Revista Espanola De Salud Publica最新文献

Despite the progress achieved in recent decades, tuberculosis continues to be a major public health problem in wide areas of the world geography, and caused more than 1.6 million deaths in 2017. The eruption of cases with multidrug-resistant tuberculosis and extremely resistant hinders its healing and its progressive eradication. Fortunately, in the past few years, molecular techniques capable of diagnosing the disease in a few hours have been introduced, also detecting genetic mutations that encode resistance to the most active drugs in its cure. With the incorporation of bedaquiline and delamanide, we count on new shorter, more effective and less toxic treatment schemes for resistant cases. The future of the fight against tuberculosis must be based on clinical suspicion in the most vulnerable groups (elderly, immunosuppressed and immigrants), an accurate and early diagnosis, a short treatment with oral drugs and the inclusion of solidarity socioeconomic strategies that improve the situation of the most vulnerable countries and groups.

Objective: Immediate-release fentanyl is indicated in the treatment of breakthrough pain in cancer patients who already receive opioids as background chronic analgesia. According to an alert issued by the Spanish Agency of Medicines, its consumption under non-authorized conditions has alarmingly increased in recent years, with a greater risk of abuse and dependence. The main objective of this study is to compare the off-label use of immediate-release fentanyl in our hospital during 2014 and 2017.

Methods: Retrospective cross-sectional descriptive study in which immediate-release fentanyl prescriptions were compared in adult patients admitted during 2014 and 2017 in a group 5 hospital. Variables were collected by the electronic medical record. The association study between qualitative variables was calculated using the χ² test, and quantitative variables with the t-student test.

Results: In 2014, 0.43 immediate-release fentanyl prescriptions were made in our center for every 100 admissions, and in 2017 0.54/100 admissions. 22.1% (n=34) prescriptions were off-label in 2014, while in 2017 31.8% (n=76) (p=0.034). Both years, the most frequent off-label indications were healing of ulcers and wounds and non-cancer chronic pain.

Conclusions: The use of immediate-release fentanyl in the hospital setting has considerably increased in comparison to 2014, as well as its off-label use.

Objective: The Covid-19 pandemic led to the establishment of the state of alarm in Spanish and the initial lockdown of the entire population. The aim of this study is to analyse the assessment of professionals working with children on the impact of quarantine on the health and health inequalities of the child population, as well as the importance given to the intermediate factors that can modulate the impact of the experience of lockdown on children's health.

Methods: A cross-sectional study was made according to an online questionnaire to professionals in health and socio-educational fields working with children (n=214) with questions concerning the potential effects of lockdown and the dimensions that could modulate those effects. For the analysis, descriptive statistics were calculated together with Chi-square tests and comparison of means to analyse differences according to professional field.

Results: 86% of the experts pointed out the potential negative impact of quarantine on the health of children, especially that of the most vulnerable, highlighting the adverse effects of conflict at home and exposure to tobacco smoke in this experience, which were scored in importance with more than 9 and 8.5 respectively.

Conclusions: The results show how, according to child professionals, lockdown can have an impact on the health of the child population that goes beyond the direct effect of Covid-19.

Objective: In the last decade, public policy makers are applying new tools to promote healthy habits, starting from the behavioral economics sciences and social psychology. These tools are known as nudges, and before being applied, the degree of acceptance that the population presents about them must be analyzed. The objective of this study was to determine if there is a relationship between the lifestyle of the university population and the degree of acceptance of tools for the promotion of public health policies.

Methods: Cross-sectional correlational study of a representative sample of 590 university students (95% CI, α=5%) from Spanish universities using an online questionnaire. Bivariate and multivariate analyzes were performed applying Chi-squared test and Student t-test for independent samples.

Results: Young university students have an inadequate diet, with a deficient consumption of fruit and vegetables (only 27.8% consume them several times a day, the recommended daily amount being 5 pieces) and a high consumption of junk food, alcohol (68.81% and 63.39%, respectively, consumed between 1 and 2 times a week) and meat (consumed 3 to 4 times a week by 46.61%). By correlating the socio-demographic variables with food, significant results were found. The group of men, the youngest students, who are more supportive of the political right, and the religious practitioners, are the ones with the worst habits. In addition, those with older, more affiliated with the political left, less religious practice and better eating habits, they performed more responsible habits. There was a positive correlation between approval of nudges and responsible habits and less meat consumption (p<0,001), being significant in the nudges on food.

Conclusions: The acceptance of public policies on health is related to healthy eating and to the most socially committed behaviors. In addition, these factors are more frequent among women, the older group, who show more support for the political left and have fewer religious beliefs.

Background: In times of this global pandemic situation, population's mental health is compromised, especially in those groups that are at the forefront of defence against the virus such as healthcare professionals. The objective of this study was to analyze the impact of the SARS-CoV-2 outbreak on healthcare professionals' mental health.

Methods: A systematic review was carried out following the PRISMA format in Pubmed, Scopus, Web of Science, CINAHL, PsycINFO and ScienceDirect electronic databases between January and May 2020. Methodological quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomized studies.

Results: A total of 13 studies were included in this review. Professionals' mental health and mental functions were compromised, being especially affected those professionals on the front line of battle against the virus. However, these stats were below the general population data. Although there is wide variability of results, medium-high levels of anxiety (26,5%-44,6%), depression (8,1%-25%), concern and insomnia are detected (23,6%-38%). Paradoxically, stress levels were below expectations (3,8%-68,3%).

Conclusions: The mental well-being of health professionals working on the front line is compromised in times of pandemic by presenting medium-high levels of anxiety, depression, nervousness and insomnia, and, to a lesser extent, stress.

Objective: Hand hygiene (HH) is essential for the prevention of health care-associated infections (HAIs). Compliance rates documented in Spain and internationally are low, although improvement is possible using some strategies and training. The aim of this study was to know the evolution of the adherence to the 5 moments for hand hygiene of the health professionals of the Hospital Universitario Fundación Alcorcón and to propose measures to implement it.

Methods: A direct observation study about the compliance of the 5 moments for HH in this hospital for seven years was carried out. Different professional groups received training, using the traditional method and simulation learning. The data was summarized using percentages and absolute frequencies. They were analyzed using SPSS version 21 for Windows.

Results: Adherence increased from 37% in 2011 to 57.8% in 2019. Compliance in the 5 moments was higher after patient contact than before it. Nurses were one of the groups with the highest compliance.

Conclusions: Even though they have improved, compliance rates need to be maintained and to increase especially in moments as crucial as before an aseptic procedure. Training and the implementation of strategies are key.

Since 2015, the Spanish Navy participates in the Operation EUNAVFOR MED Sophia, a naval operation of the European Union against the trafficking of human beings in the Mediterranean in which our ships carry out an important humanitarian work in the rescue and assistance of migrants on the sea. The attention and health care of these migrants lies mainly in the military Health Group and it is based on a series of principles and procedures among which the application of a triage adapted to the special conditions of rescue and assistance on the sea and in the diagnosis and treatment of various pathologies present among migrants. In this context, a series of epidemiological data is provided, especially the most frequent pathologies attended by rescued migrants and emphasizing the importance of adopting a series of measures to prevent the transmission of infectious pathologies that are rare or already eradicated in our country.

Objective: The justification of the study was to assess the degree of knowledge of Spanish pharmacists in the field of Pharmacovigilance, their degree of notification of adverse drug reactions and their need for training, establishing the differences between community pharmacy pharmacist and those of hospital pharmacy.

Methods: A questionnaire with twelve questions on Pharmacovigilance was designed. The distribution and collection of the questionnaires were carried out via online in collaboration with the Official Colleges of Pharmacists and the Spanish Society of Hospital Pharmacy during the period from November 2018 to June 2019. The target population were the pharmacists registered or belonging to the Spanish Society of Hospital Pharmacy. The results were processed using a descriptive and analytical analysis. The qualitative variables were presented with their frequency distribution and the quantitative with their mean and standard deviation.

Results: 99% of hospital pharmacists said they had evidence of suspected adverse reactions and 96.9% of them ever reported. 73.5% of community pharmacists stated that they had knowledge of suspected adverse reactions but only 48.7% confirmed that they notified them. In general, the pharmacists surveyed agreed on the importance of Pharmacovigilance and believed that the quality of treatments could be improved and the Spanish health system would be saved if Pharmacovigilance was applied more.

Conclusions: Our results indicated that hospital pharmacists report much more adverse drug reactions than community pharmacist does. It also hospital pharmacists who know best the obligations they have with Pharmacovigilance. The surveyed pharmacists thought that the development of actions in Pharmacovigilance would increase the adherence of pharmaceutical professionals to the notification and would imply improvements in the quality of treatments, the rational use of medications and patient safety.