FluMOMO model, which estimates the mortality attributable to influenza. Excess mortality due to influenza and pneumonia attributable to influenza were studied by a modification of the Serfling model. To detect the periods of excess, we compared observed and expected mortality.
      PubDate: 2015-03-16T15:24:51Z
       
  • Factores asociados a recibir la vacunación antigripal en
           profesionales de atención primaria

    • Abstract: Publication date: Available online 12 March 2015
      Source:Gaceta Sanitaria
      Author(s): Josep Montserrat-Capdevila , Pere Godoy , Josep Ramon Marsal , Ferran Barbé-Illa
      Objetivo Conocer la cobertura vacunal antigripal en profesionales de atención primaria y determinar los factores asociados a la vacunación (temporada 2013-2014). Métodos Estudio transversal realizado a 287 profesionales que cumplimentaron un cuestionario que incluía preguntas sobre conocimientos, creencias y actitudes frente la gripe y la vacunación. Se determinó la cobertura y aquellas variables asociadas a recibir la vacunación, utilizando modelos de regresión logística no condicional. Resultados La participación fue del 47,2%. La cobertura vacunal fue del 60,3%; fue mayor en los profesionales > 55 años de edad, mujeres y pediatras. Factores asociados a recibirla fueron la percepción de que la vacunación protege la propia salud (odds ratio ajustada [ORa]: 11,1; intervalo de confianza del 95% [IC95%]: 3,41-35,9) y de que es efectiva (ORa: 7,5; IC95%: 0,9-59,3). No se halló asociación entre la vacunación y el conocimiento sobre la gripe y la vacunación, pero sí para prescribirla en gestantes, en > 65 años y en inmunodeprimidos. Conclusiones Se recomienda diseñar estrategias para aumentar la cobertura, basadas en cambiar actitudes negativas frente a la vacunación. Objective To identify the influenza vaccination coverage in healthcare workers in primary care and to determine the factors associated with vaccination (2013-2014 season). Methods A cross-sectional study was carried out among 287 healthcare workers who completed a questionnaire that included questions about knowledge, beliefs and attitudes to influenza and vaccination. We estimated the vaccine coverage and identified the variables associated with vaccination of healthcare workers by using non-conditional logistic regression models. Results The participation rate was 47.2%. Vaccination coverage was 60.3% and was higher in workers older than 55 years, women and pediatricians. The factors associated with healthcare worker vaccination were the perception that vaccination confers protection (aOR: 11.1; 95%CI: 3.41-35.9) and the perception that it is effective (aOR: 7.5; 95%CI: 0.9-59.3). No association was found between receiving the vaccine and knowledge of influenza or vaccination. However, an association was found with prescribing vaccination to pregnant women, to persons older than 65 years, and to immunosuppressed individuals. Conclusions Strategies should be designed to increase coverage, based on changing negative attitudes of healthcare workers to vaccination.


      PubDate: 2015-03-16T15:24:51Z
       
  • Control de la dispensación de medicamentos esteroides anabolizantes
           androgénicos

    • Abstract: Publication date: Available online 13 March 2015
      Source:Gaceta Sanitaria
      Author(s): Raquel Vázquez-Mourelle , Eduardo Carracedo-Martínez , Eugenio Ces Gens , Luis Cadórniga Valiño , Pilar Álvaro Esteban , José Manuel Pose Reino
      Los esteroides anabolizantes androgénicos (EAA) pueden producir efectos adversos muy graves cuando se usan sin fin terapéutico. Este trabajo pretende mostrar que los EAA son sustancias susceptibles de desvío ilícito en el canal legal de comercialización, que a su vez, debido a ciertas limitaciones evidenciadas a la hora de perseguir estas actuaciones ilegales por parte de la Inspección de Servicios Sanitarios de la Consellería de Sanidade de la Xunta de Galicia, llevó a una iniciativa normativa para exigir actuaciones adicionales a la farmacia comunitaria en su dispensación. En cuatro inspecciones a oficinas de farmacia se detectó el desvío de un total de 3118 envases de EAA, lo que dio lugar a la apertura de cuatro procedimientos sancionadores, y en dos de ellas se dio traslado a las fuerzas policiales especializadas al haber indicios suficientes de posible desvío a gimnasios, lo cual originó una operación policial (Operación Fitness). Anabolic androgenic steroids (AAS) can cause serious adverse effects when used without a therapeutic purpose. This article aims to show that the AAS are susceptible to being sold on the black market. We also aim to describe how certain limitations on the health inspection services of the Galician health service to pursue these illegal actions prompted a regulatory initiative demanding that additional actions be granted to community pharmacies when dispensing AAS. Four pharmacy inspections detected the diversion of a total of 3118 packages of AAS, which led to the opening of four disciplinary proceedings. In two of these, specialized police forces were called in as there was sufficient evidence of possible diversion to gymnasiums, resulting in a police operation called Operation Fitness.


      PubDate: 2015-03-16T15:24:51Z
       
  • Estrés emocional y calidad de vida en personas con diabetes y sus
           familiares

    • Abstract: Publication date: Available online 14 March 2015
      Source:Gaceta Sanitaria
      Author(s): Marina Beléndez Vázquez , Iñaki Lorente Armendáriz , Mercedes Maderuelo Labrador
      Objetivo La experiencia de vivir a diario con la diabetes puede incidir negativamente en la calidad de vida de las personas con esta enfermedad y de sus familiares. En este trabajo presentamos los resultados del estudio DAWN2 para España en relación con la calidad de vida y el bienestar emocional de las personas con diabetes y sus familiares. Métodos El estudio DAWN2 es un estudio observacional transversal. En este trabajo hemos utilizado la muestra española de pacientes (N=502) y familiares (N=123). Resultados El 13,9% de los pacientes presenta riesgo de una posible depresión, y un 50,0% de las personas con diabetes y el 45,5% de los familiares refieren un alto nivel de estrés emocional asociado a la diabetes. Conclusiones Las personas con diabetes experimentan altos niveles de estrés y el impacto psicosocial de la diabetes alcanza también a los familiares. Objective The daily experience of living with diabetes can adversely affect the quality of life of people with diabetes and their families. We present the results for Spain of the DAWN2 study related to quality of life and wellbeing of patients and their families. Methods The DAWN2 study is an observational, cross-sectional study. In the present study, we used the Spanish sample of patients (N=502) and their relatives (N=123). Results A total of 13.9% of patients were at risk of possible depression while 50.0% of people with diabetes and 45.5% of family members reported a high level of diabetes-related emotional stress. Conclusions People with diabetes experience high levels of stress and the psychosocial impact of diabetes also affects family members.


      PubDate: 2015-03-16T15:24:51Z
       
  • Assessment of the magnitude of geographical variations in the duration of
           non-work-related sickness absence by individual and contextual factors

    • Abstract: Publication date: Available online 28 January 2015
      Source:Gaceta Sanitaria
      Author(s): Isabel Torá-Rocamora , José Miguel Martínez , David Gimeno , Constança Alberti , Josefina Jardí , Rafael Manzanera , Fernando G. Benavides , George Delclos
      Objective To examine variation in the duration of non-work-related sickness absence (NWRSA) across geographical areas and the degree to which this variation can be explained by individual and/or contextual factors. Methods All first NWRSA episodes ending in 2007 and 2010 were analyzed. Individual (diagnosis, age, sex) and contextual factors (healthcare resources, socioeconomic factors) were analyzed to assess how much of the geographical variation was explained by these factors. Median NWRSA durations in quartiles were mapped by counties in Catalonia. Multilevel Cox proportional hazard regression models with episodes nested within counties were fitted to quantify the magnitude of this variation. The proportional change in variance (PCV), median hazard ratios (MHR) and interquartile hazard ratios (IHR) were calculated. Results We found a geographical pattern in the duration of NWRSA, with longer duration in northwestern Catalonia. There was a small, but statistically significant, geographical variation in the duration of NWRSA, which mostly decreased after adjustment for individual factors in both women (PCV=34.98%, MHR=1.09, IHR=1.13 in 2007; PCV=34.68%, MHR=1.11, IHR=1.28 in 2010) and men (PCV=39.88%, MHR=1.10, IHR=1.27 in 2007; PCV=45.93%, MHR=1.10, IHR=1.25 in 2010); only in the case of women in 2010 was there a reduction in county-level variance due to contextual covariates (PCV=16.18%, MHR=1.12, IHR=1.32). Conclusions County-level variation in the duration of NWRSA was small and was explained more by individual than by contextual variables. Knowledge of geographic differences in NWRSA duration is needed to plan specific programs and interventions to minimize these differences.


      PubDate: 2015-01-29T02:59:06Z
       
  • ¿Quién teme al open access? Un movimiento en crecimiento,
           oportuno y necesario

    • Abstract: Publication date: Available online 9 January 2015
      Source:Gaceta Sanitaria
      Author(s): Iñaki Galán , Beatriz Pérez-Gómez , Elena Primo-Peña



      PubDate: 2015-01-10T12:30:21Z
       
  • Aplicación del benchmarking en la gestión de la cadena de
           aprovisionamiento sanitaria: efectos sobre el coste y la calidad de las
           compras

    • Abstract: Publication date: Available online 29 December 2014
      Source:Gaceta Sanitaria
      Author(s): David Naranjo-Gil , David Ruiz-Muñoz
      Objetivo El gasto en aprovisionamiento sanitario consume una gran parte de los recursos financieros asignados a la sanidad pública. El objetivo de este trabajo es analizar la aplicación de un proceso de benchmarking en la gestión de las compras hospitalarias, así como examinar su efecto en la reducción del precio y la mejora de la calidad de los productos adquiridos. Métodos Los datos fueron recogidos mediante una encuesta realizada en 29 distritos de atención primaria en el periodo 2010-11. También se usó una base de datos sanitaria relativa a precios, calidades, plazos de entregas y características de proveedores de 5373 productos. Resultados La aplicación de procesos de benchmarking consiguió la reducción o la eliminación de compras de productos con baja calidad y alto precio. Tras aplicar el benchmarking se produjo un incremento medio del 10,57% en la calidad de los productos adquiridos, con una disminución media del 28,97% en el precio de compra. Conclusión Con un proceso de benchmarking, los centros sanitarios pueden ahorrar gastos y realizar una gestión más eficiente de la cadena de aprovisionamiento. El benchmarking facilita que los centros sanitarios adquieran productos a precios más reducidos y de mayor calidad. Objective Healthcare supply expenses consume a large part of the financial resources allocated to public health. The aim of this study was to analyze the use of a benchmarking process in the management of hospital purchases, as well as its effect on product cost reduction and quality improvement. Methods Data were collected through a survey conducted in 29 primary healthcare districts from 2010 to 2011, and through a healthcare database on the prices, quality, delivery time and supplier characteristics of 5373 products. Results The use of benchmarking processes reduced or eliminated products with a low quality and high price. These processes increased the quality of products by 10.57% and reduced their purchase price by 28.97%. Conclusions The use of benchmarking by healthcare centers can reduce expenditure and allow more efficient management of the healthcare supply chain. It also facilitated the acquisition of products at lower prices and higher quality.


      PubDate: 2015-01-05T12:04:36Z
       
  • Salud autorreferida: influencia de la pobreza y la desigualdad del
           área de residencia

    • Abstract: Publication date: Available online 24 December 2014
      Source:Gaceta Sanitaria
      Author(s): Beatriz Caicedo , Dedsy Berbesi Fernández
      Objetivo Evaluar la influencia de la desigualdad de ingresos y de la pobreza de las localidades de Bogotá-Colombia sobre la percepción de mala salud de sus residentes. Métodos El estudio se basó en la encuesta multipropósito aplicada en Bogotá-Colombia. Se utilizó la estructura jerárquica de los datos (individuos=nivel 1, localidades=nivel 2) para definir un modelo logístico multinivel de tipo logit. La variable dependiente fue la percepción de mala salud, y las variables de localidad fueron la desigualdad de ingresos y la pobreza. Todos los análisis se controlaron por variables sociodemográficas y se estratificaron por sexo. Resultados La prevalencia de reportar regular o mala salud en la población estudiada fue del 23,2%. Las mujeres mostraron mayor riesgo de mala salud, así como también los hombres y mujeres de bajo nivel educativo, con edad avanzada, sin trabajo en la última semana y afiliados al régimen subsidiado de salud. Los mayores niveles de pobreza en la localidad incrementan el riesgo de mala salud. Las interacciones transnivel mostraron que mujeres jóvenes y hombres con bajo nivel educativo son los más afectados por la desigualdad de ingresos de la localidad. Conclusiones En Bogotá existen diferencias geográficas en la percepción de la salud, y mayores porcentajes de pobreza y desigualdad de ingreso se mostraron asociados a un mayor riesgo de mala salud. Destacan grandes inequidades de salud entre individuos y entre localidades. Objective To evaluate the influence of income inequality and poverty in the towns of Bogotá, Colombia, on poor self-rated health among their residents. Methods The study was based on a multipurpose survey applied in Bogotá-Colombia. A hierarchical data structure (individuals=level1, locations=level 2) was used to define a logit-type multilevel logistic model. The dependent variable was self-perceived poor health, and local variables were income inequality and poverty. All analyses were controlled for socio-demographic variables and stratified by sex. Results The prevalence of self-reported fair or poor health in the study population was 23.2%. Women showed a greater risk of ill health, as well as men and women with a low educational level, older persons, those without work in the last week and persons affiliated to the subsidized health system. The highest levels of poverty in the city increased the risk of poor health. Cross-level interactions showed that young women and men with a low education level were the most affected by income inequality in the locality. Conclusions In Bogotá, there are geographical differences in the perception of health. Higher rates of poverty and income inequ...
      PubDate: 2014-12-28T11:27:43Z
       
  • Hipotiroidismo subclínico en una muestra oportunista de la
           población de Castilla y León

    • Abstract: Publication date: Available online 15 December 2014
      Source:Gaceta Sanitaria
      Author(s): Ana Isabel Mariscal Hidalgo , José E. Lozano Alonso , Tomás Vega Alonso
      Objetivo Describir la distribución de los valores de la hormona estimulante del tiroides (TSH) y estimar la prevalencia de hipotiroidismo subclínico en la población adulta de Castilla y León. Material y método Estudio observacional en 45 consultas de medicina de familia de Castilla y León seleccionadas de manera oportunista. Se determinó la TSH en sueros, recogidos por cualquier motivo, de personas ≥35 años de edad. Se realizó análisis de confirmación, incluyendo la tiroxina libre y los anticuerpos antitiroperoxidasa. Resultados Se realizaron 3957 análisis. El 63,4% eran mujeres. La edad media fue de 61,5 años. La mediana de los valores de TSH fue de 2,3 μUI/mL (2, μUI/mL en mujeres y 2,1 μUI/mL en hombres), con tendencia ascendente con la edad. Los valores de TSH son mayores en los hipotiroidismos subclínicos desconocidos o sin tratamiento que en los tratados. Los valores más bajos se observan en los sujetos eutiroideos. La prevalencia de hipotiroidismo subclínico fue del 9,2% (intervalo de confianza del 95%: 8,3-10,2); en las mujeres fue el triple que en los hombres (12,4% frente a 3,7%) y aumenta con la edad, con un máximo del 16,9% en las mujeres de 45 a 64 años. Conclusiones La prevalencia estimada de hipotiroidismo subclínico es alta, en los límites superiores reflejados en la literatura. La posibilidad de progresión a hipotiroidismo manifiesto, así como la asociación con diversas enfermedades y factores de riesgo, aconsejan una gestión adecuada de su diagnóstico y tratamiento. Objective To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain). Method An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination. Results A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 μIU/mL (2.5 μIU/mL in women and 2.1 μIU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years. Conclusions The prevalence of subclinical hypo...
      PubDate: 2014-12-17T10:41:57Z
       
  • Portuguese children's exposure to second-hand tobacco smoke in the family
           car

    • Abstract: Publication date: Available online 5 December 2014
      Source:Gaceta Sanitaria
      Author(s): Paulo D. Vitória , José Cunha Machado , Sofia B. Ravara , Ana Carolina Araújo , Catarina Samorinha , Henedina Antunes , Manuel Rosas , Elisardo Becoña , José Precioso
      Objectives To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5±0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.


      PubDate: 2014-12-08T17:35:32Z
       
  • Adaptación y validación de la escala CCAENA© para evaluar
           la continuidad asistencial entre niveles de atención en Colombia y
           Brasil

    • Abstract: Publication date: Available online 3 December 2014
      Source:Gaceta Sanitaria
      Author(s): Irene Garcia-Subirats , Marta Beatriz Aller , Ingrid Vargas Lorenzo , María Luisa Vázquez Navarrete
      Objetivo Adaptar y validar la escala del Cuestionario de Continuidad Asistencial Entre Niveles de Atención (CCAENA©) en el contexto de los sistemas de salud colombiano y brasileño. Métodos El estudio consistió en dos fases: 1) adaptación de la escala CCAENA© al contexto de cada país mediante dos pretests y una prueba piloto; y 2) validación mediante la aplicación de la escala en una encuesta poblacional en Colombia y Brasil. Se analizaron las siguientes propiedades psicométricas: validez de constructo (análisis factorial), consistencia interna (alfa de Cronbach; correlaciones ítem-resto), multidimensionalidad de las escalas (coeficientes de correlación de Spearman) y análisis de grupos conocidos (test de ji al cuadrado). Resultados Se seleccionaron 14 de los 21 ítems de la escala original y se reformularon pasando de una afirmación con opciones de respuesta de acuerdo a una pregunta con opciones de respuesta de frecuencia. El análisis factorial mostró que los ítems se agrupan en tres factores: continuidad entre niveles asistenciales, continuidad de relación con el proveedor de atención primaria y continuidad de relación con el proveedor de atención especializada. El alfa de Cronbach indicó una buena concordancia interna (>0,80 en todas las escalas). Los coeficientes de correlación indican que los tres factores pueden interpretarse como escalas separadas (<0,70) y presentan una adecuada capacidad de diferenciar entre grupos. Conclusiones La versión adaptada del CCAENA© muestra adecuadas validez y fiabilidad en ambos países, manteniendo una alta equivalencia con la versión original. Es una herramienta útil y viable para evaluar la continuidad asistencial entre niveles asistenciales desde la perspectiva del usuario en ambos contextos. Objective To adapt and to validate the scale of the questionnaire Continuity of Care between Care Levels (CCAENA©) in the context of the Colombian and Brazilian health systems. Methods The study consisted of two phases: 1) adaptation of the CCAENA© scale to the context of each country, which was tested by two pretests and a pilot test, and 2) validation by means of application of the scale in a population survey in Colombia and Brazil. The following psychometric properties were analyzed: construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha and item-rest correlations), the multidimensionality of the scales (Spearman correlation coefficients), and known group validity (chi-square test). Results Of the 21 items of the original scale, 14 were selected and reformulated based on a statement with response options of agreement to a question with frequency response options. Factor analysis showed that items could be grouped into three factors: continuity across healthcare levels, the patient-primary care provider relationship, and the patient-secondary care provider relationship. Cronbach's alpha indicated good internal consistency (>0.80 in all the scales). The ...
      PubDate: 2014-12-05T17:35:14Z
       
  • Calidad de vida de trabajadoras inmigrantes latinoamericanas como
           cuidadoras en España

    • Abstract: Publication date: Available online 28 November 2014
      Source:Gaceta Sanitaria
      Author(s): Andreu Bover , Joana Maria Taltavull , Denise Gastaldo , Raquel Luengo , María Dolores Izquierdo , Clara Juando-Prats , Amaia Sáenz de Ormijana , Juana Robledo
      Objetivo Describir la calidad de vida percibida en trabajadoras latinoamericanas como cuidadoras en España y sus diferencias en relación a ciertas variables que les son comunes. Métodos Se utilizó el cuestionario SF-36 para la medición de la calidad de vida percibida en 517 mujeres de Baleares, Cataluña, País Vasco, Canarias y Madrid. Se estudiaron diversas variables relacionadas con su perfil sociodemográfico y proceso migratorio, usando la prueba t de Student, el test ANOVA y modelos de regresión lineal. Resultados Obtuvieron muy bajas puntuaciones en las dimensiones de rol físico y rol emocional. El trabajo como interna, la falta de contrato, las múltiples tareas, el estatus irregular y la edad más joven se relacionaron con una peor calidad de vida dentro del grupo. Conclusiones Las condiciones laborales y los factores ligados al proceso migratorio son determinantes para explicar la vulnerabilidad de estas mujeres. Objective To describe perceived quality of life in Latin American caregivers working in Spain and how it varies in relation to certain variables shared by this group. Methods We used the SF-36 to measure perceived quality of life in 517 women residing in five Spanish regions: the Balearic Islands, Catalonia, the Basque Country, the Canary Islands, and Madrid. Several variables related to the socio-demographic profile and migration process were studied using Student's t test, ANOVA and linear regression models. Results The participants scored very low on the dimensions of physical and emotional roles. The factors associated with lower quality of life scores within the group were working as a live-in caregiver, lack of contract, multitasking, irregular status, and younger age. Conclusions The vulnerability of these women can be explained by poor working conditions and other factors related to the migratory process.


      PubDate: 2014-11-30T17:34:39Z
       
 
 
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