Análisis de la relación volumen-resultado en la cirugía de cáncer digestivo

Cáncer digestivo; Mortalidad intrahospitalaria; Estancia hospitalariaDigestive cancer; Inpatient mortality; Hospital stayCàncer digestiu; Mortalitat intrahospitalària; Estada hospitalàriaL’objectiu general de l’anàlisi és conèixer el número d’intervencions anuals de càncer oncològic digestiu recomanable per centre que afavoreixi els resultats en salut (mortalitat intrahospitalària i reintervencions) i d’eficiència (estada hospitalària) per als pacients intervinguts en el període 2013-2016 als centres que formen part del Sistema Nacional de Salut (SNS).The general objective of this report is to know the number of recommended annual interventions of digestive cancer by center that favor health outcomes (inpatient mortality and reinterventions) and efficiency (hospital stay) for patients who underwent cancer surgery in the period 2013-2016 in the centres belonging to the National Health System (SNS in Spanish).El objeto general del análisis es conocer el número de intervenciones anuales de cáncer oncológico digestivo recomendable por centro que favorezcan los resultados en salud (mortalidad intrahospitalaria y reintervenciones) y de eficiencia (estancia hospitalaria) para los pacientes intervenidos en el periodo 2013-2016 en los centros pertenecientes al Sistema Nacional de Salud (SNS)

L’impacte de les noves tecnologies en la salut mental: depressió en adolescents i relació amb l’ús de tecnologies mòbils i xarxes socials

Noves tecnologies; Salut mental; AdolescentsNuevas tecnologías; Salud mental; AdolescentesNew technologies; Mental health; AdolescentsAquest treball ha tingut per objectiu identificar l'impacte que l'ús de les tecnologies mòbils i xarxes socials pot tenir sobre el desenvolupament o prevenció de trastorns depressius entre els adolescents. Es tracta d’un estudi desenvolupat a partir de la revisió sistemàtica de l'evidència disponible sobre el tema

Hacia la concentración de la cirugía oncológica digestiva: cambios en la actividad, las técnicas y los resultados

Digestive oncologic surgery; Hospital volume; MortalityCirurgia oncològica digestiva; Volum; MortalitatCirugía oncológica digestiva; Volumen; MortalidadEl objetivo de este estudio se ha centrado en examinar los cambios en la actividad, las técnicas quirúrgicas y los resultados del progresivo proceso de concentración de la cirugía oncológica digestiva de complejidad en el período 2005-2012 en los centros pertenecientes al Sistema Integral Sanitario de Catalunya (SISCAT), teniendo como referencia el estudio realizado en años anteriores (1996-2000)

Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

Average stay; Cross-sectional study; Hospital-at-home; MortalityEstancia media; Estudio transversal; Hospital en casa; MortalidadEstada mitjana; Estudi transversal; Hospital a casa; MortalitatHospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities

A meta-analysis of smokefree legislation effects on respiratory diseases

Introduction Aim: To synthesize the available evidence in scientific papers of smokefree legislations (SFL) effects on respiratory diseases (such as asthma, chronic obstructive pulmonary disease [COPD]) and lung infections (pneumoniae, bronchitis) among all populations (adults, children or general population). Methods Systematic review and meta-analysis were carried out. PRISMA guidelines were followed. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. The inclusion criteria were: 1)Original scientific studies concerning SFL, 2) With data before and after its implementation and 3) assessment of the impact of SFL on respiratory diseases. A meta-analysis was performed using the Review Manager (RevMan, version 5.3). The effect of SFL was estimated by risk ratios (RR) and risk difference (RD). Pooled effect measures were computed applying the inverse-variance method in a random-effect model. Heterogeneity was quantified with the I2 statistic. Subgroup and sensitivity analysis were performed. Results 17 studies reported effects on asthma, 9 on COPD and 4 on lung infections admissions. All the meta-analysis concerned comprehensive SFL settings. Six studies were included in a meta-analysis for asthma admissions in general population, 5 in children and 7 in adults. There was a significant decrease of 13% after SFL in general population (RR 0.87; 95%CI 0.81, 0.93; I2 78%) and of 15% both in children (95%CI 0.79, 0.91; I2 87%) and adults (95%CI 0.73, 0.99; I2 65%). In contrast, the 6 studies for COPD admissions showed a non significant decrease of 20% after SFL (95%CI 0.63, 1.00; I2 96%). For lung infections admissions, only 2 studies showed a non significant decrease of 14% after SFL (95%CI 0.67, 1.10; I2 55%). Conclusions SFL appears to decrease rates of admissions for asthma in all populations in comprehensive settings but not for COPD or lung infections. Funding This work was supported by the Instituto de Salud Carlos III (Institute of Health Carlos III, ISCiii) of the Ministry of Economy and Competitiveness (Spain) through the Network for Prevention and Health Promotion in Primary Care (redIAPP, RD12/0005/0001; RD16/0007/0001), co-financed with European Union ERDF funds

Prolonged Sitting Time : Barriers, Facilitators and Views on Change among Primary Healthcare Patients Who Are Overweight or Moderately Obese

Background and Objectives: Prolonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviour. Methods: A descriptive-interpretive qualitative study was carried out at three healthcare centres in Barcelona, Spain, and included 23 patients with overweight or moderate obesity, aged 25 to 65 years, who reported sitting for at least 6 hours a day. Exclusion criteria were inability to sit down or stand up from a chair without help and language barriers that precluded interview participation. Ten in-depth, semi-structured interviews (5 group, 5 individual) were audio recorded from January to July 2012 and transcribed. The interview script included questions about time spent sitting, willingness to change, barriers and facilitators, and the prospect of assistance from primary healthcare professionals. An analysis of thematic content was made using ATLAS.Ti and triangulation of analysts. Results: The most frequent sedentary activities were computer use, watching television, and motorized journeys. There was a lack of awareness of the amount of time spent sitting and its negative consequences on health. Barriers to reducing sedentary time included work and family routines, lack of time and willpower, age and sociocultural limitations. Facilitators identified were sociocultural change, free time and active work, and family surroundings. Participants recognized the abilities of health professionals to provide help and advice, and reported a preference for patient-centred or group interventions. Conclusions: Findings from this study have implications for reducing sedentary behaviour. Patient insights were used to design an intervention to reduce sitting time within the frame of the SEDESTACTIV clinical trial

Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis

<div><p>Aims</p><p>The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations.</p><p>Materials and methods</p><p>Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.</p><p>Results</p><p>A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1–36%) than for asthma (5–31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies.</p><p>Conclusions</p><p>Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.</p></div

Summary of studies on the impact of smoke-free legislation on admissions.

<p>Summary of studies on the impact of smoke-free legislation on admissions.</p

Flow diagram of literature search and study selection from papers evaluating smokefree legislation effects on respiratory and sensory disorders (1995–2015).

<p>Flow diagram of literature search and study selection from papers evaluating smokefree legislation effects on respiratory and sensory disorders (1995–2015).</p

Mean difference between before and after comprehensive smokefree legislation (SFL) in spirometry parameters.

<p>Abbreviations: CI, confidence interval; df, degrees of freedom; IV, Inverse Variance method.</p