Adolescents and youths’ opinions about the factors associated with cannabis use: a qualitative study based on the I-Change model

Background To learn about the experiences and opinions of adolescent non-consumers and regular cannabis users about cannabis use and the factors that determine its use, using the I-Change explanatory model as a basis. Methods Qualitative methodology with a content analysis was used. Focus groups were conducted with adolescents who were non-regular cannabis users (those who had not tried cannabis or had only experimented with it before) and semi-structured interviews were conducted with adolescent and young adult in recovery who were in a detoxification program. A deductive analysis of the audio-recorded and transcribed interviews was performed, using the domains of the I-Change Model as a reference. Results Personal problems, social problems or family problems can lead to cannabis use. There was a lack of knowledge and low risk perception about consumption of this drug. There are other factors that influence consumption, the perception of advantages, such as the feeling of freedom and the influence of the peer group. The consumption of this substance in girls is changing, becoming more and more equal to that of boys. The family has an important role to play in preventing drug use. Conclusion Knowledge of these factors is of vital importance as a prior step to the development of efficient intervention measures adjusted to the needs identified and the characteristics of the population. Keywords I-Change model, Nursing, Cannabis, Qualitative researc

Sexual behaviour, human papillomavirus and its vaccine: a qualitative study of adolescents and parents in Andalusia

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections and can be prevented by vaccination. The purpose of this study is to gain a better understanding, by analysing interview responses of adolescents and parents, of how adolescent sexual behaviour is approached in families, how widespread knowledge about HPV is in Andalusia, the autonomous region with the lowest vaccination rate in Spain, as well as to learn more about the interviewees’ position regarding vaccination. Methods: A qualitative study by means of 15 focus groups of adolescents (N = 137, aged 14–17 years) and five focus groups of parents with children of those ages (N = 37) was conducted in the provinces of Granada, Seville and Jaén (Andalusia, Spain). The audio data were transcribed verbatim, coded and analysed thematically using NVIVO-10 software. Results: There were three major results: (1) There is a lack of communication between adolescents and parents regarding sexual behaviour; (2) In both groups, scarce knowledge about HPV and vaccination was found; (3) Parents mistrust vaccination due to a lack of qualified and verified information about its benefits. Conclusions: Healthy adolescent sexual behaviour is aided by communication within the family. Families need more information based on the evidence about HPV and vaccination. Health professionals are a key element in this process

Opinions of Andalusian primary health care professionals about human papillomavirus and its vaccine

Fundamento. El virus del papiloma humano (VPH) es una de las enfermedades de transmisión sexual más comunes, pero su tasa de vacunación es de las más bajas en Andalucía. El objetivo de este estudio es conocer las opiniones de los profesionales sanitarios de Atención Primaria sobre la prevención en adolescentes de la infección por el VPH y la administración de su vacuna. Método. Investigación cualitativa mediante seis grupos focales con profesionales de centros de Atención Primaria de Sevilla, Granada y Jaén. Participaron 45 profesionales sanitarios. Se realizó un análisis de contenido de tipo semántico con categorización de respuestas en unidades temáticas. Resultados. Los profesionales reconocen las dificultades de llegar a la población adolescente en temas de prevención de conductas sexuales de riesgo, por falta de tiempo y poca preocupación de los adolescentes por las medidas preventivas. Aunque reconocen la sintomatología de la infección por el VPH, no todos tienen claro si el varón padece la enfermedad así como la asociación de la infección con canceres distintos al de cérvix. Dudan a la hora de recomendar la vacuna, dejando en manos de los progenitores la decisión de la vacunación de sus hijas. Conclusiones. Sería recomendable establecer estrategias que mejoren la información que tienen los profesionales acerca del VPH, así como de los beneficios de la vacuna, para que los trasmitan claramente y con asertividad a los padres; esto evitaría incertidumbre en los progenitores, mejoraría las tasas de vacunación y disminuiría las complicaciones de la infección (cáncer).Background. The human papillomavirus (HPV) is the most common sexually transmitted disease, but its vaccination coverage is among the lowest in Andalusia. The aim of this study is to determine what primary health care professionals think and find out about the prevention of HPV infection among adolescents and the administration of the vaccine Method. Qualitative study using six focus groups with professionals from Primary Health Care in Seville, Granada and Jaen. Fourty-five professionals participated. An analysis of the semantic content was made, and answers were categorized in thematic units. Results. Professionals recognize the difficulties in reaching the adolescent population concerning prevention of sexual risk behaviors, due to lack of time and little concern amongst adolescents about the preventive measures. Although the professionals recognize the symptoms of HPV infection, some did not know about the disease in men as well as the association with other cancers other than cervical cancer. They hesitate over whether to recommend the vaccine or not, leaving the decision to vaccinate their daughters in the hands of the parents. Conclusion. It would be advisable to establish strategies that improve the information that the professionals have about HPV as well as the benefits of the vaccine, so that they can transmit the benefits clearly and assertively to the parents. This would avoid parental uncertainty, improve vaccination rates, and decrease complications of infection (cancer)

Transexualidad y transgénero desde una visión de género

Presentamos el diseño y los primeros resultados de una investigación que desde una perspectiva antropológica y con metodología cualitativa, estamos realizando para conocer aspectos psicosociales de la construcción de género de las personas transexuales. De este modo pretendemos abarcar la problemática del colectivo transexual de manera global. Para seleccionar la muestra para la realización de las entrevistas en profundidad hemos tenido en cuenta: Un marco de edad suficientemente amplio; El nivel de estudios ;Lugar de nacimiento ; Tipo de transexualidad ; La ocupación ; Haber sido víctima o no de malos tratos. El análisis de las entrevistas a transexuales nos está permitiendo conocer que entre las transexuales de hombre a mujer existen diferencias significativas con los de mujer a hombre. Además entre el colectivo hay una gran heterogeneidad tanto en sus vivencias como en sus objetivos de vida, aunque hay que resaltar el alto grado de sufrimiento que ambos grupos padecen

Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol

Introduction Vaccination is a fundamental intervention in disease prevention; therefore, the advice and recommendations of health professionals have a major influence on the population’s decision to be vaccinated or not. Professionals must have sufficient competencies to carry out their work and recommend vaccination with evidence-based knowledge. The aim is to design and validate a strategy to improve professional competencies in vaccination to positively influence adherence and increase vaccination rates in the population. Methods and analysis Training will be designed based on evidence and previous studies and piloted with healthcare providers. To test changes in knowledge, a pretest and post-test will be conducted. To test feasibility, a think-aloud method will be used with participants and triangulated with focus groups using SWOT (strengths, weaknesses, opportunities and threats) analysis. Transfer will be measured using the questionnaire ‘factors for the indirect evaluation of transfer’ and an efficacy questionnaire 1½ months later; for satisfaction, an ad hoc questionnaire will be used. A summative approach will be used for the analysis of the focus groups and descriptive and bivariate statistics for the questionnaires. Ethics and dissemination This study was approved by the Andalusian Research Ethics Committee, Spain (approval number: 0524-N- 20). The results will be made available to the public at journal publications and scientific conferences

¿Hacia la despatologización de la transexualidad?: Apuntes desde una lógica difusa

Una breve historia del género, su origen y evolución, el concepto de transexualismo de la OMS y la APA y una crítica de la dicotomía del sistema sexo/género que constituye la base de la definición del Transexualismo como patología

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective