New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

Where are women doing research in the field of ICTs?

Peer-reviewed

Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain

OBJECTIVES: Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised. DESIGN: Cross-sectional study. SETTING: Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered). PARTICIPANTS: All insured polymedicated patients. Polymedicated patients were those with a consumption of ≥16 drugs/month. MAIN OUTCOMES MEASURES: The study variables were related to age, gender and medication intake obtained from the 2008 census and records of prescriptions dispensed in pharmacies and charged to the public health system. RESULTS: There were 36 880 polymedicated patients (women: 64.2%; average age: 74.5±10.9 years). The total number of prescriptions billed in 2008 was 2 266 830 (2 272 920 total package units). The most polymedicated group (up to 40% of the total prescriptions) was patients between 75 and 84 years old. The average number of prescriptions billed monthly per patient was 32±2, with an average cost of 452.7±27.5. The total cost of those prescriptions corresponded to 2% of the drug expenditure in Catalonia. The groups N, C, A, R and M represented 71.4% of the total number of drug package units dispensed to polymedicated patients. Great variability was found between the medication profiles of men and women, and between age groups; greater discrepancies were found in paediatric patients (5-14 years) and the elderly (≥65 years). CONCLUSIONS: This study provides essential information to take steps towards rational drug use and a structured approach in the polymedicated population in primary healthcare.

Ergonomics and musculoskeletal pain among postgraduate students and faculty members of the School of Dentistry of the University of Barcelona (Spain). A cross-sectional study

Objectives: To evaluate the intensity and location of musculoskeletal pain suffered by students and professors from different postgraduate programs of the School of Dentistry of the University of Barcelona (Spain), to identify the variables related to the occurrence of musculoskeletal symptoms and signs, and to establish possible preventive measures for such disorders. Materials and Methods: A cross-sectional study was made among students and faculty members from different postgraduate courses of the School of Dentistry at the University of Barcelona between May and June 2007. A total of 74 dentists (54 postgraduate students and 20 faculty members) completed an anonymous questionnaire containing 19 questions. The variables were divided into three main groups: sociodemographic information, ergonomic features and musculoskeletal pain arising from professional practice. Results: Most of the dentists (79.8%) had experienced some kind of musculoskeletal pain in the last 6 months. On comparing the different locations of pain (lumbar, cervical, dorsal, wrist, shoulder and others), the neck was found to be the most commonly affected location (58% of all subjects), and only 34% of the respondents took some preventive measures against musculoskeletal disorders. Women showed a higher frequency of intense pain involving the cervical, lumbar, dorsal and wrist areas (p<0.05). A higher incidence of wrist pain was recorded in professionals exclusively dedicated to oral surgery (p<0.05). No statistically significant correlation was found between the workload (hours) and pain in the different anatomical locations (p>0.05). Conclusions: An important incidence of pain symptoms secondary to musculoskeletal disorders was observed, particularly in the cervical region. Females and younger dentists showed a higher frequency of such symptoms. The implementation of preventive measures is necessary, in view of the high incidence of these disorders

Older people's university students in Spain: a comparison of motives and benefits between two models

This study examines both the motives for and the benefits of attending a uni- versity programme for older people (UPOP) in Spain, and how they vary with the type of UPOP. Two UPOP models were assessed: The"Older People"s Classes" of the University of Barcelona, which is organised as a lecture course, and the"University of Experience" at the University of Valencia, which is a three- or four- year variant of regular university degrees. A sample of 321 older students (mean age 67.5 years) was gathered from the two UPOPs, 161 participants from the former and 157 from the latter. The findings suggest that expressive motives such as acquiring knowledge, expanding the mind or learning for the joy of learning were the most important reasons for joining a UPOP, and that among the perceived benefits from taking classes at university featured"gaining more friends","enhanced self or life-satisfaction" and"joy in life". Perceived benefits were particularly high among the less educated and the older students. While students participating in the Older People"s Classes were older and included relatively more women, differences between the two models in motives and benefits did not exist or were slight. These results are discussed in the context of new strategies to improve university courses aimed at older students.

Rapid increase in incidence of breast ductal cancer in situ in Girona, Spain 1983-2007

Introduction: The aim of this study was to describe breast ductal cancer in situ (DCIS) incidence trends in women in the Girona province during a period of 25 years. The influence of age, use of mammography and implementation of the breast cancer screening programs was explored. Incidence of subsequent invasive breast cancers (IBC) and DCIS treatment was also considered. Materials and Methods: Cases diagnosed with primary pure DCIS (n=416) during 1983-2007 were extracted from the population-based Girona Cancer Registry. The estimated annual percent change was estimated using joinpoint analysis. Results: DCIS incidence showed a sharp rise until 1998, followed by a less marked upward trend. Among women aged 50-69 the increase was particularly important between 1992 and in 1996, reflecting the spread in mammography use. Conclusion: The upward trend of DCIS was mainly related to an increase in mammography use either opportunistic or as a result of screening implementation

Reliability of intraoperative ultrasound in margin status assessment in women undergoing breast conserving surgery

Background: Effective treatment for breast cancer requires accurate preoperative planning, developing and implementing a consistent definition of margin clearance, and using tools that provide detailed real-time intraoperative information on margin status. Intraoperative ultrasound (IOUS) may fulfil these requirements and may offer few advantages that other preoperative localization and intraoperative margin assessment techniques may notPurpose: The goal of the present work is to determine how accurate the intraoperative ultrasound should be to acquire complete surgical excision with negative histological margins in patients undergoing Breast Conservative SurgeryDesign: A diagnostic test study with a cross-sectional design carried out in a tertiary referral hospital in Girona within a Breast Pathology UnitParticipants: Women diagnosed with breast cancer undergoing a Breast Conservative Surgery in the Breast Pathology Unit at Hospital Universitari de Girona Dr. Josep Trueta

Repensando la relación entre la ley y la violencia hacia las mujeres. Una aproximación a los discursos de los/las agentes del ámbito judicial en relación a la ley integral de violencia de género en España = Rethinking the relationship between law and violence against women. an approach to the juridical agents' discourses in relation to the integral law of gender-based violence

Of the many dimensions of the problem of violence exercised by men toward women in the context of the relations of partner or ex partner, this article deals with the analysis of the discursive productions of the institutional actors that are part of the judicial process. Our intention is to investigate the relationship between criminal law and gender-based violence starting from the implementation of the Law of Integral Gender-based Violence in Spain (LO. 1 / 2004) from a theoretical perspective which includes contributions from social psychology, and socio-legal feminism. We have approached the legal instrument - the Law of Integral Gender-based Violence - through the discourse of legal officers with a perspective that questions the values, so often proclaimed, of universality, objectivity and neutrality of the law

Patson Approach versus the Standard Approach for increasing breast reconstruction rates in women undergoing mastectomy. A randomized, controlled, open-label clinical trial

Breast cancer is the most prevalent neoplasm among women in the majority of countries worldwide. Breast cancer treatment include mastectomy which is associated to strong impact in women. Breast reconstruction is an option for many women to re-establish their body image and also to decrease psychological impact. However, breast reconstruction rates are low and many factors are involved in not undergoing breast reconstruction. Patient involvement in the decision-making process increases breast reconstruction rates and is associated to higher satisfaction and less anxiety and depression symptoms. More physician-patient relation and more education in terms of breast reconstruction are needed to achieve our objective. A new approach of medical care, called Patson Approach, is created in order to meet our goal with more patient involvement, as well as, physician and psychological counsellingObjective: to increase breast reconstruction rates in women who are candidates for breast reconstruction after mastectomy and are included in the Patson Approach compared to women included in the Standard ApproachMethods: the study design will be a randomized, controlled, open-label clinical trial. 62 patients will be recruited during two years and randomly divided in two groups, 31 will be included in the Standard Approach and 31 will be included in the Patson Approach. Preoperative and postoperative appointments are established in order to do a follow-up of the patients and collect all the data

Material flow accounting of Spain

Material throughput is a means of measuring the so-called social metabolism, or physical dimensions of a society’s consumption, and can be taken as an indirect and approximate indicator of sustainability. Material flow accounting can be used to test the dematerialisation hypothesis, the idea that technological progress causes a decrease in total material used (strong dematerialisation) or material used per monetary unit of output (weak dematerialisation). This paper sets out the results of a material flow analysis for Spain for the period from 1980 to 2000. The analysis reveals that neither strong nor weak dematerialisation took place during the period analysed. Although the population did not increase considerably, materials mobilised by the Spanish economy (DMI) increased by 85% in absolute terms, surpassing GDP growth. In addition, Spain became more dependent on external trade in physical terms. In fact, its imports are more than twice the amount of its exports in terms of weight.

Societal metabolism of societies: the bifurcation between Spain and Ecuador

This paper presents an application of the Multiple-Scale Integrated Assessment of Societal Metabolism to the recent economic history of Ecuador and Spain. Understanding the relationship between the Gross Domestic Product (GDP) and the throughput of matter and energy over time in modern societies is crucial for understanding the sustainability predicament as it is linked to economic growth. When considering the dynamics of economic development, Spain was able to take a different path than Ecuador thanks to the different characteristics of its energy budget and other key variables. This and other changes are described using economic and biophysical variables (both extensive and intensive referring to different hierarchical levels). The representation of these parallel changes (on different levels and describable only using different variables) can be kept in coherence by adopting the frame provided by MSIASM.