RESUMO
Community participation has been put as secondary due to the management of the COVID-19 pandemic. This is despite the evidence of its importance in relation to equity and health promotion. Even so, there have been a number of experiences of community participation that can give us clues towards how to confront potential future emergencies focusing on health promotion and social determinants. The main aim of this article is reflecting critically on the role of community participation during the pandemic as well as extracting a number of ideas which could be useful and ensure a better management of a future crisis. They arise from evidence and experiences undertaken in Spain. In order to do so, it is key to build and maintain community networks whilst identifying common goals and the role that different community agents must play, adapting to different contexts and participatory assessments. Community action cannot be improvised: it demands time, resources and specific political willingness to make it sustainable and efficient.
Assuntos
COVID-19 , COVID-19/epidemiologia , Participação da Comunidade , Humanos , Pandemias , Relatório de Pesquisa , Espanha/epidemiologiaRESUMO
Promoting the adoption of healthy habits represents a great challenge for health and education professionals. In this sense, childhood and adolescence are propitious times for the acquisition and consolidation of behaviors and skills, being that numerous and different determinants act in the genesis of behavior. The purpose of this study was to test the Psychometric properties and cultural adaptation of "LifeConScale" -Life Conditions Scale for Adolescents-. A cross-sectional and multicenter study was carried out in a representative sample of adolescents enrolled in 1st and 2nd year of Compulsory Secondary Education in 18 educational centers in Aragon, during the 2018-2019 school year. Sociodemographic characteristics, life skills, daily habits, and academic performance were analyzed using an adapted questionnaire from different scales and previous studies. For the adaptation of the questionnaire, the expert panel technique was used and for its validation, exploratory factor analysis was carried out and Cronbach's Alpha was applied, assessing the global internal consistency and of each one of the factors. The instrument showed a Kaiser-Meyer-Olkin sample size adequacy of 0.8122. A 6-dimensional model was chosen that explained 75.25% of the variance. The goodness of fit obtained a value of 0.802 in the Nomed Fix Index. The Comparative Fit Index was 0.891. The result of the analysis of variances and covariances carried out according to the Standardized Root Mean Square Residual yielded a value of 0.093 The analysis showed excellent application conditions in the study population and construct validity. This instrument will be useful for the evaluation of educational programs that work to promote health in educational centers, such as Health Promoting Schools.
Assuntos
Promoção da Saúde , Adolescente , Criança , Estudos Transversais , Análise Fatorial , Humanos , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Se expone el diseño creado para la evaluación de la iniciativa Salud en Red en los Barrios desarrollada en la ciudad de Zaragoza y sus principalesresultados al año de su puesta en marcha. Esta iniciativa pretende favorecer la generación de intervenciones comunitarias, adaptadas al contexto y lascaracterísticas demográficas y socioeconómicas del mismo, con los recursos comunitarios disponibles, potenciando la colaboración entre los servicios yentidades del territorio.Para la evaluación, se creó una matriz adaptada utilizando el modelo elaborado por la Agencia Estatal de Evaluación de las Políticas Públicas y la Calidadde los Servicios para evaluar la iniciativa tras el primer año de su puesta en marcha (2019).Tras el análisis de los principales indicadores de proceso y resultado obtenidos, ha sido posible reflejar la consecución de las distintas fases de la iniciativay entender los procesos que han tenido lugar, así como identificar aspectos de mejora. (AU)
This study presents the design created for the evaluation of the project Neighbourhoods Health Network, developed in the city of Zaragoza, andits main results one year after the implementation of the pilot project. The projects main objective is to encourage the creation of communityinterventions, adapted to the context and demographic and socioeconomic characteristics of the same, with the available community resources,promoting collaboration between the services and entities of the territory.For the evaluation, an adapted matrix was created using the model developed by the State Agency for the Evaluation of Public Policies and theQuality of Services to evaluate the initiative after the first year of its implementation (2019).After analysing the process and the result indicators obtained, it has been possible to reflect the achievement of the different phases of theinitiative and understand the processes that have taken place, as well as identify areas for improvement. (AU)
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Humanos , Saúde Pública , Promoção da Saúde , Colaboração IntersetorialRESUMO
Background: There is insufficient evidence about the impact of health promoting schools on the student's health and academic performance. The aim of this study was to compare the life skills, lifestyle habits and academic performance of 7th and 8th grade students registered in health promoting and non-health promoting schools in the Autonomous Community of Aragon. Methods: An observational, descriptive, comparative study of the life skills, lifestyle habits and academic performance of 7th and 8th grade students registered in 43 randomly selected health promoting and non-health promoting schools was carried out. We used an adapted tool, which was validated through the expert panel technique, to evaluate the students' life skills (self-efficacy, social skills and affect balance), lifestyle habits (diet, sleep, physical exercise, use of screen and substance abuse) and academic performance. Results: The socioeconomic level of the mothers and fathers of the students who attended non-health promoting schools was significantly higher than that of the parents of the adolescents who attended health promoting schools (p < 0.001). The students who attended non-health promoting schools had better self-efficacy, led a healthier life generally and achieved better academic results (p = 0.03). Conclusions: As opposed to previous studies, which found a positive association between health promoting schools and life skills, lifestyle habits and academic performance, our findings suggest that the impact of these health programs on the students' health and academic performance is limited. We recommend that the degree of implementation of health promotion programs in health promoting schools is systematically evaluated, and the health promoting school accreditation process and requirements reviewed, in order to ensure that the health of school children and adolescents is safeguarded and promoted in the short, medium and long term.
Assuntos
Desempenho Acadêmico , Estilo de Vida , Criança , Adolescente , Humanos , Espanha/epidemiologia , Promoção da Saúde , HábitosRESUMO
Se expone el diseño creado para la evaluación de la iniciativa Salud en Red en los Barrios desarrollada en la ciudad de Zaragoza y sus principales resultados al año de su puesta en marcha. Esta iniciativa pretende favorecer la generación de intervenciones comunitarias, adaptadas al contexto y las características demográficas y socioeconómicas del mismo, con los recursos comunitarios disponibles, potenciando la colaboración entre los servicios y las entidades del territorio.Para la evaluación, se creó una matriz adaptada utilizando el modelo elaborado por la Agencia Estatal de Evaluación de las Políticas Públicas y la Calidad de los Servicios para evaluar la iniciativa tras el primer año de su puesta en marcha (2019).Tras el análisis de los principales indicadores del proceso y los resultados obtenidos, ha sido posible reflejar la consecución de las distintas fases de la iniciativa y entender los procesos que han tenido lugar, así como identificar aspectos de mejora. (AU)
Assuntos
Humanos , Enfermagem em Saúde Comunitária , Serviços de Saúde Comunitária , Promoção da Saúde , Saúde PúblicaRESUMO
A healthy lifestyle is important to the present and future development and health of school age people. This study aims to analyze the relationship between daily lifestyle habits and academic performance in a sample of adolescents from the autonomous community of Aragon (Spain). We performed a cross-sectional study to analyze the lifestyle habits and academic performance of a total of 1745 7th and 8th grade middle school students during the academic year 2018-2019; the participants were selected from a random sample of 43 middle schools from the region of Aragon. The following data were collected through an anonymized, previously validated questionnaire: diet, sleep, physical activity, use of screens, use of toxic substances, and academic performance. We found a statistically significant association between all the lifestyle habits analyzed and academic performance (p < 0.001) in our sample. Based on our findings, we suggest that health promotion and education in healthy lifestyles should be integrated in middle school curricula to improve academic performance and, more importantly, to promote both present and future health outcomes of adolescents.
Assuntos
Desempenho Acadêmico , Estudantes , Adolescente , Estudos Transversais , Estilo de Vida Saudável , Humanos , Instituições Acadêmicas , EspanhaRESUMO
OBJETIVO: Describir las actividades formativas en participación comunitaria en salud que se realizan en España. MÉTODO: Identificación y análisis descriptivo de las acciones formativas en el periodo 2017-2018 en los ámbitos de la universidad, la Administración pública y las unidades docentes de medicina y enfermería familiar y comunitaria. RESULTADOS: Se incluyeron 28 actividades formativas en el análisis descriptivo de ocho comunidades autónomas diferentes y dos de ámbito nacional. La mayoría de las actividades formativas son presenciales e impartidas por unidades docentes de formación especializada para profesionales de medicina y enfermería de atención familiar y comunitaria, con una duración de entre 10 y 25 horas, y sin coste de matriculación. CONCLUSIÓN: Existe un vacío formativo en la mayoría de las comunidades autónomas que evidencia que la formación en participación comunitaria en salud es escasa y está poco integrada. Las actividades formativas analizadas están incluidas principalmente en la formación de especialistas de medicina y enfermería de familia y comunitaria, si bien esta formación no está unificada ni se incorpora en todos los planes docentes. Para una mirada integral sobre la salud de las personas es esencial incluir la participación comunitaria en salud en la formación de grado y posgrado, tanto del ámbito sanitario como de otras disciplinas. Las instituciones responsables de la formación en los diferentes niveles deben incluir la participación comunitaria en salud en los itinerarios formativos de los profesionales
OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals
Assuntos
Humanos , Participação da Comunidade/tendências , Medicina Comunitária/educação , Educação em Saúde/tendências , Espanha/epidemiologia , Promoção da Saúde/organização & administraçãoRESUMO
Biosecurity measures are a set of management procedures that prevent the risk of introducing and spreading infectious diseases to a farm, although these measures are rarely implemented in dairy farms. There are some studies that have identified that the decision to implement biosecurity measures can be influenced by several psychosocial factors (attitudes and behaviours). Thus, the objective of this study was to examine the psychosocial factors (and their interactions) influencing the implementation of biosecurity measures in dairy farms in Spain, through the views of dairy farmers and veterinarians from Catalonia (northeast Spain) and Galicia (northwest Spain). Face-to-face in-depth interviews were performed with 16 dairy farmers (nine from Catalonia and seven from Galicia) and 16 veterinarians (eight from Catalonia and eight from Galicia). Grounded theory analysis was performed on the transcripts, following the subtopics of: information sources, individual factors of the farmer, social dynamics, official veterinary services and other factors. The study identified the importance of veterinarians as a source of information, including their communication skills, the individual experiences of farmers, traditions of the farms and availability of time and space in the dairy farmer's decisions making. Further, it suggests the need to deepen the knowledge of the farm workers and the obligatory biosecurity measures. This research represents a starting point to develop future strategies to improve the implementation of biosecurity measures in dairy farms.
Assuntos
Tomada de Decisões , Fazendeiros/psicologia , Criação de Animais Domésticos , Animais , Indústria de Laticínios , Fazendas , Humanos , Espanha , Inquéritos e Questionários , Médicos VeterináriosRESUMO
OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals.
Assuntos
Médicos , Saúde Pública , Humanos , EspanhaRESUMO
Cuatro voces repartidas por España dialogan sobre salud comunitaria y redes, entendiendo que estas son sistemas formados por personas interconectadas, con un interés común, que dan apoyo y sostén. Las redes requieren un espacio común y tiempo, para generar un clima de confianza y respeto que permita un trabajo horizontal. Así se consensua que son estructuras adecuadas para la promoción de la salud, facilitando el intercambio de conocimiento, la colaboración y la innovación a través de la participación de quienes las conforman. La evaluación del trabajo de las redes es importante; se realiza analizando su autonomía, liderazgo, calidad de vínculos, formación, proyección de la red hacia el exterior, capacidad de integrar colectivos y sinergia
Four voices from around Spain discuss community health and networks. These voices understand that the networks are systems formed by interconnected people, with a common interest, that provide support. Networks require a common place and time, in order to generate trust and respect for horizontal work. Thus, networks are appropriate structures for health promotion, facilitating the exchange of knowledge, collaboration and innovation through the participation of those who form them. It is important that networks are evaluated by analysing their autonomy, leadership, quality of links, training, network projection, capacity for integrating groups and synergy
Assuntos
Humanos , Centros Comunitários de Saúde/organização & administração , Planejamento em Saúde Comunitária/organização & administração , Participação da Comunidade/tendências , Promoção da Saúde/organização & administração , Redes Comunitárias/organização & administração , Rede Social , Atenção Primária à Saúde/organização & administração , LiderançaRESUMO
Four voices from around Spain discuss community health and networks. These voices understand that the networks are systems formed by interconnected people, with a common interest, that provide support. Networks require a common place and time, in order to generate trust and respect for horizontal work. Thus, networks are appropriate structures for health promotion, facilitating the exchange of knowledge, collaboration and innovation through the participation of those who form them. It is important that networks are evaluated by analysing their autonomy, leadership, quality of links, training, network projection, capacity for integrating groups and synergy.
Assuntos
Redes Comunitárias , Saúde Pública , Humanos , Relatório de Pesquisa , Sociedades Médicas , EspanhaRESUMO
Networks of community health experiences promote interaction and knowledge management in health promotion among their participants. These networks integrate both professionals and social agents who work directly on the ground in small environments, with defined objectives and inclusion criteria and voluntary participation. In this article, networks in Aragon (Spain) are reviewed in order to analyse their role as an information system. The Health Promotion Projects Network of Aragon (Red Aragonesa de Proyectos de Promoción de la Salud, RAPPS) was launched in 1996 and currently includes 73 projects. The average duration of projects is 12.7 years. RAPPS interdisciplinary teams involve 701 people, of which 89.6% are professionals and 10.6% are social agents. The Aragon Health Promoting Schools Network (Red Aragonesa de Escuelas Promotoras de Salud, RAEPS) integrates 134 schools (24.9% of Aragon). The schools teams involve 829 teachers and members of the school community, students (35.2%), families (26.2%) and primary care health professionals (9.8%). Experiences Networks boost citizen participation, have an influence in changing social determinants and contribute to the formulation of plans and regional strategies. Networks can provide indicators for a health promotion information and monitoring system on: capacity building services in the territory, identifying assets and models of good practice, cross-sectoral and equity initiatives. Experiences Networks represent an opportunity to create a health promotion information system, systematising available information and establishing quality criteria for initiatives.
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Redes Comunitárias , Promoção da Saúde , Disseminação de Informação/métodos , Saúde Pública , Instituições Acadêmicas , Fortalecimento Institucional , Humanos , Atenção Primária à Saúde , EspanhaRESUMO
CONTEXT: There are no established guidelines for the proper treatment of patients with bronchopleural fistulas (BPFs). Apart from attempts to close the fistula, emphasis of treatment and management is placed on preventive measures, early administration of antibiotics, drainage of the empyema and aggressive nutritional and rehabilitative support. CASE REPORT: A 53-year-old male presented with nausea, vomiting, and dry cough with eventual respiratory failure. He was found to have an empyema of the left hemithorax which was managed with thoracostomy drainage and antibiotics. However, he had persistent air leak through the chest tube due to a BPF. Bronchoscopy failed to localize the involved segment. Application of fibrin glue through the chest tube succeeded in completely sealing the leak. CONCLUSION: To our knowledge, this is the first case report in which fibrin glue was successfully used intrapleurally to close a BPF related to an empyema.
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Bochdalek hernias are usually congenital in nature and normally present after birth. However, in rare cases, these hernias are present in adulthood. We report an unusual case of a posttraumatic right-sided Bochdalek hernia found incidentally in an adult and treated successfully with conservative management.
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INTRODUCTION: Postpneumonectomy syndrome is a rare condition that is characterized by dyspnea resulting from an extreme mediastinal shift and bronchial compression of the residual lung following surgical pneumonectomy. It is even rarer for this syndrome to present in patients without a history of prior lung surgery but induced by autopneumonectomy due to parenchymal disease, an entity termed 'postpneumonectomy-like syndrome'. CASE PRESENTATION: We present a rare case of a 91-year-old Puerto Rican man presenting with progressively worsening dyspnea with a history of pulmonary tuberculosis diagnosed 40 years earlier who developed severe unilateral lung fibrosis. Plain X-ray and computed tomography scans confirmed the presence of postpneumonectomy-like syndrome secondary to his parenchymal lung destruction. The patient developed cor pulmonale due to his extensive lung disease and as a consequence was not a suitable candidate for surgical intervention. The patient was otherwise stable until he developed acute respiratory distress from an acute upper gastrointestinal bleed and died four days into his hospital course. CONCLUSION: We present a rare case of postpneumonectomy-like syndrome as sequelae of severe pulmonary parenchymal tuberculosis infection along with a review of literature, in the hopes of aiding clinicians to include the differential of postpneumonectomy-like syndrome in patients presenting with worsening dyspnea without a history of surgical lung resection.
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Aspiration of a foreign body into the tracheobronchial tree is rare in adults. In the majority of these cases there is an underlying condition such as mental retardation, depressed mental status, impairment in the swallowing reflex, neurological impairment, alcohol or sedative abuse, or complications from dental manipulations that contributed to the aspiration. These patients are commonly misdiagnosed with asthma and typically do not respond to mainstay anti-inflammatory and/or bronchodilator therapy. We describe the case of a patient with a foreign body aspiration in the upper trachea not recognized by radiographic studies that presented with asthma-type symptoms.