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  Subjects -> PUBLIC ADMINISTRATION (Total: 193 journals)
    - MUNICIPAL GOVERNMENT (6 journals)
    - PUBLIC ADMINISTRATION (169 journals)
    - SECURITY (18 journals)

PUBLIC ADMINISTRATION (169 journals)                  1 2 | Last

Academy of Management Annals, The     Full-text available via subscription   (Followers: 27)
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   (Followers: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 9)
AQ - Australian Quarterly     Full-text available via subscription   (Followers: 1)
Australian Social Work     Hybrid Journal   (Followers: 10)
BAR. Brazilian Administration Review     Open Access   (Followers: 1)
Cadernos EBAPE.BR     Open Access   (Followers: 1)
Canadian Public Administration/Administration Publique Du Canada     Hybrid Journal   (Followers: 11)
Cities     Hybrid Journal   (Followers: 11)
Citizenship Studies     Hybrid Journal   (Followers: 3)
Clinical Social Work Journal     Hybrid Journal   (Followers: 15)
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: 6)
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: 17)
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: 3)
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: 85)
Government and Opposition     Full-text available via subscription   (Followers: 17)
Government Information Quarterly     Hybrid Journal   (Followers: 17)
Government News     Full-text available via subscription   (Followers: 4)
Growth and Change     Hybrid Journal   (Followers: 5)
Headmark     Full-text available via subscription   (Followers: 2)
HR Highway     Full-text available via subscription   (Followers: 2)
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: 4)
International Journal of Environmental Policy and Decision Making     Hybrid Journal   (Followers: 11)
International Journal of Information Systems for Crisis Response and Management     Full-text available via subscription   (Followers: 3)
International Journal of Leadership in Public Services     Hybrid Journal   (Followers: 6)
International Journal of Public Administration     Hybrid Journal   (Followers: 14)
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   (Followers: 2)
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 Economic and Administrative Sciences     Hybrid Journal   (Followers: 5)
Journal of Economics, Finance and Administrative Science     Open Access  
Journal of Entrepreneurship and Public Policy     Hybrid Journal   (Followers: 8)
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: 19)
Journal of Nursing Management     Hybrid Journal   (Followers: 19)
Journal of Organisational Transformation & Social Change     Hybrid Journal   (Followers: 7)
Journal of Park and Recreation Administration     Full-text available via subscription   (Followers: 3)
Journal of Public Administration     Full-text available via subscription   (Followers: 19)
Journal of Public Administration and Governance     Open Access   (Followers: 11)
Journal of Public Administration Research and Theory     Hybrid Journal   (Followers: 18)
Journal of Science and Sustainable Development     Full-text available via subscription  
Journal of Social Work Education     Hybrid Journal   (Followers: 4)
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: 10)
Liinc em Revista     Open Access  
Local Government Bulletin     Full-text available via subscription   (Followers: 1)
Local Government Studies     Hybrid Journal   (Followers: 9)
Macramè. Trame e ritagli dell’urbanistica     Open Access   (Followers: 1)
Middle East Law and Governance     Hybrid Journal   (Followers: 8)
National Civic Review     Hybrid Journal  
National Journal     Full-text available via subscription   (Followers: 3)
NISPAcee Journal of Public Administration and Policy     Open Access   (Followers: 3)
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)
Philosophy & Public Policy Quarterly     Open Access   (Followers: 2)

        1 2 | Last

Journal Cover   Gaceta Sanitaria
  [SJR: 0.434]   [H-I: 27]   [2 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0213-9111
   Published by Elsevier Homepage  [2812 journals]
  • Victimización sexual autorreportada en adolescentes españoles
           comunitarios y en colectivos de riesgo

    • Abstract: Publication date: Available online 23 June 2015
      Source:Gaceta Sanitaria
      Author(s): Noemí Pereda , Judit Abad , Georgina Guilera , Mila Arch
      Objetivo Conocer la extensión de la victimización sexual de menores en cuatro grupos de jóvenes españoles/as a partir de sus propios reportes. Método Estudio observacional, transversal y multicéntrico. La victimización sexual se evaluó a partir de siete preguntas del Juvenile Victimization Questionnaire. Se encuestó a 1105 adolescentes (edad media [M]=14,52; desviación típica [DT]=1,76) de siete centros de educación secundaria, 149 adolescentes (M=14,28; DT=1,45) de 14 centros de salud mental infantojuvenil, 129 adolescentes (M=14,59; DT=1,62) institucionalizados en 18 centros residenciales (78,3%) y de acogida (21,7%) del sistema de protección, y 101 adolescentes (M=16,08; DT=0,99) reclutados/as en tres centros cerrados de justicia juvenil (77,2%) y cinco equipos de medio abierto (22,8%). Resultados La extensión de la victimización sexual oscila entre un 14,7% a lo largo de la vida del total de la muestra comunitaria, un 23,5% en los/las jóvenes atendidos/as en centros de salud mental, un 35,6% de los/las jóvenes involucrados/as en el sistema de justicia juvenil y un 36,4% de los/las menores atendidos/as por el sistema de protección. Existe una mayoría de víctimas de sexo femenino, excepto en menores de justicia juvenil. Conclusiones La victimización sexual de menores es un problema extendido en nuestro país, que se distribuye de manera diferencial en función del colectivo que se analice. Objective To determine the extent of sexual victimization in four groups of Spanish adolescents based on their own reports. Method An observational, cross-sectional, multicenter study was conducted. Sexual victimization was assessed by seven questions included in the Juvenile Victimization Questionnaire. The samples were composed of 1,105 adolescents (mean age [M]=14.52, standard deviation [SD]=1.76) from seven secondary schools; 149 adolescents (M=14.28; SD=1.45) from 14 child and adolescent mental health centers; 129 adolescents (M=14.59, SD=1.62) institutionalized in 18 long-term (78.3%) and short-term (21.7%) residential centers belonging to the child protection system; and 101 adolescents (M=16.08, SD=0.99) recruited from three detention centers (77.2%) and five open regime teams or follow-up services for court orders for minors not requiring loss of freedom (22.8%). Results The extent of lifetime sexual victimization ranged from 14.7% of the adolescents in the community sample to 23.5% of youths attended in mental health services, 35.6% of youths involved in the juvenile justice system, and 36.4% of children protected by the child welfare system. Most of the victims were female, the only exception being th...
      PubDate: 2015-06-25T19:42:58Z
       
  • Protege, y defiende tu salud también en el trabajo

    • Abstract: Publication date: Available online 22 June 2015
      Source:Gaceta Sanitaria
      Author(s): Laia Ollé-Espluga , Montse Vergara-Duarte , Joan Benach



      PubDate: 2015-06-25T19:42:58Z
       
  • Elaboración de una herramienta para la vigilancia de indicadores de
           calidad de la docencia en la formación especializada de Medicina
           Preventiva y Salud Pública

    • Abstract: Publication date: Available online 23 June 2015
      Source:Gaceta Sanitaria
      Author(s): Christian Carlo Gil-Borrelli , Pello Latasa , Laura Reques , Guadalupe Alemán
      En este trabajo se describe el proceso de creación de una herramienta para evaluar la satisfacción con la calidad de la docencia recibida en las rotaciones de la especialidad de Medicina Preventiva y Salud Pública. Para ello se adaptó la Encuesta de Satisfacción de la Formación Especializada por parte de un panel de expertos formado por 23 residentes de nueve comunidades autónomas, que valoraron y adaptaron la encuesta a las rotaciones de la especialidad mediante una escala de Likert de 5 puntos y la inclusión de nuevas dimensiones e ítems. Las dimensiones mejor valoradas fueron la planificación y la consecución de objetivos específicos, la supervisión, la delegación de responsabilidades, los recursos y el ambiente laboral del dispositivo, la valoración personal, el estímulo, el apoyo recibido y la productividad de la rotación. El desarrollo y la utilización de esta herramienta permitirán la elección informada del itinerario formativo de los residentes de Medicina Preventiva y Salud Pública. This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries.


      PubDate: 2015-06-25T19:42:58Z
       
  • Population-based multicase-control study in common tumors in Spain
           (MCC-Spain): rationale and study design

    • Abstract: Publication date: July–August 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 4
      Author(s): Gemma Castaño-Vinyals , Nuria Aragonés , Beatriz Pérez-Gómez , Vicente Martín , Javier Llorca , Victor Moreno , Jone M. Altzibar , Eva Ardanaz , Sílvia de Sanjosé , José Juan Jiménez-Moleón , Adonina Tardón , Juan Alguacil , Rosana Peiró , Rafael Marcos-Gragera , Carmen Navarro , Marina Pollán , Manolis Kogevinas
      Introduction We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.


      PubDate: 2015-06-19T17:36:53Z
       
  • Implicaciones del consumo de sustancias psicoactivas sobre la salud de
           hombres privados de libertad

    • Abstract: Publication date: July–August 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 4
      Author(s): Francisco Caravaca-Sánchez , Cristóbal Sánchez-Alcaraz Martínez , Eduardo Osuna , María Falcón Romero , Aurelio Luna
      Objetivo Describir las frecuencias de consumo de alcohol y otras drogas, así como de diferentes tipos de victimización en la población reclusa de los centros penitenciarios de Castilla-La Mancha. Material y métodos Estudio transversal analítico con una muestra de personas privadas de libertad en cuatro centros penitenciarios de Castilla-La Mancha. Se distribuyó una encuesta de victimización anónima entre un total de 425 internos, con un margen de confianza del 95%. Resultados Las agresiones verbales se presentan como las más comunes, con un 41,4% (n=176), situándose en el extremo contrario la victimización sexual con un 7,8% (n=33). Respecto a la sustancia más habitual, destaca el cannabis con un 40,2% (n=171) de consumidores en el mes previo. Conclusiones La victimización y el consumo de sustancias en prisión son una realidad, y se encuentra una asociación estadísticamente significativa entre ambos fenómenos. Resulta necesario su estudio para el planteamiento de medidas preventivas y mejorar la vida en prisión. Objective To describe the frequency of the use of alcohol and other drugs, as well as different types of victimization in men deprived of liberty in the prisons of Castile-La Mancha (Spain). Material and methods A cross-sectional study was conducted in a sample of men deprived of liberty in four prisons in Castile-La Mancha. An anonymous questionnaire on victimization was distributed among a total of 425 prisoners, with a confidence interval of 95%. Results The most commonly reported assaults were verbal, affecting 41.4% of the prisoners (n=176) and the least common were sexual, affecting 7.8% (n=33). The most commonly consumed substance was cannabis, with 40.2% (n=171) of prisoners consuming it in the previous month. Conclusions Victimization and substance use is a reality in prisons, and there is a statistically significant association between the two phenomena. This association should be further studied to design preventive measures and improve prison life.


      PubDate: 2015-06-19T17:36:53Z
       
  • El reto de la cronicidad en España: mejor transformar que racionar

    • Abstract: Publication date: Available online 15 June 2015
      Source:Gaceta Sanitaria
      Author(s): Rafael Bengoa Rentería



      PubDate: 2015-06-19T17:36:53Z
       
  • M. Porta. A dictionary of epidemiology. 6th ed. Oxford: Oxford University
           Press/International Epidemiological Association; 2014. 343 p. ISBN:
           978-0-19-997673-7

    • Abstract: Publication date: Available online 13 June 2015
      Source:Gaceta Sanitaria
      Author(s): Mercè Gotsens



      PubDate: 2015-06-19T17:36:53Z
       
  • GACETA SANITARIA A PRIMERA VISTA

    • Abstract: Publication date: July–August 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 4




      PubDate: 2015-06-19T17:36:53Z
       
  • How much do workers’ health examinations add to health and safety at
           the workplace? Occupational preventive usefulness of routine health
           examinations

    • Abstract: Publication date: July–August 2015
      Source:Gaceta Sanitaria, Volume 29, Issue 4
      Author(s): Maria Cruz Rodríguez-Jareño , Emilia Molinero , Jaume de Montserrat , Antoni Vallès , Marta Aymerich
      Objective Despite no evidence in favour, routine workers’ health examinations, mostly pre-employment and periodic, are extensively performed worldwide with important allocation of resources. In Spain they are performed within a theoretical job-specific health surveillance system. Our objective was to ascertain their occupational preventive usefulness from the perspective of occupational health professionals. Methods Cross sectional study. Online survey addressed to all physicians and nurses members of the Catalan Society of Safety and Occupational Medicine (n =539) in 2011. Univariate and bivariate analyses of prevalence and prevalence differences of answers. Results Response rate 53% (n =285). According to more than 70% of respondents the health surveillance system isn’t cost-effective, doesn’t meet the goal of early detection of health damage related to work, and doesn’t contribute to improve the occupational risk prevention system. Further deficiencies were identified regarding specificity and scientific basis for health examinations, quality of collective health surveillance and referral of suspected cases to mutual insurance companies for diagnosis and treatment. Bivariate analysis showed a significantly more negative opinion for several items amongst physicians (versus nurses) and amongst professionals working in external prevention services (versus internal services). Conclusions This study raises serious concerns about how health examinations are performed within our workers’ health surveillance system, which should be reviewed to ensure the fulfilment of its occupational preventive objective. Our results might encourage other countries with similar practices to assess them in order to assure their fitness for purpose.


      PubDate: 2015-06-19T17:36:53Z
       
  • El tratado de libre comercio entre los Estados Unidos y la Unión
           Europea y sus posibles impactos en la sanidad española

    • Abstract: Publication date: Available online 9 June 2015
      Source:Gaceta Sanitaria
      Author(s): Vicenç Navarro



      PubDate: 2015-06-12T15:54:38Z
       
  • Consumo de tabaco y alcohol según la jornada laboral en España

    • Abstract: Publication date: Available online 8 June 2015
      Source:Gaceta Sanitaria
      Author(s): Vanesa García-Díaz , Ana Fernández-Feito , Lucía Arias , Alberto Lana
      Objetivo Explorar la asociación entre el consumo de tabaco y alcohol y el tipo de jornada laboral en población española. Métodos Estudio transversal sobre una muestra de residentes en España, adultos y laboralmente activos (N=8155). La fuente de datos fue la Encuesta Nacional de Salud 2011-2012. Se recogió información sobre el tipo de jornada laboral (mañana, tarde, noche, partida, reducida y a turnos) y el consumo regular de tabaco y alcohol. También se incluyeron variables sociodemográficas y otras relacionadas con la salud y la actividad laboral. Se calcularon las odds ratios ajustadas (ORa) y sus intervalos de confianza del 95% (IC95%) mediante regresiones log-binomial. Resultados El 32,1% de las personas encuestadas fumaba regularmente, en especial aquellas que trabajaban en turno nocturno (43,5%). El 54,8% de la población trabajadora tenía un consumo alcohólico moderado y el 1,5% de riesgo. El tipo de jornada con más bebedores moderados y de riesgo fue la partida, con un 57,6% y un 1,8% respectivamente. La ORa de ser fumador fue mayor en los que trabajaban por la noche (OR=1,56; IC95%: 1,01-2,46). Ningún turno de trabajo se asoció significativamente con el consumo de alcohol. Conclusiones El turno de trabajo nocturno se asoció con el consumo regular de tabaco. Los servicios de salud laboral deberían extremar la vigilancia de este grupo de población trabajadora, incluyéndolo sistemáticamente en programas para controlar el tabaquismo y las enfermedades relacionadas. En el futuro, estudiar las razones para este fenómeno podría aportar claves para lograr el éxito preventivo y terapéutico. Objective To examine the association between smoking and alcohol consumption and the type of working day in the Spanish population Methods Cross-sectional study among employees residing in Spain aged >18 years (N=8,736). We took data from the National Health Survey (2011-2012). Information was collected on the type of working day (morning, afternoon, evening, part-time, reduced hours, and shift-work) and smoking and drinking habits. Demographic characteristics and health- and work-related factors were also taken into account. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated through log-binomial regressions. Results Among respondents, 32.1% smoked regularly, especially those working the night shift (43.5%). Moderate alcohol consumption was found in 54.8% of workers and excessive consumption in 1.5%. Most of the moderate and heavy drinkers worked part-time, with 57.6% and 1.8% respectively. The aOR of being a smoker was higher among night workers (OR=1.58; 95% CI: 1.01-2.46). None of the work shifts were significantly associated with alcohol consumption.
      PubDate: 2015-06-12T15:54:38Z
       
  • Del Llano Señarís JE, Campillo-Artero C, directores. Health
           technology assessment and health policy today: a multifaceted view of
           their unstable crossroads. En: Ortún V, director. Colección
           «Economía de la salud y gestión sanitaria». Madrid:
           Springer Healthcare Communications Ibérica; 2014. 156 páginas.
           ISBN: 978-84-940118-5-6

    • Abstract: Publication date: Available online 3 June 2015
      Source:Gaceta Sanitaria
      Author(s): Leticia García Mochón



      PubDate: 2015-06-07T13:24:39Z
       
  • Accesibilidad a los datos de investigación en salud pública:
           eficiencia y reproducibilidad versus confidencialidad

    • Abstract: Publication date: Available online 4 June 2015
      Source:Gaceta Sanitaria
      Author(s): Miguel A. Martinez-Beneito , Óscar Zurriaga



      PubDate: 2015-06-07T13:24:39Z
       
  • Pacientes frecuentadores/as en servicios de urgencias hospitalarios

    • Abstract: Publication date: Available online 4 June 2015
      Source:Gaceta Sanitaria
      Author(s): Juan Mariano Aguilar Mulet , Cesáreo Fernández Alonso , Manuel Enrique Fuentes Ferrer , Juan Jorge González Armengol



      PubDate: 2015-06-07T13:24:39Z
       
  • Menú escolar de los centros de enseñanza secundaria de Madrid:
           conocimiento y cumplimiento de las recomendaciones del Sistema Nacional de
           Salud

    • Abstract: Publication date: Available online 4 June 2015
      Source:Gaceta Sanitaria
      Author(s): Belén Berradre-Sáenz , Miguel Ángel Royo-Bordonada , María José Bosqued , María Ángeles Moya , Lázaro López
      Objetivo Establecer, en la Comunidad de Madrid, el grado de conocimiento y cumplimiento de las recomendaciones del Documento de consenso del Sistema Nacional de Salud sobre la alimentación en los centros educativos. Métodos Estudio transversal con una muestra aleatoria de 182 centros de enseñanza secundaria de Madrid con comedor escolar en el curso 2013-2014. A través de Internet y entrevista telefónica se recogió información sobre las características de los centros y el conocimiento de las recomendaciones, y se recabó una copia del menú escolar. Para cada ítem alimentario se calculó la media de raciones consumidas y el porcentaje de centros dentro del rango recomendado. La adherencia global se calculó como la media del número de alimentos (0-12) dentro del rango. Resultados El 65,5% de los centros desconocían el documento de consenso. La oferta de arroz, pasta, pescados, huevos, ensalada y fruta fue inferior a la recomendada, y la de carne, guarniciones y otros postres fue superior. El porcentaje de colegios dentro del rango para cada ítem alimentario varió entre el 13% y el 95%. La media de adherencia global fue de 6,3, sin diferencias en función de si el centro disponía o no de cocina propia o de un responsable de nutrición. Conclusión El grado de adherencia a las recomendaciones fue variable. Se aconseja aumentar la oferta de cereales, huevos, pescado, ensalada y fruta. Se requieren programas de difusión e implementación de las recomendaciones del documento de consenso, contando con profesionales adecuadamente formados, para mejorar el valor nutricional del menú escolar. Objective To establish the degree of knowledge and adherence to the Spanish National Health System recommendations on nutrition in schools in the Autonomous Community of Madrid. Methods Cross-sectional study of a random sample of 182 secondary schools from Madrid, during 2013-2014 school year. Information on the characteristics of the schools and the knowledge of the recommendations was collected by internet and telephone interviews, as well as a copy of the school menu. The average number of rations per week offered for each food item and the percentage of schools within the recommended range were calculated. The overall adherence was obtained as the mean of food items (0-12) within the range. Results 65.5% of the schools were unaware of the national recommendations. The supply of rice, pasta, fish, eggs, salad and fruit was lower than recommended, whereas for meat, accompaniment and other desserts was higher. The percentage of schools within the range for each food item varied between 13% and 95%. The mean of overall adherence was 6.3, with no differences depending on whether the menu was prepared or not at schools or there was or not a person in charge of nutrition standards.
      PubDate: 2015-06-07T13:24:39Z
       
  • Prevalence of Chagas disease in the Bolivian population of Majorca (Spain)

    • Abstract: Publication date: Available online 27 May 2015
      Source:Gaceta Sanitaria
      Author(s): Pedro Favila Escobio , Joana Ribas , Marta G. Morillo , Ginna Rodríguez-Ramírez , Jeronima Vicens-Ferrer , Magdalena Esteva
      Objective To establish the prevalence of Trypanosoma cruzi infection in Bolivian (Spain) participants. Methods A cross sectional study was carried out in Majorca. Bolivian residents older than 18 years assigned to the family physicians of two primary care centers were randomly selected from the health card population database. Participants were invited to attend a serology test and an interview. T. cruzi infection was confirmed after two positive ELISA tests. If the result was positive or dubious, the serological test was sent to the National Microbiology Center for confirmation. Results A total of 251 participants were included (response rate 36.3%). The overall seroprevalence of Chagas infection was 19.1% (95% CI: 14.06-24.19). Seroprevalence was higher in participants from highly endemic provinces, those from rural areas, those who had lived in mud houses, and in those whose mother or a family member had contracted this infection. Conclusion This study demonstrates a high prevalence of T. cruzi in Bolivian residents, which was strongly associated with established risk factors.


      PubDate: 2015-05-31T21:54:18Z
       
  • ¿Es posible una atención primaria «amigable para las/los
           jóvenes» en España?

    • Abstract: Publication date: Available online 28 May 2015
      Source:Gaceta Sanitaria
      Author(s): Isabel Goicolea , Elena Aguiló , Juan Madrid



      PubDate: 2015-05-31T21:54:18Z
       
  • Algo no estamos haciendo bien cuando informamos a los/las pacientes tras
           un evento adverso

    • Abstract: Publication date: Available online 28 May 2015
      Source:Gaceta Sanitaria
      Author(s): José Joaquín Mira , Susana Lorenzo
      Objetivo Analizar qué hacen hospitales y atención primaria para asegurar una información franca a los/las pacientes tras un evento adverso (EA). Método Encuesta a 633 directivos/as y responsables de seguridad (colectivo de dirección) y 1340 profesionales de ocho comunidades autónomas. Se exploró el nivel de implantación de recomendaciones para una correcta información tras un EA. Resultados 112 (27,9%) directivos/as y 386 (35,9%) profesionales consideraron que en su centro se informaba correctamente tras un EA; 30 (7,4%) directivos/as afirmaron disponer en su centro de un protocolo sobre cómo informar; sólo 92 (17,4%) médicos/as y 93 (19,1%) enfermeros/as habían recibido entrenamiento para informar a un/a paciente tras un EA. Conclusiones Existen importantes carencias a la hora de planificar, organizar y asegurar que el/la paciente que sufre un EA reciba una disculpa e información franca de lo sucedido y de lo que puede pasar a partir de ese momento. Objective To analyze which actions are carried out in hospitals and primary care to ensure open disclosure to the patient after an adverse event (AE). Methods We surveyed 633 managers and patient safety coordinates (staff) and 1340 physicians and nurses from eight autonomous communities. The level of implementation of open disclosure recommendations was explored. Results A total of 112 (27.9%) staff and 386 (35.9%) professionals considered that patients were correctly informed after an EA; 30 (7.4%) staff claimed to have a guideline on how to report EA; only 92 medical professionals (17.4%) and 93 nurses (19.1%) had received training on open disclosure. Conclusions There are gaps in the way of planning, organizing and ensuring that patients who suffer an AE will receive an apology with honest information about what has happened and what could subsequently happen.


      PubDate: 2015-05-31T21:54:18Z
       
  • Maximizar la rentabilidad de la inversión para la salud pública
           con hardware médico de código abierto

    • Abstract: Publication date: Available online 26 May 2015
      Source:Gaceta Sanitaria
      Author(s): Joshua M. Pearce



      PubDate: 2015-05-26T20:25:02Z
       
  • Percepción y experiencias en el acceso y el uso de los servicios
           sanitarios en población inmigrante

    • Abstract: Publication date: Available online 12 May 2015
      Source:Gaceta Sanitaria
      Author(s): Pilar Bas-Sarmiento , Martina Fernández-Gutiérrez , M.a Jesús Albar-Marín , Manuel García-Ramírez
      Objetivo Identificar y describir las necesidades y los problemas percibidos por la población inmigrante en relación con el acceso y la utilización de los servicios de salud. Método Estudio cualitativo descriptivo de orientación fenomenológica mediante grupos focales. El ámbito de estudio fue la comarca del Campo de Gibraltar, puerta de entrada a Europa para la inmigración procedente de África. La saturación teórica determinó el tamaño final de la muestra (51 inmigrantes de 11 nacionalidades). Se llevó a cabo un análisis narrativo del contenido con el software informático QSR NVivo9. Resultados Los discursos muestran cuatro categorías de análisis: respuesta ante un problema de salud, acceso al sistema, conocimiento de recursos sociosanitarios y necesidades de alfabetización en salud. Las respuestas desplegadas ante los problemas de salud y la forma de acceder al sistema sanitario son distintas en función de algunas características sociodemográficas (nacionalidad/cultura de origen, tiempo de estancia y estatus económico). En general utilizan principalmente la asistencia sanitaria a demanda cuando presentan problemas de salud, y quedan relegados los servicios de promoción y prevención de la salud. Las necesidades de alfabetización en salud detectadas se relacionan sobre todo con el dominio del idioma y el funcionamiento del sistema sanitario. Conclusiones Es necesario fomentar intervenciones destinadas a potenciar la alfabetización en salud de la población inmigrante, que atiendan a la diversidad, tengan en cuenta el tiempo de estancia y partan de una metodología de acción-participación. Objective To identify and describe the needs and problems of the immigrant population related to access and utilization of health services. Method A descriptive, qualitative, phenomenological study was conducted using focus groups. The study area was the county of Campo de Gibraltar (Spain), which represents the gateway to Europe for immigration from Africa. The final sample size (51 immigrants from 11 countries) was determined by theoretical saturation. A narrative analysis was conducted with QSR NVivo9 software. Results Immigrants’ discourse showed four categories of analysis: response to a health problem, system access, knowledge of social and health resources, and health literacy needs. Responses to health problems and the route of access to the health care system differed according to some sociodemographic characteristics (nationality/culture of origin, length of residence, and economic status). In general, immigrants primarily used emergency services, hampering health promotion and prevention. The health literacy needs identified concerned language proficiency and the functioning of the health system.
      PubDate: 2015-05-16T18:39:35Z
       
  • La precariedad laboral medida de forma multidimensional: distribución
           social y asociación con la salud en Cataluña

    • Abstract: Publication date: Available online 14 May 2015
      Source:Gaceta Sanitaria
      Author(s): Joan Benach , Mireia Julià , Gemma Tarafa , Jordi Mir , Emilia Molinero , Alejandra Vives
      Objetivo Mostrar por vez primera la prevalencia de la precariedad laboral medida en forma multidimensional en Cataluña y su asociación con la salud mental y autopercibida. Método Estudio transversal con datos de la II Encuesta Catalana de Condiciones de Trabajo (2010) con una submuestra de personas asalariadas con contrato. Se calculó la prevalencia de precariedad laboral usando una escala multidimensional, y su asociación con la salud mediante regresiones log-binomiales multivariadas estratificadas por sexo. Resultados La prevalencia de la precariedad en Cataluña es alta (42,6%). Encontramos mayor precariedad en las mujeres y en los/las trabajadores/as jóvenes, inmigrantes, manuales y con menor educación. Existe un gradiente positivo en la asociación con la mala salud. Conclusiones La precariedad laboral se asocia con peor salud en la población trabajadora. Deberían incluirse preguntas sobre precariedad e indicadores de salud en las encuestas de condiciones de trabajo para poder realizar una posterior vigilancia y un análisis de las desigualdades en salud. Objective To show the prevalence of precarious employment in Catalonia (Spain) for the first time and its association with mental and self-rated health, measured with a multidimensional scale. Method A cross-sectional study was conducted using data from the II Catalan Working Conditions Survey (2010) with a subsample of employed workers with a contract. The prevalence of precarious employment using a multidimensional scale and its association with health was calculated using multivariate log-binomial regression stratified by gender. Results The prevalence of precarious employment in Catalonia was high (42.6%). We found higher precariousness in women, youth, immigrants, and manual and less educated workers. There was a positive gradient in the association between precarious employment and poor health. Conclusions Precarious employment is associated with poor health in the working population. Working conditions surveys should include questions on precarious employment and health indicators, which would allow monitoring and subsequent analyses of health inequalities.


      PubDate: 2015-05-16T18:39:35Z
       
  • Electronic clinical records in primary care for estimating disease burden
           and management. An example of COPD

    • Abstract: Publication date: Available online 8 May 2015
      Source:Gaceta Sanitaria
      Author(s): Luis Verde-Remeseiro , Estrella López-Pardo , Alberto Ruano-Ravina , Francisco Gude-Sampedro , Ramón Castro-Calvo
      Chronic obstructive pulmonary disease (COPD) is a significant health problem in developed countries. We aimed to estimate the prevalence of COPD in a single Spanish healthcare area. We also aimed to assess if there are any differences in prevalence and spirometry use among primary care services by utilizing already registered information. We designed a cross-sectional study to determine the prevalence of COPD and the performance of spirometries in each primary care service. A total of 8,444 patients were diagnosed with COPD, with a prevalence of 2.6% for individuals older than 39 years. The prevalence increased with age and was much higher in men. Significant heterogeneity was found in the prevalence of COPD and spirometry use among primary care services. COPD was underdiagnosed and there was wide variability in spirometry use in our area. Greater efforts are needed to diagnose COPD in order to improve its clinical outcomes and to refine registries so that they can be used as reliable sources of information


      PubDate: 2015-05-11T17:28:19Z
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
 
 
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