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Mayoral Cortes J.M.,Consejeria de Salud de Andalucia | Aragones Sanz N.,Institute Salud Carlos III | Sierra Moros M.J.,Ministerio de Sanidad | Cano Portero R.,Institute Salud Carlos III | And 2 more authors.
Gaceta Sanitaria | Year: 2016

At present, epidemiological surveillance in Spain remains focused on the communicable diseases included in the list of notifiable diseases. However, there has been a change in epidemiological pattern that predominated until the last few decades of the twentieth century. Infectious diseases, which used to be the leading causes of morbidity and mortality, have given way to a predominance of chronic diseases. In this regard, progress has been made in the drafting and adoption of specific legal regulations on public health monitoring. However, Spain has yet to develop this legislation which, among other elements, includes the mandate to organize the surveillance of non-communicable diseases in Spain. This article aims to describe some points that should be considered in the development of a national surveillance system linked to existing strategies for the prevention and control of chronic diseases. © 2016 SESPAS.

Borrell C.,Agencia de Salut Publica de Barcelona | Malmusi D.,Agencia de Salut Publica de Barcelona | Artazcoz L.,Agencia de Salut Publica de Barcelona | Diez E.,Agencia de Salut Publica de Barcelona | And 13 more authors.
Gaceta Sanitaria | Year: 2012

In November 2008, at the request of the Directorate General of Public Health of the Ministry of Health and Social Policy, the Commission to Reduce Social Inequalities in Health in Spain was established with a mandate to develop a proposal for interventions to reduce health inequalities. This article aims to present the work carried out and the documents prepared by the Commission. The Commission, consisting of 18 members, conducted a situational analysis of health inequalities and of the policies to reduce them, reviewed international documents and consulted 56 experts from distinct fields to develop a proposal for recommendations to reduce health inequalities. In May 2010, the Commission presented the document " Moving toward equity: a proposal for policies and interventions to reduce social inequalities in health in Spain" The document listed a total of 166 recommendations, divided into 14 areas and ordered by priority. These recommendations highlight that health inequalities cannot be reduced without a commitment to promote health and equity in all policies and to move toward a fairer society. © 2011 SESPAS.

Perez K.,Agencia de Salut Publica de Barcelona | Perez K.,CIBER ISCIII | Perez K.,Biomedical Research Institute Sant Pau | Novoa A.M.,Agencia de Salut Publica de Barcelona | And 18 more authors.
Accident Analysis and Prevention | Year: 2012

Aims: The aim of the present study was to estimate the incidence of hospital discharges for traumatic spinal cord injury (TSCI) and traumatic brain injury (TBI) in Spain by injury circumstances (traffic crashes and others), injury severity, gender and age group and to describe its trends over the period 2000-2009. Methods: It is a study of trends that includes hospital discharges with a primary diagnosis of TSCI or TBI. Crude and age-standardised rates were calculated per million inhabitants. Changes in rates between 2000 and 2009 were assessed through calculation of the relative risk adjusted for age, using Poisson regression. Results: Between 2000 and 2009 in Spain, 10,274 patients were admitted for traumatic TSCI, and 206,503 for TBI. The annual incidence rate for TSCI was 23.5 per million, that for TBI was 472.6 per million. The overall incidence rate for TSCI fell significantly between 2000 and 2009 by 24.2% (traffic-related 40.9%, other 12.9%), as did that for TBI (23.8% overall, 60.2% traffic-related, with no change for other circumstances). Among people aged 65 years and over, no change was observed for TSCI, incidence of TBI fell significantly when due to traffic crashes, but there was a dramatic increase of 87% in men and 89.3% in women when due to other circumstances. Conclusions: Over the last decade the incidence of these types of injury has fallen significantly when the injury resulted from traffic crashes, and to a lesser extent when from other circumstances. However TBI incidence among people aged 65 and over injured in non-traffic-related circumstances has risen dramatically. © 2011 Elsevier Ltd. All rights reserved.

Royo-Bordonada M.A.,Institute Salud Carlos III | Lizcano A.,Federacion de Asociaciones de Enfermeria Comunitaria y Atencion Primaria | Lizarbe V.,Ministerio de Sanidad | Armario P.,Sociedad Espanola de Hipertension Liga Espanola de la Lucha Contra la HTA
Revista Espanola de Salud Publica | Year: 2013

Based on the two main frameworks for evaluating scientific evidence SEC and GRADE European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of populationbased and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions, led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions-such as smoking ban in public areas or the elimination of trans fatty acids from the food chain are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure (BP) within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.

Sanchez P.M.,University of Leon | Perez M.E.G.,Servicio de Medicina Preventiva | Varela Y.A.,Ministerio de Sanidad | Nunez J.V.,Spanish University for Distance Education (UNED) | And 2 more authors.
Revista Espanola de Salud Publica | Year: 2013

Patient safety depends on the culture of the healthcare organization involving relationships between professionals. This article proposes that the study of these relations should be conducted from a network perspective and using a methodology called Social Network Analysis (SNA). This methodology includes a set of mathematical constructs grounded in Graph Theory.With the SNAwe can know aspects of the individual's position in the network (centrality) or cohesion among team members. Thus, the SNA allows to know aspects related to security such as the kind of links that can increase commitment among professionals, how to build those links, which nodes have more prestige in the team in generating confidence or collaborative network, which professionals serve as intermediaries between the subgroups of a teamto transmit information or smooth conflicts, etc. Useful aspects in stablishing a safety culture. The SNAwould analyze the relations among professionals, their level of communication to communicate errors and spontaneously seek help and coordination between departments to participate in projects that enhance safety. Thus, they related through a network, using the same language, a fact that helps to build a culture. In summary, we propose an approach to safety culture from a SNA perspective that would complement other commonly used methods.

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