Adverse Effects in Patients with Intellectual and Developmental Disabilities Hospitalized at the University Clinical Hospital.

(1) Background: Providing the patient with the health care they need in a personalized and appropriate manner and without adverse effects (AEs) is a part of quality of care and patient safety. The aim of this applied research project was the assessment of AEs as a clinical risk in patients with high social vulnerability such as persons with intellectual and developmental disabilities (PwIDD). (2) Methods: A retrospective epidemiological cohort study was performed on exposed and unexposed groups (the control group) in order to estimate the incidence of AEs in PwIDDs and assess their importance for this category of patients. (3) Results: AEs were observed with a frequency of 30.4% (95% CI) in the PwIDD exposed group, with significant differences to the unexposed group (p = 0.009). No differences were observed with regards to gender. Age was as a marker of care risk, with the highest incidence of AEs in the group of 60-69 years. (4) Conclusions: PwIDDs have a high risk of suffering AEs while receiving health care assistance due to their high social and clinical vulnerability. Health care practitioners must therefore be aware of these results and keep these observations in mind in order to carry out personalized, preventive, competent, effective, and safe medical care.

B-learning training in the certification of causes of death.

INTRODUCTION: An adequate certification of causes of death is essential for Public Health. The objective of this work is to improve the professional competence of medicine students and family doctors with regard to the certification of causes of death according to the international regulations of the WHO. METHODS: Intervention-formation, before and after design, addressed to students of Medicine in their last year (6th year), and Family Doctors and Interns. The blended learning or b-learning program consisted in an on-site seminar-workshop, plus basic information/documentation stored in an on-line platform, together with the preparation of Certificates of Causes of Death based on Clinical Histories of real cases. RESULTS: 308 students participated in the program. We observed an individual improvement in the professional competence in all certifications of death, which was significant in 3 out of 5 cases (it was not significant in a medical-legal case of violent death and the case of a pluripathological chronic patient). The intermediate causes improved in all cases. Most formal aspects of the certification improved with significant changes. In the group of 62 Family Doctors and interns who took part in the program there were improvements in the basic or underlying causes in 4 of the 5 cases and improvements in the formal quality of the assessment, although less significantly than in students, because they started with better basal indexes in their certificates in the Before stage of the study. CONCLUSIONS: Blended learning training has shown to be effective in improving the professional competence, both in students of the Degree of Medicine and in practicing Family Doctors and Interns.

¿La información sobre automedicación disponible en internet reúne criterios de calidad? / Does the information about self-medication available in the internet meet standards of quality? / A informação sobre automedicação disponível em internet reúne critérios de qualidade?

El estudio tiene por objetivo analizar la calidad de la información en relación con la automedicación en las páginas web de internet y estimar si se cumplen criterios de calidad. Para conseguir dicho propósitose efectuó un estudio observacional tipo transversal basado en la valoración de 15 páginas web institucionales relacionadas con la automedicación y que fueron seleccionadas aleatoriamente para ser revisadas por 59 usuarios habituales de internet como herramienta fundamental en su trabajo profesional. Como instrumento de medida se utilizó un cuestionario elaborado específicamente para este trabajo de investigación. El 66 % de los usuarios del estudio confirmaron la existencia de información sobre automedicación en dichas web. De acuerdo con las observaciones realizadas por los usuarios -la mayor parte de páginas web con información sobre automedicación- en 9 (60 %) se cumplen criterios de calidad en un 70-75 %. Las variables mejor evaluadas han sido la actualización de la información, la responsabilidad y la accesibilidad. Las peor evaluadas han sido la arquitectura de la información y la existencia de acreditación o sello de calidad en la web. La calidad de las web analizadas es aceptable, pero mejorable en accesibilidad universal, acreditación y/o certificación. Las web mejor valoradas globalmente han sido la del Ministerio de Sanidad, Política Social e Igualdad de España y la de la Organización Mundial de la Salud.

The study aims at analyzing the quality of information on self-medication in Internet websites and assess whether quality criteria are met. In view of this, an observational cross-sectional study was carried out as based on the assessment of 15 institutional websites related to self-medication and randomly chosen for review by 59 regular internet users as a fundamental tool in their professional work. A survey developed specifically for this research was conducted. The 66 % of this study's users confirmed the existence of information on self-medication in these websites. According to the observations made by users -most web pages with information about self-medication- in 9 (60 %), standards of quality are met in 70-75 %. The best assessed variables have been updating of information, responsibility and accessibility. The worst assessed ones have been the information architecture and the existence of accreditation or quality seal on the Web. The quality of the websites analyzed is acceptable, but improvable regarding universal accessibility, accreditation and/or certification. The Webs best rated globally have been the Ministry of Health's, Social Policy and Equality's of Spain and the World Health Organization's.

O estudo tem por objetivo analisar a qualidade da informação em relação com a automedicação nas páginas webs de internet e estimar se são cumprido critérios de qualidade. Para conseguir o referido propósito foi efetuado um estudo observacional tipo transversal baseado na valoração de 15 páginas webs institucionais relacionadas com a automedicação e que foram seleccionadas aleatoriamente para ser revistas por 59 usuários habituais de internet como ferramenta fundamental no seu trabalho profissional. Como instrumento de medida foi utilizado um inquérito elaborado especificamente para este trabalho de investigação. O 66 % dos usuários do estudo confirmaram a existência de informação sobre automedicação nas referidas webs. De acordo com as observações realizadas pelos usuários -a maior parte de páginas webs com informação sobre automedicação- em 9 (60 %) são cumpridos critérios de qualidade em um 70-75 %. As variáveis melhor avaliadas têm sido a actualização da informação, a responsabilidade a acessibilidade. As pior avaliadas têm sido a arquitetura da informação e a existência de acreditação ou selo de qualidade na web. A qualidade das webs analisadas é aceitável, mas melhorável em acessibilidade universal, acreditação e/ou certificação As webs melhor valoradas globalmente têm sido a do Ministério de Sanidade, Política Social e Igualdade (MSPS) da Espanha e a da Organização Mundial da Saúde.

Información sobre medicamentos y automedicación en las redes sociales / Information on drugs and self-medication in social networks

Las redes sociales emergen como una de las principales fuentes de información mediante el uso de Internet. Objetivo: valorar la información sanitaria que se utiliza en las redes sociales en relación con los medicamentos y la automedicación. Métodos: se realizó un estudio observacional en Facebook y Twitter durante tres meses para explorar y analizar los comentarios realizados sobre información sanitaria según tres descriptores: salud, enfermedad y medicamentos. Se analizaron 334 comentarios en Facebook y en Twitter, elegidos aleatoriamente de 1 002 extraídos. Resultados: la información sobre medicamentos representa el 20,8 % en Facebook y el 24,15 % en Twitter. Sobre la automedicación supone el 6,9 % y el 8,5 % respectivamente. Los medicamentos más comentados corresponden al sistema nervioso (Grupo N) con 76 (22,7 %) en Facebook y 78 (23,3 %) en Twiter, el grupo más prevalente en ambas redes. Se destacan los mismos subgrupos terapéuticos: N02 (analgésicos), donde es superior Facebook, N06 (psicoanalépticos) y N05 (Psicolépticos). En relación con los medicamentos utilizados en automedicación predomina el grupo N (sistema nervioso) en ambas, pero superior en Facebook. Los grupos que le siguen y que se destacan en todos los casos sobre Twiter son: grupo R (sistema respiratorio), A (sistema digestivo) y M (sistema músculo-esquelético). Los grupos M y R con igual número ocupan el segundo lugar en Twiter. Conclusión: los usuarios de Facebook y Twitter comparten más información sobre medicamentos que sobre automedicación. Las redes sociales, por el momento, se usan prioritariamente para compartir experiencias, resolver dudas y recibir información sobre problemas de salud.

Social networks are one of the main sources of information on the Internet. Objective: evaluate the health information provided by social networks concerning drugs and self-medication. Methods: an observational study was conducted in Facebook and Twitter for three months based on the search terms health, disease and drugs, with the purpose of exploring and analyzing comments on health information. 334 comments were analyzed, randomly selected from the total 1 002 collected. Results: Information on drugs was 20,8 % in Facebook and 24,15 % in Twitter. Information on self-medication was 6,9 % in Facebook and 8,5 % in Twitter. The drugs most commonly commented on were those for the nervous system (Group N) with 76 (22,7 %) comments in Facebook and 78 (23,3 %) in Twitter. This was the prevailing group in both networks. The same therapeutic subgroups stand out in the two networks: N02 (analgesics), higher in Facebook, N06 (psychoanaleptics) and N05 (psycholeptics). As to the drugs used for self-medication, there is a predominance of Group N (nervous system) in both networks, but the prevalence is higher in Facebook. The groups following, all of which stand out in Twitter, are Group R (respiratory system), A (digestive system) and M (musculoskeletal system). Groups M and R rank second in Twitter with the same number of hits. Conclusions: Users of Facebook and Twitter share more information about drugs than about self-medication. Social networks are mostly used to exchange experiences, make inquiries and obtain information about health problems.