Gaceta Sanitaria最新文献

{"title":"Aborto en Melilla: barreras de océano y frontera","authors":"Eva Estévanez Jiménez ,&nbsp;Maite Cruz Piqueras","doi":"10.1016/j.gaceta.2024.102355","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102355","url":null,"abstract":"<div><h3>Objective</h3><p>To provide insights into the challenges faced by women seeking abortion services in Melilla, Spain. It seeks to describe the journey these women undertake and to identify and analyze the barriers they encounter in accessing abortion care.</p></div><div><h3>Method</h3><p>A qualitative research approach was employed, involving a series of eight semi-structured interviews during 2022. Three interviews were conducted with national experts in the field of abortion, while five interviews were conducted with healthcare professionals from the Melilla Health Area who are directly involved in providing abortion services and supporting women throughout the process. The study was guided by a theoretical framework that focuses on barriers to abortion access and sexual and reproductive rights. The collected data was analyzed using content analysis and categorized based on key dimensions of the study.</p></div><div><h3>Results</h3><p>The study identified several significant barriers to abortion care access in Melilla. These include conscientious objection among healthcare providers, the geographical remoteness of Melilla, the legal challenges faced by Moroccan women due to their irregular status, and the requirement of parental consent for minors aged 16 and 17. Consequently, women seeking abortion services are forced to travel to mainland Spain, continue with undesired pregnancies, or resort to unsafe clandestine abortions in Morocco, thereby endangering their lives in the worst cases.</p></div><div><h3>Conclusions</h3><p>The barriers to abortion access identified in this study represent a violation of women's reproductive rights in Melilla. Urgent action is required to review the current process, ensuring that access is improved and the right to safe abortion is guaranteed for all women residing in Melilla.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102355"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000025/pdfft?md5=51bfe659080b31405fb4ca03b370b8c4&pid=1-s2.0-S0213911124000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"John E. Wennberg (1935-2024). Apoyando la hipótesis nula","authors":"Enrique Bernal-Delgado","doi":"10.1016/j.gaceta.2024.102431","DOIUrl":"10.1016/j.gaceta.2024.102431","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102431"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption of hypnosedatives in Spain: characterization and time trends, 2005-2022","authors":"Nerea Mourino ,&nbsp;Ana Teijeiro ,&nbsp;Carla Guerra-Tort ,&nbsp;Julia Rey-Brandariz ,&nbsp;Cristina Candal-Pedreira ,&nbsp;Lucía Martín-Gisbert ,&nbsp;Marta Mascareñas-García ,&nbsp;Guadalupe García ,&nbsp;Leonor Varela-Lema ,&nbsp;Mónica Pérez-Ríos","doi":"10.1016/j.gaceta.2024.102433","DOIUrl":"10.1016/j.gaceta.2024.102433","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the evolution of hypnosedative use in the Spanish population aged 15 to 64 (2005-2022), identifying regional variations and changes in users profile.</div></div><div><h3>Method</h3><div>We used data from the Survey on the Use of Alcohol and other Drugs in Spain. Past 30-day use was analyzed by sex, age and autonomous community between 2005 and 2022. A multivariate logistic regression was used to identify characteristics of consumption; the temporal trend of prevalence and adjusted odds ratio were evaluated using joinpoint regression models.</div></div><div><h3>Results</h3><div>Between 2005 and 2022, the prevalence of hypnosedative use in Spain increased (from 3.7% to 9.7%) with an annual percentage change of 4.7%. The maximum increase was observed among women aged 55 to 64, reaching a prevalence of 21.4% in 2022. Use increased in all autonomous communities, with Cantabria, La Rioja and Andalusia standing out. The likelihood of using hypnosedatives was higher among women, the oldest age groups, those with basic or intermediate education, those unemployed or economically inactive, those not living with a partner or family, Spanish citizens, and tobacco or cannabis users.</div></div><div><h3>Conclusions</h3><div>An upward trend in the use of hypnosedatives in Spain has been observed since 2005, with variations according to sex, age, and autonomous community. It is crucial to update regional addiction plans, promote preventive strategies and foster collaboration between health authorities, medical professionals and the population to address mental health inequalities and ensure adequate care and responsible prescribing.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102433"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone use by children in fast food restaurants in Barcelona (Spain): a direct observation study","authors":"Sonia de Paz-Cantos ,&nbsp;Adrián González-Marrón ,&nbsp;Cristina Lidón-Moyano ,&nbsp;Íñigo Cabriada ,&nbsp;María Cerrato-Lara ,&nbsp;Rafael Gómez-Galán ,&nbsp;José M. Martínez-Sánchez","doi":"10.1016/j.gaceta.2024.102421","DOIUrl":"10.1016/j.gaceta.2024.102421","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To explore the use of smartphones at mealtimes by children in fast food restaurants in the city of Barcelona and to assess the variables associated with this use.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A cross-sectional study was carried out. Data from 1616 children of estimated ages between 4 to 10 years were collected in fast-food restaurants in the ten districts of Barcelona between October 2021 and July 2022. The percentage of smartphone use, overall and according to covariates, were calculated. Chi-squared and Fisher's exact tests, and crude and adjusted Poisson regression models with robust variance, were carried out to assess the association between use and covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Direct observation revealed that in 28.1% of meals with children at fast food restaurants, children used smartphones. Smartphone use was significantly higher in older children if their caregivers were younger than 30 years and when there was no caregiver-child interaction. In the adjusted model, higher patterns of smartphone use were associated with older children (aPR [95% CI]: 1.36[1.20-1.55]) and younger parents (aPR [95% CI]: 1.38[1.09-1.73]).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Almost one in three meals with children at fast-food restaurants in Barcelona involves smartphone use. This finding underlines the importance of raising awareness of responsible screen use and promoting healthier environments for children at mealtimes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objetivo&lt;/h3&gt;&lt;div&gt;Explorar el uso de &lt;em&gt;smartphones&lt;/em&gt; en los actos de comida en niños/as en restaurantes de comida rápida de la ciudad de Barcelona y evaluar las variables asociadas a este uso.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Método&lt;/h3&gt;&lt;div&gt;Se llevó a cabo un estudio transversal. Se recogieron datos de 1616 niños/as de edades estimadas entre 4 y 10 años en restaurantes de comida rápida de los diez distritos de Barcelona entre octubre de 2021 y julio de 2022. Se calculó el porcentaje de uso de &lt;em&gt;smartphones&lt;/em&gt;, global y según covariables. Se realizaron pruebas de Chi-cuadrado y exacta de Fisher, y modelos de regresión de Poisson crudos y ajustados con varianza robusta, para evaluar la asociación entre el uso y las covariables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Resultados&lt;/h3&gt;&lt;div&gt;La observación directa reveló que en el 28,1% de las comidas realizadas con niños/as en restaurantes de comida rápida, estos/estas utilizaban &lt;em&gt;smartphones&lt;/em&gt;. El uso de &lt;em&gt;smartphones&lt;/em&gt; fue significativamente mayor en niños/as mayores, si sus cuidadores/as eran menores de 30 años y cuando no había interacción entre cuidador/a y niño/a. En el modelo ajustado, los patrones más altos de uso de teléfonos inteligentes se asociaron con niños mayores (aPR [95% IC]: 1.36[1.20-1.55]) y padres más jóvenes (aPR [95% IC]: 1.38[1.09-1.73]).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusiones&lt;/h3&gt;&lt;div&gt;En casi una de cada tres comidas con niños/as en restaurantes de comida rápida de Barcelona se utiliza el &lt;em&gt;smartphone&lt;/em&gt;. Es","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102421"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reclutamiento, selección y retención de profesionales en servicios de salud de gestión directa. Informe SESPAS 2024","authors":"Ricard Meneu","doi":"10.1016/j.gaceta.2024.102381","DOIUrl":"10.1016/j.gaceta.2024.102381","url":null,"abstract":"<div><p>In an organization with highly specialized and changing services over the course of a working life, such as health services managed directly by public administrations (DM-NHS) are, the issues related to the recruitment, selection and retention of professionals should receive special attention. much larger than what is provided. For too long, the DM-NHS has mainly been working to resolve the problems that affect the organization, with enormous disregard for those suffer by the recipients of its services, the real population to which it provides assistance. In the DM-NHS, its administration (rather than management) of human resources is circumscribed by the contours of the Framework Statute and its implementing regulations and rulings. This is an inadequate instrument, both empirically in view of the results obtained (50% temporary employment among professionals working in the NHS), and conceptually, since it fails to comply with the reasons that normatively justify its existence: “that its legal regime is adapts to the specific characteristics of the practice of health professions, as well as the organizational peculiarities of the National Health System”. The text describes the characteristics of statutory regulation and reviews how regulatory restrictions affect recruitment, selection and retention policies. Finally, possible alternatives are proposed to have coherent and rational permanent staffing policies that cover the real needs of the health services.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102381"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000281/pdfft?md5=0e5f68edc4fc4687a6b75d9cd590416f&pid=1-s2.0-S0213911124000281-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestión de recursos humanos en sanidad. Vías de avance consensuables. Informe SESPAS 2024","authors":"Miguel Angel Negrín ,&nbsp;Vicente Ortún","doi":"10.1016/j.gaceta.2024.102394","DOIUrl":"10.1016/j.gaceta.2024.102394","url":null,"abstract":"<div><p>Healthcare professionals deserve good management, and Spain, stagnant in its productivity, needs it. Good management is possible, as evidenced during the states of alarm in 2020. None of the lessons learned have been consolidated. Dismissing the term “public management” as an oxymoron is extreme, as there has never been a greater need for a well-functioning state, along with a better market, for reasons beyond the consolidation of the welfare state. The opposite extreme of thinking that salvation lies only within the civil service is also unhelpful. Bureaucratic sclerosis, a sign of deterioration, focused on legality or its appearance, cannot continue to ignore the need for effectiveness. The quality of management, both in general and in the healthcare sector, can be measured, and there is knowledge on how to improve it. More flexible models of labor relations —for selection, recruitment, and retention based on improved criteria of “equality, merit, and capability”— require modifications in institutional architecture, as proposed in this article: competitor benchmarking among autonomous centers and responsible entities that share standardized rules. The healthcare system, the jewel of the country, thanks in large part to the quality of its human resources, not only deserves to have its potential unleashed but can also lead the necessary increase in its resolution capacity, ensuring its impact on social well-being. It can also document its research and innovative capabilities in intellectual property, thereby contributing to the gross domestic product.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102394"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000414/pdfft?md5=7abd87a1cf775db7e0bc687c3e2f68ab&pid=1-s2.0-S0213911124000414-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance and inequalities in catastrophic health spending in cancer patients. A cross-sectional study in China","authors":"Wenqi Fu ,&nbsp;Jufang Shi ,&nbsp;Chaojie Liu ,&nbsp;Wanqing Chen ,&nbsp;Guoxiang Liu ,&nbsp;Jie He","doi":"10.1016/j.gaceta.2024.102397","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102397","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the role of social health insurance programs in reducing inequality in the incidence and intensity of catastrophic health expenditure (CHE) of cancer patients in China.</p></div><div><h3>Method</h3><p>A convenient sample of 2534 cancer patients treated in nine hospitals in 2015 and 2016 were followed up through face-to-face interviews in March-December 2018. The incidence and intensity (mean positive overshoot) of CHE (≥ 40% household consumption) were calculated.</p></div><div><h3>Results</h3><p>About 72% of cancer patients experienced CHE events after insurance compensation, with the catastrophic mean positive overshoot amounting to 28.27% (SD: 15.83%) of the household consumption. Overall, social insurance contributed to a small percentage of drop in CHE events. Income-related inequality in CHE persisted before and after insurance compensation. Richer patients benefit more than poorer ones.</p></div><div><h3>Conclusions</h3><p>Cancer treatment is associated with high incidence of CHE events in China. The alleviating effect of social health insurance on CHE events is limited.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102397"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021391112400044X/pdfft?md5=ea69f9f4e1fa7648ab7dd9b6879e1259&pid=1-s2.0-S021391112400044X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Qué necesitamos para «hacer comunitaria»? Veinticinco medidas prácticas para gerencias y equipos de atención primaria","authors":"Asier Calvo Álvarez de Arkaia ,&nbsp;Carmen Belén Benedé Azagra ,&nbsp;Mikel Gandarias Jaio ,&nbsp;Adrián Cardo Miota ,&nbsp;Mariano Hernán García","doi":"10.1016/j.gaceta.2024.102403","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102403","url":null,"abstract":"<div><h3>Objective</h3><p>Identify and clarify what practical organizational measures would promote the development of level 2 (community-oriented group health education) and level 3 (community action) community activities in Primary Health Care (PHC) from the perspective of medical professionals with training and experience in this area.</p></div><div><h3>Method</h3><p>Exploratory, descriptive and cross-sectional study carried out using qualitative methodology using two techniques: 3 focus groups (24 participants) and 12 open questionnaires (12 participants).</p></div><div><h3>Results</h3><p>25 measures are defined to promote the development of these activities that are the responsibility of management and Primary Care Teams (PCT). The most notable proposals are: enhance training in community health, incorporate community activity into the work agendas of professionals, political prioritization and support from management, ensure the job stability of the teams, strengthen the recognition of activities community, resize the patient population of professionals, strengthen multidisciplinary work, cohesion and an autonomous and flexible organization in the PCT, and have the support of the coordinations-directions of the PCT.</p></div><div><h3>Conclusions</h3><p>Three proposals have been considered fundamental to promote the development of level 2 and level 3 community activities in PHC: 1) promote training in community health; 2) incorporate community activity into the work agendas of professionals; 3) political prioritization and support from management for the development of these two levels of work in PHC. Six other proposals have been recognized as being of special importance.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102403"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000542/pdfft?md5=3671b95a53ee783b812db2026ed3f0a9&pid=1-s2.0-S0213911124000542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lack of data and the conceptual mistakes in assessing public-private partnerships as a form of healthcare privatization","authors":"Guillem López-Casasnovas","doi":"10.1016/j.gaceta.2024.102363","DOIUrl":"10.1016/j.gaceta.2024.102363","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102363"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000104/pdfft?md5=8fa323df8f3aea7a9823e972446746ac&pid=1-s2.0-S0213911124000104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitude towards health promotion in university students. Construction and validation of a scale","authors":"Francisca María García-Padilla,&nbsp;Miriam Sánchez-Alcón,&nbsp;Elena Sosa-Cordobés,&nbsp;Ángela María Ortega-Galán,&nbsp;Almudena Garrido-Fernández","doi":"10.1016/j.gaceta.2024.102395","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102395","url":null,"abstract":"<div><h3>Objective</h3><p>To construct and validate a questionnaire about the attitude of university students toward health promotion.</p></div><div><h3>Method</h3><p>A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales.</p></div><div><h3>Results</h3><p>A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate.</p></div><div><h3>Conclusions</h3><p>The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102395"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000426/pdfft?md5=9e485d925a9021bfe5d9cd705c98225f&pid=1-s2.0-S0213911124000426-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}