El tractament amb perfusors d'insulina a Catalunya

Control glucèmic; Insulina; DiabèticsGlycemic control; Insulin; DiabeticsControl glucémico; Insulina; DiabéticosEn aquest article s'exposen els criteris que han de complir els pacients per determinar si són tributadors del tractament amb perfusor d'insulina, així com els requeriments que han de complir els centres assistencials que els prescriguin.This article sets out the criteria that must be met to determine if patients are recipients to be treated with insulin perfusor, as well as the requirements to be met by the prescribed health centers.En este artículo se exponen los criterios que deben cumplir los pacientes para determinar si son tributadores del tratamiento con perfusor de insulina, así como los requerimientos que deben cumplir los centros asistenciales que los prescriban

Nous perfils professionals a l’atenció primària: revisió ràpida

Rols professionals; Atenció primària; Pla d’enfortiment i transformacióRoles profesionales; Atención primaria; Plan de fortalecimiento y transformaciónProfessional roles; Primary care; Strengthening and transformation planEl nou Pla d’enfortiment i transformació de l’AP de salut treballa des de diferents mitjans d’intervenció, un dels quals és el vinculat a professionals. Des d’aquest àmbit d’actuació, es vol enfortir el rol del metge/essa i del infermer/a i maximitzar les competències professionals mitjançant la promoció dels tècnics en cures auxiliars d’infermeria (per donar suport a infermeria en seguiment de pacients, realització de tècniques i promoció de la salut), o a través de la incorporació de nous rols com el de gestor de salut (per donar suport als professionals sanitaris, descarregar-los de tasques administratives, millorar l’experiència del pacient i la satisfacció dels professionals), el de dietista-nutricionista (per ajudar a cobrir les necessitats assistencials de la població i la comunitat en matèria de nutrició i dietètica), així com amb la incorporació d’altres rols (per ex.: el referent de benestar emocional comunitari per ajudar en la prevenció i promoció del benestar emocional de la comunitat).El nuevo Plan de fortalecimiento y transformación de la AP de salud trabaja desde diferentes medios de intervención, uno de los cuales es el vinculado a profesionales. Desde este ámbito de actuación, se quiere fortalecer el rol de médico/a y del enfermero/a y maximizar las competencias profesionales mediante la promoción de los técnicos en cuidados auxiliares de enfermería (para dar apoyo a enfermería en el seguimiento de pacientes, realización de técnicas y promoción de la salud), o a través de la incorporación de nuevos roles como el de gestor de salud (para dar apoyo a los profesionales sanitarios, descargándolos de tareas administrativas, mejorando la experiencia del paciente y la satisacción de los profesionales), el de diestista-nutricionista (para ayudar a cubrir las necesidades asistenciales de la población y de la comunidad en materia de nutrición y dietética), así como la incorporación de otros roles (por ejemplo: el referente de bienestar emocional comunitario para ayudar en la prevención y promoción del bienestar de la comunidad).The new Plan for the strengthening and transformation of health PC works through different means of internvention; one of them is linked to professionals. In this field of action, it is aimed to strengthen the role of doctors and nurses to maximise professional competences by promoting auxiliary nursing care technicians (to support nurses in the monitoring of patients, carrying out techniques and promoting health), or through the incorporation of new roles such as health manager (to suppot health professionals, relieving them of administrative tasks and improving patient experience and professional satisfaction), dietitian-nutritionist (to help meet the nutrition and dietetic care needs of the population and the community), as well as the incorporation of other roles (e.g. the community health and emotional well-being to assist in the prevention and promotion of the community’s wellbeing)

School Menu Review Programme (PReME): evaluation of compliance with dietary recommendations during the period 2006–2020 in Catalonia

Menús escolars; Compliment de les recomanacions dietètiques; Nutrició infantilMenús escolares; Cumplimiento de las recomendaciones dietéticas; Nutrición infantilSchool menus; Compliance with dietary recommendations; Child nutritionBackground: The School Menu Review Programme (PReME) has been offering complimentary revisions of meal plans to all schools in Catalonia since 2006. This study aims to assess the evolution of compliance with PReME’s recommendations in the meals provided by school cafeterias in Catalonia during the period 2006–2020. Methods: Pre-post study with a sample of 6,387 meal plans from 2221 schools assessed during the period. The information was collected mainly by public health specialists within the annual technical and sanitary inspection of school kitchens and cafeterias. Meal plans were evaluated by Dietitian-Nutritionists team according to the criteria of the National Health System’s “Consensus document on nutrition in schools” and the Public Health Agency of Catalonia’s current guide “Healthy eating at school”. Reports were sent to each participating school. A few months later, a new meal plan and another questionnaire were collected and evaluated in comparison with the first meal plan. Compliance with the recommendations was analysed based on the type of canteen management and the school category. Results: Compliance improved during the study period. The percentage of schools that complied with dietary recommendations in relation to the five PReME indicators (fresh fruit, pulses, daily vegetables, fresh food and olive oil for dressing) has steadily increased since PReME began, (over 70% in all indictors; p = < 0.001), with variations depending on school category and cafeteria management. Furthermore, an improvement in the levels of compliance with de recommended food frequencies was observed. with statistically significant differences for all items (p < 0.001), except for pulses whose compliance had been high since the beginning of the study (p = 0.216). Conclusions: The positive evolution in compliance with PReME’s recommendations provides evidence of the programme’s effectiveness, with an improvement in the quality of school meals delivered in Catalonia

Aplicació de metodologia qualitativa en l’avaluació de serveis sanitaris i promoció de la salut

Metodologia qualitativa; Avaluació de serveis sanitaris; Promoció de la salutMetodología cualitativa; Evaluación de servicios sanitarios; Promoción de la saludQualitative methodology; Evaluation of health services; Health promotionAquest article fa una breu pinzellada de l’ús de la metodologia qualitativa tant en l’avaluació de serveis sanitaris i de promoció de la salut com en el desenvolupament i implementació de programes de salut. Alhora fa una breu reflexió al voltant de les barreres i els facilitadors per a la incorporació d’aquests tipus d’aproximacions qualitatives, així com els reptes futurs que s’espera que anirem superant.Este artículo hace una breve pincelada del uso de la metodología cualitativa tanto en la evaluación de servicios sanitarios y de promoción de la salud como en el desarrollo e implementación de programas de salud. Asimismo hace una breve reflexión en torno a las barreras y los facilitadores para la incorporación de estos tipos de aproximaciones cualitativas, así como los retos futuros que se espera que iremos superando.This article gives a brief overview of the use of qualitative methodology in the assessment of health services and health promotion as well as in the development and implementation of health programs. At the same time, it makes a brief reflection on the barriers and facilitators for the incorporation of these types of qualitative approaches, as well as the future challenges that are expected to be overcome

Promoting physical activity through primary health care: the case of Catalonia

Background: In adults, as little as 10 minutes of moderate physical activity (PA) three times a day can help prevent non-communicable diseases and prolong life expectancy. The aim of the study was to evaluate the process and impact of scaling up a complex intervention (PAFES) implemented in Catalonia, aimed to increase the proportion of adults complying with PA recommendations (especially those with cardiovascular risk factors). Methods: The intervention, piloted in 2005, had three elements: 1) establishing clinical guidelines for PA; 2) identifying local PA resources; 3) PA screening and advice in primary health care (PHC) settings, based on stage of change. Central and local level implementation activities included training, support to municipalities, dissemination through a web page, and promotion of World Physical Activity Day (WPAD). Evaluation followed the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), identifying 3-6 variables for annual evaluation of each dimension. These included coverage of PA screening and advice and individuals with access to a healthy exercise route (Reach), increased PA level between 2006 and 2010-15 (Effectiveness), PAFES adoption by PHC centres and municipalities (Adoption), process evaluation data (Implementation), and cost (Maintenance). Results: PHC screening coverage increased from 14.4% (2008) to 69.6% (2015) and advice coverage from 8.3% (2012) to 35.6% (2015). In 2015, 82.5% patients had access to a “healthy route” (Reach). The proportion of patients with at least one cardiovascular risk factor who were “sufficiently active” increased from 2006 to 2010-2013 (Effectiveness). By 2015, PAFES was applied by all PHC teams, 8.3% municipalities and 22.7% PHC centres had organized WPAD events (Adoption). The Plan showed good penetration in all health regions by 2013, with relatively low use of resources and estimated cost (Implementation). By 2013 the Plan was embedded within the health system (Maintenance). Conclusions: In the first application of the RE-AIM framework to evaluate the scaling-up of a PA plan, PAFES showed good results for most RE-AIM indicators. Changes in priority and investment in health promotion programs affect reach, adoption, and effectiveness. It is important to maintain support until programs are strongly embedded into the health system

Bases per a la promoció de l'envelliment actiu i saludable

Envelliment saludable; Gent gran; RecomanacionsHealthy aging; Old People; RecommendationsEnvejecimiento saludable; Gente mayor; RecomendacionesAquest document de bases per a la promoció de l'envelliment actiu i saludable s'ha elaborat en col·laboració amb diferents Departaments, entitats, institucions i esperem que ajudi a millorar la salut de la gent gran de Catalunya

Recomanacions per a l’alimentació en la primera infància (de 0 a 3 anys) [manual]

Hàbits alimentaris; Infància; Nous alimentsHábitos alimenticios; Infancia; Nuevos alimentosFeeding Habits; Childhood; New foodsAquesta guia, fruit del treball i consens de diferents professionals de la pediatria, la docència i la nutrició hauria de ser un instrument útil d’informació i d’assessorament tant per als professionals dels centres d’atenció primària que ofereixen consell alimentari com per a les famílies i les persones responsables d’escoles bressol, amb l’objectiu de millorar la qualitat de l’alimentació dels infants i el seu desenvolupament

Fatty liver index as a predictor for type 2 diabetes in subjects with normoglycemia in a nationwide cohort study

Our aim was to evaluate whether fatty liver index (FLI) is associated with the risk of type 2 diabetes (T2DM) development within the Spanish adult population and according to their prediabetes status; additionally, to examine its incremental predictive value regarding traditional risk factors. A total of 2260 subjects (Prediabetes: 641 subjects, normoglycemia: 1619 subjects) from the [email protected] cohort study were studied. Socio-demographic, anthropometric, clinical data and survey on habits were recorded. An oral glucose tolerance test was performed and fasting determinations of glucose, lipids and insulin were made. FLI was calculated and classified into three categories: Low ( 60). In total, 143 people developed diabetes at follow-up. The presence of a high FLI category was in all cases a significant independent risk factor for the development of diabetes. The inclusion of FLI categories in prediction models based on different conventional T2DM risk factors significantly increase the prediction power of the models when all the population was considered. According to our results, FLI might be considered an early indicator of T2DM development even under normoglycemic condition. The data also suggest that FLI could provide additional information for the prediction of T2DM in models based on conventional risk factors

El tractament amb perfusors d'insulina a Catalunya

Control glucèmic; Insulina; DiabèticsGlycemic control; Insulin; DiabeticsControl glucémico; Insulina; DiabéticosEn aquest article s'exposen els criteris que han de complir els pacients per determinar si són tributadors del tractament amb perfusor d'insulina, així com els requeriments que han de complir els centres assistencials que els prescriguin.This article sets out the criteria that must be met to determine if patients are recipients to be treated with insulin perfusor, as well as the requirements to be met by the prescribed health centers.En este artículo se exponen los criterios que deben cumplir los pacientes para determinar si son tributadores del tratamiento con perfusor de insulina, así como los requerimientos que deben cumplir los centros asistenciales que los prescriban

Factores asociados al sobrepeso y la obesidad en escolares de 8 a 9 años de Barcelona

ABSTRACT Background: Childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. The aim of this study was to identify the prevalence of overweight, obesity and its determinants in schoolchildren between 8-9 years old from Barcelona. Methods: Cross-sectional study of a representative sample of 3,262 schoolchildren in 2011. Body Mass Index (BMI) was calculated following the criteria established by the World Health Organization (z-scores). Variables on eating behaviour, physical activity and use of new technologies were studied through 2 questionnaires. Logistic regression models were adjusted, obtaining adjusted odds ratio and their confidence intervals (95%). Results: The prevalence of overweight was 24.0% and 12.7% for obesity. Obesity was significantly higher in boys than in girls (14.8% vs 10.8%.). No statistically significant differences were observed in the compliance of recommendations of physical activity practice and use of new technologies according to BMI. Factors associated with obesity in boys were to attend a school located in a neighbourhood of disadvantaged socio-economic status [ORa=1.88 (1.35-2.63)], to belong to an immigrant family [ORa=1.57 (1.12-2.20)], to do not eat at school [ORa=1.76 (1.20-2.59)] and to have some meal alone [ORa=1.95 (1.27-3.00)]. In girls associated factors were to belong to a single-parent family [ORa=1.58 (1.06-2.34)] and to an immigrant family [ORa=1.53 (1.07-2.18)]. Conclusions: The prevalence of childhood obesity in Barcelona is high. It is more common in boys, being the social determinants most relevant associated factors.RESUMEN Fundamentos: El sobrepeso y la obesidad infantil han aumentado progresivamente en las últimas décadas, especialmente en países del sur de Europa. El objetivo del estudio fue identificar la prevalencia de sobrepeso, obesidad y sus determinantes en escolares de 8-9 años de Barcelona. Métodos: Estudio transversal descriptivo de una muestra representativa de 3.262 escolares en 2011. Se calculó el Índice de Masa Corporal (IMC) siguiendo los criterios establecidos por la Organización Mundial de la Salud (z-scores). Se estudiaron variables sobre conducta alimentaria, actividad física y uso de nuevas tecnologías mediante 2 cuestionarios. Se ajustaron modelos de regresión logística, obteniendo odds ratio ajustadas e intervalos de confianza (95%). Resultados: La prevalencia de sobrepeso fue del 24,0% y de obesidad del 12,7%. La obesidad fue significativamente mayor en niños que en niñas (14,8% vs. 10,8%). No se observaron diferencias estadísticamente significativas según IMC en el cumplimiento de las recomendaciones de práctica de actividad física ni uso de nuevas tecnologías. Los factores asociados a la obesidad en niños fueron asistir a escuela situada en barrios de nivel socioeconómico desfavorable [ORa=1,88 (1,35-2,63)], pertenecer a familia inmigrante [ORa=1,57 (1,12-2,20)], no comer en el colegio [ORa=1,76 (1,20-2,59)] y hacer alguna comida solo [ORa=1,95 (1,27-3,00)]. En niñas fueron pertenecer a familia monoparental [ORa=1,58 (1,06-2,34)] y familia inmigrante [ORa=1,53 (1,07-2,18)]. Conclusiones: La prevalencia de obesidad infantil en Barcelona es alta. Es más frecuente en niños, siendo los determinantes sociales los factores asociados de mayor relevancia