Gaceta Sanitariahttps://scielosp.org/feed/gs/2018.v32n5/2024-01-10T00:01:00ZVol. 32 No. 5 - 2018WerkzeugHas the quality of health care for the immigrant population changed during the economic crisis in Catalonia (Spain)?. Opinions of health professionals and immigrant users10.1016/j.gaceta.2017.03.0102024-01-10T00:01:00Z2017-01-14T00:03:00ZPorthé, VictoriaVargas, IngridRonda, ElenaMalmusi, DavideBosch, LolaVázquez, M Luisa
<em>Porthé, Victoria</em>;
<em>Vargas, Ingrid</em>;
<em>Ronda, Elena</em>;
<em>Malmusi, Davide</em>;
<em>Bosch, Lola</em>;
<em>Vázquez, M Luisa</em>;
<br/><br/>
Abstract Objective To analyse changes in health professionals’ and immigrant users’ perceptions of the quality of care provided to the immigrant population during the crisis. Methods A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. Results Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals’ working conditions and users’ attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. Conclusion The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants.Drivers for human papillomavirus vaccination in Valencia (Spain)10.1016/j.gaceta.2017.05.0082024-01-10T00:01:00Z2017-01-14T00:03:00ZNavarro-Illana, PedroNavarro-Illana, EstherVila-Candel, RafaelDíez-Domingo, Javier
<em>Navarro-Illana, Pedro</em>;
<em>Navarro-Illana, Esther</em>;
<em>Vila-Candel, Rafael</em>;
<em>Díez-Domingo, Javier</em>;
<br/><br/>
Abstract Objective To describe the drivers associated with HPV vaccination in adolescent girls and their parent's opinion on the vaccine. Methods We conducted an observational and cross-sectional study on adolescent girls and their parents in Valencia (Spain), between September 2011 and June 2012. A consultation was made at a random sample of schools of the 14-year-old girls that should have received the vaccine in the free vaccination programme. We ran a personal survey on knowledge and attitudes regarding HPV infection and the vaccine. A binary logistic regression model was performed to determine which factors were most associated with vaccination. Results The survey was run on a binomial of 1,278 girls/mothers in 31 schools, to which 833 girls and their mothers responded (64.0%). The factors associated with vaccination were: country of origin of the families (adjusted OR [aOR]: 0.49; 95% confidence interval [95%CI]: 0.24-0.98), civil status of the parents (aOR: 0.33; 95%CI: 0.13-0.81), knowledge/beliefs about the vaccine when the source of information was the nurse (aOR: 1.83; 95%CI: 1.01-3.35), information source about the vaccine (aOR: 2.32; 95%CI: 1.37-3.92), preventive health centre visits (aOR: 2.1; 95%CI: 1.10-4.07), and nurse advice (aOR: 6.6; 95%CI: 3.19-13.56). Conclusions The main factor associated with HPV vaccination was the advice of health professionals. Therefore, the most effective interventions to improve vaccination coverage should focus on health professionals.Análisis comparativo de indicadores de eficiencia en cirugía mayor ambulatoria10.1016/j.gaceta.2017.02.0032024-01-10T00:01:00Z2017-01-14T00:03:00ZRodríguez Ortega, MaríaPorrero Carro, José LuisAranaz Andrés, Jesús MaríaCastillo Fe, María JoséAlonso García, María TeresaSánchez-Cabezudo Díaz-Guerra, Carlos
<em>Rodríguez Ortega, María</em>;
<em>Porrero Carro, José Luis</em>;
<em>Aranaz Andrés, Jesús María</em>;
<em>Castillo Fe, María José</em>;
<em>Alonso García, María Teresa</em>;
<em>Sánchez-Cabezudo Díaz-Guerra, Carlos</em>;
<br/><br/>
Resumen Objetivo Buscar elementos comparativos para el control de calidad en unidades de cirugía mayor ambulatoria (CMA). Método Estudio descriptivo comparativo del índice de ambulatorización (IA) y el índice de sustitución (IS) en el Servicio de Cirugía del Hospital Santa Cristina, de Madrid (España), respecto a indicadores clave (IC) del Sistema Nacional de Salud (SNS). Resultados Se analizaron 7817 procedimientos de CMA (entre 2006 y 2014) y se obtuvo un IA anual medio del 54%, superior (p <0,0001) al IC «Porcentaje de ambulatorización quirúrgica». Igualmente, la ambulatorización herniaria (media 72%) superó al IC nacional (p <0,0001), mientras que el IS «Hemorroidectomía» (media 33,6%) fue claramente inferior (p <0,0001). Conclusiones Los IC del SNS son útiles y han permitido determinar un buen desarrollo en la ambulatorización global y de hernia, existiendo oportunidades de mejora en hemorroidectomía. Debe cuidarse su recogida, sin incluir cirugías menores, y su utilidad aumentaría si se ofrecieran datos desglosados por especialidades y complejidad.Adherence to nutritional recommendations in vending machines at secondary schools in Madrid (Spain), 2014-201510.1016/j.gaceta.2017.05.0062024-01-10T00:01:00Z2017-01-14T00:03:00ZMonroy-Parada, Doris XiomaraJácome-González, María LuisaMoya-Geromini, María ÁngelesRodríguez-Artalejo, FernandoRoyo-Bordonada, Miguel Ángel
<em>Monroy-Parada, Doris Xiomara</em>;
<em>Jácome-González, María Luisa</em>;
<em>Moya-Geromini, María Ángeles</em>;
<em>Rodríguez-Artalejo, Fernando</em>;
<em>Royo-Bordonada, Miguel Ángel</em>;
<br/><br/>
Abstract Objective To describe the nutritional content of products offered in food and drink vending machines at secondary schools in the Madrid Autonomous Community (Spain), and to evaluate these items’ adherence to the nutritional recommendations of the National Health System Consensus Document on School Food. Methods Cross-sectional study of a sample of 330 secondary schools in Madrid across the period 2014-2015. Secondary school vending machines were identified by telephone interview. The products offered in a representative sample of six machines were identified by inspection in situ, and their nutritional composition was obtained from the labelling. Results A total of 94.5% of the 55 products on offer failed to comply with at least one nutritional criterion of the Consensus Document on School Food. The recommendation relating to sugar content registered the highest level of non-compliance, with 52.7% of products, followed by the recommendations relating to energy (47.3%) and fats (45.5%). The mean number of unmet criteria was 2.2, with this figure being higher in foods than in drinks (2.8 versus 1; p <0.01). Conclusion Almost all the products on display in secondary school vending machines in Madrid were in breach of the Consensus Document on School Food, mainly due to an excess of calories, sugars and fats. Compulsory nutritional criteria and a procedure for monitoring adherence should be established, specifying those responsible for performing this task and the corrective measures to be applied in the event of non-compliance.Differences in the economic valuation and determining factors of informal care over time: the case of blood cancer10.1016/j.gaceta.2017.02.0062024-01-10T00:01:00Z2017-01-14T00:03:00ZOrtega-Ortega, MartaMontero-Granados, RobertoJiménez-Aguilera, Juan de Dios
<em>Ortega-Ortega, Marta</em>;
<em>Montero-Granados, Roberto</em>;
<em>Jiménez-Aguilera, Juan De Dios</em>;
<br/><br/>
Abstract Objective To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. Methods 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant). Economic value of informal care was estimated using proxy good and opportunity cost methods. Ordered and binary logistic models were performed to identify factors associated with informal care. Results 123 patients reported having received informal care. A progressive reduction of the number of hours of care was observed between phases. Monetary value per patient ranged from 1,288 to 3,409; 1,045 to 2,786; and 336 to 854 €/month in the short, medium and long term, respectively. Patients with acute leukaemia and those who received an unrelated allogeneic transplantation were 22% (short-term) and 33.5% (medium-term) more likely to receive more than 8hours/day of care respect to patients diagnosed with lymphoma and autologous transplantation. In the long term, patients with multiple myeloma were more likely to receive more care. Better health status and higher educational level were associated with fewer daily hours of care. Conclusions Informal care varies greatly between stages of the treatment depending on the clinical and sociodemographic factors. Significant caring time and societal costs are associated with such care in blood cancer patients.Inequities in visual health and health services use in a rural region in Spain10.1016/j.gaceta.2017.03.0092024-01-10T00:01:00Z2017-01-14T00:03:00ZLatorre-Arteaga, SergioFernández-Sáez, JoséGil-González, Diana
<em>Latorre-Arteaga, Sergio</em>;
<em>Fernández-Sáez, José</em>;
<em>Gil-González, Diana</em>;
<br/><br/>
Abstract Objective To analyse perceived visual health and health services use in a rural population in relation to socioeconomic characteristics and compared with the general population in Spain. Method Cross-sectional study in a rural population using a structured questionnaire including questions comparable to the Spanish National Health Survey (2012). A descriptive analysis was carried out through the calculation of frequencies and prevalence, the χ2 test for independent variables, contrasts of proportions and logistic regression to obtain associations between the rural and general populations and socioeconomic variables. Results For the rural population studied, the prevalence of poor perceptions of visual health is 40.8% in men and 39.4% in women, and is strongly associated with age, employment situation, income and presence of chronic diseases (p<0.001). Compared with the general population, the rural population has a higher risk of presenting with serious difficulties related to farsightedness (OR: 2.56; 95% CI: 1.32-4.95) and make less use of optical correction (OR: 0.57; 95%CI: 0.44-0.74). The use of health services is not sufficient for adequate prevention, particularly in diabetics. For those affected by poor vision, the distance to travel to receive an eye exam, the belief that eyesight problems come with age and the cost of glasses are the principal reasons used to explain why eyesight problems are not resolved. Conclusions The rural population presents worse visual health that is influenced by social and economic factors. Improving accessibility and reducing barriers is essential to tackle avoidable visual disability and reduce health inequities.Explaining differences in perceived health-related quality of life: a study within the Spanish population10.1016/j.gaceta.2017.05.0162024-01-10T00:01:00Z2017-01-14T00:03:00ZMartín-Fernández, JesúsAriza-Cardiel, GloriaPolentinos-Castro, ElenaSanz-Cuesta, TeresaSarria-Santamera, AntonioCura-González, Isabel del
<em>Martín-Fernández, Jesús</em>;
<em>Ariza-Cardiel, Gloria</em>;
<em>Polentinos-Castro, Elena</em>;
<em>Sanz-Cuesta, Teresa</em>;
<em>Sarria-Santamera, Antonio</em>;
<em>Cura-González, Isabel Del</em>;
<br/><br/>
Abstract Objective To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions. Method Cross-sectional study. Data were obtained from the Spanish National Health Survey (2012), and HRQOL was measured using the EQ-5D-5L questionnaire (utility and visual analogue scale -VAS- scores). Demographic variables, physical health condition, social variables, mental health status, and lifestyle were also analysed. Tobit regression models were employed to study the relationships between expressed HRQOL and personal characteristics. Results A total of 20,979 surveys were obtained. Of them, 62.4% expressed a utility score of 1, corresponding to perfect health (95%CI: 61.8%-63.2%), and 54.2% showed VAS scores ≥80 (95%CI: 53.5%-54.9%). HRQOL was mainly described as a function of age, chronic limitation in daily activities, and mental health status. Belonging to a higher-class strata and physical activity were related to better self-perceived HRQOL. Ageing worsened perceived HRQOL, but did not influence its determinants, and differences in HRQOL by regions were also not significant after model adjustment. Conclusion HRQOL perception in the Spanish population varied slightly depending on the measure used (utilities index or VAS). Age, chronic limitations in daily life, and mental health status best explained the variability in perception, and no meaningful differences in HRQOL perception among regions were found after adjustment.Systematic review of guidelines in estimating social costs on drugs10.1016/j.gaceta.2017.10.0092024-01-10T00:01:00Z2017-01-14T00:03:00ZVella, Vincenzo AlbertoGarcía-Altes, AnnaSegura García, LidiaIbáñez Martínez, NuriaColom Farran, Joan
<em>Vella, Vincenzo Alberto</em>;
<em>García-Altes, Anna</em>;
<em>Segura García, Lidia</em>;
<em>Ibáñez Martínez, Nuria</em>;
<em>Colom Farran, Joan</em>;
<br/><br/>
Abstract Objective To systematically review guidance documents for the estimation of the social cost of illegal drugs, and to define standards for this estimation. Method A systematic literature search was conducted between April and May 2015 and updated in November 2015. Pubmed, Scopus, and Google Scholar were searched. Studies were included only if they provided indications of analytical methods for calculating the social cost of illegal drugs consumption. Results A total of 21 papers were selected for a final review. Four main areas of discussion were identified: a) alternative theories for the framework design; b) basic concepts definition; c) theoretical issues in the application of the framework and; d) definition of the cost matrix and its elements. The review exercise enabled the definition of two analytical approaches, which are proposed as references for estimation in the field. Conclusions although social cost is a well-established method in the literature, there is a lack of agreement on the most appropriate approaches in the area of estimation of the social cost of illegal drugs consumption. Moreover, the two analytical approaches proposed are aimed at promoting more research focused at sophisticating the methodology in the field.Batas Nómadas en Madrid Salud: el arte y los artistas en equipos profesionales de salud comunitaria10.1016/j.gaceta.2018.03.0082024-01-10T00:01:00Z2017-01-14T00:03:00ZCastillejo, MarFernández-Cedena, JorgeSiles, SilviaClaver, María DoloresÁvila, Noemí
<em>Castillejo, Mar</em>;
<em>Fernández-Cedena, Jorge</em>;
<em>Siles, Silvia</em>;
<em>Claver, María Dolores</em>;
<em>Ávila, Noemí</em>;
<br/><br/>
Resumen Objetivo Este artículo describe la estrategia de incorporación de artistas en los equipos de profesionales de salud comunitaria en la ciudad de Madrid, en concreto en los Centros Madrid Salud. Método El colectivo artístico Batas Nómadas, formado por tres artistas expertos en artes plásticas y visuales, ha utilizado la performance y dinámicas participativas para explicar la incorporación del arte y los artistas en estos equipos de profesionales de Madrid Salud. Resultados El colectivo Batas Nómadas ha intervenido en 14 equipos de trabajo de los Centros Madrid Salud (CMS) y recogido datos de forma creativa, de los y las 179 profesionales participantes. Conclusiones Se han visualizado necesidades de intervención en salud comunitaria, y reflexionado acerca de la utilidad del arte para favorecer el trabajo participativo de los equipos Madrid Salud.¿Medicina herbal o fitoterapia?. No hay lugar para barbarismos en la tierra de Cervantes10.1016/j.gaceta.2018.01.0052024-01-10T00:01:00Z2017-01-14T00:03:00ZLópez-Briz, EduardoLópez-Salvador, BelénEsteban-Fernández, Javier
<em>López-Briz, Eduardo</em>;
<em>López-Salvador, Belén</em>;
<em>Esteban-Fernández, Javier</em>;
<br/><br/>
Número especial de Gaceta Sanitaria sobre la toma de decisiones en salud pública basada en la evidencia10.1016/j.gaceta.2018.05.0012024-01-10T00:01:00Z2017-01-14T00:03:00ZEpstein, DavidBermúdez-Tamayo, ClaraCantarero, DavidNegrín Hernández, Miguel ÁngelÁlvarez-Dardet, Carlos
<em>Epstein, David</em>;
<em>Bermúdez-Tamayo, Clara</em>;
<em>Cantarero, David</em>;
<em>Negrín Hernández, Miguel Ángel</em>;
<em>Álvarez-Dardet, Carlos</em>;
<br/><br/>
Adecuación de las intervenciones selectivas en eventos multitudinarios10.1016/j.gaceta.2017.07.0172024-01-10T00:01:00Z2017-01-14T00:03:00ZGasch Gallén, ÁngelObón Azuara, BlancaTomás Aznar, Concepción
<em>Gasch Gallén, Ángel</em>;
<em>Obón Azuara, Blanca</em>;
<em>Tomás Aznar, Concepción</em>;
<br/><br/>
WebSurvCa: estimación vía web de las probabilidades de fallecimiento y de supervivencia de una cohorte10.1016/j.gaceta.2017.10.0152024-01-10T00:01:00Z2017-01-14T00:03:00ZClèries, RamonAmeijide, AlbertoBuxó, MariaVilardell, MireiaMartínez, José MiguelAlarcón, FranciscoCordero, DavidDíez-Villanueva, AnaYasui, YutakaMarcos-Gragera, RafaelVilardell, Maria LoretoCarulla, MariàGalceran, JaumeIzquierdo, ÁngelMoreno, VíctorBorràs, Josep M
<em>Clèries, Ramon</em>;
<em>Ameijide, Alberto</em>;
<em>Buxó, Maria</em>;
<em>Vilardell, Mireia</em>;
<em>Martínez, José Miguel</em>;
<em>Alarcón, Francisco</em>;
<em>Cordero, David</em>;
<em>Díez-Villanueva, Ana</em>;
<em>Yasui, Yutaka</em>;
<em>Marcos-Gragera, Rafael</em>;
<em>Vilardell, Maria Loreto</em>;
<em>Carulla, Marià</em>;
<em>Galceran, Jaume</em>;
<em>Izquierdo, Ángel</em>;
<em>Moreno, Víctor</em>;
<em>Borràs, Josep M</em>;
<br/><br/>
RESUMEN La supervivencia relativa se ha utilizado habitualmente como medida de la evolución temporal del exceso de riesgo de mortalidad en cohortes de pacientes diagnosticados de cáncer, teniendo en cuenta la mortalidad de una población de referencia. Una vez estimado el exceso de riesgo de mortalidad pueden calcularse tres probabilidades acumuladas a un tiempo T: 1) la probabilidad de fallecer asociada a la causa de diagnóstico inicial (enfermedad en estudio), 2) la probabilidad de fallecer asociada a otras causas, y 3) la probabilidad de supervivencia absoluta en la cohorte a un tiempo T. Este trabajo presenta la aplicación WebSurvCa (https://shiny.snpstats.net/WebSurvCa/), mediante la cual los registros de cáncer de base hospitalaria y poblacional, y los registros de otras enfermedades, estiman dichas probabilidades en sus cohortes seleccionando como población de referencia la mortalidad de la comunidad autónoma que consideren.Differences in the prevalence of diagnosis of overweight-obesity in Spanish children according to the diagnostic criteria set used10.1016/j.gaceta.2017.07.0142024-01-10T00:01:00Z2017-01-14T00:03:00ZAjejas Bazán, María JuliaJiménez Trujillo, María IsabWärnberg, JuliaDomínguez Fernández, SilviaLópez de Andrés, AnaPérez Farinós, Napoleón
<em>Ajejas Bazán, María Julia</em>;
<em>Jiménez Trujillo, María Isab</em>;
<em>Wärnberg, Julia</em>;
<em>Domínguez Fernández, Silvia</em>;
<em>López De Andrés, Ana</em>;
<em>Pérez Farinós, Napoleón</em>;
<br/><br/>
Abstract Objective To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher.Claves infantiles para prevenir la siniestralidad en el contexto escolar10.1016/j.gaceta.2016.07.0072024-01-10T00:01:00Z2017-01-14T00:03:00ZGabari Gambarte, M InésSáenz Mendía, Raquel
<em>Gabari Gambarte, M Inés</em>;
<em>Sáenz Mendía, Raquel</em>;
<br/><br/>
Resumen Objetivo Conocer la percepción infantil sobre las causas y las estrategias de prevención de los accidentes escolares. Método Muestra de 584 escolares de 8 y 9 años de edad, de Navarra. Se elige un diseño mixto mediante cuestionario con tres ítems de respuesta abierta y uno de valoración sugerida y respuesta múltiple. El análisis se realiza en dos fases: 1) cualitativa de elaboración de categorías y dimensiones de las respuestas de contenido narrativo, y 2) cuantitativa de recodificación de variables para análisis correlacional. Resultados Emergen 22 categorías que conforman tres dimensiones perceptivas: 1) atribución de causalidad (5), 2) identificación de mecanismos de evitación (11) y 3) elaboración de estrategias de afrontamiento (6). La correlación intravariables evidencia diversos grados: por un lado, cifras positivas moderadas (r >0,5) en atribución de causalidad y en identificación de mecanismos de evitación, y por otro, valores de correlación positiva elevados (r >0,7) referidos a elaboración de estrategias de afrontamiento. Discusión La población infantil sabe identificar los accidentes como problema de salud, se cuestiona la multiplicidad de elementos implicados y relaciona el origen y el tipo de los accidentes con mecanismos de prevención y de ayuda.Corrigendum to: Population based multicase-control study in common tumours in Spain (MCC-Spain): rationale and study design (Gaceta Sanitaria 2015;29:308-15)10.1016/j.gaceta.2018.04.0042024-01-10T00:01:00Z2017-01-14T00:03:00ZCastaño-Vinyals, GemmaAragonés, NuriaPérez-Gómez, BeatrizMartín, VicenteLlorca, JavierMoreno, VictorAltzibar, Jone MArdanaz, EvaSanjosé, Sílvia deJiménez-Moleón, José JuanTardón, AdoninaAlguacil, JuanPeiró, RosanaMarcos-Gragera, RafaelNavarro, CarmenPollán, MarinaKogevinas, Manolis
<em>Castaño-Vinyals, Gemma</em>;
<em>Aragonés, Nuria</em>;
<em>Pérez-Gómez, Beatriz</em>;
<em>Martín, Vicente</em>;
<em>Llorca, Javier</em>;
<em>Moreno, Victor</em>;
<em>Altzibar, Jone M</em>;
<em>Ardanaz, Eva</em>;
<em>Sanjosé, Sílvia De</em>;
<em>Jiménez-Moleón, José Juan</em>;
<em>Tardón, Adonina</em>;
<em>Alguacil, Juan</em>;
<em>Peiró, Rosana</em>;
<em>Marcos-Gragera, Rafael</em>;
<em>Navarro, Carmen</em>;
<em>Pollán, Marina</em>;
<em>Kogevinas, Manolis</em>;
<br/><br/>
Hacia una salud pública orientada desde los determinantes sociales de la salud: informe de un taller10.1016/j.gaceta.2017.09.0032024-01-10T00:01:00Z2017-01-14T00:03:00ZGonzález Rojo, ElenaÁlvarez-Dardet, CarlosLópez Fernández, Luis Andrés
<em>González Rojo, Elena</em>;
<em>Álvarez-Dardet, Carlos</em>;
<em>López Fernández, Luis Andrés</em>;
<br/><br/>
RESUMEN Este artículo es el producto de los resultados de un taller con expertos y expertas en salud pública realizado en Granada en octubre de 2015, que tuvo por objetivo reflexionar sobre qué elementos clave deberían caracterizar una salud pública orientada desde los determinantes sociales de la salud. La labor de abogacía y la formación de profesionales críticos en defensa de la salud pública fueron señalados como elementos centrales. Hubo acuerdo en que el enfoque de género, la mirada salutogénica, el trabajo con otros sectores y una particular atención a colectivos más desfavorecidos son también elementos indispensables. Se subrayó la importancia de trabajar desde un marco de derechos humanos y de promover cambios legislativos. Además, el grupo señaló como reto la necesidad de generar conocimiento sobre cómo intervenir para reducir las brechas de desigualdad en salud, porque hasta ahora solo se ha avanzado identificando determinantes sociales de la salud y generando marcos conceptuales.Cancer-related knowledge and health status among cancer survivors in Portugal10.1016/j.gaceta.2017.06.0072024-01-10T00:01:00Z2017-01-14T00:03:00ZCosta, Ana RuteMoura-Ferreira, PedroLunet, Nuno
<em>Costa, Ana Rute</em>;
<em>Moura-Ferreira, Pedro</em>;
<em>Lunet, Nuno</em>;
<br/><br/>
Ingesta de flúor a través del consumo de agua de abastecimiento público en la cohorte INMA-Gipuzkoa10.1016/j.gaceta.2017.02.0082024-01-10T00:01:00Z2017-01-14T00:03:00ZJiménez-Zabala, AnaSanta-Marina, LoretoOtazua, MónicaAyerdi, MikelGalarza, AneGallastegi, MaraUlibarrena, EnriqueMolinuevo, AmaiaAnabitarte, AsierIbarluzea, Jesús
<em>Jiménez-Zabala, Ana</em>;
<em>Santa-Marina, Loreto</em>;
<em>Otazua, Mónica</em>;
<em>Ayerdi, Mikel</em>;
<em>Galarza, Ane</em>;
<em>Gallastegi, Mara</em>;
<em>Ulibarrena, Enrique</em>;
<em>Molinuevo, Amaia</em>;
<em>Anabitarte, Asier</em>;
<em>Ibarluzea, Jesús</em>;
<br/><br/>
Resumen Objetivo Estimar la ingesta de flúor en mujeres embarazadas y sus hijos/as de la cohorte INMA-Gipuzkoa a través del consumo de agua de la red municipal y comparar estas ingestas con los valores recomendados. En Euskadi, la fluoración del agua de consumo es obligatoria en abastecimientos de más de 30.000 habitantes. Método Se han incluido 575 mujeres embarazadas (reclutamiento en 2006-2008) y 424 niños/as de 4 años (seguimiento en 2010-2012). Las concentraciones de fluoruros en el agua se obtuvieron del sistema de información de aguas de consumo de Euskadi (EKUIS). Los hábitos de consumo de agua y las variables socioeconómicas se obtuvieron mediante cuestionario. Resultados El 74,9% de las mujeres y el 87,7% de los/las niños/as consumían agua de red municipal. En agua fluorada, el valor medio de fluoruro fue de 0,805mg/l (desviación estándar [DE]: 0,194) durante el periodo de reclutamiento, y de 0,843mg/l (DE: 0,080) durante el seguimiento de los/las niños/as. La ingesta media de flúor y el percentil 95 en las zonas fluoradas fueron de 0,015 y 0,026mg/kg al día en las mujeres y de 0,033 y 0,059mg/kg al día en los/las niños/as. Considerando solo el flúor aportado por el agua, el 8,71% de los/las niños/as residentes en zonas con fluoración superaban la ingesta de 0,05mg/kg al día recomendada por la European Food Safety Authority. Conclusión Los resultados obtenidos muestran que las ingestas de flúor a través del agua de consumo pueden superar lo recomendado en población infantil, y propician futuros estudios que aporten evidencias que puedan ayudar en las políticas de fluoración de las aguas de consumo público.Factores asociados a la respuesta a la violencia del compañero íntimo en atención primaria de salud en España10.1016/j.gaceta.2017.03.0032024-01-10T00:01:00Z2017-01-14T00:03:00ZMurillo, PilarSan Sebastián, MiguelVives-Cases, CarmenGoicolea, Isabel
<em>Murillo, Pilar</em>;
<em>San Sebastián, Miguel</em>;
<em>Vives-Cases, Carmen</em>;
<em>Goicolea, Isabel</em>;
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Resumen Objetivo Analizar la capacidad de respuesta a la violencia del compañero íntimo (VCI) de profesionales sanitarios/as españoles/as en atención primaria e identificar posibles determinantes que puedan favorecer una mejor respuesta. Método Estudio transversal con muestreo no probabilístico y por conveniencia en profesionales sanitarios/as de 15 centros de atención primaria españoles. El instrumento Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), en su versión validada y traducida al español, permitió recolectar información sobre conocimientos, opiniones y prácticas sobre VCI. Se realizaron análisis estadísticos descriptivo y de regresión lineal bivariada y multivariada. Resultados Se recibieron 265 cuestionarios diligenciados, con una tasa de respuesta del 80,3%. Se observó un efecto exposición-respuesta, en el que a más horas de formación, mayor puntuación en las escalas del cuestionario (p <0,05). La edad, el tipo de profesión, los años de experiencia en atención primaria, las horas de formación en VCI y la lectura del protocolo mostraron asociación positiva con conocimientos (preparación percibida, conocimiento percibido, conocimiento real), opiniones (preparación del equipo, requerimientos legales, autoeficacia, disponibilidad de recursos en el lugar de trabajo, barreras, entendimiento de la víctima) y prácticas del personal sanitario. Conclusiones Leer el protocolo de actuación regional/nacional y recibir formación en VCI fueron las intervenciones más importantes asociadas a una mejor capacidad de respuesta a la VCI de los/las profesionales sanitarios/as en atención primaria.