Gaceta Sanitaria

Unequal impact of COVID-19 on excess deaths, life expectancy, and premature mortality in Spanish regions (2020-2021)
Islam N, García López FJ, Jdanov DA, Royo-Bordonada MÁ, Khunti K, Lewington S, Lacey B, White M, Morris EJA and Zunzunegui MV
We aimed to estimate regional inequalities in excess deaths and premature mortality in Spain during 2020 and 2021, before high vaccination coverage against COVID-19.
[Primary health care reforms in Latin America: advances in Brazil, Chile, Colombia, Mexico and Peru]
Juárez Herrera Y Cairo LA, Carrasco-Portiño M, Cuba-Fuentes MS, García LP, Bermúdez-Tamayo C and Pérez-Muto V
Since the 1990s, structural reforms have been initiated in Latin America, with varying degrees of success. One of their main objectives has been to transform health systems, with an emphasis on strengthening primary health care (PHC). This implies promoting a comprehensive and cohesive approach, reducing fragmentation in the provision of services, improving coordination between the different levels of care, and ensuring better quality of care. The purpose of this article is to briefly reflect on the initiatives and reforms related to the implementation of PHC in recent years in Brazil, Chile, Colombia, Mexico, and Peru. These countries have had structural and historical differences between their PHC reforms, as well as some common characteristics. Despite the heterogeneity between the countries analyzed, there are common challenges to achieve universal access and equity in health. The reforms and programs implemented have recognized the importance of PHC as a central axis to improve access and reduce health inequities. Although different models of PHC have been designed, most share comprehensive, preventive and health-promoting approaches, with an emphasis on community participation. However, recent challenges accentuated by the pandemic have revealed the fragilities of PHC in these countries. To achieve effective and equitable universal access, greater political commitment, strong intersectoral initiatives, training and retention of PHC professionals, and sustainable financing mechanisms will be crucial.
[Pilot evaluation of the «Transformem els patis» program in elementary schools in Barcelona]
Periañez J, Continente X, Sanz-Mas M, Drou G, Espelt A, Cortés E and López MJ
To evaluate the "Transformem els patis" (Let's transform the schoolyards) program in Barcelona in terms of schoolyard use, social interaction, physical activity, and diverse forms of play with a gender perspective.
[Implementing a strategy to manage frequent emergency room visits in a district of Barcelona]
Giménez E, Abadías MJ, San-José A, Losada M, Acezat J, Ibáñez J, Marte L, Barrecheguren M, Méndez AB, Aguayo-Álvarez M, Arranz M and Ramos R
Visits to hospital emergency departments by patients with multimorbidity, complex chronic conditions, and frailty are becoming an increasing challenge. A territorial strategy has been developed, based on automated preselection lists, a nurse case manager with specialized experience, and a multi-level territorial referral consensus. The feasibility of this approach has been demonstrated, with 368 alerts detected, 85% of which were well-selected. Age, frailty, home care percentage, Barthel index, and cognition were progressively aligned with levels of care/referral (primary, intermediate, and specialized) according to previously agreed criteria. In 2024, there is extensive structured technical information, an expanding role for advanced nursing, and well-established inter-level service resources. Therefore, through automated selection, a consensual territorial protocol of pathways and clinical profiles, and autonomous nursing assessments managing multi-frequent cases, it would be possible to achieve, in a proactive, simple, and scalable manner, an appropriate distribution of alerts across levels, consistent with the social and healthcare needs of the patients.
Smartphone use by children in fast food restaurants in Barcelona (Spain): a direct observation study
de Paz-Cantos S, González-Marrón A, Lidón-Moyano C, Cabriada Í, Cerrato-Lara M, Gómez-Galán R and Martínez-Sánchez JM
To explore the use of smartphones at mealtimes by children in fast food restaurants in the city of Barcelona and to assess the variables associated with this use.
[Race, health and the health system: the need to address institutional racism in Spain]
González-Rábago Y, La Parra-Casado D, Jacques-Aviñó C, , Bee Nchama M and Manzano Lorenzo J
[Project Alifara: a participatory health needs assessment in a rural area in the Valencian County]
García Carbó C, Cassetti V and Monfort Lázaro M
A description of the Alifara Project is provided a participatory process to promote community health. In 2020, a core working group was created in the rural region of Els Ports, in the north of the Valencian Community, Spain, with the participation of 39 people, including professionals and community members. The core group itself designed the first health needs assessment survey, based on the health determinants they considered relevant in their context, and 1180 responses were collected. The results were presented in each town through focus groups or world café to gather suggestions for health promoting activities to implement locally. Finally, the process set the basis for the creation of a local health council, to implement the new Community Health Care Plan of the Valencian Community. Community engagement and partnerships were the key to the success of the process, while the limited resources and lack of training in data analysis were the main challenges.
Photovoice versus focus groups: a comparative study of qualitative health research techniques
Conde P, Rivera-Navarro J, Gutiérrez-Sastre M, González-Salgado I, Franco M and Sandín Vázquez M
To compare, from an empirical point of view, the use of focus group and photovoice as we conducted two studies on food environment in neighbourhoods with different socio-economic profiles.
[The machismo dresses up to party]
Obón Azuara B, Gasch Gallén Á and Gutiérrez Cía I
[How is the compliance with the tobacco control law in hospitaty terraces?]
López MJ, Fu M, Fernández E, Henderson E and Continente X
To describe tobacco consumption and the compliance with the law on hospitality terraces in Barcelona.
Self-perceived quality of life by institutionalised adults with cerebral palsy in Spain
Nova Díaz DM, Errea Rodríguez M, Cabasés Hita JM and Sánchez Iriso E
To assess the self-perceived quality of life of institutionalized adults with cerebral palsy and to identify factors that influence their well-being, including sociodemographic, clinical, and diagnostic characteristics, as well as the degree of institutionalization.
Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women
Requena M and Stanek M
Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition.
[Specific proposals for organising an agency for evaluating the efficiency of health technologies and policies]
Lobo F, Oliva J and Vida J
We describe in detail a twofold proposal for the creation, organization and sequential development of two bodies responsible for evaluating the efficiency of health technologies and policies in Spain and its possible design. It would constitute a key element in the process of re-organising the National Health System. The first, which could be adopted immediately, would be called the Office for the Evaluation of the Efficiency of Medicines, would be attached to the Spanish Agency for Medicines and Medical Devices as a functionally independent body and limited to evaluating the efficiency of medicines. The second, the National Health Evaluation Commission, in the form of an independent administrative body, would evaluate health technologies and possibly public health policies. Functional independence, adequate resources and anchoring in the values of good governance are the defining characteristics of this dual proposal.
[Compliance with tobacco legislation on open and covered spaces in hospital facilities]
Cánovas Pérez C and Monteagudo-Piqueras O
[Burnout in healthcare professionals: time for occupational health]
Rolando N, Serra C, Utzet M, Ramada JM and Benavides FG
[Perception of cannabis use in the adolescent population: metasynthesis of qualitative studies]
Rey-Brandariz J, Teijeiro A, Pérez-Ríos M, Candal-Pedreira C, Vila Fariñas A, Mourino N, Casal Acción B, Varela-Lema L and
To assess the perceptions and beliefs of adolescents about cannabis consumption, studying the incentive and disincentive factors for consumption.
[Assessment of exposure to seconhand smoke in health surveys in Spain]
Blanco-Ferreiro A, Varela-Lema L, Rey-Brandariz J, Candal-Pedreira C, Ruano-Ravina A, Teijeiro A, José López M, Guerra-Tort C, Mourino N and Pérez-Ríos M
To describe the questions used to assess exposure to secondhand smoke (SHS) in Spanish health surveys.
[Community orientation levels in primary care]
Montaño-Caicedo JI
[Menstrual experiences and acceptability of a menstrual equity intervention among adolescents in Catalonia (Spain)]
García-Egea A, López-Jiménez T, Jacques-Aviñó C, Morero Beltrán AM, Pi Sánchez A, Martínez-Bueno C, Carrilero-Carrió N, Berenguera A and Medina-Perucha L
To explore menstrual knowledge, menstrual management, the use of menstrual products, the prevalence of menstrual poverty and to assess the acceptability of a menstrual equity intervention among students in the fourth grade of compulsory secondary education in Catalonia (Spain).
Social capital as a moderator of the relationship between violent community environment and psychological distress
Pérez-Sastré MA, García-Peña C, Ramos-Lira L and Ortiz-Hernández L
To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico.
[Moral distress: a useful concept?]
Verdaguer M, Beroiz-Groh P, Busquet-Duran X, Moreno-Gabriel E, Arreciado Marañón A, Feijoó-Cid M, Domènech M, Íñiguez-Rueda L, Vallès-Peris N, Cantarell-Barella G and Torán-Monserrat P