Gaceta Sanitaria最新文献

{"title":"La eutanasia: un estudio de metodología mixta sobre la experiencia de los referentes en Cataluña","authors":"Núria Masnou ,&nbsp;Anna Quintanas ,&nbsp;Carla Planas ,&nbsp;Albert Planes","doi":"10.1016/j.gaceta.2024.102435","DOIUrl":"10.1016/j.gaceta.2024.102435","url":null,"abstract":"<div><h3>Objective</h3><div>To identify strengths and challenges in the provision of assistance in dying (PAM) based on the experiences of the Catalan Health Institute (ICS) euthanasia referents.</div></div><div><h3>Method</h3><div>Mixed-methods study (n<!--> <!-->=<!--> <!-->31), using two closed-ended questionnaires (quantitative analysis) and two structured interviews with open-ended fields (qualitative analysis), self-administered via email. All ICS referents (n<!--> <!-->=<!--> <!-->50) received them. The first questionnaire (n<!--> <!-->=<!--> <!-->31) and interview (n<!--> <!-->=<!--> <!-->12) were addressed to all referents. The second questionnaire (n<!--> <!-->=<!--> <!-->7) and interview (n<!--> <!-->=<!--> <!-->6) were directed only to those who had also directly participated in a PAM. The results were triangulated and are presented as an integrated analysis.</div></div><div><h3>Results</h3><div>From the integration of quantitative and qualitative responses, six thematic blocks emerged: 1) dedication and compensation; 2) training; 3) weak points and difficulties; 4) emotional and psychological impact; 5) considerations on end-of-life issues; and 6) motivations and advice from contacts. From the joint analysis, proposals for improvement were concluded: compensate for the workload that PAM implies, improve training, ensure that conscientious objection is in accordance with the law, and review aspects of the LORE, as procedures, deadlines, interdisciplinarity, ambiguities, and excluded cases. It was established: the usefulness of the referent role; respecting patient autonomy offsets negative emotions in professionals; PAM promotes reflection on the purposes of medicine.</div></div><div><h3>Conclusions</h3><div>Euthanasia referents’ experiences can guide other professionals and suggest guidelines for institutional leaders and health managers.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102435"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782230","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 ley de eutanasia y experiencias profesionales: tensiones en la práctica clínica","authors":"Maria Verdaguer ,&nbsp;Patricia Beroiz-Groh ,&nbsp;Xavier Busquet-Duran ,&nbsp;Eduard Moreno-Gabriel ,&nbsp;Antonia Arreciado Marañón ,&nbsp;Maria Feijoo-Cid ,&nbsp;Miquel Domènech ,&nbsp;Lupicinio Íñiguez-Rueda ,&nbsp;Núria Vallès-Peris ,&nbsp;Gloria Cantarell-Barella ,&nbsp;Pere Toran-Monserrat","doi":"10.1016/j.gaceta.2024.102373","DOIUrl":"10.1016/j.gaceta.2024.102373","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the process of assisted death provision in Catalonia and identify the main tensions, difficulties, and/or sources of discomfort related to professional practice.</div></div><div><h3>Method</h3><div>A qualitative study was conducted based on interviews (n<!--> <!-->=<!--> <!-->29) and focus groups (n<!--> <!-->=<!--> <!-->19) with professionals who participated in the euthanasia process. The selection of participants combined the snowball and maximization of variability procedures, taking into account the variables of professional profile, setting, gender, age and territoriality. Intentional and theoretical sampling process.</div></div><div><h3>Results</h3><div>The assisted death process is divided into four main moments: 1) reception of the request, 2) medical-bureaucratic procedure, 3) the actual procedure, and 4) closure. At each of these moments, difficulties arise that can be a source of discomfort and have to do with the limits and tensions between the legal and moral, the conception of one's own professional role, the lack of recognition of some professional roles, stress and overload, the lack of formal and informal support, and the relationship with the patient and his/her family. The bureaucratic-administrative stress derived from a protective law, with both prior and subsequent verifying control, stands out, given that it stresses the professionals immersed in a healthcare system already under high pressure after budget cuts and the COVID-19 epidemic.</div></div><div><h3>Conclusions</h3><div>Throughout the assisted death process, the sources of distress are diverse and of a psychological, psychosocial, and structural nature. These results may lead to interventions for psychological and peer support, information, training, institutional involvement, and burden reduction.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102373"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112489","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":"Primera cita de Aedes albopictus para Galicia, obtenida mediante ciencia ciudadana por Mosquito Alert","authors":"Yasmina Martínez-Barciela ,&nbsp;Alejandro Polina González ,&nbsp;José Manuel Pereira Martínez ,&nbsp;Fernando Cobo Gradín ,&nbsp;Josefina Garrido González ,&nbsp;Xabier Abalo Costa ,&nbsp;Ánxela Pousa Ortega ,&nbsp;Elvira Íñiguez Pichel ,&nbsp;Manuel Álvarez Cortiñas ,&nbsp;Roger Eritja","doi":"10.1016/j.gaceta.2024.102374","DOIUrl":"10.1016/j.gaceta.2024.102374","url":null,"abstract":"<div><div>The first detection of the tiger mosquito, <em>Aedes (Stegomyia) albopictus</em> (Skuse, 1894), in the autonomous community of Galicia (Spain) is reported. The finding has been possible thanks to the collaboration between citizens, the citizen science application Mosquito Alert and the Rede Galega de Vixilancia de Vectores (ReGaViVec). At the beginning of August 2023, a same person submitted through the app several reports consistent with the tiger mosquito in the municipality of Moaña, in Pontevedra. The ReGaViVec entomological team confirmed the species and conducted vector surveillance in the area by placing traps (11 ovitraps and 3 BG-Sentinel 2 with BG-Lure attractant) with a weekly collection frequency. This finding represents the most northwestern detection of the tiger mosquito in the Iberian Peninsula and shows the crucial role of citizen science in vector surveillance.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102374"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190500","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":"Desgaste profesional: tiempo para la política sanitaria","authors":"Vicente Ortún","doi":"10.1016/j.gaceta.2024.102389","DOIUrl":"10.1016/j.gaceta.2024.102389","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102389"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756759","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":"Los retos de la gobernanza de los recursos humanos de la sanidad pública. Informe SESPAS 2024","authors":"Javier Hernández Pascual","doi":"10.1016/j.gaceta.2024.102377","DOIUrl":"10.1016/j.gaceta.2024.102377","url":null,"abstract":"<div><p>Recurrent imbalances between supply, demand and personnel needs are one of the main challenges facing the National Health System (NHS). This situation has its origin both in supply factors and in the conditioning factors of the demand for human resources in the public health sector. The demographic structure of the NHS health professionals is generating an increasing number of outflows of doctors and nurses. On the other hand, the complex institutional architecture of the public health system produces dysfunctions in the structure of demand and in the form of recruitment. This paper argues for the need to articulate a strategic response that addresses the improvement of the governance of the human resources of the NHS and the reform of the instruments of coordination and harmonization of actions at the three levels of government of public healthcare.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102377"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000244/pdfft?md5=1e70c471989272847cae605b00317ee5&pid=1-s2.0-S0213911124000244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872812","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":"Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women","authors":"Miguel Requena ,&nbsp;Mikolaj Stanek","doi":"10.1016/j.gaceta.2024.102419","DOIUrl":"10.1016/j.gaceta.2024.102419","url":null,"abstract":"<div><h3>Objective</h3><p>Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition.</p></div><div><h3>Method</h3><p>Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories.</p></div><div><h3>Results</h3><p>Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate.</p></div><div><h3>Conclusions</h3><p>The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102419"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000712/pdfft?md5=3ed209b019af3d76eff4314c9dd420f6&pid=1-s2.0-S0213911124000712-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918357","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":"Recensión bibliográfica","authors":"José Pulido Manzanero","doi":"10.1016/j.gaceta.2024.102396","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102396","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102396"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000438/pdfft?md5=e0b471ece746b2676a4e79a0aa4730b8&pid=1-s2.0-S0213911124000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918824","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 protección de la salud de jóvenes y adolescentes exige una subida urgente de los precios del tabaco","authors":"Josep M. Suelves ,&nbsp;Ángel López-Nicolás ,&nbsp;Eduardo Satué de Velasco ,&nbsp;Anna García-Altés","doi":"10.1016/j.gaceta.2024.102405","DOIUrl":"10.1016/j.gaceta.2024.102405","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102405"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000566/pdfft?md5=125def502e75d7dcfe61962dcebb533b&pid=1-s2.0-S0213911124000566-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181654","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":"Evaluación piloto del programa «Transformem els patis» en escuelas de primaria de Barcelona","authors":"Jesús Periañez ,&nbsp;Xavier Continente ,&nbsp;Marta Sanz-Mas ,&nbsp;Gemma Drou ,&nbsp;Albert Espelt ,&nbsp;Emma Cortés ,&nbsp;María José López","doi":"10.1016/j.gaceta.2024.102429","DOIUrl":"10.1016/j.gaceta.2024.102429","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the “Transformem els patis” (Let's transform the schoolyards) program in Barcelona in terms of schoolyard use, social interaction, physical activity, and diverse forms of play with a gender perspective.</div></div><div><h3>Method</h3><div>A cross-sectional pilot evaluation study with mixed methodology involving eight primary schools (four in intervention group and four in control group). For the quantitative analysis, 16 systematic observations were performed in the schoolyards of both groups. The group size, group composition according to sex, physical activity, the carried-out activity and play structures or material use, and environmental variables were analyzed. For the qualitative analysis, three structured group interviews were held with teachers and the monitoring team of the intervention group. A thematic content analysis with a phenomenological perspective was conducted, exploring changes related to the physical schoolyard transformation, its educational use, and interactions among children, and the overall assessment of the schoolyard transformation.</div></div><div><h3>Results</h3><div>192 groups of schoolchildren were observed in the intervention group and 203 in the control group. The transformed schoolyards had more natural elements, play structures, places to sit and non-cemented flooring. Compared to the non-transformed schoolyards, both in the boys’ and girls’ groups, a higher proportion of active play was registered, as well as a higher proportion of non-sport games and imaginative games among boys and a lower proportion of girls watched the schoolyard.</div></div><div><h3>Conclusions</h3><div>Transformed the schoolyards are more inclusive, naturalized, playable, and equitable, with a greater diversity of elements and play structures.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102429"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607674","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 sabemos y qué deberíamos saber sobre los desequilibrios de médicos en España? Diagnóstico y propuestas. Informe SESPAS 2024","authors":"Beatriz González López-Valcárcel,&nbsp;Patricia Barber Pérez","doi":"10.1016/j.gaceta.2024.102366","DOIUrl":"10.1016/j.gaceta.2024.102366","url":null,"abstract":"<div><p>This article characterizes the main features of the supply, demand, and labor markets for physicians in Spain, with an international and territorial perspective. It also presents some of the results of the simulation model for specialist physicians with a 2035 horizon and proposes strategic and short-term lines of action in the planning, regulation, and management of health professionals in Spain, with a focus on specialist physicians. In Spain there are high rates of physicians and medical graduates, but low rates of nurses, compared to other developed countries. Approximately 30% of practicing physicians (not considering residents) practice only in the private network. In the last two decades, competition from the private sector for health professionals has intensified, competing with the public network, which is subject to an excessively rigid regulatory framework. There is currently a shortage of physicians in some specialties, particularly in family medicine, which urgently needs specific incentives to stimulate vocations. Numbers consider only part of the story. The imbalances in the educational and labor markets are not resolved by creating vacancies, but by reforming the regulatory framework, the incentive systems, and the slack in public management to compete with the private sector in attracting and retaining talent.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102366"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021391112400013X/pdfft?md5=83c9ff5c3c6442f78ebad7c10fdc65b9&pid=1-s2.0-S021391112400013X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907082","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}