Analysis of the formulation of policies on aging in plans for social and health care and care of the elderly in autonomous communities in Spain

Objetivo: Describir y comparar la formulación de las políticas autonómicas sobre envejecimiento en España disponibles en el año 2002. Material y método: Se analiza la formulación de las políticas sobre envejecimiento en las comunidades autónomas que tienen publicado un plan específico de atención a las personas mayores o un plan sociosanitario, que incluye atención a las personas mayores, comparando con un estándar de referencia. Resultados: Siete comunidades autónomas tenían en 2002 un documento de las características del estudio. Seis de ellos son planes sociosanitarios, que incluyen una parte específica de atención a las personas mayores; en Canarias hay un plan específico de atención a las personas mayores en el nivel primario de salud. Existen diferencias en el número de intervenciones que propone cada región, entre un rango de 14 (Cataluña) hasta 44 acciones (Cantabria), de las 62 propuestas en el estándar de referencia. Cantabria y Extremadura son las únicas que plantean acciones en todos los ámbitos posibles. Existe una gran variabilidad en los planes, en función de su orientación al aspecto individual y curativo (Extremadura), o hacia los aspectos sociales y preventivos (Cantabria). Conclusiones: El número de propuestas de los diferentes planes está por debajo de lo que sería posible realizar según el estándar de referencia utilizado en esta comparación. En general, los planes están más orientados hacia fases más tardías de la dependencia y al entorno próximo de las personas mayores.Objective: To describe and compare the formulation of policies on aging in the autonomous communities of Spain available in 2002. Material and method: The formulation of policies on aging in autonomous communities that published a specific plan on the care of the elderly or a social and health care plan that included elderly care were compared with a standard. Results: In 2002, seven autonomous communities had a document with the above-mentioned characteristics. Six of these were social and health care plans that included a specific section on the care of the elderly; the Canary Islands had a plan for the care of the elderly in primary care. Differences were found in the number of interventions proposed by each autonomous community, ranging between 14 (Catalonia) and 44 (Cantabria) out of the 62 proposed in the standard. Cantabria and Extremadura were the only autonomous communities that established interventions in all the possible areas. Wide variability was found in the plans, depending on their orientation toward an individual and treatment focus (Extremadura) or toward a social and preventive focus (Cantabria). Conclusions: The number of proposals in the various plans was lower that that in the standard used for comparison. In general, the plans focused on the later phases of dependency and on the immediate setting of the elderly.Merck Sharp & Dohme

RIU project: Perceived changes by health agents and professionals after a health intervention in an urban area of socioeconomic disadvantage

Objetivo: Describir los cambios percibidos por la población y los profesionales en relación con la salud y el uso de servicios tras la intervención RIU con agentes comunitarios en un barrio vulnerable. Diseño: Estudio descriptivo cualitativo con entrevistas individuales y grupales y observación participante de octubre de 2008 a julio de 2009. Emplazamiento: Barrio Raval (Algemesí-Valencia). Participantes: Selección por muestreo opinático de 7 mujeres agentes de salud, todas las que finalizaron la intervención, y 10 profesionales implicados en la misma. Método: Con las mujeres se mantuvo una entrevista grupal a los 6 meses, y una entrevista grupal y 7 individuales a los 9 meses de intervención. Se realizó un análisis temático de tipo descriptivo desde el modelo de promoción de salud. Con los profesionales se utilizó observación participante en una reunión a los 9 meses, analizándose las notas de campo según: valoración del proyecto, cambios detectados, dificultades y recomendaciones. Resultados: Las mujeres adquirieron información sobre salud, anticoncepción, embarazo y servicios sanitarios; señalaron cambios en autocuidados y habilidades sociales y liderazgo; interiorizaron el rol de agente de salud difundiendo lo aprendido y manifestando mejor autoestima y reconocimiento social. Provocaron cambios en su entorno relativos al cuidado de la salud y el acceso a los servicios. Los profesionales no incorporaron a su trabajo la perspectiva comunitaria; valoraron el proyecto, coincidieron con las mujeres en la mejora del acceso y uso de servicios y en el acercamiento población-profesionales. Conclusiones: RIU aumenta las capacidades de las personas participantes, su reconocimiento social y mejora el acceso y uso de servicios sanitarios.Objective: To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. Design: A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Location: Raval (Algemesí-Valencia). Participants: We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. Method: We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Results: Women acquired information about health, contraception, pregnancy and health services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn’t incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. Conclusions: RIU increases the capabilities of the participants, their social recognition and improves access and use of health services.Agencia de Calidad del Sistema Nacional de Salud-Observatorio de Salud de las Mujeres del Ministerio de Sanidad, Servicios Sociales e Igualdad y Ayuntamiento de Algemesí

Legislation on Teacher Training, the cases of Valencia, Spain and Chiapas, Mexico

El asesor técnico pedagógico (ATP) tiene la función de formar de manera continua, a través de cursos, a los profesores de educación básica en servicio; interesa conocer cómo estos desarrollan sus funciones y el marco normativo que las rige. En este artículo se da cuenta de la percepción que sobre dicha función tienen los ATP y se revisan dos marcos normativos, los casos de España y México, ambos sistemas educativos tienen similitudes organizativas sobre la formación permanente del profesorado. Este análisis es parte de la Investigación denominada Competencias del Asesor Técnico Pedagógico de educación básica en la Región Altos Tsotsil-Tseltal de Chiapas.The pedagogical technical advisor (ATP) has the function of forming teachers of basic education in service through courses, in a continuous fashion, interested in how they develop their functions and the regulatory framework that governs them. This article gives the reader data about the role of the ATP and reviews two regulatory frameworks in this case, specifically from Spain and Mexico, both educational systems have organizational similarities on permanent teacher training. This analysis is part of Investigation called the Pedagogical Competencies Technical Advisor basic education in Tsotsil - Tseltal Altos Region of Chiapas

Work, family and daily mobility: a new approach to the problem through a mobility survey

AbstractObjectivesTo analyze gender inequalities in socioeconomic factors affecting the amount of time spent travelling for work-related and home-related reasons among working individuals aged between 30 and 44 years old during a weekday in Catalonia (Spain).MethodsA cross-sectional study was conducted. Data were obtained from employed individuals aged between 30 and 44 years of age who reported travelling on the day prior to the interview in the Catalan Mobility Survey 2006 (N = 23,424). Multivariate logistic regression models were adjusted to determine the factors associated with longer time spent travelling according to the reason for travelling (work- or home-related journeys). Odds ratios and 95% confidence intervals are presented.ResultsA higher proportion of men travelled and spent more time travelling for work-related reasons, while a higher proportion of women travelled and spend more time travelling for home-related reasons. A higher educational level was associated with greater time spent travelling for work-related reasons in both men and women but was related to an increase in travelling time for home-related reasons only in men. In women, a larger household was associated with greater travel time for home-related reasons and with less travel time for work-related reasons.ConclusionThis study confirms the different mobility patterns in men and women, related to their distinct positions in the occupational, family and domestic spheres. Gender inequalities in mobility within the working population are largely determined by the greater responsibility of women in the domestic and family sphere. This finding should be taken into account in the design of future transport policies

Calidad sobre la Información de Salud y Cáncer en Internet.

Internet es una fuente de información que cada día es utilizada por miles de personas para consultar temas de salud, y especialmente, sobre cáncer. La Conselleria de Sanitat a través del"Plan oncológico de la Comunitat Valenciana 20072010" orienta y define la política sanitaria frente al cáncer en nuestro territorio durante este periodo. Entre sus ejes de actuación básica se encuentra el apoyo al desarrollo continuado del Sistema de Información sobre Cáncer. Esta información es de gran importancia a la hora de conseguir una participación informada de la población en la toma de decisiones que afectan a su salud, contribuyendo además, a su alfabetización digital en salud, objetivo prioritario de la UNESCO para el desarrollo de los todos los países. El problema es que esta información se presenta en tal cantidad que valorar la calidad de la misma llega a ser un problema para quienes buscan y reclaman herramientas que les ayuden a seleccionar estos contenidos. Con el fin de proporcionar a la población herramientas con las que alcanzar este objetivo se presenta el siguiente informe en el que se muestra el diseño y elaboración de una Guía de Ayuda a la Lectura para Información sobre Cáncer para la población

Strategic responses to intimate partner violence against women in Spain: a national study in primary care

Research on women"s responses to intimate partner violence (IPV) has largely been limited to women who have been exposed to severe physical violence with scarce generalisation. This study aimed to analyse how Spanish abused women from different backgrounds and with different IPV characteristics respond to violence

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

Risk of breast cancer and residential proximity to industrial installations: New findings from a multicase-control study (MCC-Spain)

Breast cancer is the most frequent tumor in women worldwide, although well-established risk factors account for 53%-55% of cases. Therefore, other risk factors, including environmental exposures, may explain the remaining variation. Our objective was to assess the relationship between risk of breast cancer and residential proximity to industries, according to categories of industrial groups and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). Using the current residence of cases and controls, this study was restricted to small administrative divisions, including both breast cancer cases (452) and controls (1511) in the 10 geographical areas recruiting breast cancer cases. Distances were calculated from the respective woman's residences to the 116 industries located in the study area. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (between 1 km and 3 km) to industrial plants, adjusting for matching variables and other confounders. Excess risk (OR; 95%CI) of breast cancer was found near industries overall (1.30; 1.00-1.69 at 3 km), particularly organic chemical industry (2.12; 1.20-3.76 at 2.5 km), food/beverage sector (1.87; 1.26-2.78 at 3 km), ceramic (4.71; 1.62-13.66 at 1.5 km), surface treatment with organic solvents (2.00; 1.23-3.24 at 3 km), and surface treatment of plastic and metals (1.51; 1.06-2.14 at 3 km). By pollutants, the excess risk (OR; 95%CI) was detected near industries releasing pesticides (2.09; 1.14-3.82 at 2 km), and dichloromethane (2.09; 1.28-3.40 at 3 km). Our results suggest a possible increased risk of breast cancer in women living near specific industrial plants and support the need for more detailed exposure assessment of certain agents released by these plants.The authors thank all those who took part in this study providing questionnaire data. The study was partially funded by the “Acción Transversal del Cáncer", approved on the Spanish Ministry Council on the 11th October 2007, by the Scientific Foundation of the Spanish Association Against Cancer (Fundación Científica de la Asociación Española Contra el Cáncer (AECC) – EVP-1178/14), by the Spain's Health Research Fund (Fondo de Investigación Sanitaria - FIS 12/01416), by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359 PS09/01286-León, PS09/00773-Cantabria, PS09/02078-Huelva, PS09/01903-Valencia, PS09/01662-Granada, PI11/01403, PI11/01889-FEDER, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/00613, PI15/00069, PI15/00914, PI15/01032), by the ICGC International Cancer Genome Consortium CLL (The ICGC CLL-Genome Project is funded by Spanish Ministerio de Economía y Competitividad (MINECO) through the Instituto de Salud Carlos III (ISCIII) and Red Temática de Investigación del Cáncer (RTICC) del ISCIII (RD12/0036/0036)), by the Fundación Marqués de Valdecilla (API 10/09), by the Consejería de Salud of the Junta de Andalucía (PI-0571-2009, PI-0306-2011, salud201200057018tra), by the Junta de Castilla y León (LE22A10-2), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10), by the Regional Government of the Basque Country, by the Recercaixa (2010ACUP 00310), by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the Catalan Government DURSI grant 2017SGR723, by the University of Oviedo, and by the Fundación Caja de Ahorros de Asturias. ISGlobal is a member of the CERCA Program, Generalitat de Catalunya.S

Desigualdades de acceso a los programas de cribado del cáncer en España y cómo reducirlas: datos de 2013 y 2020

Fundamentos: La Comisión Europea recomienda asegurar la equidad en el cribado del cáncer. El objetivo de este estudio fue conocer si existían desigualdades en el acceso a los programas de cribado del cáncer en España. Métodos: Se realizó un estudio transversal mediante encuesta dirigida a las personas responsables de los programas de cribado del cáncer de mama, colorrectal (CCR) y cérvix de las diecinueve Comunidades Autónomas (CCAA) del Estado Español en 2013 y 2020. Se recogió información sobre características organizativas, desigualdades de acceso e intervenciones para reducirlas. Se hizo un análisis descriptivo por CCAA y periodo temporal, mediante el cálculo de frecuencias y porcentajes, en función del tipo de programa (mama, CCR y cérvix). Resultados: En 2013 participaron catorce CCAA para el programa de mama, ocho para el de CCR y siete para el de cérvix, y en 2020, catorce, trece y once CCAA, respectivamente. Todos los programas de mama eran poblacionales en ambos periodos (14/14 en 2013 y 14/14 en 2020), así como los de CCR (8/8 en 2013 y 13/13 en 2020), con un aumento en el caso de los programas de cribado del cáncer de cérvix (0/7 en 2013 y 6/11 en 2020). Se identificaron en ambos periodos grupos sociales no incluidos en la población diana y grupos que, estando incluidos, participaban menos, con diferencias según el tipo de programa. Se realizaron un total de cincuenta y tres intervenciones para reducir desigualdades en el acceso (veintisiete en mama, veintidós en CCR y cuatro en cérvix), el 66% de ellas dirigidas a grupos sociales específicos (35/53). Conclusiones: Se identifican desigualdades de acceso a los programas de cribado del cáncer en España, así como intervenciones para reducirlas