80 research outputs found
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
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
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
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
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
High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study
BACKGROUND: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.The study was supported by the “Acción Transversal del Cáncer,” approved by the Spanish Ministry Council on 11 October 2007, by the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), by the Instituto de Salud Carlos III grants, co-funded by FEDER funds: a way to build Europe-PI08/1770 (to M. Kogevinas), PI09/0773 (to J. Llorca), PI09/1286 (to V. Martín), PI09/1903 (to R. Peiró), PI09/2078 (to F.J. Caballero), PI09/1662 (to J.J. Jiménez-Moleón), PI11/01403 (to N. Aragonés), and PI12/00150 (to B. Pérez-Gómez), by the Fundación Marqués de Valdecilla grant API 10/09 (to J. Llorca), by Catalan Government DURSI grant 2014SGR647 (to V. Moreno) and 2014SGR756 (to S. de Sanjose), by the Junta de Castilla y León Grant LE22A10-2 (to V. Martín), by the Consejería de Salud of the Junta de Andalucía Grant 2009-S0143 (to J. Alguacil), by the Conselleria de Sanitat of the Generalitat Valenciana grant AP061/10 (to R. Peiró), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Región de Murcia, by the Fundación Caja de Ahorros de Asturias, by the University of Oviedo, by the Spanish Association Against Cancer (AECC) Scientific Foundation, and by the Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporación Grant IJCI-2014-20900 (to A. Castelló). None of the sponsors intervened in any stage of the research.S
Menstrual and Reproductive Factors and Risk of Gastric and Colorectal Cancer in Spain
BACKGROUND:
Sex hormones play a role in gastric cancer and colorectal cancer etiology, however, epidemiological evidence is inconsistent. This study examines the influence of menstrual and reproductive factors over the risk of both tumors.
METHODS:
In this case-control study 128 women with gastric cancer and 1293 controls, as well as 562 female and colorectal cancer cases and 1605 controls were recruited in 9 and 11 Spanish provinces, respectively. Population controls were frequency matched to cases by age and province. Demographic and reproductive data were directly surveyed by trained staff. The association with gastric, colon and rectal cancer was assessed using logistic and multinomial mixed regression models.
RESULTS:
Our results show an inverse association of age at first birth with gastric cancer risk (five-year trend: OR = 0.69; p-value = 0.006). Ever users of hormonal contraception presented a decreased risk of gastric (OR = 0.42; 95%CI = 0.26-0.69), colon (OR = 0.64; 95%CI = 0.48-0.86) and rectal cancer (OR = 0.61; 95%CI = 0.43-0.88). Postmenopausal women who used hormone replacement therapy showed a decreased risk of colon and rectal tumors. A significant interaction of educational level with parity and months of first child lactation was also observed.
CONCLUSION:
These findings suggest a protective role of exogenous hormones in gastric and colorectal cancer risk. The role of endogenous hormones remains unclear
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