Gaceta Sanitaria最新文献

{"title":"Proyecto Alifara: experiencia de un análisis de salud participativo en comunidades rurales de la Comunidad Valenciana","authors":"Consuelo García Carbó ,&nbsp;Viola Cassetti ,&nbsp;Manel Monfort Lázaro","doi":"10.1016/j.gaceta.2024.102426","DOIUrl":"10.1016/j.gaceta.2024.102426","url":null,"abstract":"<div><div>A description of the Alifara Project is provided a participatory process to promote community health. In 2020, a core working group was created in the rural region of Els Ports, in the north of the Valencian Community, Spain, with the participation of 39 people, including professionals and community members. The core group itself designed the first health needs assessment survey, based on the health determinants they considered relevant in their context, and 1180 responses were collected. The results were presented in each town through focus groups or world café to gather suggestions for health promoting activities to implement locally. Finally, the process set the basis for the creation of a local health council, to implement the new Community Health Care Plan of the Valencian Community. Community engagement and partnerships were the key to the success of the process, while the limited resources and lack of training in data analysis were the main challenges.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102426"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484105","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":"Experiencias menstruales y aceptabilidad de una intervención sobre equidad menstrual en adolescentes en Cataluña","authors":"Andrea García-Egea ,&nbsp;Tomàs López-Jiménez ,&nbsp;Constanza Jacques-Aviñó ,&nbsp;Anna María Morero Beltrán ,&nbsp;Aina Pi Sánchez ,&nbsp;Cristina Martínez-Bueno ,&nbsp;Neus Carrilero-Carrió ,&nbsp;Anna Berenguera ,&nbsp;Laura Medina-Perucha","doi":"10.1016/j.gaceta.2024.102415","DOIUrl":"10.1016/j.gaceta.2024.102415","url":null,"abstract":"<div><h3>Objective</h3><p>To explore menstrual knowledge, menstrual management, the use of menstrual products, the prevalence of menstrual poverty and to assess the acceptability of a menstrual equity intervention among students in the fourth grade of compulsory secondary education in Catalonia (Spain).</p></div><div><h3>Method</h3><p>Post-intervention mixed-methods study (cross-sectional study and qualitative study with focus groups) with a critical and gender perspective. It was conducted between July 2022 and March 2023. Descriptive and bivariate statistical analyses stratified by gender were carried out. Qualitative data were analysed using thematic analysis.</p></div><div><h3>Results</h3><p>Women and people who menstruate rated the intervention favourably, while some men were reluctant. The intervention promoted the use of some reusable menstrual products, although some barriers to use menstrual cups were identified. Participants reported institutional barriers to menstrual management in the school setting and 19.4% stopped attending school during menstruation in the 6 months prior to the study. Between 10.9-16.4% reported menstrual poverty in the 6 months prior to the study, and 29,0% took actions to reduce the environmental impact of menstrual products.</p></div><div><h3>Conclusions</h3><p>This study highlights the need for co-designing menstrual interventions that consider gender dynamics and sexist attitudes with students, as well as targeting it to teachers. The provision of reusable menstrual products can be helpful in promoting their use, although accompaniment should be provided. In parallel, it is crucial to strengthen menstrual education, as well as to reduce menstrual poverty and school absenteeism during menstruation.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102415"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000670/pdfft?md5=f5df787c09134ffa5af5a31ef6b60de0&pid=1-s2.0-S0213911124000670-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763488","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":"La práctica dual público-privada en la sanidad española. ¿Solución o problema? Informe SESPAS 2024","authors":"Ariadna García-Prado ,&nbsp;Paula González","doi":"10.1016/j.gaceta.2024.102379","DOIUrl":"10.1016/j.gaceta.2024.102379","url":null,"abstract":"<div><p>The Spanish public health system is overburdened. As a result, heath care professionals are showing symptoms of burnout, while private health services are expanding more than ever. As revealed by numerous strikes in recent years, health care professionals want better pay and work conditions and feel frustrated by their inability to give proper time and care to their patients. The institutional response from regional governments in Spain has been to remove the exclusivity clause that provided a salary bonus for physicians who worked entirely in the public sector; now all physicians receive this bonus, effectively promoting dual (public and private) practice. Although dual practice may increase the income of physicians and other health professionals, it poses several challenges that are analyzed in this paper. We also discuss alternative and more far-reaching policies that we believe should be implemented by the government in order to deal with the current crisis of the health system.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102379"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000268/pdfft?md5=687eddb9c106d2aae98da69c10a83746&pid=1-s2.0-S0213911124000268-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871769","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":"Recursos humanos del Sistema Nacional de Salud. Formación. Informe SESPAS 2024","authors":"Felipe Rodríguez de Castro ,&nbsp;Teresa Carrillo Díaz ,&nbsp;Arcadi Gual i Sala ,&nbsp;Jordi Palés Argullós","doi":"10.1016/j.gaceta.2024.102380","DOIUrl":"10.1016/j.gaceta.2024.102380","url":null,"abstract":"<div><p>The problems posed by medical education in Spain are diverse. This paper analyzes the system currently used to select candidates who will be admitted to a public faculty of medicine in Spain and some issues arising from the unprecedented increase in both public and private medical schools in our country. The importance of generic competencies in today's medicine and the need to return to a core design in specialist training are other aspects that are discussed. The degree of development of advanced accreditation diplomas and areas of specific competence is also subject to analysis. Finally, the authors emphasize the importance of continuous professional development and the idea of professional recertification as a system that guarantees patients the quality of the care they receive.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102380"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021391112400027X/pdfft?md5=6e1c1c9846edf4e1cbddb28c61cef436&pid=1-s2.0-S021391112400027X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873941","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":"An overview of health workforce mobility in the European Union under the current supply challenges. SESPAS Report 2024","authors":"Angela Blanco Moreno","doi":"10.1016/j.gaceta.2024.102393","DOIUrl":"10.1016/j.gaceta.2024.102393","url":null,"abstract":"<div><h3>Objective</h3><p>Providing a general overview of the European Union's health workforce mobility under the challenges facing health systems regarding the supply of health workers.</p></div><div><h3>Method</h3><p>We use a descriptive method<em>,</em> based on the analysis of secondary data, qualitative and quantitative, concerning the European Semester from the European Union, complemented with statistical data from both the Union and some international organisations.</p></div><div><h3>Results</h3><p>The mobility of health professionals in the Union, associated to strong reliance on recruiting abroad and shortages due to emigration, was identified as a challenge in the European Semester process in a significant number of times during 2017-2023. The pandemic aggravated pre-existing shortages and the need to strike a balance between maintaining the resolution capacity of health systems while abiding by the free movement of health professionals. The information shows that Romania, Slovakia, Spain, Lithuania, Latvia, Portugal, Bulgaria, Greece, Croatia, Hungary, Italy, and Slovenia could be flagged with an <em>“issuer profile”.</em> Luxembourg, Ireland, Malta, and Sweden could be flagged with a <em>“recipient profile”.</em> We benefited from improvements in the information system concerning the Union's health workforce. Further advances regarding the harmonisation of health professions’ definition are needed, especially for nurses.</p></div><div><h3>Conclusions</h3><p>The European Union faces internal migrations of health professionals. Mobility is used as a solution to shortages. The pandemic aggravated pre-existing shortages bringing to the forefront the need to strike a balance between health objectives and internal market objectives. Member States are immersed in health reforms, some financed with European Funds. Promoting health workforce planning and forecasting would emerge as a necessary action, including improving harmonised information. Drawing in a systematic way on the available information from the European Semester reports may provide some clues to give answers to policymaking concerning health professionals’ mobility.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102393"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000402/pdfft?md5=8630c8e61dfe4dd9c58eafe3376cc9fa&pid=1-s2.0-S0213911124000402-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878211","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":"Estimación retrospectiva de los casos iniciales de COVID-19 en Santiago Región Metropolitana en Chile","authors":"Jenny Márquez ,&nbsp;David García-García ,&nbsp;María Isabel Vigo ,&nbsp;César Bordehore","doi":"10.1016/j.gaceta.2024.102357","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102357","url":null,"abstract":"<div><h3>Objective</h3><p>Estimate daily infections of COVID-19 during the first year of the pandemic in the Santiago Metropolitan Region (SRM) in Chile and Chile that are more realistic than those officially registered.</p></div><div><h3>Method</h3><p>Retrospective estimate of daily infections from daily data on COVID-19 deaths, a seroprevalence study, and the REMEDID (Retrospective Methodology to Estimate Daily Infections from Deaths) algorithm.</p></div><div><h3>Results</h3><p>In SRM, it is observed that: 1) the maximum peak of infections was more than double that registered in the official statistics; 2) such peak was reached on May 22 (95% <span>C</span>I: 20–24 May), 2022, that is, 24 days before the official date of the peak of infections; and 3) the first estimated contagion took place on January 28, 2020 (95% CI: January 21 to February 16), that is, 36 days before the official date. In Chile, the situation is similar. During the first wave SRM accounted for 70%–76% of those infected in Chile, while from August 2020 onwards it accounted for 36%–39%.</p></div><div><h3>Conclusions</h3><p>The official records of COVID-19 infections in SRM and Chile underestimated the real number of positives and showed a delay of about a month in the dynamics of infections. This is not an isolated situation, as it is known to have been the case in other countries as well. However, it is important to have reliable estimates for a correct modeling of the spread of the virus.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102357"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000049/pdfft?md5=7bcb116adde386e16feaee75691a2bde&pid=1-s2.0-S0213911124000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139738411","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":"Diseño de la evaluación de los grupos socioeducativos para hombres en atención primaria","authors":"Antonio Iáñez-Domínguez ,&nbsp;María Soledad Palacios-Gálvez ,&nbsp;Elena Morales-Marente ,&nbsp;Violeta Luque-Ribelles","doi":"10.1016/j.gaceta.2024.102354","DOIUrl":"10.1016/j.gaceta.2024.102354","url":null,"abstract":"<div><p>The Public Health System of Andalusia develops the Socio-Educational Groups Strategy (GRUSE), focused on promoting the health and emotional well-being of those who present somatic symptoms without organic cause in primary care health centers. This intervention began with groups of women and has been extended to groups of men, after verifying that the unemployment caused by the economic crisis, generated discomfort due to the loss of the “productive role”. A mixed methodology research has been designed to measure the effects of GRUSE in male participants. The quantitative design has longitudinal and quasi-experimental section, in which a battery of scales are used as instruments for collecting information. The qualitative design includes semi-structured interviews and focus groups. The objective of this article is to present the design of the research, with which it is expected to collect evidence of the impact of the intervention.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102354"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000013/pdfft?md5=9bf6f90278d64e371c8773e7a821bbf6&pid=1-s2.0-S0213911124000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546848","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":"Políticas en salud laboral en personas trabajadoras mayores: análisis comparativo entre España y Chile","authors":"Cynthia Basualto-Cárcamo ,&nbsp;Nora Gray-Gariazzo ,&nbsp;Fernando G. Benavides","doi":"10.1016/j.gaceta.2024.102382","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102382","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze and compare the current Spanish and Chilean regulations regarding occupational risk prevention, regarding the existence of specific indications that protect the occupational health and safety of people over 55 years of age.</p></div><div><h3>Method</h3><p>Qualitative study in which a documentary content analysis was carried out using ATLAS/ti. The sample was 88 regulatory documents on occupational risk prevention for Spain and Chile. The guidance of the European Agency for Safety at Work (EU-OSHA) regarding age-critical risks was followed.</p></div><div><h3>Results</h3><p>In global terms, 21.9% of the total Spanish documents analyzed show the explicit presence of considerations on aging, while for Chile this occurs in 9%. Both countries mention indications regarding ergonomic risks and noise. Shift work and psychosocial risks are considered only in Spain, while extreme temperatures, vibrations and geographical altitude appear exclusively in Chilean regulations. Neither country refers to issues inherent to working women (care responsibilities, menopause).</p></div><div><h3>Conclusions</h3><p>The Spanish regulations present a greater presence of indications on aging compared to the Chilean one. However, development in this area is insufficient in both countries. Chile and Spain have guides of recommendations, which are not mandatory, and their application is voluntary. This suggests that the prevention of occupational risks has a great pending challenge with people over 55 years of age.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102382"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000293/pdfft?md5=caec459d5f8b4af0c45ac62c3c6ecb41&pid=1-s2.0-S0213911124000293-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140328518","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 case against outsourcing from healthcare services","authors":"Benjamin Goodair,&nbsp;Aaron Reeves","doi":"10.1016/j.gaceta.2024.102362","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102362","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102362"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000098/pdfft?md5=762ed9a51942055178f5eb2eaa2ecc42&pid=1-s2.0-S0213911124000098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674792","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":"La profesión de la salud pública en España: un reto urgente para fortalecer su práctica","authors":"Mireia Llimós ,&nbsp;Andreu Segura-Benedicto ,&nbsp;Fernando G. Benavides","doi":"10.1016/j.gaceta.2024.102364","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102364","url":null,"abstract":"<div><p>The recent health crises have highlighted the weakness of public health structures in Spain. The causes are, among others, the scarcity of economic resources and the delay in their institutional modernization. In addition, there is the weakness of the training processes and the employability. The Spanish Society of Public Health and Health Administration (SESPAS) has developed a White paper of the public health profession with the aim of contributing to strengthening professional practice. The sociodemographic characteristics of the associations federated to SESPAS have been described and the discourse of professionals has been analyzed through six focus groups and 19 interviews (72 people). To agree on the conclusions and recommendations, a meeting was organized with the participation of 29 participants. The demographic and employment data of the 3467 people belonging to seven SESPAS societies show that, overall, about 60% are women and 40% were under 50 years of age. Undergraduate degrees were medicine (35.9%), nursing (17.4%) and pharmacy and veterinary medicine (10.4%). Key aspects of the meaning of public health, training, employability and career and institutionalization of public health were collected through interviews and focus groups. The final meeting agreed on 25 conclusions and 24 recommendations that aim to contribute to strengthening professionals and the public health profession in Spain. Some of them, related to training, employability and professional career, have been shared in a workshop at the School of Public Health of Menorca with public health officials from the Ministry of Health and some autonomous communities.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102364"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000116/pdfft?md5=0e7f9a487c9d9a7e780b61a94ab5f72f&pid=1-s2.0-S0213911124000116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992413","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}