Revista espanola de salud publica最新文献

Objective: The justification for the research was the economic approach to breast cancer in order to introduce improvements. The objectives were to know the final cost in each subgroup of women with non-metastatic breast cancer, to know the average cost per patient, to predict the cost and to identify groups with the greatest economic impact for health systems.

Methods: A retrospective descriptive study was carried out in 411 women, after systematic random sampling, diagnosed with non-metastatic breast cancer and undergoing surgery in Abente y Lago Hospital (A Coruña) during 2010-2013. The information was obtained from medical records and databases. For cost evaluation, rates for health services in the Galician Health Service were taken into account. Univariates and multivariates analysis were performed.

Results: The average cost of non-metastatic breast cancer in women was €23,752.16±€16,015.82 and varied according to ten care profiles based on therapeutic management (p<0.001 in six of the profiles in relation to non-adjuvant surgery; in one, p=0.004; in one, p=0.022; not demonstrable in one with p=0.132). In the profiles with immunotherapy (14.6%) the cost was €54,190.54; €55,238; €69,278.45 and €57,364.81.

Conclusions: In non-metastatic breast cancer, ten care profiles according to therapeutic management best approximate the cost. In addition to having the average cost, the cost per patient can be predicted with a mathematical formula that includes age, origin of screening, infiltrated nodes and care profile. The groups with anti-HER2 treatment have a greater economic impact.

Objective: Poliomyelitis and post-polio syndrome (PPS) continue to affect many people in Spain. Despite the eradication of the virus in much of the world, its sequelae persist and cause significant functional and social limitations. The lack of recent studies on the reality of this population makes it difficult to design appropriate interventions. This study aimed to investigate the current situation of individuals with polio and PPS, focusing on their functional, nutritional, psychological, emotional, and social status.

Methods: A descriptive cross-sectional study was conducted with a sample of eighty-seven individuals from various polio associations in Spain. Data were collected using self-administered questionnaires. Descriptive statistical analyses were applied to interpret the data.

Results: The results showed that the majority of participants (85.1%) exhibited some degree of dependence in daily activities and a high concern about the risk of falls, with 78.2% identified at risk of falling and 80.5% expressing high concern. Additionally, a significant risk of malnutrition was observed in 49.3% of the participants, along with a tendency toward overweight and obesity affecting 40.3%. Emotional issues such as anxiety (mean 7.26) and depression (mean 5.10), as well as sleep difficulties (mean insomnia score 25.77), were common among those affected. While social support was adequate for most, 31.7% perceived limited support.

Conclusions: The findings highlights the need for a multidisciplinary approach that integrates physical rehabilitation, psychological support, and nutrition programs to improve the well-being of individuals with polio and PPS in Spain.

This paper examines the significance of surgical waiting list objectives within healthcare program contracts from eight Spanish regional health services in 2024. Healthcare program contracts are strategic tools used to set clear objectives, measurable indicators, and efficient resource allocation between health authorities and care facilities. Common goals identified include reducing surgical waiting times, establishing maximum waiting periods, applying clinical prioritization criteria, and incorporating complementary indicators linked to surgical efficiency and demand refinement. However, the analysis identifies significant limitations, notably the limited use of postoperative outcome indicators and patient satisfaction metrics. The authors conclude by recommending the standardization of objectives and indicators across autonomous communities, systematic integration of pre- and postoperative quality evaluations, adequate financial planning, and enhancement of health information systems to promote transparency and efficiency in Spain's National Health System.

The Spanish prison system faces a growing challenge regarding the mental health of inmates, especially those convicted of crimes related to Islamist terrorism. A recent study by the Elcano Royal Institute, based on interviews with twenty-four inmates, has revealed the psychological complexities involved in the reintegration of these prisoners, particularly those who have renounced jihadist ideology. This analysis not only addresses the difficulties in the deradicalization process but also underscores the need for effective mental health strategies that address the emotional and psychological demands of inmates, from a comprehensive public health perspective.

From an ontoepistemic perspective, Public Health is attuned to the technological advances developing in humanity. Such is the case with the incorporation of Artificial Intelligence (AI), a complexity that invites us to a dialogue of knowledge where we transcend the disciplinary to explore the transcomplex, thus enabling the construction of networked knowledge and providing alternative responses to health-disease processes from other ontoepistemological perspectives.

Objective: Gender-based violence experienced by older women encompasses aspects of vulnerability and invisibility, making it a public health concern. The objective was to describe the different forms of violence suffered by women over sixty-five years old and their relationship with the use of health services in Spain.

Methods: A cross-sectional study was carried out. Sociodemographic variables, violence and its types, social support, and use of health services were collected. A descriptive analysis of the variables and binary logistic regression models were performed, calculating Odds Ratios (OR) and confidence intervals (95% CI). The SPSS programme, v.22, was used.

Results: 2,357 women with an average age of 74.2±6.9 years were analyzed. 552 (23.4%) of older women had experienced intimate partner violence throughout their lives (14.1% experiencing psychological violence and 17.1% experiencing controlling behavior), 219 (9.3%) experienced violence from individuals other than their partner, and 684 (29%) experienced interpersonal violence. Women who suffered intimate partner violence and interpersonal violence were more likely to use health services (health centre [OR=1.41, OR=1.62], hospitalisation [OR=1.64, OR=1.38] and emergency services [OR=1.31, OR=1.25]). Women who experienced any type of violence were more likely to use specialist services than those who did not (intimate partner violence [OR=2.34], interpersonal violence [OR=2.38] and violence by individuals other than the partner [OR=1.82]).

Conclusions: Older Spanish women predominantly experience intimate partner and interpersonal violence. They are more likely to use healthcare and specialist services than those who do not experience this. Programs against gender-based violence are needed to prevent and treat it.

Objective: The consumption of antidepressants has increased considerably worldwide, including in Spain. Despite their efficacy in cases of moderate to severe depression, their long-term use in mild cases is questioned. This study aimed to evaluate the effectiveness of a deprescribing intervention in Primary Care, to reduce the unnecessary consumption of these drugs and improve patients' quality of life.

Methods: A before-after community clinical trial will be carried out in an adult population, residents in an urban area of Cadiz (Spain), and with a prescription of antidepressants in the last year. Participants will be randomly selected and followed up for a determined period prior to consensus. The intervention will consist of a comprehensive evaluation of antidepressant treatment by a team of health professionals. Factors such as indication, dosage, and response to treatment will be evaluated, and the Hamilton Scale for anxiety and the Beck Inventory for depression will be used. In those cases in which it is considered appropriate, a gradual reduction or suspension of the drug will be proposed, always under medical supervision.

Conclusions: This research will contribute to generating scientific evidence on the safety and efficacy of deprescription in Primary Care, promoting a more rational use of antidepressants, and improving patients' quality of life. The results obtained could have important implications for clinical practice and the development of clinical practice guidelines.

Objective: Young adults may be more likely to spread COVID-19 as they have low adherence to public health guidelines and are more reluctant to get vaccinated. The purpose of this review was to provide the most current evidence regarding the assessment of adherence to COVID-19 vaccination in young adults.

Methods: The bibliographic search was carried out in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, Scielo, MedLine/PubMed, Cochrane databases and in the Google Scholar search engine, with free and controlled language, using the MeSh search terms: "Treatment Adherence and Compliance", "COVID-19 Vaccines", "Young Adult". Ten selected articles were analyzed. The articles were selected based on their relevance, published in peer-reviewed academic journals and published between 2021 and 2024.

Results: The main study tool represents the adherence of COVID-19 vaccines. The most important discussion topics extracted in the analyzed articles refer to concern about side effects, mistrust, beliefs or low income level.

Conclusions: The findings of this study indicate the need to carry out vaccination promotion programs to provide accessible, transparent and age-appropriate information. Thus, it could be considered a useful tool to improve adherence and confidence in the COVID-19 vaccine.

The tenth anniversary of the Strategic Plan for Addressing Hepatitis C in the National Health System (PEAHC) is a milestone in Spanish healthcare, consolidating the country as a global leader in the fight against this disease. In these ten years it has been demonstrated that a well-structured strategy can transform a health crisis into an opportunity, reducing the prevalence of active hepatitis C virus (HCV) infection in the general population from 1.2% (95% CI: 0.3%-1.8%) in 2014 to 0.12% (95% CI: 0.03-0.24) in 2022, achieving a cure rate greater than 94% in the more than 172,000 patients treated with direct-acting antivirals until 2024, a marked and sustained improvement in all morbidity and mortality indicators in the last decade such as the reduction from 32% in 2015 to 7% in 2024 of patients with HCV on the waiting list for liver transplant. Reductions in active HCV infection among people living with the human immunodeficiency virus, people who inject drugs (PID), and people in the prison setting have been spectacular. Key factors ensuring success have been political commitment and sustainable funding, integrated Public Health strategies for the primary prevention of new HCV cases (improvements in health care safety, transfusion safety, risk and harm reduction programs for PID), a universal public health system that ensures equitable access to treatment, decentralized tasks and, finally, interinstitutional coordination.

Social eating or communal dining is an activity that transcends dietary and nutritional concerns throughout all stages of life, enabling older adults to strengthen social bonds, transmit food-related knowledge, and contribute to overall biopsychosocial well-being. In order to provide an analytical point of view on commensality and its future for older people, an overview of the subject is presented from a socio-health approach, beginning with a conceptualisation of the role and importance of commensality, reflecting on the reality of eating together today and looking in depth, among other aspects, at the influence that technologies and globalisation will have on the future of eating together. It is concluded that the future of eating together for the elderly is in line with other stages of the life course, and that this action can be visualised for clinical or community health care.