Revista espanola de salud publica最新文献

Objective: Infection Prevention and Control nurses (IPCN) are members of infection prevention and control (IPC) teams in healthcare facilities. The aim of the study was to describe the composition of the IPC teams, the profile of the IPCN and to describe structural and functional dependencies in both the team and the organization.

Methods: A cross-sectional descriptive study was carried out between July 2019 and January 2020 in Spanish hospitals with recruitment of IPCN through non-probabilistic snowball sampling. Based on the variables collected, a univariate and bivariate descriptive analysis was performed.

Results: 108 surveys were received from 108 centers, 83% public. 26 models of IPC were described. Of the centers, 45% declared ratios of one IPCN for more than 200 beds and only 13% declared ratios of one for less than 150 beds. Only 22% had all nurses trained at the postgraduate level. 84% of IPCN were structurally dependent on nursing and 70% were functionally dependent on physicians. According to the opinion of the IPCN, efficiency would be favored with: 1) multidisciplinarity (72.2%); 2) having reference nurses (93.5%); 3) IPCN with a management position (64.8%).

Conclusions: Spanish IPCN are part of heterogeneous IPC teams, with ratios far from recommendations, deficient training and structurally dependent on nursing and functionally on medical services.

Objective: Healthcare systems are a major source of greenhouse gas (GHG) emissions. In hospitals, the areas with the greatest environmental impact are anesthetic-surgical practice and intensive care. The aim of the study was to identify self-reported sustainable practices and attitudes of anesthesiologists at a public university hospital, their opinion on priority practices and barriers to their implementation.

Methods: A cross-sectional study was carried out using an anonymous self-administered questionnaire adapted from an internationally validated instrument. All anesthesiology staff at the aforementioned hospital were invited to participate. Descriptive statistics and bivariate analysis using prevalence ratios were used.

Results: The participation rate was 71.6% (44 specialists and 4 residents). The most frequent sustainable practices were the choice of anesthetic gases according to their environmental impact and the use of prefilled drug syringes (58.3%). A total of 85.4% expressed a desire to recycle, although only 22.9% reported actually doing so. The majority (95.8%) considered that the environmental impact of products should be taken into account; however, 52.1% indicated that their knowledge to do so was insufficient. It was observed that women were less likely to consider carbon footprint when choosing inhalation anesthetics; this effect was statistically significant. For the rest of the factors analyzed, the variations did not reach statistical significance.

Conclusions: Although there is a predisposition to consider sustainable practices in Anesthesiology, their implementation is scarce. This highlights the urgency of improving the environmental training of professionals, developing multilevel strategies to facilitate individual decisions, encouraging support of decision-makers, and creating participatory environmental hospital goals.

Objective: Infertility problems affect 15% of the world's population, with male factors accounting for up to 30% of cases. The relationship between male infertility and nutritional status remains inconclusive, as most studies rely on BMI without considering other parameters in their evaluation. Therefore, this study aimed to comprehensively assess male body composition and its impact on semen parameters. The aim of our study was to evaluate the relationship between seminal quality (seminogram) and nutritional status (body mass index, waist-hip index and percentage of muscle, fat and visceral mass).

Methods: 117 men from infertile couples were recruited from December 2021 to October 2023 who attended the Gynecology-Esterility consultation at the Hospital of Denia (Spain). Anthropometric variables were collected by physical examination and clinical variables by semen analysis. Statistical analysis was performed using the Mann-Whitney U test and linear regression models.

Results: Our work showed a direct and significant linear relationship (p=0.027) between hip circumference and seminal volume. No association was found between the rest of anthropometric parameters and seminal quality.

Conclusions: The results of this study suggest that there is a statistically significant positive association between seminal volume and hip circumference, but we found no association between the rest of anthropometric parameters and seminal quality.

Objective: Stroke Units (SU) are specialized in-hospital spaces in our Public Health system. They require multidisciplinary professional specialization and an exhaustive evaluation and treatment of patients. The aim of this study was to describe the presence and usefulness of the work performed by speech therapists in Spanish SU and to define their professional functions.

Methods: A non-systematized narrative literature review was carried out on the professional role of the speech therapist in the SUs in the last ten years. The descriptors used were: stroke AND speech therapy; stroke unit AND speech therapy. A total of twenty eight papers were extracted. The method of synthesis and summary of the data was integrative-narrative. The results were compared with international stroke care guidelines.

Results: Great importance is given to intensive, quality and early language rehabilitation in the acute phase of stroke. There is sufficient consensus regarding the professional contribution of speech-language pathologists in language/communication intervention and associated neurogenic dysphagia. However, their competencies need to be defined and updated at the national level, which vary heterogeneously from center to center and province to province.

Conclusions: Most of the studies consulted take into account the professional work of speech therapists in the SU, their intervention being favorable for the overall improvement of the patient. It is necessary to refer the data in each autonomous community in Spain. In the international comparison, these professionals are already fully integrated in all the SUs.

Objective: Suicide constitutes a Public Health challenge whose demographic and geographical heterogeneity demands targeted interventions. The paucity of subnational studies integrating advanced data analytics restricts the precise identification of risk patterns. We therefore aimed to characterise the sociodemographic, temporal, and forensic profiles of suicides in Málaga during 2024, through integration of data from the Institute of Legal Medicine and Forensic Sciences (IMLCF).

Methods: A retrospective observational study of all suicide cases (N=197) registered by the IMLCF in 2024 was carried out. Sociodemographic, temporal, geographical, and circumstantial variables were analysed using multivariate statistical techniques and machine learning algorithms (hierarchical clustering and k-means) to identify risk patterns and distinctive profiles.

Results: There was male predominance (80.2%; male-female ratio=4:1) with a mean age of 54.51 years (SD=17.00). The most frequent methods were hanging (40.61%), jumping from height (26.90%) and substance ingestion (16.24%), with statistically significant sex differences (p<0.001). Geographical distribution showed higher rates in inland municipalities (mean 53.79/100,000 inhabitants) compared with coastal areas (mean 11.56/100,000). Cluster analysis revealed four profiles: middle-aged adults in inland areas, young adults in coastal regions, jumping-related deaths in coastal areas, and older adults in coastal regions.

Conclusions: This study represents the first detailed epidemiological mapping of suicide in Málaga, highlightingcontextual vulnerabilities and specific risk patterns, and supports stratified interventions in accordance with the WHO Mental Health Action Plan 2013-2030.

Objective: The health of male migrants who engage in prostitution in Colombia has historically been invisible in academic research. This population faces structural and symbolic barriers that shape health practices shaped by exclusion, stigma and precariousness. From the critical perspective of collective health, this research is justified in the need to analyse health practices as an expression of historical, social, economic and cultural processes that structure ways of living, to become ill and take care of oneself, in line with the social determinant of health approach. The aim of this paper was to analyse the health practices of male migrants who engaged in prostitution in the cities of Cali or Popayán (Colombia).

Methods: A qualitative approach was used with an ethnographic method focused on participant observation, semi-structured interview and field diary. Triangulation of the data was carried out and the information was analyzed based on what Graham had established. The inclusion criteria were migrant men, over eighteen years of age. The selection of participants was through snowball sampling. Eight interviews with migrant men living in Colombia were analyzed. No statistical analysis was carried out, due to the study methodology.

Results: 405 codes, 140 citations, eleven memos and two networks were identified, organized into a main category (health self-management) and an emerging category (living conditions), with three subcategories: access to services, cultural care practices and self-care practices. Health practices were linked to experiences of marginalization, job insecurity and adaptive strategies in the face of institutional barriers.

Conclusions: The social determination of health manifests itself as a structural axis that conditions the decisions, knowledge and practices of health in this population, reflecting a web of exclusion, stigmatization and social resilience.

Objective: The current situation of alcohol and substance use in Spain suggests the need to invest efforts in early detection and intervention. It is necessary for professionals to have simple instruments that are adapted to consultation times and that have demonstrated their psychometric properties. This study aimed to validate the Spanish version of the POSIT_UAS as a generic tool for the detection of a possible alcohol or substance use disorders, thus enhancing its use compared to the simultaneous application of different screening scales specific to each use.

Methods: A descriptive, observational and cross-sectional study was conducted among secondary school students in Galicia (Spain), using a selective methodology. An ad hoc questionnaire was developed including sociodemographic variables and the Spanish versions of the POSIT_UAS, AUDIT, HONC and CAST. A total of 1,027 students (44.7% female), aged between twelve and eighteen years (M=15.40; SD=1.638) participated. The data were statistically analyzed using descriptive and inferential procedures, as well as psychometric analyses of internal consistency, validity, and screening ability.

Results: The POSIT_UAS was found to be a unidimensional instrument, with high internal consistency (KR-20=0.84) and excellent screening ability. It showed a balance between sensitivity and specificity and an acceptable area under the ROC curve, both in detecting alcohol (se=0.84; es=0.90; ROC curve=0.92), tobacco (se=0.79; es=0.83; ROC curve=0.87) and cannabis (se=0.97; es=0.73; ROC curve=0.93) use.

Conclusions: This article provides psychometric evidence supporting the use of POSIT_UAS as a generic tool for detecting possible alcohol or substance use disorders, as it offers good results in the case of alcohol, tobacco, and cannabis.

Objective: Chronic kidney disease (CKD), characterized by progressive renal function loss, often necessitates replacement therapies to prevent mortality, with kidney transplantation being the most effective option. The COVID-19 pandemic profoundly affected healthcare systems, reducing transplant activities and lengthening waiting times. This study assesses differences in kidney transplant activity, waiting list durations, and renal replacement therapy usage during pre-pandemic and pandemic periods.

Methods: This observational study was conducted at Miguel Servet University Hospital in Zaragoza, analyzing 326 kidney transplants performed between 2017 and 2022. Two periods were defined: pre-pandemic (2017-2020) and pandemic (2020-2022). Data were sourced from hospital records, excluding living or combined donor transplants. Statistical analyses included Kaplan-Meier survival curves and Cox regression models.

Results: Median waiting list times increased from 3 months in the pre-pandemic period to 7.5 months during the pandemic (p=0.0014). Transplant density decreased from 5.02 to 4.21 cases per month. The proportion of donors in asystole rose significantly from 15.1% to 34.8%. Men over 61.9 years were the most impacted demographic.

Conclusions: The pandemic significantly extends waiting times and reduces kidney transplant activities, disproportionately affecting older male patients. These findings underscore the necessity of optimizing healthcare resources in future crises.

Objective: Three clinical conditions related to wheat consumption and associated with gluten are recognized: celiac disease; gluten sensitivity; wheat allergy. The World Health Organization defines food safety as a fundamental aspect of public health. Allergen management is an integral part of the food safety management system. The objective of this study was to understand the knowledge, attitudes, and practices of food handlers, administrative, and care staff involved in the production of gluten-free food in hospital settings for patients with disorders related to gluten consumption.

Methods: A qualitative case study was conducted using various ethnographic techniques, including observation, field diaries, document review, and semi-structured interviews. Additionally, a format was used to verify the Hazard Analysis and Critical Control Points (HACCP) plan, facilitating the triangulation of information from sources for analysis.

Results: While there was general awareness of the importance of food safety, limitations persisted in the continuous and specific training of the involved staff. This suggested that, without adequate and updated knowledge, allergen management practices may be insufficient, increasing the risk of cross-contact and compromising patient safety.

Conclusions: In the institutions evaluated, staff demonstrates a positive attitude toward allergen management. Nevertheless, it is essential to provide training in allergen handling and establish standardized protocols to guarantee food safety.

Objective: Smoking is a chronic addictive disease with high morbidity and mortality, and its consumption patterns vary by sex. Among its many associated pathologies, smoking is a leading cause of cardiovascular diseases and chronic obstructive pulmonary disease (COPD). It represents the principal Public Health issue in our country and a global epidemic. Its treatment encompasses the use of pharmacological therapies for nicotine dependence, cognitive-behavioural interventions, and fundamental Public Health measures aimed at promoting health and preventing initiation. Since 2023, cytisinicline has been available as a publicly funded active ingredient for smoking cessation. The objective of the present study is to evaluate the effectiveness of cytisinicline and explore the benefits of pulmonary function tests for the early detection of smoking-related pulmonary diseases.

Methods: A prospective observational study will be conducted with convenience sampling in primary care patients attempting to quit smoking with cytisinicline, involving continuous follow-up and interventions based on an integrated care pathway. Abstinence will be measured at three, six, and twelve months, alongside assessments of pharmacological adherence, the presence of adverse effects, and their relationship with sex and other personal and smoking-related factors.

Conclusions: This study provides an important opportunity to evaluate the effectiveness of cytisinicline for smoking cessation in real-world conditions, while addressing the underdiagnosis of COPD by optimising the use of spirometry in primary care.