[Malnutrition and inequalities in Francoist Spain: the impact of a milk supplement on the growth of Spanish schoolchildren (1954-1978)]. / Malnutrición y desigualdades en la España del franquismo: el impacto del complemento alimenticio lácteo en el crecimiento de los escolares españoles (1954-1978).

The Spanish nutritional and food transition was consolidated over the course of the twentieth century. In the pre-transition stage, a renewed interest emerged in the deficiencies presented by children''s diets, and food and nutritional education was considered the best course of action to correct them. The aim of this study was to analyse the changes over time and regional differences in the nutritional status of Spanish schoolchildren in rural areas in the 1950s and 1970s, using their height as an anthropometric parameter. The results revealed the existence of two categories at the beginning of the 1960s: a first group in which the height of children from the Cantabrian coast, the Levante, Catalonia and the Balea - ric Islands was similar to that of well-nourished children, and a second group from the regions of Andalusia, Extremadura and Galicia, who were not as tall. Between 1954 and 1977, the height of well-nourished children rose, particularly between 1954 and the first half of the 1960s. There was also a significant increase in the height of children attending national schools in rural areas, and the regional differences that had existed at the beginning of the 1960s disappeared. These advances were undoubtedly influenced both by the milk supplement and the food and nutritional education activities carried out within the framework of the Spanish Diet and Nutrition Education programme (EDALNU).

A lo largo del siglo XX, la población española fue consolidando su proceso de transición nutricional y alimentaria. En la etapa pre-transicional, se produjo un renovado interés por las deficiencias que mostraba la alimentación de los niños y se apostó por la educación alimentaria-nutricional para superarlas. El objetivo del trabajo es analizar el estado nutricional, a través de la talla como parámetro antropométrico, que mostraba la población escolar del ámbito rural español, entre las décadas de 1950 y 1970, su evolución y las diferencias que existían entre regiones. Los resultados ponen de manifiesto que al inicio de la década de 1960 se apreciaban dos patrones: un primer grupo donde la estatura de los niños de la costa cantábrica, zona de Levante, Cataluña y Baleares, mostraba niveles similares a los de niños bien alimentados; y un segundo grupo donde las tallas eran inferiores, en el que se encontraban las regiones de Andalucía, Extremadura y Galicia. Entre 1954 y 1977, las tallas de los niños bien alimentados mostraron un incremento que fue especialmente intenso entre 1954 y la primera mitad de la década de 1960. En el caso de los niños y niñas que acudían a las escuelas nacionales del ámbito rural, también se produjo un significativo incremento en la talla, además de corregirse las diferencias regionales que existían al principio de los años sesenta. En todos aquellos avances habrían influido tanto el complemento alimenticio, como las actividades de educación alimentación y nutrición que se llevaron a cabo en el marco del Programa EDALNU.

Malnutrición y desigualdades en la España del franquismo; el impactodel complemento alimenticio lácteo en el crecimiento de los escolares españoles (1954-1978) / Malnutrition and inequalities in francoist Spain; the impact of a milk supplement on the growth of spanish school children (1954-1978)

A lo largo del siglo XX, la población española fue consolidando su proceso de transición nutricional y alimentaria. En la etapa pre-transicional, se produjo un renovado interés por las deficiencias que mostraba la alimentación de los niños y se apostó por la educación alimentaria-nutricional para superarlas. El objetivo del trabajo es analizar el estado nutricional, a través de la talla como parámetro antropométrico, que mostraba la población escolar del ámbito rural español, entre las décadas de 1950 y 1970, su evolución y las diferencias que existían entre regiones. Los resultados ponen de manifiesto que al inicio de la década de 1960 se apreciaban dos patrones: un primer grupo donde la estatura de los niños de la costa cantábrica, zona de Levante, Cataluña y Baleares, mostraba niveles similares a los de niños bien alimentados; y un segundo grupo donde las tallas eran inferiores, en el que se encontraban las regiones de Andalucía, Extremadura y Galicia. Entre 1954 y 1977, las tallas de los niños bien alimentados mostraron un incremento que fue especialmente intenso entre 1954 y la primera mitad de la década de 1960. En el caso de los niños y niñas que acudían a las escuelas nacionales del ámbito rural, también se produjo un significativo incremento en la talla, además de corregirse las diferencias regionales que existían al principio de los años sesenta. En todos aquellos avances habrían influido tanto el complemento alimenticio, como las actividades de educación alimentación y nutrición que se llevaron a cabo en el marco del Programa EDALNU (AU)

The Spanish nutritional and food transition was consolidated over the course of the twentieth century. In the pre-transition stage, a renewed interest emerged in the deficiencies presented by children''s diets, and food and nutritional education was considered the best course of action to correct them. The aim of this study was to analyse the changes over time and regional differences in the nutritional status of Spanish schoolchildren in rural areas in the 1950s and 1970s, using their height as an anthropometric parameter. The results revealed the existence of two categories at the beginning of the 1960s: a first group in which the height of children from the Cantabrian coast, the Levante, Catalonia and the Balearic Islands was similar to that of well-nourished children, and a second group from the regions of Andalusia, Extremadura and Galicia, who were not as tall. Between 1954and 1977, the height of well-nourished children rose, particularly between 1954 and the first half of the 1960s.There was also a significant increase in the height of children attending national schools in rural areas, and the regional differences that had existed at the beginning of the 1960s disappeared. These advances were undoubtedly influenced both by the milk supplement and the food and nutritional education activities carried out within the framework of the Spanish Diet and Nutrition Education programme (EDALNU) (AU)

[Perception among college students of the healthcare law against smoking]. / Tabaco y universidad. Percepción de los estudiantes universitarios sobre la ley de medidas sanitarias frente al tabaquismo.

OBJECTIVE: To understand smoking habits among college students and their opinion about the anti-smoking law. METHOD: Cross-sectional descriptive study conducted. Data gathering was carried out through surveys. RESULTS: Sample of 284 students. 42.6% were smokers and 11.6% were ex-smokers. The heaviest smokers were among the 24-29 age group and those who combined work and school. 13.2% did not perceive any risk in smoking, and 16.1% were unconcerned about the risks to passive smokers. 66.3% of smokers were worried about the effects of smoking on their health. Women perceived more than men that the anti-smoking law implementation was effective and was socially beneficial. Since the anti-smoking law came into effect, 16.5% of the sample had quit smoking and 35.5% had considered quitting. 24.6% did not abide by the law. Agreeing with the law was correlated with being a non-smoker or an ex-smoker being between 18 and 23 years of age or older than 30, studying health sciences, perceiving that smoking creates health hazards and being female. CONCLUSION: These results are of interest because they facilitate the planning of specific activities targeted to this type of people, who in the future will become social points of references. Since smoking constitutes one of the biggest public health problems it should be tackled with a greater commitment from health and academic authorities, including assistance for those willing to quit smoking.

Tabaco y Universidad. Percepción de los estudiantes universitarios sobre la ley de medidas sanitarias frente al tabaquismo / Perception among college students of the healthcare law against smoking

Objetivo: conocer el consumo de tabaco de los estudiantes universitarios y su opinión respecto a la ley antitabaco. Método: estudio descriptivo transversal. La recogida de datos se realizó mediante cuestionario. Resultados: se estudiaron 284 estudiantes. Fumaba el 42,6% y era ex-fumador el 11,6%. Los más consumidores de cigarrillos se encuentran en la franja de 24-29 años y compaginan estudios y trabajo. El 13,2% no percibe el riesgo del tabaco y al 16,1% no le preocupa sus efectos en el fumador pasivo. El 66,3% de fumadores está preocupado por sus efectos en la salud. Las mujeres perciben más que los hombres que la ley antitabaco se cumple y que resulta beneficiosa socialmente. A partir de dicha ley ha dejado de fumar el 16,5% y se ha planteado abandonarlo el 35,5%. El 24,6% no la respeta. Estar de acuerdo con la ley antitabaco se relacionó con no fumar o ser ex-fumador, tener entre 18 y 23 años o más de 30 años, estudiar ciencias sanitarias, percibir que el tabaco supone riesgo para la salud y ser mujer. Conclusión: estos resultados tienen interés porque facilitan planificar actividades específicas dirigidas a este grupo de personas que, en un futuro, serán referentes sociales. Puesto que el tabaquismo constituye uno de los principales problemas de salud pública debería abordarse un mayor compromiso de las autoridades sanitarias y académicas y facilitar ayuda para dejar de fumar(AU)

Objective: to understand smoking habits among college students and their opinion about the anti-smoking law. Method: cross-sectional descriptive study conducted. Data gathering was carried out through surveys. Results: sample of 284 students. 42.6% were smokers and 11.6% were ex-smokers. The heaviest smokers were among the 24-29 age group and those who combined work and school. 13.2% did not perceive any risk in smoking, and 16.1% were unconcerned about the risks to passive smokers. 66.3% of smokers were worried about the effects of smoking on their health. Women perceived more than men that the anti-smoking law implementation was effective and was socially beneficial. Since the anti-smoking law came into effect, 16.5% of the sample had quit smoking and 35.5% had considered quitting. 24.6% did not abide by the law. Agreeing with the law was correlated with being a non-smoker or an ex-smoker, being between 18 and 23 years of age or older than 30, studying health sciences, perceiving that smoking creates health hazards and being female. Conclusion: these results are of interest because they facilitate the planning of specific activities targeted to this type of people, who in the future will become social points of references. Since smoking constitutes one of the biggest public health problems it should be tackled with a greater commitment from health and academic authorities, including assistance for those willing to quit smoking(AU)

Self-reported chronic mental health problems and mental health service use in Spain.

OBJECTIVES: To determine the prevalence of self-reported chronic mental health problems (MHPs) and mental health service use and their determinants, among the Spanish population over 14 years of age. METHODS: Data from the 1999 Spanish Survey on Disabilities, Deficiencies, and State of Health were used. The survey is a cross-sectional study based on a multi-stage stratified sample of all the non-institutionalized Spanish population aged over 14 years (n=59,101, 11% non-responders). Multivariate logistic regression analysis were used. RESULTS: 10.7% of the Spanish population suffer from an MHP. The highest prevalences were found in women, divorced/separated persons, those with a lower level of education and income, and those suffering from a chronic somatic problem. The number of days of daily activity lost was 2-fold greater among those with an MHP than among those with a chronic somatic problem. Greater use of mental health services was associated with loss of daily activity, having a higher level of education, invalidity or disability. The probability of MHP being referred from primary to mental healthcare is reduced if somatic comorbidity is present. CONCLUSION: MHPs have a high prevalence and a significant repercussion on the patient's life. An inverse relationship was found between certain risk factors for MHPs and the use of services, which suggests inequality. Problems of accessibility are identified.

Quality of life in simultaneous pancreas-kidney transplant recipients.

BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK Tx) allows dialysis and insulin therapy to be discontinued and improves the complications of diabetes mellitus type 1 (DM1). This study measure quality of life (QoL) in SPK transplant recipients and determine if there are differences in QoL between these patients and those with DM1 in renal replacement therapy (RRT). METHODS: Short Form Health Survey 36-Item (SF-36) was administered to 69 SPK transplant recipients and 34 patients with DM1 under RRT. A descriptive analysis, multiple linear regression, ANOVA, and ordinal regression (PLUM) models were constructed. RESULTS: QoL was higher in SPK transplant recipients than in patients receiving RRT. The best results were in the recently transplanted patients. Respect to Spanish population the men with SPK transplants scored higher on vitality and lower on general health, role limitations-physical and role limitations-emotional. Women with SPK transplants scored lower on general health. Among patients under RRT, men scored lower on the general health, physical functioning, vitality, and bodily pain while women scored lower on all dimensions. In both groups, greater age was associated with better mental health. CONCLUSION: Positive predictive factors of QoL are SPK Tx and age while negative predictive factors are female sex and RRT.

Proceso de adaptación a la diabetes mellitus tipo 1 (DM1). Concordancia con las etapas del proceso de duelo descrito por Kübler-Ross / Alignment of the Kübler-Ross grief cycle phases with the process of adaptation to type 1 diabetes mellitus

Objetivo: Conocer el proceso de adaptación a la diabetes mellitus tipo 1 (DM1) y analizar su correspondencia con las etapas del proceso de duelo descritas por Kübler-Ross. Sujetos y método: Estudio etnográfico mediante entrevistas en profundidad a 20 pacientes, 10 familiares y 12 profesionales (6 médicos y 6 enfermeras). Para el análisis se siguió el esquema de análisis de datos cualitativos de Miles y Huberman. Resultados: El paciente diagnosticado de DM1 y su familia afrontan la pérdida del estilo de vida y los objetos reales o imaginarios de su vida pasada. Enfermos y familiares experimentan reacciones emocionales que, en algún caso, pueden asemejarse a las etapas de duelo descritas por Kübler-Ross en una enfermedad terminal (negación, rebeldía, negociación, depresión y aceptación), pero hay diferencias que dependen de factores personales y psicosociales. Los profesionales tienden a relacionar la mala adherencia con la negación de la enfermedad, pero algunos pacientes se sienten amenazados por las exigencias de tratamiento y control y por sus consecuencias en su calidad de vida, y conscientemente optan por no seguir las recomendaciones. Es más realista hablar de adaptación a la enfermedad que de aceptación, puesto que los procesos de pérdida son constantes y el enfermo debe reconstruir nuevas identidades según su estado. El proceso de duelo afecta también a la familia y puede ser diferente que el del enfermo en tiempo, intensidad y valoración de los problemas. Conclusiones: La adaptación es un proceso complejo en el que intervienen muchas variables. Se observan diferencias en los mecanismos que utiliza cada sujeto en particular. Los profesionales sanitarios y, particularmente la enfermera, deben considerar las múltiples dimensiones psicosociales de la enfermedad crónica (AU)

Objective: To understand the process of adaptation to type 1 diabetes mellitus (DM1) and analyze its alignment with the grief cycle phases described by Kübler-Ross. Subjects and method: We performed an ethnographic study through in-depth interviews with 20 patients, 10 relatives and 12 health professionals (6 physicians and 6 nurses). For the analysis, the Miles and Huberman qualitative data analysis model was used. Results: Patients diagnosed with DM1 and their families face a loss of lifestyle and of the objects, real or imaginary, of their previous life. Patients and relatives experience emotional reactions that in some cases can be similar to the grief cycle phases described by Kübler-Ross for terminal diseases (denial, anger, bargaining, depression and acceptance). However, there are some differences depending on personal and psycho-social factors. Health professionals tend to relate low adherence to denial of the disease, but some patients feel threatened by the demands of treatment and control and their effects on their quality of life, and consciously choose not to follow recommendations. It is more realistic to talk about disease adaptation than acceptance, since the loss processes are ongoing and patients must reconstruct their identity according to their situation. The grief cycle also affects the family and may differ from that of the patient in its duration, intensity and assessment of problems. Conclusions: Adaptation is a complex process in which many variables intervene. There are observable differences among the mechanisms used by each specific individual. Healthcare professionals, and specifically nurses, should consider the multiple psycho-social dimensions of chronic disease (AU)

Alignment of the Kübler-Ross grief cycle phases with the process of adaptation to type 1 diabetes mellitus.

OBJECTIVE: To understand the process of adaptation to type 1 diabetes mellitus (DM1) and analyze its alignment with the grief cycle phases described by Kübler-Ross. SUBJECTS AND METHOD: We performed an ethnographic study through in-depth interviews with 20 patients, 10 relatives and 12 health professionals (6 physicians and 6 nurses). For the analysis, the Miles and Huberman qualitative data analysis model was used. RESULTS: Patients diagnosed with DM1 and their families face a loss of lifestyle and of the objects, real or imaginary, of their previous life. Patients and relatives experience emotional reactions that in some cases can be similar to the grief cycle phases described by Kübler-Ross for terminal diseases (denial, anger, bargaining, depression and acceptance). However, there are some differences depending on personal and psycho-social factors. Health professionals tend to relate low adherence to denial of the disease, but some patients feel threatened by the demands of treatment and control and their effects on their quality of life, and consciously choose not to follow recommendations. It is more realistic to talk about disease adaptation than acceptance, since the loss processes are ongoing and patients must reconstruct their identity according to their situation. The grief cycle also affects the family and may differ from that of the patient in its duration, intensity and assessment of problems. CONCLUSIONS: Adaptation is a complex process in which many variables intervene. There are observable differences among the mechanisms used by each specific individual. Healthcare professionals, and specifically nurses, should consider the multiple psycho-social dimensions of chronic disease.

[Numbers are also words]. / El número también es palabra.

The author, leaving aside his development as a statistician, opens up to other proposals, reviewing some studies about qualitative research methodology as related to health sciences. He concludes that qualitative research complements quantitative research and that a subjective element exists in both: numbers are also words because behind numbers there is a reflexive process and a human interpretation.

El número también es palabra / Numbers are also words

El autor, abstrayéndose de su formación estadística, se abre a otras propuestas. revisando algunos trabajos sobre la metodología de investigación cualitativa en el entorno de las ciencias de la salud. Concluye que la investigación cualitativa es complementaria a la cuantitativa y que en ambas existe un factor subjetivo: el número también es palabra, porque detrás del número hay un proceso reflexivo y una interpretación humana

The author leaving aside his development as a statistician, opens up to other proposals, reviewing some studies about qualitative research methodology as related to health sciences. He concludes that qualitative research complements quantitative research and that a subjective element exists in both: numbers are also words beca use behind numbers there is a reflexive process and ahuman interpretarían

[Intrepid: Second nursing cycle. First step, first desire in European Spain]. / Intrepidos. 2 ciclo de enfermería. Primer paso, primer anhelo en la España Europea.

When we started to write this article for ROL the first question which confronted us was first step? Why? The beginning of second cycle studies in 1998 did not correspond to any European desire, but rather consolidated a real desire which Spanish Nursing had: attain the highest possible academic title through growth inside the nursing discipline itself, having as an objective to place nursing in equal conditions as the majority of titles in the Spanish university system. This meant it was necessary to carry out research and investigation inside one's own scientific field, develop future professionals, administrate under equal conditions, and specifically consolidate a way deserving of one who bears responsibility over health care.

Intrépidos. Segundo ciclo de enfermería. Primer paso, primer anhelo en la España europea / Intrepid: second nursing cycle. First step, first desire in European Spain

En el momento de escribir este documento para ROL, la primera pregunta que nos asaltó fue ¿primer paso? ¿por qué? El inicio de los estudios de segundo ciclo en 1998 no respondía a ningún anhelo europeo, sino a consolidar un deseo real de la Enfermería española: lograr el máximo grado académico creciendo desde la propia disciplina, con el fin de estar en condiciones de igualdad con la mayoría de titulaciones de la Universidad Española. Esto es, investigar dentro del propio campo científico, formar a los futuros profesionales, gestionar en condiciones de igualdad y en definitiva consolidar un camino que se merece quien tiene responsabilidad sobre el cuidado de la salud (AU)