Gaceta Sanitaria最新文献

{"title":"Barreras y facilitadores para la participación en el cribado de cáncer colorrectal de la población migrante y gitana","authors":"Iratxe López-López de Araya ,&nbsp;Yolanda González-Rábago ,&nbsp;Isabel Portillo","doi":"10.1016/j.gaceta.2026.102585","DOIUrl":"10.1016/j.gaceta.2026.102585","url":null,"abstract":"<div><h3>Objective</h3><div>To identify barriers and facilitators to participation in the colorectal cancer screening program (CCSP) in the Basque Country among migrant and Roma populations (aged 50-69), and to explore the differential elements of these factors compared with the general population.</div></div><div><h3>Method</h3><div>We conducted an explanatory–interpretative qualitative study from a socioconstructivist perspective. Data was collected through four focus groups and five triangular groups, with a total of 42 participants, between October 2023 and May 2024, in the Basque Country. A reflexive thematic analysis was done.</div></div><div><h3>Results</h3><div>Barriers identified among migrant and Roma participants differ from hegemonic population’ ones, including educational, linguistic, sociocultural (beliefs about health and prevention), and gender-related factors (care responsibilities, constructions of masculinity). Personalized and in-person care, along with awareness raising by trusted community figures, emerged as key facilitators. While family history and previous health issues acted as facilitators among the hegemonic population, those did not have the same effect among migrant and Roma populations.</div></div><div><h3>Conclusions</h3><div>Participation in the CCSP is constrained by educational, linguistic, sociocultural, and gender-related barriers, manifested in care responsibilities and models of masculinity. An intersectional perspective is essential to understanding how gender, socioeconomic status, and race or ethnicity influence participation in screening programs. The barriers and facilitators identified can guide the development of targeted outreach strategies to engage these communities, such as in-person care and awareness raising through community figures.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102585"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comunicación estratégica de las instituciones y los profesionales de salud pública en tiempos convulsos. Informe SESPAS 2026","authors":"Miguel Ángel Royo-Bordonada ,&nbsp;Pampa García Molina ,&nbsp;Pello Latasa ,&nbsp;Joan Carles March","doi":"10.1016/j.gaceta.2025.102556","DOIUrl":"10.1016/j.gaceta.2025.102556","url":null,"abstract":"<div><div>Misinformation is one of the main global risks threatening public health. During public health crises, which often involve a high degree of scientific uncertainty and a high social demand for information, the infodemic contributes to misinformation. The objective of this article is to analyze how to communicate effectively to contribute to the fulfillment of the public health mission while avoiding misinformation. Strategic communication, one of the essential functions of public health, involves not only providing the right message at the right time, delivering it to the right messenger, and disseminating it through the appropriate channels (mass, community, and interpersonal media), but also defending against the corporate capture of public health. In public health crises, the goal of communication is to enable people to make informed decisions to reduce risk and mitigate the impact of the crisis, recognizing and addressing community concerns and emotions, providing clear and truthful information, without hiding the uncertainties. Traditional media and social media are the primary sources of public health information for the population, especially during crises, so the active presence of public health institutions and professionals in these media is essential. Interinstitutional collaboration between levels of government with expertise in public health, including primary care professionals, and community leaders increases the coherence and effectiveness of messages, avoiding confusion and promoting public trust.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102556"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto de la coordinación en la calidad de la atención y los resultados de salud. Informe SESPAS 2026","authors":"Ana Magdalena Vargas-Martínez ,&nbsp;Gonzalo Duarte Clíments ,&nbsp;Leticia García Mochón ,&nbsp;Asensio López","doi":"10.1016/j.gaceta.2026.102570","DOIUrl":"10.1016/j.gaceta.2026.102570","url":null,"abstract":"<div><div>Care coordination constitutes a fundamental pillar for improving the efficiency of healthcare systems and ensuring the sustainable use of resources. The aim of this chapter is to demonstrate the impact of various coordination strategies on clinical practice variability, continuity of care, patient safety, user satisfaction and experience, as well as on the efficiency and sustainability of health systems. Effective healthcare coordination does not rely on a single intervention, but rather on the synergy between clinical, organizational, technological, and financial components. Reducing unwarranted variations requires a multifaceted approach, including the promotion of evidence-based practice, ongoing professional education, the implementation of clinical audits, and the reinforcement of shared decision-making. At the organizational level, the successful implementation of integrated care models requires a systemic approach tailored to the local context, with a long-term vision that prioritizes patient health outcomes, quality of care, efficiency, and system sustainability.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102570"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buenas prácticas de coordinación en salud comunitaria. Informe SESPAS 2026","authors":"María Isabel Mármol-López ,&nbsp;María Rosa Fraile-Escriche ,&nbsp;Nadia Rodríguez García-Abad ,&nbsp;Jessica Rafael Lafuente ,&nbsp;Ainhoa Ruiz Azarola ,&nbsp;Marc Olivella-Cirici","doi":"10.1016/j.gaceta.2025.102560","DOIUrl":"10.1016/j.gaceta.2025.102560","url":null,"abstract":"<div><div>Community health is currently a key pillar of public health for reducing inequalities, improving quality of life, and ensuring responses tailored to local needs. However, depending on the context, discipline, or location, different perspectives are adopted, sometimes leading to heterogeneous practices and varied approaches that hinder intersectoral work and effective coordination in community health. This coordination involves co-designing interventions adapted to the social, cultural, and economic characteristics of each community, prioritizing prevention and equity, and incorporating a gender, diversity, and sustainability perspective that ensures universal accessibility and environmental justice. Likewise, ongoing professional development and intersectoral coordination, establishing local governance mechanisms, are essential for addressing social and environmental determinants in a comprehensive manner, promoting well-being and equity. The World Health Organization's Framework for Integrated and People-Centered Health Services highlights the centrality of the community. In Spain, there are various coordination initiatives and integrated models involving primary healthcare, public health, the third sector, citizen platforms, and local governments, all collaborating to empower the community and improve collective health. The aim of this article is to review and analyze the initiatives developed in the field of Community Health in Spain, while also identifying examples of best practices.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102560"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European policies on child obesity prevention, health promotion and responsive parenthood within Joint Action Health4EUKids","authors":"Angela Giusti ,&nbsp;Vincenza Di Stefano ,&nbsp;Paola Scardetta ,&nbsp;Francesca Zambri ,&nbsp;Vittorio Palermo ,&nbsp;Annachiara Di Nolfi ,&nbsp;Flavia Splendore ,&nbsp;Apostolos Vantarakis ,&nbsp;Georgios Karydas ,&nbsp;Péter Csizmadia ,&nbsp;Marta García-Sierra ,&nbsp;Päivi Mäki ,&nbsp;Chiara Cattaneo ,&nbsp;Health4EUKids working group","doi":"10.1016/j.gaceta.2026.102584","DOIUrl":"10.1016/j.gaceta.2026.102584","url":null,"abstract":"<div><h3>Objective</h3><div>In the context of the Health4EUKids Joint Action, this study aims to outline the current state of policies and programs related to children's obesity prevention, health promotion, and responsive parenthood for children aged 0-12 years across participating European Union Member States, and to identify gaps.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted between October and December 2023, exploring the main dimensions of the questionnaire: policies and programs general information, target groups and settings, key characteristics, formulation and design, implementation, monitoring and evaluation, dissemination, and inclusion of evidence-based actions. All European Union Member States participating in the Joint Action were invited to respond, and responders were professionals holding key roles in public health, health system governance, and policy implementation<em>.</em> Descriptive statistical analyses were used to summarize quantitative data on policies and programs across countries, while a qualitative descriptive approach was applied to open-ended responses.</div></div><div><h3>Results</h3><div>The survey collected data on 79 policies and programs from 12 European Union Member States. Most policies and programs focus on healthcare (63%), education (25%), and social sectors (10%), targeting primarily children aged 6–11 years. The settings include primary schools, communities, and health services. An inter/multi-sectoral approach was reported in 92% of policies and programs. Policies and programs show varying degrees of innovation, controversy, equity, transferability, and sustainability, while systemic impact and public visibility appear less frequent. The formulation and design of policies and programs included problem analysis in 80%, based on national or local data (79%) and stakeholders’ consultation (79%). Implementation was indicated for most policies and programs (59%), though funding (41%), human resources (29%), stakeholder engagement (46%), and structured planning (46%) appeared relatively strong. Monitoring frameworks were present in 68%, but only 52% reported regular indicator tracking. Dissemination to decision-makers (43%) and the public and media (37%) remains limited.</div></div><div><h3>Conclusions</h3><div>The Health4EUKids Joint Action offers valuable insights into childhood obesity prevention policies across European Union Member States, revealing both promising practices and persistent gaps. Despite strong multisectoral commitment, challenges remain in implementation, monitoring, and resource allocation. Addressing these challenges requires sustained investment in integrated, equity-oriented, and context-sensitive strategies to empower children, families, and communities and to support long-term public health goals.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102584"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial conflicts of interest among authors of clinical practice guidelines in Spain: a cross-sectional analysis","authors":"Sergio Martín-Benlloch ,&nbsp;Sergio Morales-Garzón ,&nbsp;Ángel María Martín Fernández-Gallardo ,&nbsp;Ildefonso Hernández-Aguado","doi":"10.1016/j.gaceta.2026.102582","DOIUrl":"10.1016/j.gaceta.2026.102582","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the financial conflicts of interest (COI) reported by authors of major clinical practice guidelines (CPG) in Spain, based on their COI declaration.</div></div><div><h3>Method</h3><div>We conducted a cross-sectional study comparing the financial COI declared by CPG authors with the transfers of value reported by pharmaceutical companies. Author declarations were extracted from CPG developed for the management of diverse disease conditions. Data on industry transfers of value was obtained from pharmaceutical company websites. The results are presented using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 60 CPG were included, comprising 704 individual authors. As some individuals contributed to more than one CPG, analyses were conducted at the authorship level (n<!--> <!-->=<!--> <!-->810). Only 137 authorships (16.9%) provided accurate COI disclosures, while 430 (53.1%) were inaccurate or missing. In addition, 376 authorships (46.4%) lacked a COI declaration. Overall, more than three quarters of the authorships of CPG supported by five scientific societies were associated with unreliable COI declarations, despite 564 authors (80%) having received transfers of value from the pharmaceutical industry.</div></div><div><h3>Conclusions</h3><div>This study assessed the accuracy of financial COI disclosures among authors of CPGs and identified gaps in transparency. Further research is needed to determine their implications on clinical recommendations and healthcare decision-making.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102582"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Control epidémico y certificado médico de defunción con recuento rápido de causas de muerte. Réplica","authors":"Susana Monge ,&nbsp;Sandra Campos ,&nbsp;María Sastre ,&nbsp;Diana Gómez-Barroso ,&nbsp;Elena Vanessa Martínez ,&nbsp;María José Sierra","doi":"10.1016/j.gaceta.2025.102557","DOIUrl":"10.1016/j.gaceta.2025.102557","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102557"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimación de la resistencia a la insulina mediante antropometría y glucosa en ayunas en población mexicana","authors":"María Guadalupe López-Velázquez,&nbsp;Nicolás Camacho-Calderón,&nbsp;Jorge Arturo Torres-Juárez,&nbsp;María del Rosario Moreno-Ramírez,&nbsp;Aida Guadalupe Díaz-Martel,&nbsp;David Salvador Díaz-Ortegón,&nbsp;Siddhartha Mondragón-Rodríguez,&nbsp;César Campos-Ramírez","doi":"10.1016/j.gaceta.2025.102551","DOIUrl":"10.1016/j.gaceta.2025.102551","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and internally validate a mathematical model to estimate insulin resistance (IR) using two variables: body mass index (BMI) and fasting glucose. This model is called “BMI-glucose index”.</div></div><div><h3>Method</h3><div>Cross-sectional study in a Mexican population. 112 participants were evaluated using standardized blood sampling methods and anthropometric measurements. A mathematical model was obtained using binomial logistic regression, internally validated, and its clinical utility was determined.</div></div><div><h3>Results</h3><div>The BMI-glucose index had an AUC of 0.872 (95%<span>C</span>I: 0.807-0.936; p &lt;<!--> <!-->0.001) and a cutoff point of 0.30, with a sensitivity of 93% and a specificity of 69%.</div></div><div><h3>Conclusions</h3><div>Our results show good preliminary diagnostic capacity, which should be confirmed in larger, longitudinal population studies for its possible application in primary healthcare as a screening method to detect individuals with IR<strong>.</strong></div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102551"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relación entre el índice de privación y los sucesos adversos en cáncer colorrectal y de mama en el País Vasco","authors":"Nerea González-Hernández ,&nbsp;María José Legarreta ,&nbsp;Urko Aguirre ,&nbsp;Susana García-Gutiérrez ,&nbsp;Eduardo Millán Ortuondo ,&nbsp;Nere Larrea ,&nbsp;José María Quintana","doi":"10.1016/j.gaceta.2025.102549","DOIUrl":"10.1016/j.gaceta.2025.102549","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the relationship between deprivation index and mortality, readmissions, and recurrences in two cohorts of cancer patients in the Basque Country.</div></div><div><h3>Method</h3><div>Analytical observational study in two cohorts, colorectal cancer and breast cancer. Patients with colorectal cancer were recruited from eight hospitals in the Basque Health Service - Osakidetza between June 2010 and December 2012. Patients with breast cancer were recruited from six hospitals in the Basque Health Service - Osakidetza between April 2013 and May 2015. Sociodemographic and clinical data were collected at the start of the study and 1, 2, 3, and 5 years after surgery in the first cohort, and at the start of the study and 2 years after diagnosis in the second cohort.</div></div><div><h3>Results</h3><div>In the bivariate analyses, the deprivation index showed no relationship with any of the three parameters studied in any of the follow-up periods in the colorectal cancer cohort. In the breast cancer cohort, a statistically significant association was found between the deprivation index and recurrence, which was higher in quintiles 1 and 5 (p<!--> <!-->=<!--> <!-->0.001), and in the probability of readmission, which was higher in quintiles 1, 2, and 3 (p<!--> <!-->=<!--> <!-->0.001). In the multivariate analyses, no differences were found according to the deprivation index in any of the outcomes studied in either of the two cohorts.</div></div><div><h3>Conclusions</h3><div>In this study, no significant differences were found in mortality, recurrence, or readmission according to the deprivation index.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102549"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El Sistema Único de Salud de Brasil: trayectoria y desafíos","authors":"Eleonor Minho Conill ,&nbsp;Ligia Giovanella","doi":"10.1016/j.gaceta.2026.102573","DOIUrl":"10.1016/j.gaceta.2026.102573","url":null,"abstract":"<div><div>Established in 1988, the Unified Health System (SUS) unified the public system by transferring social security resources to states and municipalities. Its principles are universal access, fiscal financing, decentralization, and regional organization guided by primary health care. Financing is the responsibility of the three levels of government, with increasing municipal participation. Total health expenditure is 9.8% of GDP, with 44% public, 29% from private insurance, and 22% out-of-pocket spending. Underfunding has been an obstacle since SUS's creation, as public spending being lower than private constitutes a barrier to the principle of universal access. Governance proposes collegial decision-making between government levels and social participation, but in practice management is still fragmented, influenced by political-party interests and high turnover of managers, making it difficult the build of integrated networks. Nevertheless, the expansion of primary health care through the Family Health Strategy in 5570 municipalities, with 53,000 teams and 280,000 community agents, has had positive impacts. The current agenda of regionalization and expansion of specialized care aims to reduce waiting times, strengthen system legitimacy, and could promote its reconstruction from the ground up. Integrated public-private regulation and structural limits on social spending remain persistent challenges.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102573"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}