39 research outputs found
Everything is on the map: Integrated Mental Health Atlases as support tools for service planning. SESPAS Report 2020
Objetivo: Este artículo revisa y evalúa el uso de los Atlas Integrales de Salud Mental como herramientas de apoyo a la planificación de servicios dentro del modelo de investigación de ecosistemas de atención de salud.
Método: Se describen los tipos de atlas y el procedimiento para su elaboración. Se presentan los realizados en España y se evalúa su impacto en la planificación de servicios de salud mental. Los atlas agregan información sobre las características locales del sistema de atención, la disponibilidad geográfica de recursos recogida mediante el instrumento DESDE-LTC, y su uso. Utilizan un sistema de información geográfica y otras herramientas visuales. Siguen una metodología de abajo arriba con colaboración de personas decisoras de agencias de planificación para su elaboración y validación externa.
Resultados: Desde 2005 se han realizado Atlas Integrales de Salud Mental en nueve comunidades autónomas que comprenden alrededor del 65% de la población de España. Los atlas han tenido un impacto desigual en la planificación de servicios, con un mayor impacto en Cataluña, Vizcaya y Guipúzcoa, y Andalucía, donde responsables sociales han participado activamente en su codise ˜no y su aplicación a la planificación de servicios sociosanitarios.
Conclusiones: Los atlas permiten detectar carencias o duplicidades en la atención, monitorizar cambios a lo largo del tiempo, realizar comparaciones nacionales e internacionales, modelar la eficiencia y hacer análisis benchmark. Este conocimiento puede incorporarse a los sistemas de apoyo a la decisión para una más eficaz planificación de los servicios de salud mental basada en evidencia informada.Objective: This article reviews the usability of the Integrated Atlases of Mental Health as a decision support tool for service planning following a health ecosystem research approach. Method: This study describes the types of atlases and the procedure for their development. Atlases carried out in Spain are presented and their impact in mental health service planning is assessed. Atlases comprise information on the local characteristics of the health care system, geographical availability of resources collected with the DESDE-LTC instrument and their use. Atlases use geographic information systems and other visualisation tools. Atlases follow a bottom-up collaborative approach involving decision-makers from planning agencies for their development and external validation. Results: Since 2005, Integrated Atlases of Mental Health have been developed for nine regions in Spain comprising over 65% of the Spanish inhabitants. The impact on service planning has been unequal for the different regions. Catalonia, Biscay and Gipuzkoa, and Andalusia reach the highest impact. In these areas, health advisors have been actively involved in their co-design and implementation in service planning.
Conclusions: Atlases allow detecting care gaps and duplications in care provision; monitoring changes of the system over time, and carrying out national and international comparisons, efficiency modelling and benchmarking. The knowledge provided by atlases could be incorporated to decision support systems in order to support an efficient mental health service planning based on evidence-informed policy
Borderline Intellectual Functioning: Consensus and good practice guidelines
Objectives: To elaborate a conceptual framework and to establish consensus guidelines.
Method: A mixed qualitative methodology, including frame analysis and nominal groups techniques, was used. The literature was extensively reviewed in evidence based medical databases,
scientific publications, and the grey literature. This information was studied and a framing
document was prepared.
Results: Scientific publications covering BIF are scarce. The term that yields a bigger number
of results is ‘‘Borderline Intelligence’’. The Working Group detected a number of areas in which
consensus was needed and wrote a consensus document covering the conclusions of the experts
and the framing document.
Conclusions: It is a priority to reach an international consensus about the BIF construct and
its operative criteria, as well as to develop specific tools for screening and diagnosis. It is also
necessary to define criteria that enable its incidence and prevalence. To know what interventions are the most efficient, and what are the needs of this population, is vital to implement
an integral model of care centred on the individual
Occurrence of genes of putative fibrinogen binding proteins and hemolysins, as well as of their phenotypic correlates in isolates of S. lugdunensis of different origins
<p>Abstract</p> <p>Background</p> <p><it>Staphylococcus lugdunensis </it>is an important human pathogen that causes potentially fatal endocarditis, osteomyelitis and skin and soft tissue infections similar to diseases caused by <it>Staphylococcus aureus</it>. Nevertheless, in contrast to <it>S. aureus</it>, data on pathogenicity factors of <it>S. lugdunensis </it>is scarce. Two adhesins, a fibrinogen and a von Willebrand factor binding protein, and a <it>S. lugdunensis </it>synergistic hemolysin (SLUSH) have been previously described. Moreover, the newly sequenced genome of <it>S. lugdunensis </it>revealed genes of other putative fibrinogen binding adhesins and hemolysins. The aim of this study was to gain more insight into the occurrence of genes likely coding for fibrinogen binding adhesins and hemolysins using clinical strains of <it>S. lugdunensis</it>.</p> <p>Findings</p> <p>Most of the putative adhesin genes and hemolysin genes investigated in this study were highly prevalent, except for the SLUSH gene cluster. In contrast to previous reports, binding to fibrinogen was detected in 29.3% of the <it>S. lugdunensis </it>strains. In most strains, hemolysis on blood agar plates was weak after 24 h and distinct after 48 h of incubation. The fibrinogen binding and hemolysis phenotypes were also independent of the type of clinical specimen, from which the isolates were obtained.</p> <p>Conclusion</p> <p>In this study we described a pyrrolidonyl arylamidase negative <it>S. lugdunensis </it>isolate. Our data indicate that a matrix-assisted laser desorption ionisation time-of-flight MS-based identification of <it>S. lugdunensis </it>or species-specific PCR's should be performed in favour of pyrrolidonyl arylamidase testing. In contrast to the high occurrence of putative fibrinogen binding protein genes, 29.3% of the <it>S. lugdunensis </it>strains bound to fibrinogen. Putative hemolysin genes were also prevalent in most of the <it>S. lugdunensis </it>strains, irrespective of their hemolysis activity on Columbia blood agar plates. Similar to a previous report, hemolysis after 48 h of incubation is also indicative for <it>S. lugdunensis</it>. The SLUSH gene cluster was detected in an estimated 50% of the strains, indicating that this locus is different or non-prevalent in many strains.</p
Desigualdade social e exposição a campos magnéticos na Região Metropolitana de São Paulo
Comparative study of mental health services availability and use in Chile and Spain
INTRODUCTION: There is an enormous interest about improving international comparisons to provide relevant information for policy and planning in mental health. Most of the available information is provided at the macro-level (countries or regions). However, information gathered at the meso-level may diverge from data aggregated at higher territorial levels. OBJECTIVES: This study describes the comparison on availability and use of mental health services between Chile and Spain. METHODS: Availability and utilization of services for the adult population were assessed in two urban areas in Chile and in three (two urban and one rural) areas in the South of Spain by using the European Service Mapping Schedule (meso-level data). RESULTS: For the two countries, local data on availability differed from data provided at the national level. There were differences in use of residential and day care between the benchmark area in Spain and the areas explored in Chile. In Chile’s catchment areas there was no availability of non-acute hospital services, any work-related services for persons with mental disorders, or 24-h mobile or non-mobile emergency psychiatric care. The meso-level data indicated that delivery and use of care in Chile was more similar to the pattern found in the poorer area in Southern Spain than macro-level data would indicate. CONCLUSIONS: The European Service Mapping Schedule was useful for describing mental health care outside of Europe and allowed for an international comparison between Chile and Spain. The meso-level description gathered in this study adds to the macro-level information on the mental health care system that has been provided in other reports
The mental health care gap in Intellectual Disabilities in Spain: Impact analysis and knowledge to action plan
BACKGROUND: Intellectual developmental disorder or Intellectual disability (ID) is a prevalent condition with a high impact along the life-span particularly when associated to other mental disorders (MD). SPECIFIC AIM: To estimate the unmet needs and to design a knowledge to action plan to reduce the care gap in ID-MD in Spain. METHOD: We followed a 5-step `maxi' impact assessment and a mixed qualitative/quantitative design including expert panels, secondary analysis of databases and a prospective survey in the 17 regions in Spain. Schizophrenia was used as comparator due to similar prevalence rates and burden. RESULTS: Persons with ID-MD had ten times less outpatient contacts and hospital admissions than patients with schizophrenia. The outpatient case load was 2.31% in ID and 14.6% in schizophrenia. ID had the lowest hospitalization rate amongst all mental disorders but the highest length of stay. The expert panel estimated that half of persons with ID-MD are not adequately assessed and 95% do not receive the required care in Spain. Basic care needs include 6.5 beds and an ID-MD outpatient service per 1 million population. At least 134 specialized psychiatrists and psychologists and 277 beds are needed to reach the minimum standards in Spain. CONCLUSION: This study quantifies the ID-MD care gap in Spain and the basic specialized services needed. In spite of the societal and health implications of ID-MD the knowledge-to-action plan had a modest impact limited at the regions where ID-MD programmes were already implemented. IMPLICATIONS FOR HEALTH POLICY: Specific priority setting on ID-MH should be incorporated to mental health strategy at the Ministry of Health within a broader health and ID plan. National and regional policies should incorporate an integrative care approach through the life cycle. The development of excellence centers on ID-MD and a national observatory on this topic should be encouraged
Todo está en el mapa: Atlas Integrales de Salud Mental para la planificación de servicios. Informe SESPAS 2020
nObjetivo: Este artículo revisa y evalúa el uso de los Atlas Integrales de Salud Mental como herramientasde apoyo a la planificación de servicios dentro del modelo de investigación de ecosistemas de atenciónde salud.Método: Se describen los tipos de atlas y el procedimiento para su elaboración. Se presentan los realizadosen Espa˜na y se evalúa su impacto en la planificación de servicios de salud mental. Los atlas agreganinformación sobre las características locales del sistema de atención, la disponibilidad geográfica derecursos recogida mediante el instrumento DESDE-LTC, y su uso. Utilizan un sistema de informacióngeográfica y otras herramientas visuales. Siguen una metodología de abajo arriba con colaboración depersonas decisoras de agencias de planificación para su elaboración y validación externa.Resultados: Desde 2005 se han realizado Atlas Integrales de Salud Mental en nueve comunidades autó-nomas que comprenden alrededor del 65% de la población de Espa˜na. Los atlas han tenido un impactodesigual en la planificación de servicios, con un mayor impacto en Catalu˜na, Vizcaya y Guipúzcoa, yAndalucía, donde responsables sociales han participado activamente en su codise˜no y su aplicación a laplanificación de servicios sociosanitarios.Conclusiones: Los atlas permiten detectar carencias o duplicidades en la atención, monitorizar cambiosa lo largo del tiempo, realizar comparaciones nacionales e internacionales, modelar la eficiencia y haceranálisis benchmark. Este conocimiento puede incorporarse a los sistemas de apoyo a la decisión para unamás eficaz planificación de los servicios de salud mental basada en evidencia informada.© 2020 SESPAS. Publicado por Elsevier Espa˜na, S.L.U