Revista espanola de salud publica最新文献

Objective: Rising temperatures, altered precipitation patterns, and the increasing frequency of extreme weather events are changing the distribution of mosquitoes, ticks, and other vectors, facilitating the spread of tropical diseases to regions where they were previously absent. With the present study, we aimed to analyze the role of Nursing in the prevention, surveillance, community education, and clinical management of emerging tropical diseases.

Methods: A systematic review was conducted of articles published between January 2015 and December 2024, following the PRISMA protocol. The databases consulted included PubMed/PMC, Scopus, Web of Science, EMBASE, LILACS, Scielo, and Google Scholar, along with complementary searches in the European Centre for Disease Prevention and Control and World Health Organization repositories. MeSH and DeCS terms were used, combined with the Boolean operators AND and OR. A specific search strategy was developed for each database. The evidence was synthesized using a qualitative and thematic approach, integrating studies with diverse methodologies and assessing their methodological quality to weigh the strength of the findings.

Results: A total of 18 studies were selected, conducted in European countries (n=15), the Middle East (n=2) and North America (n=1). The studies demonstrated the strategic role of Nursing in surveillance, prevention, community education, and clinical management of tropical diseases. The findings highlighted the need to strengthen education, research, and health policies aimed at climate adaptation. The incorporation of clinical simulation methodologies and continuous training on emerging outbreaks proved to be effective tools to enhance the response capacity to health crisis scenarios.

Conclusions: Nursing, due to its close contact with the community and its ability to lead preventive interventions, is positioned to play a key role in building health systems resilient to climate change.

Objective: Current scientific evidence supports the view that pain is the result of central processing of nociceptive input, in which contextual, cognitive and emotional factors intervene, along with other comorbidities. This new paradigm implies a substantial modification in the way pain is considered as an occupational health problem, particularly affecting Nursing Assistants (NA). Given the lack of studies on the subject, this research aimed to analyse the prevalence and perception of pain experienced by NAs working in Spain, from the updated paradigm of pain.

Methods: A cross-sectional, descriptive, observational study was conducted between September and December 2021, with a study population of NAs in Spain. Sample size was estimated using an a priori calculation with G*Power. Participants completed an online questionnaire, after which analyses of associations between variables were performed using Student t-tests, ANOVA, chi-squared and Pearson's correlation. Predictive models were also analysed using multiple linear regression and binary logistic regression analyses.

Results: The final sample consisted of 1,228 NAs, 91.45% of whom reported pain in the past twelve months. Of those with pain, 39.4% had central sensitization levels in the moderate, severe and extreme categories. A significant statistical association was found between the type of workplace (p=0.029) or physical activity (p=0.043) with reporting pain. Women reported more extensive pain than men (p=0.019). Age (p=0.0001) or length of service (p=0.003) showed a significant statistical association with chronicity of pain. The predictive ability of the proposed regression models did not reach relevant values in any case.

Conclusions: The present study follows a line of research that considers pain associated with an occupational role and environment as a complex health problem in which different types of variables interact. It is necessary to deepen the application of the model used, taking into account the role of psychosocial variables that allow a more accurate prediction of the characteristics of the personal experience of pain.

Objective: Health promotion is a process that enables people to increase control over their own health. In this context, the concept of Salutogenesis stands out, focusing on health assets as health-generating factors. The university environment is a key context for identifying and enhancing these health assets. The objective of this project was to conduct a health asset diagnosis of the external campus of the University of Alcalá (Madrid, Spain) using the photovoice methodology by students, and to propose interventions to improve health at the university.

Methods: Eleven second-year students of Environmental Science degree were selected to participate in the study. The project was structured into six sessions, where students identified health assets, took representative photographs of them, and reflected on them in group dialogues. The photographs were analysed and classified into related categories. The analysis conducted was a qualitative descriptive analysis.

Results: A total of 141 photographs were obtained, classified into individual and structural assets. Individual assets included categories such as bravery, freedom of expression and solidarity. Structural assets were divided into categories such as social nature and accessibility, among others.

Conclusions: The health assets identified, both individual and structural, reflect the diversity of factors that contribute to the well-being of the university community. The proposed improvements are related to increased participation and socialization, as well as enhanced sustainability in food and mobility within the university environment. The photovoice methodology empowered the students to identify and analyse the health assets in their environment.

Objective: Public health requires operational classifications that organize studies according to the complexity of data analysis, not just by design or purpose. The objective of this paper was to construct a classification of levels of public health research based on the analytical treatment of data using Grounded Theory.

Methods: A theoretical-constructive qualitative research was conducted between January 1 and April 30, 2025, with iterative searching in PubMed, Scopus, Web of Science, SciELO, and the Virtual Health Library, theoretical sampling, and documentary analysis of thirty-five traceable sources. Open, axial, and selective coding was applied with constant comparison and coder consensus until theoretical saturation.

Results: Six levels emerged, defined by the type of analysis: exploratory (without statistics), descriptive (univariate), relational (bivariate), explanatory (multivariate), predictive (modeling), and applicative (improvement methodologies). Each level was operationally delimited (purpose, unit of analysis, techniques, and example) for reproducible use in evaluation and planning.

Conclusions: The proposed classification is coherent, verifiable, and replicable; it places data analysis as a structuring criterion and facilitates alignment between objectives, design, and techniques, providing an operational framework for researchers, reviewers, and decision-makers in public health. Its empirical validation in applied contexts is recommended.

Objective: The identification of cancer stem cells (CSCs), involved in therapy resistance, tumor progression, and metastasis, has led to exponential growth in cancer research. The aim of this study was to analyze the knowledge, beliefs, and attitudes of Spanish research and clinical staff working on CSC regarding the sharing of research data.

Methods: Semi-structured interviews were conducted with a sample consisting of the key actors in CSC research in Spain, based on three variables: type of research (basic, clinical, translational), research experience (junior with less than ten years of experience, and senior with more than ten years), and type of workplace (public and private). The analysis procedure used was based on Grounded Theory. Following a criterion of theoretical saturation, the final sample included sixteen interviewees.

Results: The interviewees reported having limited knowledge and identified a lack of available training on these topics. They agreed that the obligation to publish raw research data in journals would eventually create a habit, provided certain challenges, such as the cost of Article Processing Charges (APCs), are addressed. They valued making raw data available to other teams positively, although they identified significant competitiveness in the scientific field, leading to some reluctance to share.

Conclusions: The study on data sharing in CSC reveals that knowledge is limited, and beliefs highlight some perceived threats, although attitudes toward sharing research data are generally positive.

Liver cirrhosis is the final stage of chronic liver disease and can lead to deterioration of liver function. Because the liver is the main metabolizing organ, patients with liver cirrhosis experience changes that can affect drug effectiveness and safety. There are many drugs whose dosage must be adjusted or which are contraindicated. A lack of information in this field has been detected among health professionals who care for these patients, partly due to the lack of specific clinical guidelines on the management of drugs. The objective is to present the protocol of a study for the evaluation of a strategy to minimize risks related to the use of medications. This consisted of medication reviews of patients with liver cirrhosis carried out by primary care pharmacists and specific training for health professionals. The pharmacists made proposals (dose adjustment, substitution for safer alternatives, suspension or monitoring of adverse reactions) through the computerized clinical history, taking into account the stage of the disease (Child-Pugh) and other comorbidities, directed to the doctors responsible for the patient's pharmacotherapy (hepatologist, primary care doctor or other specialists), who will make the changes they deem appropriate. To evaluate this strategy, an analysis will be conducted to assess the degree of acceptance of these proposals. The results obtained will provide us with information on the impact of the pharmacist's review on reducing the risks associated with medications in these patients. This study will help us to design prescription support tools integrated into electronic prescribing to aid decision-making for all healthcare professionals involved in the patients' pharmacotherapy.

Objective: The study analyzed how job precariousness affects the mental health of workers and the role of age in this relationship. Despite extensive research on job precariousness and mental health, few studies have addressed the multidimensionality of job precariousness or its differential impact by age.

Methods: The research was carried out in the Valencian Community with a hundred participants. An online questionnaire with the EPRES scale was used to measure job precariousness and the GHQ-12 to assess mental health. Correlation and linear regression analyses were performed.

Results: Significant statistical correlations were found between mental health and various dimensions of job precariousness: wages (r=0.444), vulnerability (r=0.530), rights (r=0.307) and capacity to exercise rights (r=0.340). Global precariousness correlated with mental health problems (r=0.429). Age showed a negative correlation with global precariousness (r=-0.389) but not with mental health. Only wages (f=4.810) and vulnerability (f=20.425) showed explanatory ability. The interaction between wages and age was significant (f=3.997). The impact of wage precariousness on mental health was greater in the young and almost nonexistent in the elderly.

Conclusions: Job precariousness negatively affects the mental health of workers. Specific dimensions such as wages and vulnerability have a significant impact. Wage precariousness affects young people more, suggesting that age moderates this impact, with mental health of young people being more vulnerable to wage precariousness.

Objective: Tobacco and alcohol are risk factors for preventable chronic diseases. Analyzing their environmental presence enables the development of measures that promote healthy environments. The aim of this paper was to describe and analyze differences in the density of alcohol and tobacco retail outlets (number of outlets/km²) by locality, census tract, and income level in the municipality of Siero (Asturias).

Methods: A cross-sectional descriptive study was conducted between October 2023 and June 2024. The units of analysis were all streets within sixteen census tracts of Lugones (n=5), La Fresneda (n=3), and Pola de Siero (n=8), located in one of the municipalities with the highest prevalence of chronic diseases in Asturias. Data collection on tobacco and alcohol retail outlets was carried out through direct observation. Statistical data analysis was performed, including descriptive analyses (median and IQR), ANOVA to compare densities, and Spearman correlation, using IBM SPSS v27, with spatial analyses conducted in QGIS v3.34.

Results: No significant statistical differences were observed in the densities of alcohol and tobacco outlets between census tracts within each town. However, differences were found between the three localities, with higher densities in Lugones (tobacco p=0.008; alcohol p=0.01). A strong correlation was found between the density of tobacco and alcohol outlets (r=0.997; p<0.001), but no significant correlation was found between outlet density and income for tobacco (p=0.082) or alcohol (p=0.076).

Conclusions: In small towns such as those included in this study, when developing public health policies on tobacco and alcohol, it may be more appropriate to consider the locality as a whole rather than individual census tracts, unlike recommendations for larger populations.

Objective: Drowning and suicide are interconnected complex phenomena and represent significant Public Health issues. The aim of this paper was to identify and describe the characteristics and factors associated with intentional drownings in Galicia (Spain), analyzing a retrospective cohort of twenty-one years.

Methods: A descriptive, retrospective, and longitudinal study (2001-2021) was conducted analyzing a cohort of patients aged 0 to 100 years who were treated by Basic and Advanced Life Support (BLS/ALS) units of the FPUS 061 and by hospitals within the Galician Health Service (SERGAS). Records coded with a diagnosis of drowning or near-drowning were included and were recoded as fatal or non-fatal drowning according to international recommendations. Additionally, records containing the terms suicide, self-harm, or suicide attempt in prehospital or hospital documentation were also included.

Results: Ninety-nine cases were documented, representing 9% of all drownings in Galicia and 14% of individuals aged over sixty five who drowned. Eighty-two percent of the victims were residents of the municipality where the incident occurred, and 60% were women. Ninety-nine percent had a prior diagnosis of mental health disorder. Individuals over sixty five accounted for 53% of the cases, with a mortality rate of 50%. The presence of witnesses was associated with lower mortality.

Conclusions: There is a relationship between intentional drownings and mental health disorders. In these events, the presence of witnesses is a protective factor, while advanced age is a risk factor for mortality. Intentional drowning is a complex and understudied health issue, so prevention and Public Health strategies should be implemented to reduce these preventable deaths.

Objective: The COVID-19 pandemic affected the mental health of university students, particularly those enrolled in health-related degrees. In Nursing, the high proportion of female students and exposure to clinical settings may have influenced emotional well-being and academic engagement. The aim of this study was to analyze gender differences in anxiety, fear, and academic engagement among Nursing students in Spain during the pandemic.

Methods: A cross-sectional observational study was conducted using snowball sampling. Between October 2021 and May 2022, 1,197 online questionnaires were collected, from which a balanced subsample of 175 men and 175 women was selected. The AMICO Scale and the UWES-S were administered. Data were analyzed using the Mann-Whitney U test, Spearman correlations, and MANOVA (p<0.05).

Results: Women showed higher levels of anxiety and fear (M=4.06; SD=1.01) than men (M=3.54; SD=0.98; p=0.002). Men demonstrated higher academic engagement (M=3.81; SD=0.85) than women (M=3.58; SD=0.79; p=0.047), with statistically significant differences. A positive correlation was observed between academic engagement and perceived health (ρ=0.163; p=0.002), and a negative correlation between anxiety and perceived health (ρ=-0.129; p=0.015). MANOVA confirmed a significant effect of gender (p=0.011).

Conclusions: Women present higher levels of anxiety and fear, whereas men show greater academic engagement, highlighting the influence of gender in nursing education. These findings support the implementation of gender-sensitive psychoeducational interventions, particularly in university settings and during public health crises.