Hacia una salud pública orientada desde los determinantes sociales de la salud: informe de un taller

This article is the result of a workshop with public health experts held in Granada (Spain) in October 2015 in order to reflect upon the components of the framework that should be part of a public health approach based on the social determinants of health. Advocacy and training professionals in health advocacy were identified as key elements where this was needed. During the workshop, it was agreed that the gender perspective, the salutogenic approach, interdisciplinary work and particular attention to disadvantaged groups are crucial. The importance of working from a human rights’ framework and promoting legislative changes were also mentioned. Moreover, the group mentioned that even though much progress has been made identifying social determinants of health and creating conceptual frameworks, there is limited knowledge about how to intervene to reduce health inequality gaps in our societies.     

Tipologías de los madrileños ante la etapa final de la vida mediante un análisis de clusters

Objective

To establish typologies within Madrid's citizens (Spain) with regard to end-of-life by cluster analysis.

Validación de un cuestionario para evaluar la cultura de seguridad del paciente de los profesionales de atención primaria en España

ObjetiveTo validate a tool to measure patient safety culture in Spanish primary care professionals.MethodsMedical Office Survey on Patient Safety Culture (MOSPSC), from the Agency for Healthcare and Research in Quality (AHRQ). The process has been performed in five steps: original version traslation, conceptual equivalence evaluation, acceptability and viability assessment, content validity and questionnaire test and response analysis and psichometric properties assessment.SettingPrimary care.Subjects185 Primary care professionals from different Spanish regions represented the sample test.Main outcome measuresFrecuency, response pattern and discrimination power of each item.Cronbach's alpha coefficient and dimensions obtained through factor analysis.Results17, 8% of respondents answered all the items and 28, 7% of them did not answer, or answered the option “Don’t know/Does not apply”, to one to four items. All the sentences, with only one exception, present discrimination capacity. Cronbach's alpha coefficient results 0,96 and information is sumarized in 15 factors obtaining the same items in 7 of the total 12 factors in the original questionnaire.ConclusionsTraslated, adapted, extended and validated AHRQ questionnaire is, in this setting, a reliable and useful instrument and it must be used for international comparisons.     

Distribución municipal de la incidencia de los tumores más frecuentes en un área de elevada mortalidad por cáncer

Objective

To describe the geographic distribution patterns of the municipal incidence of the most common tumours in the Huelva province (Spain) as compared to the estimated incidence for all of Spain.

Evaluación de la efectividad de los programas de vacunación

Vaccines have contributed enormously to reducing the incidence of many communicable diseases. The protective efficacy of a vaccine refers to the health effects of the vaccine applied in optimal, ideal conditions, whereas the effectiveness of a vaccination program refers to the health effects of vaccination in the vaccinated individuals in clinical practice or within public health programs, which may differ widely from optimal conditions. Vaccine efficacy is estimated by randomized clinical trials. In contrast, effectiveness can be measured by various types of epidemiological studies: randomized community trials, in which the target vaccine is randomly assigned to a group and disease incidence in this group is compared with that of an unvaccinated group; cohort studies, which are observational epidemiological studies in which the vaccination status is known in healthy vaccinated (vaccinated cohort) and unvaccinated (unvaccinated cohort) people and the occurrence of the disease in the two groups is studied; and observational case-control studies, in which two groups are selected; one with the disease under investigation (cases) and the other without (controls), and vaccination histories are investigated in the two groups. Vaccine effectiveness may also be estimated by comparing attack rates in epidemic outbreaks or secondary attack rates in the home, or by screening.     

Utilidad de los estudios serológicos en los centros de Atención Primaria para el diagnóstico precoz de la enfermedad de Lyme

Objective

The main aim of this study was to determine the usefulness of an early diagnosis of Lyme disease (LD) in Primary Health Care Centres (PHCC) using the ELISA test as serological screening technique.

Impacto poblacional de un programa de salud escolar podológica

This article presents an overview of the work done over the past 12 years in a collaboration between the school communities at various primary and secondary schools and the practical experience managers working in the Preventive and Community Podiatry area of the Podiatry degree at the University of Seville (Spain). The article presents several strategies, which were carried out in the fields of Foot Health for All and Preventive and Community Podiatry as part of the Hermes Research Group (CTS-601) aimed at promoting general foot health. Foot examinations were conducted in a total of 4,630 school pupils, with foot problems being confirmed in 677 of them. Some 7,145 members of the school community were also helped, with these people being reached through educational activities around foot care. The aim of the initiative was to prevent foot damage among children, which could have a harmful impact on their quality of life as adults.     

Desarrollo y validación de un cuestionario genérico para la evaluación de la satisfacción de los pacientes crónicos: Cuestionario SAT-Q

ObjectivesTo develop and validate a brief general questionnaire to assess satisfaction in patients with chronic disease.Designepidemiological, observational, multicentre cross-sectional study.Location4 Primary Health Care Centers from the IV Health Area in the Principality of Asturias.SubjectsA total of 202 patients diagnosed with chronic illness who were following a pharmacological regimen for at least one year.MethodsAn extensive literature review was conducted to create an initial item pool of 61 questions regarding patient satisfaction. Then, a forward-backward translation into Spanish was carried out. Next, both the expert (n=8) and patient (n=30) panels led to a new version of 34 items (concerning satisfaction with medication and satisfaction with health service). Finally, scale item reduction (item-total correlation and exploratory factorial analysis —EFA—) and psychometrical validation (feasibility, reliability and criterion validity) of the SAT-Q— were evaluated. Both the SAT-Q and the SF-12 (to assess patient health related quality of life) were applied.ResultsItem reduction analysis resulted in 18 items: general satisfaction with medication (3), adverse-events (3), oversights (2), effectiveness (3), convenience (4) and Health services (3). Internal consistency (Cronbach α) and Intraclass Correlation Coefficients were moderate-high. Moreover, significant positive correlations between SAT-Q scores and SF-12 Physical and Mental Summary Components were found (with the exception of oversights).ConclusionsA brief questionnaire for measuring satisfaction in chronic patients has been developed and preliminary validated.