Organización sanitaria y de la higiene pública en la provincia de Valencia (1854-1936)

RESUMEN Analizar el desarrollo de un marco normativo sobre salud pública, asistencia sanitaria e higiene social y su influencia en la realidad socio-sanitaria valenciana, a través de nuevas instituciones y nuevas políticas de salud. El material utilizado ha consistido en una combinación de fuentes históricas que incluyen fuentes legislativas, de archivo e impresas, que nos ha permitido desarrollar una perspectiva transversal entre el marco normativo y la realidad social. El trabajo se ha estructurado en siete capítulos que abordan sucesivamente: introducción, historiografía sobre historia de la sanidad, la evolución histórica del modelo sanitario español, la organización de la higiene pública valenciana (1882-1936), la organización de la asistencia sanitaria valenciana (1854-1936), conclusiones y bibliografía. En las conclusiones hemos diferenciado la respuesta del sistema sanitario a los problemas colectivos de salud y las medidas de política sanitaria de las instituciones municipales y provinciales (institutos municipal y provincial de higiene, despensarios, etc.) y de asistencia (hospital, beneficiencia domiciliaria)

A corazón abierto: vivencias de madres y padres de menores con anomalías congénitas cardiacas

ResumenObjetivoExplorar con perspectiva de género las vivencias de madres y padres en los primeros momentos tras el diagnóstico de una anomalía congénita cardiaca en un/una hijo/a, integrando la visión de personal sanitario que atiende a estos/as menores y a sus familiares.MétodoEstudio de diseño cualitativo. Se realizaron cuatro entrevistas en profundidad a personal sanitario y cuatro grupos de discusión con madres y padres residentes en la Comunitat Valenciana. Los participantes se seleccionaron mediante muestreo intencionado. El análisis del discurso se trianguló entre ambas técnicas y entre investigadores, y se verificaron los resultados con madres, padres y profesionales sanitarios.ResultadosExisten diferencias entre madres y padres en la manera de expresar emocionalmente y afrontar el diagnóstico de una enfermedad grave en un/una hijo/a. Sin embargo, ambos progenitores manifiestan la necesidad de disponer de apoyo psicológico formal, y valoran positivamente el apoyo informal de otros/as padres/madres con vivencias similares.ConclusionesLa vivencia de la enfermedad en un/una hijo/a es diferente para madres y padres. Desde los servicios de salud debería prestarse atención al bienestar psicológico de las familias, incorporando los grupos de apoyo entre iguales y las asociaciones de pacientes como activos en salud.AbstractObjectiveTo explore, from a gender perspective, the experiences of mothers and fathers of children with congenital heart disease at the time of diagnosis, including the opinions of medical staff taking care of these children and their families.MethodsQualitative research. Four individual interviews with medical staff and four focus groups with mothers and fathers living in Valencia Region (Spain) were carried out. Participants were selected by purposive sampling. The discourse analysis was triangulated between techniques and researchers and the results were verified with mothers, fathers and medical staff.ResultsMothers and fathers differed in the way they expressed their emotions and in how they accepted the diagnosis of a serious illness in their child. However, both parents expressed the need for psychological support and highly appreciated the informal support from other parents with similar experiences.ConclusionsThe experience of the disease in a child is experienced differently by mothers and fathers. Health servies should pay attention to the psychological well-being of families, by including peer support groups and patient associations, which can play an important role as health assets

Fortalecimiento de la competencia social en estudiantes de noveno grado, a través de la lúdica en la Institución Educativa Núcleo Escolar Rural Caloto

El presente trabajo de investigación se desarrolló con el propósito de presentar una propuesta pedagógica que permita que los estudiantes de noveno grado de la IE. Núcleo Escolar Rural Caloto en el municipio de Caloto, departamento del Cauca, fortalezcan las habilidades de la competencia social, ya que en su mayoría se evidencian apáticos y con poco interés de participar en clase, compartir opiniones e ideas, trabajar en equipo y compartir con los compañeros de su misma clase. Mediante una metodología con enfoque mixto y de tipo investigación-acción, se recopila la información del Cuestionario de Desarrollo Emocional para Educación Secundaria CDE –SEC con 36 afirmaciones que permiten evaluar las competencias emocionales, tomando como referencia principal al investigador y teórico Rafael Bisquerra Alcina y sus estudios sobre las competencias sociales, la educación emocional y las competencias básicas para la vida. Como resultado del estudio, se presenta una propuesta metodológica que involucra cuatro juegos didácticos que incentivan la participación, comunicación e interacción entre y con compañeros y los docentes. Al ser una propuesta no implementada, se recomienda que se aplique de nuevo el cuestionario CDE-SEC para validación de impacto positivo o negativo en los estudiantes y su proceso comunicativo.This research work was developed with the purpose of presenting a methodological proposal that allows ninth grade students of the IE. Núcleo Escolar Rural Caloto in the municipality of Caloto, department of Cauca, to strengthen the skills of socioemotional competence, since most of them are apathetic and have little interest in participating in class, sharing opinions and ideas, working as a team and sharing with classmates. By means of a methodology with a mixed approach and action-research type, the information of the Emotional Development Questionnaire for Secondary Education CDE - SEC is compiled with 36 statements that allow evaluating the socioemotional competencies and micro competencies, taking as main reference the researcher and theorist Rafael Bisquerra Alcina and his studies on socioemotional competencies and emotional education and basic competencies for life. As a result of the study, a methodological proposal is presented that involves two didactic games that encourage participation, communication and interaction between and with classmates and teachers. As this proposal has not been implemented, it is recommended that the CDE-SEC questionnaire be applied again to validate the positive or negative impact on students and their communicative process

Health literacy: association with socioeconomic determinants and the use of health services in Spain

Background: Health literacy (HL) is the set of social and cognitive skills that determine person’s level of motivation and the ability to access, understand and use information to promote and maintain good health. The aim of this study is to assess the level of health literacy, and to analyze its relationship with sociodemographic variables, state of health, and use of health services in the population aged 15 and over in the Valencian Community (Spain). Methods: Cross-sectional study based on a sample of 5,485 subjects participating in the Health Survey of the Valencia Community. The HLS-EU-Q16 was used. As outcome variables we considered HL categorized into 2 levels: Inadequate or Problematic HL and Sufficient HL and the standardized literacy index. Prevalence rates and HL means were estimated and OR were calculated to analyze the association between variables. Results: A total of 12.8% of the subjects surveyed presented an inadequate or problematic degree of HL. This percentage was higher in people >85 years (63.1%), with a low level of education (46.5%), in retired people (27.4%) or in other work situations (25.0%), in foreigners (18.1%), in low-income people (16.2%), with a perception of poor health status (26.9%), chronic disease (18.5%) or with activity limitations (56.4% severe, 19.7% not severe). Significant differences were found. With the exception of chronic disease, all the variables analyzed were associated with HL. Low HL was associated with a lower consumption of medicines, a greater use of health services, general medical consultations, poorer knowledge of new health technologies and fewer preventive health visits. Conclusion: The percentage of inadequate or problematic HL was globally not very high, but certain population subgroups notably presented a high degree of inadequate or problematic HL. Raising the HL level of such groups should be regarded as a priority. HL was shown to be associated with the service use and new health technology use. Enhancing the population’s HL should lead to the following: a greater probability of adopting preventive practices; improving the use of the health system; and boosting people’s abilities to manage and to improve their own health

Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects

Background: In recent years the use of orthopantomography has been proposed as a low-cost, reliable and noninvasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Patient and Methods: The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. Results: For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). Conclusions: The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque

Immediate post-extraction implants subject to immediate

Since Brånemark first started developing its implant system, there has been a continuous and significant evolution in oral implantology through experimental and clinical research, and many of the concepts that were once considered valid have now become the subject of debate. The insertion of the implant immediately after extraction of the tooth to be substituted has now become the implant treatment of choice and is associated with preserving the bone structure and the gingival architecture, as well as with reducing the treatment time, which ultimately benefits the patient. Objective: To evaluate the success rate of the immediate post-extraction implants (IPI) subject to immediate loading. Study Design: A meta-analytic study was carried out on 659 immediate post-extraction implants obtained from a bibliographic review of 25 articles published within the last 9 years. Results: We obtained a sample of 322 patients who had been treated with a total of 659 implants placed immediately following extraction. The mean age of the patients was 51 years old. A total of 441 implants were inserted in the maxilla, 152 in the mandible and 64 were placed in an unspecified location. The survival rate ranged between 85% and 100%. Conclusions: Immediate post-extraction implant treatment is an implant alternative with a survival rate similar to that of the conventional technique for implant placement and enables preserving both the bone structure and gingival architecture, as well as providing immediate functional loading, thus improving the quality of the treatment as far as the patient is concerned. © Medicina Oral S. L

Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background: Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Methods: Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. Results: By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Conclusions: Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender

Las expresiones artísticas en el fortalecimiento de la convivencia escolar

Ante las manifestaciones agresivas identificadas en la interacción cotidiana de los estudiantes de la Institución Educativa General Alfredo Vásquez Cobo de Cali - jornada de la mañana, el proyecto “Espacios para IN…CORPOR…ARTE en la escuela”, promovió el diseño de una secuencia didáctica desde la asignatura de educación artística con la integración curricular de otras disciplinas, a partir de un Carnaval lúdico-pedagógico, buscando la participación de la comunidad estudiantil, la distensión de los modos de interacción, la construcción de nuevas relaciones y el goce estético en la socialización de los actos creativos genuinos. Desde esta perspectiva, la investigación optó por un tipo cualitativo con un enfoque descriptivo–interpretativo, y se matriculó en la línea institucional Pedagogía Medios y Mediaciones de la Fundación Universitaria los Libertadores; con este diseño se evidenciaron prácticas artísticas y el positivo encuentro de los saberes previos en espacios escolares, ello a partir de un aprendizaje significativo contextualizado en la realidad de un sujeto y generado a través de la lúdica, la cual, dentro del proyecto, permitió trascender las posibilidades de la creación artística, dando lugar a las expresiones sensibles y estéticas en el imaginario de los estudiantes, la fortaleza del trabajo colaborativo y los buenos resultados cuando en la escuela se integran las disciplinas para brindar una propuesta pedagógica atractiva y fundamentada en las necesidades reales del entorno de los estudiantes

Construction of an individual socioeconomic status index for analysing inequalities in colorectal cancer screening

Objective: To construct an individual socioeconomic status index (ISESI) with information available in the Population Information System of the Region of Valencia, Spain, and use it to analyse inequalities in a colorectal cancer screening programme (CRCSP). Methods: Cross-sectional study of men and women aged between 50 and 75 at the time of the study (2020) that were selected from the target population of the Region of Valencia CRCSP. (study sample 1,150,684). First, a multiple correspondence analysis was performed to aggregate information from the Population Information System of the Region of Valencia into an ISESI. Second, data from the 2016 Region of Valencia Health Survey were used for validation, and finally the relationship between CRCSP participation and the ISESI was analysed by logistic regression models. Results: The variables included in the index were nationality, employment status, disability, healthcare coverage, risk of vulnerability and family size. The most important categories for determining the highest socioeconomic status were being employed and not being at risk of social vulnerability, and being unemployed and at risk of social vulnerability for determining the lowest socioeconomic status. Index validation demonstrated internal and external coherence for measuring socioeconomic status. The relationship between CRCSP participation and the ISESI categorised by quartile (Q) showed that Q4 (the lowest socioeconomic status) was less likely to participate OR = 0.769 (0.757–0.782) than Q1 (the highest socioeconomic status), and the opposite was found for Q2 OR = 1.368 (1.347–1.390) and Q3 OR = 1.156 (1.137–1.175). Conclusions: An ISESI was constructed and validated using Population Information System data and made it possible to evaluate inequalities in colorectal cancer screening.AMB, DS: PI18/01669, the Instituto de Salud Carlos III, co-founded by the European Regional Development Fund (ERDF). https://www.isciii.es

Health literacy: psychometric behaviour of the HLS-EU-Q16 questionnaire

Objetivo: Describir las propiedades psicométricas y el nivel de comprensión del cuestionario de alfabetización en salud HLS-EU-Q16 en español, implementado en la Encuesta de Salud de la Comunitat Valenciana de 2016. Método: Estudio descriptivo transversal para describir la comprensión, la fiabilidad, la estructura y la consistencia interna del cuestionario sobre la muestra de 5485 sujetos, de 15 o más años de edad, participantes en la encuesta. Resultados: Los porcentajes de comprensión sin mucha dificultad fueron elevados. La fiabilidad fue alta (coeficiente de correlación intraclase: 0,923; kappa: 0,814). El análisis factorial sugirió una estructura unifactorial (79,1% de variabilidad explicada por el factor común), con altas cargas factoriales. La consistencia fue alta (alfa de Cronbach: 0,982). Conclusiones: El HLS-EU-Q16 en español es un instrumento breve, adecuado y válido para medir el nivel de alfabetización en salud de la población.Objective: To describe the psychometric properties and the level of understanding of the health literacy questionnaire HLS-EU-Q16 in Spanish, implemented in the Health Survey of the Valencian Region (Spain) of 2016. Method: Descriptive cross-sectional study to describe understanding, reliability, structure and internal consistency of the questionnaire on a sample of 5485 subjects, aged 15 or over, who participated in the survey. Results: The percentages of understanding without much difficulty were high. Reliability was high (intraclass correlation coefficient:.923; kappa:.814). The factorial analysis suggested a unifactorial structure (79.1% of variability explained by the common factor), with high factorial loads. The consistency was high (Cronbach's alpha: 0.982). Conclusions: The HLS-EU-Q16 in Spanish is a short, adequate and valid instrument to measure the level of health literacy in the population.Este estudio cuenta con financiación parcial procedente de una ayuda a la investigación concedida por la Fundación para la Investigación Sanitaria y Biomédica (FISABIO) de la Comunitat Valenciana (UGP-15-166)