Balneario: La definición de una tradición milenaria en Andalucía

We define the health resorts as establishments that have as a fundamental characteristic the use of medicinal mineral waters declared of public utility, with facilities and medical equipment to perform the treatments derived from this speciality. A health resort in Andalusia is subject to different legal competencies in relation to the Administration: the declaration of public utility will depend on the Autonomous Administration; also of the Ministry of Healthcare, because many of them are considered sanitary places and follow the protocol of clinics regarding requirements and inspections; of Tourism Ministry because these places are declared tourist interest, and the Local Administration depends on their relationship in terms of building permits, maintenance of public roads, drinking water and urban waste. Thus, experts consulted in a study carried out between 2009 and 2010 on this type of establishments in Andalusia support the need for specific legislation on them in Andalusia.Definimos a los balnearios como los establecimientos que tienen como característica fundamental la de utilizar aguas minero medicinales declaradas de utilidad pública, con equipamientos e instalaciones y equipo médico para realizar los tratamientos derivados de esta especialidad. Un balneario en Andalucía está sujeto a distintas competencias de Administraciones: de la Administración Autonómica dependerá la declaración de utilidad pública; de Sanidad porque muchos de ellos son considerado lugares sanitarios sujetos y siguen el protocolo de clínicas en cuanto a exigencias e inspecciones; de Turismo porque estos lugares están recogidos y definidos como de interés turístico y de la Administración Local depende su relación en cuanto a permisos de construcción, mantenimiento de vías públicas, agua potable y residuos urbanos. Así, los expertos consultados en un estudio realizado entre 2009 y 2010 sobre balnearios de Andalucía apoyan la necesidad de una legislación específica sobre balnearios de Andalucía

Asbestosis: un riesgo no siempre visible que amenaza a los trabajadores de la construcción.

If we propose a new approach to organisations synthesised in the "Management of Happiness" that seeks human talent so that companies can improve their competitiveness, productivity and profitability, we cannot leave aside one of the great threats that looms over workers and that affects happiness at work and, in short, organisational management, such as the issue addressed in this communication, which is the great threat posed by the indiscriminate use of asbestos in our societies. Asbestos is a carcinogenic element recognised as such by the International Office of Cancer and although it is banned in many countries such as the European Union, there are many others where it is still used such as China or Russia and despite this ban, its massive use since the Second World War has meant that the trace of materials with asbestos is extensive and present in many buildings forming part of pipes, water tanks, roof coverings, etc., which constitutes a major problem of environmental pollution and public health which can be affected especially workers in the construction sector. Therefore, the aim of this work was to see from a practical point of view the difficulty of managing the prevention of occupational risks due to asbestosis in the workers of Micro-SMEs and Self-Employed Workers in the Construction Sector. The study was carried out using the Expert Panel technique with a total of 10 professionals with extensive experience in the Construction Sector and Occupational Risk Prevention.The experts concluded that the greatest difficulty in carrying out an adequate Asbestosis Prevention Management of the group studied was the hidden asbestos as there is no census of affected buildings and constructions and the lack of awareness in a disease with a latency period of between 35-40 years where the cause-effect relationship is not so evidentUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Antecedentes y consecuentes de la satisfacción online : el caso de las webs comparadoras de precios de moda.

Las webs comparadoras de precios han modificado el comportamiento del consumidor de moda, siendo clave en la elección del producto. En este sentido, la evaluación que realiza el consumidor sobre ellas marca sus actitudes hacia la compra. En caso de ser positiva, se demuestra que la satisfacción y la lealtad se ven aumentadas, permitiendo el éxito de la web. Por ello, este trabajo analiza cómo la un diseño accesible, navegable y que facilite la transacción favorecen una evaluación positiva, llevando al consumidor a estar satisfecho, y así percibir mayores beneficios, confiar y ser leal. A partir de una muestra de 141 usuarios habituales de webs comparadores de precios se han obtenido unos resultados, mediante la técnica de PLS (SmartPLS 3.1), que permiten extender al sector de la moda las conclusiones obtenidas en otros ámbitos, destacando la importancia del diseño web en la mejora de las actitudes del consumidor de moda.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

El sindrome de burnout en los dentistas en España

[ES] Cualquier profesional o trabajador en el desarrollo de su labor, centrada en el trato a los demás, puede desarrollar el síndrome de burnout. En concreto a la profesión de dentista se le suma el entorno de crisis económica que presumiblemente ha provocado que las familias reduzcan el gasto en salud dental y de un importante aumento de la oferta de servicios dentales debido a la incorporación masiva de nuevos titulados. En esta tesis comprobamos la validez del cuestionario MBI-GS para medir el grado de riesgo de síndrome de burnout y evaluar la asociación de variables sociodemográficas, socioprofesionales y económicas con el riesgo de padecer este síndrome en los dentistas españoles con actividad privada

Prevention of Occupational Hazards Due to Asbestos Exposure in Dentistry. A Proposal from a Panel of Experts

Asbestos in all its forms is a Group 1 material agent with proven carcinogenic effects in the human being since 1977. Exposure to asbestos can be considered unsafe. The use of asbestos in the field of dentistry had a common use in the manufacture of dental prostheses in the 1960s and 1970s. Taking into account the long induction period of this agent and the plausibility for being a risk factor in dentistry, the objective of this study is to propose a plan for the prevention of occupational risks due to asbestos exposure in dentistry by means of the contribution of a panel of experts. An Expert Panel (EP) approach was used in which a group of nine experts identified and documented the use of asbestos in the dental profession. EP was created and followed the protocol in accordance with the EuropeAid Assessment Guidelines. As a result of this study, EP documented the common use and sources of asbestos in dentistry in prosthetic materials, dental dressings, and in the coating of casting cylinders. EP also created a consensus document on the priority measures for the Plan for the Prevention of Risks from Asbestos in Dentistry, based on previous reports from the European Commission Senior Labour Inspectors’ Committee. The document concluded that obtainment of information, receiving specific training on the subject and performing epidemiological studies, and the proper risk assessments were the priority measures to adopt

Validation of a Satisfaction Questionnaire on Spa Tourism

The authors’ line of research is within the existing methodological debate around the concepts of quality of services, destinations, and quality measurements methods. The authors consider that the most appropriate way to measure quality is to develop instruments according to the destination and context in question, defining the quality of the tourist destination for practical purposes based on the satisfaction experienced by the tourist or the SERVPERF model, weighted and used to measure the quality of sun and beach tourist destinations. The authors of this work propose the knowledge of spa tourism, its quality and its level of satisfaction as a research gap and consider it as a starting point to validate a questionnaire that would allow the measurement and comparison of parameters with other segments already studied and that can also serve as a measuring instrument for tourist segments with similar characteristics, not as well known in the international literature as inland, ecological or nature tourism. Good internal reliability results were obtained in all items and in all dimensions. The factor analysis distributed the weights of the variables in the theoretical model, and construct validity was obtained with an association between the global evaluation by dimension and the general significance. The score of the main questionnaire was statistically significant

Usability Analysis of Andalusian Spas’ Websites

Health tourism is booming all over the world, and thermal spa tourism in Spain is a type of tourism aimed at integrating with nature, achieving sustainable development. In general, its facilities are located in areas specially protected by environmental legislation. This tourism sector attracts an increasingly wide market segment that has become more demanding and better informed and that more frequently uses the Internet to gather information. Tourists’ shopping and consumption habits are increasingly influenced by new information and communication technologies (ICTs), making these a topic of interest among academics and professionals. Website development has been shown to be an area of innovation for spa facilities, but evidence has also been found that this sector has experienced difficulty in adopting ICTs. This research sought to analyse spa websites’ usability by conducting an exploratory investigation of different websites’ contents. The results reveal that the use of new web technologies by spas is underdeveloped, although these facilities have achieved good positions in Internet search engines due to the synergistic effect of the official tourism websites. That is why most of them tell their story, detail their nature and the protection of their spaces. In this way, spas turn their websites into communication channels that convey to tourists their commitment to the environment and sustainable development

Factors Associated with Spa Tourists’ Satisfaction

Most spas are surrounded by beautiful natural environments, so these facilities contribute to sustainable economic development and their guests are national and local tourists with a high average stay. This study has the objective of analyzing the factors associated with the level of satisfaction and the profile of spa tourists in Andalusia, southern Spain. The methodology used was a quantitative study based on a stratified cross-sectional survey. Each stratum was a spa, with a population of 53,231 users per year, whose final sample included 725 users. The results found were that the profile of Andalusian spa tourists is predominantly female, over 56 years old, and retired with average incomes below one thousand euros. The level of satisfaction of its users is above the average in the factors of accommodation, restaurants, spa, and public roads and natural environment and most of these clients would recommend it to others [92.4%] and express the intention to return [63.6%] which indicates that Andalusian spas show a very high level of customer loyalty. The study has the limitation of being cross-sectional quantitative research carried out in Andalusia that could be complemented in future research with a qualitative study with experts. The research presents contributions for companies since they could develop strategies to attract users with younger profiles with activities, prices, or spaces that are more appropriate to their needs and seek the conditions to increase the satisfaction of these segments. The study is original since this research is a quantitative study that shows the real profile of the Andalusian spa tourist and their high level of satisfaction with the spa and their loyalty. The surveys were conducted at each spa by a face-to-face researcher with a response rate of 98%

A Typology of Spa-Goers in Southern Spain

This study sought to obtain conglomerates of spa-goers in Andalusia, Spain, based on a survey of 10 spas’ users. The data from 725 valid survey questionnaires were analysed using a quantitative approach. The results show that 44.6% of users are between 65 and 88 years old and more than 60% are women. Approximately 50% of the respondents are retired, and 60% report a monthly income of less than 1000 euros. Three clusters were identified in the segmentation analysis: users with lower, partial and higher satisfaction. Over half (58%) of the respondents belong to the higher satisfaction segment. Thermal tourism evidently has a strong potential for attracting other tourist segments. Andalusia has thermal springs that attract many tourists, which are located in places of great natural beauty and are part of inland towns’ economic development. The findings confirm the need to improve the existing understanding of spa-user typologies. The benefits derived from health tourism can be analyzed from the concept of value proposition for the company, the user, the community and its environment. To generate income, spa companies must meet the expectations of stakeholders and this begins with an organization that constantly learns and innovates to satisfy users. The managers of the spas lead these projects, introducing important changes in their offer, from traditional medical aspects to facilities and therapies based on relaxation and sustainable natural tourism, promoting their organizations with sustained objectives over time capable of satisfying all stakeholders, creating value capable of attracting and satisfying the different segments of spa tourists, as this study shows