Impact of a Primary Care intervention on the colorectal cancer early detection programme. / Impacto de una intervención de Atención Primaria en el programa de detección precoz de cáncer colorrectal.

AIM: To assess the effectiveness of a telephonic interview performed by primary care professionals among non-participants in the first round of the colorectal cancer early detection programme in the basic urban health area Guineueta in Barcelona, Spain. PATIENTS AND METHODS: The Primary Healthcare Team of La Guineueta contacted people who did not respond to the invitation to the first round of the colorectal cancer early detection programme using a standardised telephone call protocol. We analysed the impact of the intervention based on participation and diagnosed disease. RESULTS: We made 3,327 phone calls to 2,343 people. After the intervention the participation rate was 54.9%, which meant an increase of 5.7% with respect to the participation in the usual protocol for the programme (49.2%). The intervention allowed 5cancers, 2high-risk neoplasms and 8low- and intermediate-risk lesions to be diagnosed. An average of 9phone calls was necessary to achieve the participation of one additional person. DISCUSSION: The telephonic intervention performed by primary care professionals has significantly increased the population participation rate and the detection of neoplasms with respect to the usual colorectal cancer early detection programme protocol.

Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial.

BACKGROUND: Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population's reasons for refusing to take part in the screening programme and to find out the health professionals' opinion about the official programme implementation and on the new computerised tool. METHODS/DESIGN: This is a parallel randomised trial with a cross-sectional second stage. PARTICIPANTS: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50-69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient's electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach. DISCUSSION: We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals. TRIAL REGISTRATION: Clinical Trials.gov identifier NCT01877018.

[Description of sexual assaults treated in the emergency department of a referral hospital]. / Descripción de las agresiones sexuales atendidas en el servicio de urgencias de un centro hospitalario de referencia.

OBJECTIVE: To describe the factors related to adult sexual assaults attended in a referral hospital in the city of Barcelona (Spain). METHODS: We carried out an individual-based cross-sectional study of sexual assaults treated in the emergency department between 2005 and 2008. RESULTS: A total of 712 patients (95.5% female) were treated. The median age of assaulted women was 25 years. Complaints were made in 87.5% of cases and assaults were made by a single attacker in 84.5%. When the perpetrator was known, the profile of the victim (p ≤ 0.05) was as follows: the victim was assaulted at home (81.5%), the perpetrator acted alone (94.2%), the mechanism of aggression was penetration (89.3%) and the attack took place during the week (63.3%). CONCLUSIONS: Analysis of sexual assaults allows for different risk groups to be established, which facilitates the development of specific protocols and guidelines for effective aid and full treatment.

Impacto de una intervención de Atención Primaria en el programa de detección precoz de cáncer colorrectal / Impact of a Primary Care intervention on the colorectal cancer early detection programme

Objetivo: Evaluar la efectividad de una entrevista telefónica realizada por profesionales de Atención Primaria en personas no participantes en la primera ronda del Programa de detección precoz de cáncer colorrectal (PDPCCR), en el área básica de salud (ABS) urbana Guineueta de Barcelona (España). Pacientes y métodos: Un grupo de profesionales de Atención Primaria del ABS Guineueta contactó, mediante un protocolo de llamadas telefónicas estandarizadas, con personas que no atendieron la invitación a participar en la primera ronda del PDPCCR. Se analiza el impacto de esta intervención en la tasa de participación y las enfermedades detectadas. Resultados: Se realizaron 3.327 llamadas telefónicas a 2.343 personas. Tras la intervención, la tasa de participación fue del 54,9%, lo que supone un incremento del 5,7% con respecto a la participación del protocolo habitual del programa (49,2%). Se han diagnosticado 5 cánceres, 2 neoplasias de riesgo alto y 8 lesiones de riesgo bajo e intermedio. En promedio, han sido necesarias 9 llamadas para conseguir la aceptación de una persona adicional. Discusión: La intervención telefónica de los profesionales de Atención Primaria ha aumentado de forma significativa la tasa de participación de la población y la detección de neoplasias con respecto al protocolo habitual del PDPCCR

Aim: To assess the effectiveness of a telephonic interview performed by primary care professionals among non-participants in the first round of the colorectal cancer early detection programme in the basic urban health area Guineueta in Barcelona, Spain. Patients and methods: The Primary Healthcare Team of La Guineueta contacted people who did not respond to the invitation to the first round of the colorectal cancer early detection programme using a standardised telephone call protocol. We analysed the impact of the intervention based on participation and diagnosed disease. Results: We made 3,327 phone calls to 2,343 people. After the intervention the participation rate was 54.9%, which meant an increase of 5.7% with respect to the participation in the usual protocol for the programme (49.2%). The intervention allowed 5cancers, 2high-risk neoplasms and 8low- and intermediate-risk lesions to be diagnosed. An average of 9phone calls was necessary to achieve the participation of one additional person. Discussion: The telephonic intervention performed by primary care professionals has significantly increased the population participation rate and the detection of neoplasms with respect to the usual colorectal cancer early detection programme protocol

Descripción de las agresiones sexuales atendidas en el servicio de urgencias de un centro hospitalario de referencia / Description of sexual assaults treated in the emergency department of a referral hospital

Objetivo: Describir los factores relacionados con las agresiones sexuales que se atienden en el hospital de referencia de la ciudad de Barcelona.Métodos: Estudio transversal de base individual de las agresiones sexuales atendidas en el servicio de urgencias entre los años 2005 y 2008. Resultados: Se atendieron 712 pacientes, con predominio femenino (95,5%). Las mujeres agredidas y atendidas presentan una edad mediana de 25 años, realizaron denuncia el 87,5% de los casos y fueron agredidas por un único agresor el 84,5%. El perfil de la agredida (p≤0,05) cuando el agresor es conocido es: agredida en el domicilio (81,5%), el agresor actúa solo (94,2%), el mecanismo de agresión es la penetración(89,3%) y en días laborables (63,3%).Conclusiones: El análisis de las agresiones sexuales permite establecer distintos grupos de riesgo, lo cual facilita la elaboración de protocolos y guías de actuación específicos para una ayuda eficaz y un tratamiento completo (AU)

Objective: To describe the factors related to adult sexual assaults attended in a referral hospital in thecity of Barcelona (Spain).Methods: We carried out an individual-based cross-sectional study of sexual assaults treated in the emergency department between 2005 and 2008.Results: A total of 712 patients (95.5% female) were treated. The median age of assaulted women was25 years. Complaints were made in 87.5% of cases and assaults were made by a single attacker in 84.5%.When the perpetrator was known, the profile of the victim (p≤0.05) was as follows: the victim was assaulted at home (81.5%), the perpetrator acted alone (94.2%), the mechanism of aggression was penetration(89.3%) and the attack took place during the week (63.3%).Conclusions: Analysis of sexual assaults allows for different risk groups to be established, which facilitates the development of specific protocols and guidelines for effective aid and full treatment (AU)