Necesidades de orientación profesional de usuarios de servicios públicos de empleo en España / Necessidades de orientação profissional dos usuários de serviços públicos de emprego na Espanha / Career counseling needs of employment public services users in Spain

Este artículo explora las necesidades de orientación profesional de 1816 usuarios de servicios públicos de empleo, en relación con las competencias requeridas para la planificación del proyecto vital y profesional. Pretende identificar diferencias entre la población general y los grupos de atención prioritaria (mujeres, jóvenes, personas con baja cualificación, parados mayores de 45, población rural). La recogida de información se realizó a través de un cuestionario diseñado ad-hoc. Los resultados permiten identificar tres dimensiones en el conjunto de necesidades de orientación profesional: 1. las relativas a la gestión de la carrera profesional, a 2. la planificación de metas realistas y a 3. la búsqueda de empleo, en las que se encuentran diferencias significativas en función de alguna o varias de las variables consideradas.

Este artigo aborda as necessidades de orientação profissional de 1816 usuários dos serviços públicos de emprego, em relação às competências requeridas para o planejamento dos projetos de vida e profissional. Como objetivo, pretende identificar as diferenças entre a população geral de usuários e os grupos de atenção prioritárias (mulheres, jovens, pessoas com baixa qualificação profissional, desempregados com mais de 45 anos, população rural). A coleta de informação foi realizada através de um questionário ad-hoc. Os resultados permitem identificar três dimensões nas necessidades de orientação vocacional: 1. as relativas à gestão de carreiras profissionais, 2. o planejamento de metas realistas e 3. a procura por emprego, nas quais se encontrou diferenças significativas com base em uma ou mais variáveis sócio-demográficas consideradas na pesquisa.

This article explores the career counseling needs of 1816 users of employment public services, in relation to the competencies required for the planning of the vital and professional project. It aims to identify differences between the general population and the priority attention groups (women, young people, people with low skills, unemployed over 45, rural population). The collection of information was done through an ad-hoc designed questionnaire. The results allow to identify three dimensions in the set of career counseling needs: 1. those related to career management, 2. realistic goal planning and 3. job search, in which are found significant differences depending on one or several of the variables considered.

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico.

BACKGROUND: Several low and middle-income countries are implementing electronic health records (EHR). In the near future, EHRs could become an efficient tool to evaluate healthcare performance if appropriate indicators are developed. The aims of this study are: a) to develop quality of care indicators (QCIs) for type 2 diabetes (T2DM) in the Mexican Institute of Social Security (IMSS) health system; b) to determine the feasibility of constructing QCIs using the IMSS EHR data; and c) to evaluate the quality of care (QC) provided to IMSS patients with T2DM. METHODS: We used a three-stage mixed methods approach: a) development of QCIs following the RAND-UCLA method; b) EHR data extraction and construction of indicators; c) QC evaluation using EHR data from 25,130 T2DM patients who received care in 2009. RESULTS: We developed 18 QCIs, of which 14 were possible to construct using available EHR data. QCIs comprised both process of care and health outcomes. Several flaws in the EHR design and quality of data were identified. The indicators of process and outcomes of care suggested areas for improvement. For example, only 13.0% of patients were referred to an ophthalmologist; 3.9% received nutritional counseling; 63.2% of overweight/obese patients were prescribed metformin, and only 23% had HbA1c <7% (or plasma glucose≤130 mg/dl). CONCLUSIONS: EHR data can be used to evaluate QC. The results identified both strengths and weaknesses in the electronic information system as well as in the process and outcomes of T2DM care at IMSS. This information can be used to guide targeted interventions to improve QC.

Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City.

BACKGROUND: In Mexico, inappropriate prescription of drugs with potential interactions causing serious risks to patient health has been little studied. Work in this area has focused mainly on hospitalized patients, with only specific drug combinations analyzed; moreover, the studies have not produced conclusive results. In the present study, we determined the frequency of potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age, who used Mexican Institute of Social Security (IMSS) family medicine clinics. In addition, we aimed to identify the associated factors for these interactions. METHODS: We collected information on general patient characteristics, medical histories, and medication (complete data). The study included 624 ambulatory patients over 50 years of age, with non-malignant pain syndrome, who made ambulatory visits to two IMSS family medicine clinics in Mexico City. The patients received 7-day prescriptions for non-opioid analgesics. The potential interactions were identified by using the Thompson Micromedex program. Data were analyzed using descriptive, bivariate and multiple logistic regression analyses. RESULTS: The average number of prescribed drugs was 5.9 +/- 2.5. About 80.0% of patients had prescriptions implying one or more potential drug-drug interactions and 3.8% of patients were prescribed drug combinations with interactions that should be avoided. Also, 64.0% of patients had prescriptions implying one or more potential drug disease interactions. The factors significantly associated with having one or more potential interactions included: taking 5 or more medicines (adjusted Odds Ratio (OR): 4.34, 95%CI: 2.76-6.83), patient age 60 years or older (adjusted OR: 1.66, 95% CI: 1.01-2.74) and suffering from cardiovascular diseases (adjusted OR: 7.26, 95% CI: 4.61-11.44). CONCLUSION: The high frequency of prescription of drugs with potential drug interactions showed in this study suggests that it is common practice in primary care level. To lower the frequency of potential interactions it could be necessary to make a careful selection of therapeutic alternatives, and in cases without other options, patients should be continuously monitored to identify adverse events.