La disfunción sexual femenina, un problema de salud infradiagnosticado

Màster d'Estudis de Dones, Gènere i Ciutadania, Universitat de Barcelona, Facultat de Geografia i Història, any: 2016-2017, Tutores: Carme Bertrán y Dolors JuvinyàEste trabajo de investigación es fruto del interés por querer aprender y dar respuesta a las numerosas dudas y reflexiones planteadas en consulta de fisioterapia. La fisioterapia es una ciencia de la salud definida por la Organización Mundial de la Salud (OMS) desde 1958 como la ciencia del tratamiento a través de medios físicos, ejercicio terapéutico, masoterapia y, según la Confederación Mundial por la Fisioterapia (WCPT), esta profesión sanitaria tiene como objetivo facilitar el desarrollo, mantención y recuperación de la máxima funcionalidad y movilidad del individuo o grupo de personas a través de su vida (WCPT, 2017). Trabajo como fisioterapeuta desde 1996 y estoy especializada en Suelo Pélvico y, sus disfunciones, desde el año 2007. Durante todos estos años he tenido la oportunidad de compartir mi tiempo de trabajo con mujeres que han confiado sus problemas de salud en mi experiencia profesional..

Estrategias para la detección y prevención del acoso escolar en diferentes contextos sociales

El presente trabajo muestra una síntesis teórica de un fenómeno que sigue revolucionando las aulas: el acoso escolar. Para ello, he investigado sus orígenes, las consecuencias que tiene, los tipos que hay y el perfil de los protagonistas. Para profundizar más en el tema, he reflexionado acerca de cómo detectar y prevenir este fenómeno en las aulas, planteando una propuesta de actuación dirigida a los alumnos de primer, segundo y tercer ciclo de educación primaria del colegio Miguel Vallés. Dicha propuesta tiene la finalidad de presentar numerosos mecanismos que nos ayuden a identificar este fenómeno. Entre los materiales que vamos a utilizar destaca la observación directa y los cuestionarios. He realizado esta revisión bibliográfica con el fin de recopilar información valiosa acerca del acoso y plantear una propuesta que pueda ayudar a los centros educativos a erradicar cualquier caso de este tipo

Face Mask Exemptions, Respiratory Patients, and COVID-19 in Spain. Data From the 2021 ITC EUREST-PLUS Spain Survey

Dear Editor, During the initial waves of the COVID-19 pandemic, respiratory patients received confusing messages by several patient associations and the World Health Organization1, 2 to be exempted from wearing face masks. Allegedly, many assumed that difficult breathing through face masks might exacerbate their respiratory condition, producing asthma attacks or chronic obstructive pulmonary disease (COPD) exacerbations. In its December 2020 Interim Guidance on Mask use in the context of COVID-19, WHO cited studies suggesting that masks might have an adverse impact on respiratory disease patients, but they did not provide any guidance about whether respiratory disease patients should or should not wear masks; explicitly, it reads in page 10 of 22 the following paragraph and references

Actividades motivacionales para favorecer el aprendizaje de las habilidades motrices básicas en niños de 4 a 5 años que participan en el “programa educa a tu hijo” (Original)

The present investigation is based on a diagnosis that shows difficulties in the development of basic motor skills (walking, running, jumping, throwing and catching), in children between 4 and 5 years of age who do not attend the Pink Popular Council child care centers. la Bayamesa To contribute to the solution of this problem, the following objective is proposed: to propose motivational activities to develop the basic motor skills of children between 4 and 5 years of age, from the Educate Your Child Program, from the Rosa la Bayamesa Popular Council. To do this, from a population of 25 children, a sample of 15 was taken to whom diagnostic instruments were applied that corroborate the need for this type of activity based on their motor development.La presente investigación parte de un diagnóstico que arroja dificultades en el desarrollo de las habilidades motrices básicas (caminar, correr, saltar, lanzar y atrapar), en niños de 4 a 5 años de edad que no asisten a los círculos infantiles del Consejo Popular Rosa la Bayamesa,para contribuir a la solución de esta problemática se plantea como objetivoproponer actividades motivacionales para desarrollar las habilidades motrices básicas de los niños de 4 a 5 años, del Programa Educa a tu Hijo, del Consejo Popular Rosa la Bayamesa. Para ello de una población de 25 niños, se toma una muestra de 15 a los cuales se le aplicaron los instrumentos de diagnóstico que corroboran la necesidad de este tipo de actividad en función de su desarrollo motriz

Long‐term effectiveness of a nurse‐led smoking cessation clinic at a comprehensive cancer center

Purpose: Smoking cessation interventions should be promoted in cancer centers to improve clinical outcomes among cancer patients and the quality of life of cancer-free patients and survivors. The aim of the present study was to examine long-term abstinence (1, 3, and 5 years) among smokers who received an intensive nurse-led smoking cessation intervention.Design: A prospective follow-up study was conducted in a smoking cessation clinic in Barcelona.Methods: The study included 479 smokers who received a nurse-led smoking cessation intervention that included motivational interviewing, psychological support, behavioral change counseling, promotion of smoke-free policies, and relapse-prevention strategies, as well as pharmacotherapy if necessary, for 12 months. We calculated overall and sex-specific 1-, 3-, and 5-year abstinence probabilities (Kaplan-Meier curves) and adjusted hazard ratios (aHRs) of relapse with 95% confidence intervals (CIs) using Cox regression.Findings: The overall probability of abstinence at 1 and 5 years was 0.561 (95% CI: 0.516-0.606) and 0.364 (95% CI: 0.311-0.417), respectively. Females had a higher, but not significant, hazard ratio for relapse compared to males (aHR = 1.180; 95% CI: 0.905-1.538). Attending <5 visits was the most remarkable determinant of relapsing compared to attending 5-9 visits or =10 visits, both overall and by sex (p for trend: overall, p < 0.001; males, p = 0.007; and females, p < 0.001).Conclusions: Abstinence probability decreased over the 5-year follow-up but was relatively high. Males had higher abstinence rates than females in all follow-up periods. Completeness of the intensive intervention was the main predictor of cessation.Clinical Relevance: Smoking cessation interventions should consider sex and incorporate strategies to increase adherence to obtain higher long-term abstinence rates

Diferencias en el consumo de drogas ilegales entre nativos e inmigrantes en una amplia muestra de consumidores de droga por vía parenteral en Cataluña (España)

Programas de reducción de daños; Inyectores de drogas; Inmigrante; HeroínaHarm reduction programs; Injected drug user; Immigrant; Heroin.Programes de reducció de danys; Injectors de drogues; Immigrant; HeroïnaEl objetivo del estudio era describir los patrones de abuso de drogas ilegales en relación con el proceso migratorio y el uso de centros de tratamiento entre los usuarios de drogas por vía inyectada (IDUs) de los programas de reducción de daños, y comparar las características de los IDUs nativos e inmigrantes. Estudio de diseño transversal de 748 IDUs de más de 18 años que fueron atendidos en los centros de reducción de daños entre 2008 y 2009. Se exploraron las diferencias en las condiciones socioeconómicas, de consumo de drogas ilegales, de estado de salud y de uso de los centros de tratamiento de drogas entre los IDUs nativos y los inmigrantes. Además, también se ha descrito si los IDUs inmigrantes empezaron a inyectarse drogas ilegales antes o después de entrar en el país de acogida. Los IDUs inmigrantes tienden a vivir solos más frecuentemente, a empezar la inyección a edad más avanzada, a usar heroína inyectada más frecuentemente y a usar menos los centros de tratamiento de drogas que los nativos. Un 66% de los inmigrantes empezaron a usar drogas ilegales antes de llegar al país de acogida. Los que empezaron en otros países llevaban 5 o menos años residiendo en el país de acogida (63,9%). En general, los IDUs inmigrantes (36,9%) frecuentaban menos los centros de tratamiento de drogas que los nativos (71,8%). En conclusión, la migración podría ser un factor de riesgo para la iniciación en el abuso de las drogas ilegales o el aumento de su consumo, a menudo adoptando los patrones de consumo local y agravándose debido al menor acceso a los centros de tratamiento de drogas.The aims of this study were to describe illegal drug abuse patterns in relation to the migration process and use of drug treatment centers among immigrant injected drug users (IDUs) involved in harm reduction programs, and to compare the characteristics of immigrant and native IDUs. Cross-sectional study of 748 IDUs aged ≥18 years attending harm reduction centers between 2008 and 2009. We explored differences in socio-economic status, illegal drug consumption, health status and use of treatment centers in native versus immigrant IDUs. We also described whether immigrant IDUs started using injected drugs before or after entering the host country. Immigrant IDUs tend to live alone more frequently, start injection at later ages, use heroin and inject it more frequently and use drug treatment centers less frequently than native IDUs. Seventy-six percent of immigrants began using illegal drugs before arriving at the host country. Those who started in other countries were residing in the host country for 5 years or less (63.9%). Overall, immigrant IDUs attended drug treatment centers (36.9%) less frequently than native IDUs (71.8%). In conclusion, migration could be a risk factor for illegal drug abuse initiation or increase in consumption, often with the adoption of local consumption patterns and aggravated due to a lower access to drug treatment centers.The study was supported by the following: Direcció General de Salut Pública, Departament de Salut, Generalitat de Catalunya; Subdirecció General de Drogodependències, Departament de Salut, Generalitat de Catalunya; Agència de Gestió d’Ajuts Universitaris i de Recerca - AGAUR (2005/SGR/00505), Departament d’Universitats, Recerca i Societat de la Informació, de la Generalitat de Catalunya; and Red de Trastornos Adictivos [RD06/0001/1018] & [RD12/0028/0018]

Metodología de reclutamiento y características de una cohorte de jóvenes consumidores habituales de cocaína de tres ciudades españolas (Proyecto Itínere-cocaína)

ResumenFundamentoLos sistemas de información sociosanitaria que monitorizan el consumo de drogas no profundizan en el análisis de las características sociodemográficas y de los patrones de consumo, ni en los factores que condicionan los problemas de salud. Se describe la metodología de reclutamiento y las características de una cohorte de jóvenes consumidores de cocaína.MétodosCohorte prospectiva de 720 consumidores de cocaína que no consumen habitualmente heroína, captados en la comunidad, independientemente de los servicios asistenciales, mediante métodos de referencia en cadena en las áreas metropolitanas de Madrid, Barcelona y Sevilla. Cuestionario administrado por ordenador y parcialmente autoadministrado. Análisis estratificado por ciudad y por frecuencia de consumo de cocaína base.ResultadosEn los últimos 12 meses el 58,8% había consumido cocaína entre 1 y 2 días por semana; el 91,9% habitualmente la había esnifado, un 5,3% fumado y sólo un 2,8% inyectado; el 6,1% la había utilizado la mitad de las veces o más en forma de base. Hubo policonsumo con cannabis (93,6%), éxtasis (73,2%) y anfetaminas (60,6%); un 4,0% se había inyectado alguna droga. Los que habían usado «crack» (22,1%) tenían un menor nivel educativo, un consumo de cocaína más intenso, mayor prevalencia de consumo de otras drogas, en especial opioides, y prevalencia de inyección mucho más alta.ConclusionesEl estudio confirma y completa el perfil sociodemográfico y de consumo ofrecido por los sistemas de información basados en servicios o las encuestas poblacionales, en especial que una gran parte de los consumidores jóvenes son esporádicos y que existen dos subpoblaciones muy diferenciadas según el consumo o no de cocaína base.AbstractBackgroundHealth information systems that monitor drug use do not perform in-depth analyses of sociodemographic characteristics and patterns of use, or of the factors that influence health problems. We describe the recruitment methodology and characteristics of a cohort of young cocaine users.MethodsA prospective cohort of 720 cocaine users who were not regular heroin users, recruited in the community independently of the health services by chain referral methods in the metropolitan areas of Madrid, Barcelona and Seville was studied. A computer-administered and partially self-administered questionnaire was used. A stratified analysis by city and by frequency of base cocaine use was performed.ResultsIn the previous 12 months, 58.8% had used cocaine 1-2 days/week; 91.9% sniffed it regularly, 5.3 smoked it, and only 2.8% injected it; 6.1% had used it at least half the time in the form of base cocaine. Polydrug use was observed with cannabis (93.6%), ecstasy (73.2%) and amphetamines (60.6%). Approximately 4.0% had injected at least one drug. Crack users (22.1%) had a lower educational level, more intensive cocaine use, a higher prevalence of other drug use, especially opioids, and a much higher prevalence of injection.ConclusionsThis study confirms and completes the sociodemographic and drug profile provided by the information systems based on health services or population surveys. The results show that a large proportion of young cocaine users consume the drug sporadically and that two very different subpopulations exist, according to whether or not they use base cocaine

ITC EUREST-PLUS Spain: protocol of a prospective longitudinal study of smokers in Spain

Objective: The ITC EUREST-PLUS Spain Survey is a longitudinal study of a representative sample of Spanish adult (≥18 years old) smokers. This protocol describes the methods of the 2021 follow-up survey. Method: The ITC EUREST-PLUS Survey, a prospective cohort study of a representative sample of smokers in six European countries, was conducted in 2016 (baseline) and 2018 (waves 1 and 2). The 2021 ITC EUREST-PLUS Spain Survey is a continuation of the Spanish cohort with a new interview in 2021 (wave 3). Lost participants were replaced with new smokers recruited using the same multi-stage sampling design. This latest follow-up aims to examine current patterns and transitions of tobacco use and to evaluate the impact of new tobacco-related policies. Comments: The ITC EUREST-PLUS Spain Survey will provide recent information about the impact of tobacco control policies on smoking behaviour

Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries

Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students' motivation to enroll and complete online training

Measuring cigarette dependence: A comparison of two scales in two different groups of smokers

INTRODUCTION The Fagerstrom Test for Cigarette Dependence (FTCD) and the Cigarette Dependence Scale (CDS) are usually used to assess cigarette dependence in clinical-and population-based studies. Our objective was to compare these two scales within groups of smokers from both contexts. METHODS The study was observational with smokers from a representative sample of the adult general population (n=188) and smokers attending a smoking cessation clinic in Barcelona, Spain (n=759). The FTCD and the CDS-5 (short version of 5 items) were used to assess cigarette dependence. We compared the standardized median scores obtained with both scales within each group of smokers by selected variables. To this aim, we re-scaled the scores of both scales to allow their comparison and assess their correlation within both groups. RESULTS The scores obtained with both scales were highly correlated within both groups of smokers (p60 min; 1.7 vs 1.1; p<0.001). CONCLUSIONS While the CDS-5 scored higher more frequently in the population group, the FTCD scored higher more frequently in the clinical group. These differences should be considered when designing either clinical-or population -based studies