Revista espanola de salud publica最新文献

Objective: The health plan is a guiding tool for territorial health planning where the proposed objectives and measures should prioritize vulnerable groups. The aim of this study was to identify if the Regional Government health plans in Spain included measures related to frailty, dependence and unwanted loneliness aimed at elderly.

Methods: Institutional websites were scanned to identify the most recent health plan of each Regional Government. Information concerning the diagnosis, objectives, specific programs and types of measures on the three domains: frailty, dependence and loneliness was extracted manually. The search was performed on 10 July 2023.

Results: Sixteen health plans published between 2010 and 2023 were identified. Twelve of these had incorporated intervention measures on frailty, fourteen on dependence and eight on loneliness, with a considerable heterogeneity. Only eight Regional Governments provide for measures to detect and assess frailty. Aragón, Castilla-La Mancha, Cataluña, Extremadura, País Vasco, Principado de Asturias, Comunidad Foral de Navarra and Comunitat Valenciana were the Regional Governments that presented objectives in the three domains.

Conclusions: The measures proposed by the Regional Governments on frailty, dependence and unwanted loneliness are highly heterogeneous. In the same manner that exists for frailty, it is recommended to stablish a consensus including dependency and unwanted loneliness. Surprisingly, the measures focus more on late stages (dependence) than on prevention (frailty). This study could serve the Regional Governments to in-depth review their health plans, and to examine the actions carried out in other regions to improve the quality of their proposals.

Objective: Smoking is a Public Health problem. Half of all women smokers continue to smoke during pregnancy, putting their health and that of their foetus at risk. The aim of this review was to synthesise the main studies on the prevalence and sociodemographic, psychological and obstetric profile of women who smoke during pregnancy, the relationship of stress, personality and depression with smoking during pregnancy and the most effective treatments.

Methods: We conducted a literature review in the MEDLINE and PsycInfo databases from 2013 to 2023 on the most relevant aspects of smoking in pregnancy, including thirty studies.

Results: The prevalence of smoking in pregnancy is 15.7% in Spain. The socio-demographic profile of women who smoke during pregnancy is that of women with a low socioeconomic and educational level, generally without a partner or with partners who smoke and are unemployed. A relationship had been found between smoking in pregnancy and a higher probability of suffering from perinatal depression. High self-perceived stress may be a predictor variable for continued smoking in pregnancy. Personality traits such as high neuroticism appear to be related to smoking in pregnancy. Intervention to help pregnant women quit smoking must be tailored to the profile of the pregnant woman to be effective. Cognitive behavioural interventions show efficacy, especially in the long term.

Conclusions: In order to design effective prevention and intervention programmes to help pregnant women quit smoking, not only the socio-demographic profile of the pregnant women should be taken into account, but also psychological variables such as personality and stress. These programmes should include cognitive behavioural interventions that teach adaptive stress management strategies to maximise their effectiveness. Special emphasis should be placed on reaching those women with the most disadvantaged profiles.

Objective: Research on factors that modify the intention to donate blood voluntarily in the general population in Peru is scarce, and most of it are focused on health science personnel. The aim of the present study was to estimate the factors associated with the intention to donate blood in patients attending an outpatient clinic in a hospital in northern Peru.

Methods: A prospective unpaired study of cases (n=185) and controls (n=185) was designed. A case was defined as a patient who responded "if I would voluntarily donate blood in the future" to the initial filter question. The response variable was intention to donate blood and the exposure variables were sex, age, marital status, educational level, employment status, monthly income, religion, donation practices, and knowledge about donation. In addition, the motivations for blood donation were explored. To identify the associated factors, crude odds ratios (ORc) were calculated by means of generalized linear models, using the Poisson family, log link function and robust models; then the variables that showed a significant statistical association were adjusted by multivariate analysis, adjusting for sociodemographic variables, and the adjusted odds ratios (ORa) were obtained.

Results: In the multivariate analysis, male sex (ORa=1.37), having a high monthly income (ORa=1.26), professing the catholic religion (ORa=5.27), having a higher score in the knowledge questionnaire (ORa=1.04), having previously donated (ORa=1.64) and having a family member who had previously donated (ORa=1.72) increased the probability of intention to donate blood. On the other hand, older age (ORa=0.97) decreased said probability.

Conclusions: Several factors associated with the intention to donate blood are identified, most of which were similar to previous studies. It is highlighted that a high level of knowledge, as well as previous donation experiences, increase the intention to donate blood.

Objective: It is necessary to facilitate the implementation of evidence-based practice in clinical practice to improve patients' health results. Sumamos Excelencia^® is an implementation project led by nurses that aims to improve the evidence-based practice uptake. Building on the first edition, we have improved the project design and proposed new intervention topics. The objective is to evaluate the effects of the implementation of evidence-based recommendations through a multifaceted implementation strategy.

Methods: This study is an implementation research with a quasi-experimental, multicentre, before-and-after design and audits for data collection at baseline, 3, 6, and 12 months. It will be developed in hospital units, primary care centres, and nursing homes. Units choose to implement recommendations of one of these topics: assessment and management of pain, conservative management of urinary incontinence, prevention of childhood obesity, or breastfeeding promotion. All units will implement recommendations about hand hygiene. Audits will assess changes in process and patient outcomes, barriers and strategies, and evidence-based practice competencies through specific questionnaires and clinical records data. Analysis will be descriptive and inferential.

Conclusions: Sumamos Excelencia^® will aim to improve the use of evidence-based practice in the Spanish National Health System and to advance implementation science. This study will also provide important insight into the barriers that nurses face to implementing evidence-based practice in clinical practice and the strategies that they can use to overcome them. This generated knowledge can be used in other evidence-based practice implementation projects in a similar context to enhance adherence to evidence-based recommendations.

Objective: In July 2022, an outbreak of Raoultella ornithinolytica infection was detected in users of a hemodialysis center in Granada and central venous catheter (CVC) users. The aim of this study was to describe the development of the outbreak and the control measures implemented as well as to identify the risk factors that may have been related to its origin.

Methods: A study of a series of thirteen cases with positive blood culture for Raoultella ornithinolytica was conducted during July 2022. Two hypotheses were considered: direct transmission through contamination of the antiseptic product or cross-contamination through the hands of healthcare personnel. A descriptive data analysis was carried out, with the calculation of attack rates and attributable risk in the exposed group (CVC users).

Results: The center performed dialysis on 117 patients. 36 patients had a CVC, and 81 had an arteriovenous fistula (AVF). The total number of infected cases was 13. The attack rate was 11.1%, being 36.1% in patients with CVC and 0% in patients with AVF. The symptoms occurred between 1 and 3 hours after the start of dialysis, except in three cases that occurred after receiving dialysis in other centers. Samples of water, liquids and antiseptics were negative.

Conclusions: An outbreak of Raoultella ornithinolytica bacteraemia is confirmed, due to possible cross-contamination in the CVC handling and antisepsis process. Possibly, the germ was carried by a container of alcoholic chlorhexidine that contaminated the catheter and caused bacteremia during the hemodialysis process.

Objective: Since COVID-19 pandemic, screen time (ST) seems to have increased among children and young people. There is controversy about its impact in the physical and mental well-being of children. The aim of this study was to analyse the possible influence of excessive ST on child health through a systematic review of the literature.

Methods: Systematic review was done by two independent reviewers. We analysed the medical literature (MEDLINE data base) from 2017 to 2022. Data related to the effects of ST on children´s health were analysed along with strategies that can mitigate those effects.

Results: The search identified 3,151 articles, 37 finally selected as they fulfilled the demanded methodological quality criteria. Negative effects on children's health such as obesity, linked to a sedentary lifestyle, sleep disorders or anxiety problems in adolescents were detected. However, a better development of language or memory functioning, when interactive media were used, have also been described. Educational measures have proven useful in controlling exposure time and reducing exposure-related negative effects.

Conclusions: Although high levels of ST could affect children`s health, we have recorded some positive effects that are enhanced when parents get involved in TV watching (co-viewing). Exposure time should be customized according to every child's lifestyle.

Objective: The use of non-pharmacological preventive measures during the COVID-19 pandemic has helped to reduce the incidence of multiple airborne or contact diseases. The objective of this paper was to evaluate the impact that all preventive measures have had on the transmission of different microorganisms, both by respiratory and contact transmission.

Methods: We compared the incidence of different infectious episodes coded with the CIAP-2 code (International Classification of Primary Care second edition of the WONCA International Classification Committee) collected from the computerized history of primary care, both with respiratory tract and digestive tract involvement, in the period from March 2018 to February 2020 (pre-pandemic period) and from March 2020 to February 2022 (pandemic period). The data corresponded to the entire region, with an estimated average population for the four years of 650,000 people. The statistical treatment of the data consisted of a descriptive analysis with the calculation of absolute values and percentages. Rates were calculated and compared using data provided by the National Institute of Statistics as a denominator. The P was obtained by statistical comparison by the exact method. A comparison of rates was made.

Results: The incidence in the number of CIAP-2 episodes studied, both corresponding to respiratory and gastrointestinal pathologies, comparing the period March 2018-February 2020 with the period March 2020-February 2022 decreased by 65.81%, from 534,439 cases to 182,707.

Conclusions: The preventive measures applied during the pandemic produce a significant decrease in pathology involving the respiratory or the digestive tract.

Objective: Air pollution is a global public health issue, with particulate matter (PM) being the pollutant with the greatest impact on health. The main objective of this article was to estimate the impact of mortality attributable to particulate pollution in the city of Valencia during the period 2015-2017.

Methods: The Health Impact Assessment (HIA) methodology from the Aphekom project was used. Scenarios of a 5 µg/m³ reduction in the annual mean concentration of PM₁₀ and PM_2.5 were employed, along with the assumption of meeting the World Health Organization (WHO) recommendations in effect during the study period, to estimate both short- and long-term impacts.

Results: The estimated average concentrations for 2015-2017 were 18.4 µg/m³ for PM₁₀ and 12.3 µg/m³ for PM_2.5. The short-term HIA, assuming a reduction of 5 µg/m³ in the averages, resulted in a total of 65.4 premature deaths that could be postponed during that period (21.8 annually), corresponding to a rate of 2.8 deaths per 100,000 inhabitants. In the long term, if PM_2.5 concentrations had been reduced by 5 µg/m³, 124 premature deaths could have been postponed annually.

Conclusions: The annual average concentrations of these pollutants meet the limits set by European regulations. However, compared to WHO recommendations, PM_2.5 levels are higher by 2.3 µg/m³. An air quality scenario in line with WHO recommendations would have resulted in a reduction of 122 premature deaths annually.

The aging of the world population is now an unquestionable fact. The World Health Organization (WHO) points out in its World Report on Aging and Health published in 2015 two main causes: the increase in life expectancy and the decrease in fertility rates. The United Nations (UN) announced that Spain will become the oldest country in the world in 2050, with 44% of citizens over 60 years of age and the median age of 55.2 years. Whether this event is interpreted optimistically or as a demographic problem will depend on the quality of the years of life gained.