Estudio de percepción del tabaco en escolares: ensayo comunitaria de intervención

El consum de tabac segueix sent actualment, en els països industrialitzats, la primera causa prevenible de mort i invalidesa. Entre altres processos que s'esdevenen en l'adolescencia, l'inici al consum de tabac es situa principalment en aquesta etapa de la vida, i segons els darrers estudis al voltant d'un 21% dels joves del nostre territori són fumadors. Tot i el gran número d'estudis sobre programes d'educació en l'àmbit de la salut, existeix controversia en relació a l'eficacia, efectivitat i cost-benefici sobre els programes centrats en el tabac. Objectiu: analitzar l'efecte d'una intervenció educativa de llarga duració, dirigida a adolescents per a la prevenció del tabaquisme i integrada en el sistema educatiu, observant el seu efecte en la percepció del tabac i la seva relació amb el consum. Participaren en l'estudi tots els centre d'educació secundaria de les ciutats de Reus i Tarragona. El treball de camp de l'assaig es va iniciar durant el curs escolar 2007/08, i es va realitzar un seguiment de 3 anys. Dues infermeres realitzaren el treball de camp; recolecció de les dades i les intervencions d'educació sanitaria. Es va utilitzar un qüestionari validat en el Programa Marc Euroepu de Prevenció del tabaquisme (ESFA) a l'inici que va ser subjecte d'analisis estadístic. Es van recollir anotacions de camp per al seu estudi qualitatiu. La percepció incorrecta del tabac es relaciona amb una major prevalença i incidencia de consum de tabac. Activitas d'educació sanitaria integrades en l'àmbit escolar sobre el tabac milloren la percepció correcta del tabac i disminueixen el consum d'aquest entre els joves.El consumo de tabaco sigue siendo actualmente, en los países industrializados, la primera causa prevenible de muerte e invalidez. Entre otros procesos que acontecen en la adolescencia, el inico al consumo de tabaco se sitúa principalmente en esta etapa de la vida, y según los últimos estudios alrededor de un 21% de los jóvenes de nuestro territorio son fumadores. A pesar del gran numero de estudios sobre programas de educación en el ámbito de la salud, existe controversia en relación a la eficacia, efectividad y coste-beneficio sobre los programas centrados en el tabaco. Objetivo: Analizar el efecto de una intervención educativa de larga duración, dirigida a adolescentes para la prevención del tabaquismo e integrada en el sistema educativo, observando su efecto en la percepción del tabaco y su relación con el consumo. Participaron en el estudio todos los centros de educación secundaria de las ciudades de Reus y Tarragona. El trabajo de campo del ensayo se inició durante el curso escolar 2007/08, y se hizo un seguimiento durante 3 años. Dos enfermeras realizaron el trabajo de campo; recolección de los datos y las intervenciones de educación sanitaria. Se utilizó un cuestionario validado en el Programa Marco Europeo de Prevención del tabaquismo (ESFA) al inicio que fue sujeto de análisis estadístico. Se recogieron anotaciones de campo para su estudio cualitativo. La percepción incorrecta del tabaco se relaciona con una mayor prevalencia e incidencia de consumo de tabaco. Actividades de educación sanitaria integradas en el ámbito escolar sobre el tabaco mejoran la percepción correcta del tabaco y disminuyen el consumo de este entre los jóvenes.Tobacco consumption remains today, in industrialized countries, the leading preventable cause of death and disability. Other processes that occur in adolescence, starting tobacco consumption is mainly in this stage of life, and according to recent studies about 21% of young people of our country are smokers. Despite the large number of studies on educational programs in the field of health, there is controversy regarding the efficacy, effectiveness and cost-benefit programs focusing on tobacco. To analyze the effect of a long-term educational intervention aimed at teenagers to smoking prevention and integrated in the educational system, noting its effect on the perception of tobacco and its relation to consumption. They participated in the study all secondary schools of the cities of Reus and Tarragona. The field trial was initiated during the school year 2007/08, and were followed for 3 years. Two nurses made the field work; data collection and health education interventions. A validated in the European Framework Programme for Prevention of smoking (ESFA) at the start that was the subject of statistical analysis questionnaire was used. Field notes were collected for qualitative study. The wrong perception of tobacco is associated with a higher prevalence and incidence of consumption. Integrated health education activities in schools on tobacco improve the correct perception and decrease the consumption in young people

Evaluation of the Tobbstop Mobile App for Smoking Cessation: Cluster Randomized Controlled Clinical Trial

Mobile application; Primary public health; Tobacco smoking cessationAplicación móvil; Atención primaria de salud pública; Dejar de fumar tabacoAplicació mòbil; Salut pública primària; Cessament del consum de tabacBackground: Mobile apps provide an accessible way to test new health-related methodologies. Tobacco is still the primary preventable cause of death in industrialized countries, constituting an important public health issue. New technologies provide novel opportunities that are effective in the cessation of smoking tobacco. Objective: This paper aims to evaluate the efficacy and usage of a mobile app for assisting adult smokers to quit smoking. Methods: We conducted a cluster randomized clinical trial. We included smokers older than 18 years who were motivated to stop smoking and used a mobile phone compatible with our mobile app. We carried out follow-up visits at 15, 30, and 45 days, and at 2, 3, 6, and 12 months. Participants of the intervention group had access to the Tobbstop mobile app designed by the research team. The primary outcomes were continuous smoking abstinence at 3 and 12 months. Results: A total of 773 participants were included in the trial, of which 602 (77.9%) began the study on their D-Day. Of participants in the intervention group, 34.15% (97/284) did not use the app. The continuous abstention level was significantly larger in the intervention group participants who used the app than in those who did not use the app at both 3 months (72/187, 38.5% vs 13/97, 13.4%; P<.001) and 12 months (39/187, 20.9% vs 8/97, 8.25%; P=.01). Participants in the intervention group who used the app regularly and correctly had a higher probability of not being smokers at 12 months (OR 7.20, 95% CI 2.14-24.20; P=.001) than the participants of the CG. Conclusions: Regular use of an app for smoking cessation is effective in comparison with standard clinical practice

Type 2 diabetes mellitus and COVID-19: a narrative review

Type-2 diabetes mellitus (T2DM) is a chronic metabolic disorder. The incidence and prevalence of patients with T2DM are increasing worldwide, even reaching epidemic values in most high- and middle-income countries. T2DM could be a risk factor of developing complications in other diseases. Indeed, some studies suggest a bidirectional interaction between T2DM and COVID-19. A growing body of evidence shows that COVID-19 prognosis in individuals with T2DM is worse compared with those without. Moreover, various studies have reported the emergence of newly diagnosed patients with T2DM after SARS-CoV-2 infection. The most common treatments for T2DM may influence SARS-CoV-2 and their implication in infection is briefly discussed in this review. A better understanding of the link between TD2M and COVID-19 could proactively identify risk factors and, as a result, develop strategies to improve the prognosis for these patients

Lay People Training in CPR and in the Use of an Automated External Defibrillator, and Its Social Impact: A Community Health Study

Cardiopulmonary resuscitation; Automatic external Defibrillator; Community healthReanimació cardiopulmonar; Desfibril·lador extern automàtic; Salut comunitàriaReanimación cardiopulmonar; Desfibrilador externo automático; Salud comunitariaOut-of-hospital cardiac arrest (OHCA) mortality remains high. The best survival rates are achieved when trained people provide OHCA victims with cardiopulmonary resuscitation (CPR); however, it is estimated that only 25% of victims receive CPR. This community health study aims to evaluate the effectiveness of a training programme in basic CPR and in the use of an automatic external defibrillator (AED) on knowledge and skills for lay people, and its social impact. The training courses were based on Catalan Council of Resuscitation guidelines. Data were collected on sociodemographic characteristics, evaluation of knowledge and practical skills at baseline and at the end of the training courses, and also on the social impact of the programme. A total of 36 training courses with 482 participants were carried out, and most participants achieved a qualification of suitable. The mean score in knowledge was 3.1 ± 1.1 at baseline and 3.8 ± 1.2 (p = 0.001) at the end of the programme. Participants rated the training courses as very satisfactory, considered the training useful, and felt more qualified to respond to an emergency. This study shows that a high percentage of participants acquired skills in basic CPR and use of an AED, which confirms the usefulness and effectiveness of training courses and its important social impact

Les vacunacions a l'atenció primària de Salut

Vacunacions; Atenció primària; InfermeriaVacunaciones; Atención primaria; EnfermeríaVaccinations; Primary care; NurseryEls programes de vacunacions constitueixen un dels pilars fonamentals de la prevenció en l’àmbit de la salut pública. El seu objectiu és proporcionar immunitat a les persones vacunades individualment i, com a grup, respecte de determinades malalties i, en conseqüència, reduir la morbiditat i mortalitat o eliminar-la. L’èxit d’un programa de vacunacions, doncs, depèn no només de l’eficàcia de les vacunes emprades, sinó també de la seva implantació màxima en la població diana. L’objectiu d’aquesta Guia és el d'unificar criteris i proporcionar pautes d’actuació similars en l’activitat de vacunació a tots els centres de la xarxa d’atenció primària de l’Institut Català de la Salut

Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study

Dejar de fumar; Espirometría; Ateción primariaDeixar de fumar; Espirometria; Atenció primàriaSmoking cessation; Spirometry; Primary healthcareObjective: This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results. Design: Randomised, parallel, controlled, multicentre clinical trial. Setting: This study involved 12 primary healthcare centres (Tarragona, Spain). Participants: Active smokers aged 35–70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters. Main outcome: Prolonged abstinence (12 months) validated by expired-CO testing. Results: Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04). Conclusions: In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare

Analysis of Patient Safety Incidents in Primary Care Reported in an Electronic Registry Application

Incident notification; Patient safety; Risk managementNotificació d'incident; Seguretat dels pacients; Gestió de riscNotificación de incidentes: Seguridad del paciente; Gestión de riesgoObjectives: (1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed. Design: Descriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service. Setting: 24 Catalan Institute of Health PC health centres of the Tarragona region (Spain). Participants: Professionals from the PC health centres and a Patient Safety Functional Unit. Measurements: Data obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions. Results: A total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%). Conclusions: PS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS

Coping Strategies and Social Support in a Mobile Phone Chat App Designed to Support Smoking Cessation : Qualitative Analysis

Smoking is one of the most significant factors contributing to low life expectancy, health inequalities, and illness at the worldwide scale. Smoking cessation attempts benefit from social support. Mobile phones have changed the way we communicate through the use of freely available message-oriented apps. Mobile app-based interventions for smoking cessation programs can provide interactive, supportive, and individually tailored interventions. This study aimed to identify emotions, coping strategies, beliefs, values, and cognitive evaluations of smokers who are in the process of quitting, and to analyze online social support provided through the analysis of messages posted to a chat function integrated into a mobile app. In this descriptive qualitative study, informants were smokers who participated in the chat of Tobbstop. The technique to generate information was documentary through messages collected from September 2014 through June 2016, specifically designed to support a smoking cessation intervention. A thematic content analysis of the messages applied 2 conceptual models: the Lazarus and Folkman model to assess participant's experiences and perceptions and the Cutrona model to evaluate online social support. During the study period, 11,788 text messages were posted to the chat by 101 users. The most frequent messages offered information and emotional support, and all the basic emotions were reported in the chat. The 3 most frequent coping strategies identified were physical activity, different types of treatment such as nicotine replacement, and humor. Beliefs about quitting smoking included the inevitability of weight gain and the notion that not using any type of medications is better for smoking cessation. Health and family were the values more frequently described, followed by freedom. A smoke-free environment was perceived as important to successful smoking cessation. The social support group that was developed with the app offered mainly emotional and informational support. Our analysis suggests that a chat integrated into a mobile app focused on supporting smoking cessation provides a useful tool for smokers who are in the process of quitting, by offering social support and a space to share concerns, information, or strategies

Puesta en marcha de un programa de prácticas de traducción en departamentos e institutos universitarios de la Universidad de Salamanca

Memoria ID-0113. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

Type 2 Diabetes Mellitus and Cancer: Epidemiology, Physiopathology and Prevention

Individuals with type 2 diabetes mellitus are at greater risk of developing cancer and of dying from it. Both diseases are age-related, contributing to the impact of population aging on the long-term sustainability of health care systems in European Union countries. The purpose of this narrative review was to describe, from epidemiological, pathophysiological and preventive perspectives, the links between type 2 diabetes mellitus and the most prevalent cancers in these patients. Multiple metabolic abnormalities that may occur in type 2 diabetes mellitus, particularly obesity, could explain the increased cancer risk. In addition, the effectiveness of drugs commonly used to treat type 2 diabetes mellitus (e.g., metformin and thiazolidinediones) has been broadly evaluated in cancer prevention. Thus, a better understanding of the links between type 2 diabetes mellitus and cancer will help to identify the contributing factors and the pathophysiological pathways and to design personalized preventive strategies. The final goal is to facilitate healthy aging and the prevention of cancer and other diseases related with type 2 diabetes mellitus, which are among the main sources of disability and death in the European Union and worldwide