Cost-effectiveness and cost-utility analyses of a web-based computer-tailored intervention for prevention of binge drinking among Spanish adolescents.

BACKGROUND: Binge drinking (BD) among adolescents is a public health concern worldwide. This study assessed the cost-effectiveness and cost-utility of a web-based computer-tailored intervention to prevent BD in adolescence. METHODS: The sample was drawn from a study evaluating the Alerta Alcohol program. The population consisted of adolescents 15 to 19 years of age. Data were recorded at baseline (January to February 2016) and after 4 months (May to June 2017) and were used to estimate costs and health outcomes, as measured by the number of BD occasions and quality-adjusted life years (QALYs). Incremental cost-effectiveness and cost-utility ratios were calculated from National Health Service (NHS) and societal perspectives and for a time horizon of 4 months. A multivariate deterministic sensitivity analysis of best/worst scenarios by subgroups was used to account for uncertainty. RESULTS: The cost of reducing BD occasions by one per month was €16.63 from the NHS perspective, which from the societal perspective resulted in savings of €7986.37. From the societal perspective, the intervention resulted in an incremental cost of €71.05 per QALY gained from the NHS perspective and this was dominant, resulting in savings of €34,126.64 per QALY gained in comparison with the control group. Subgroup analyses showed that the intervention was dominant for girls from both the perspectives and for individuals 17 years or older from the NHS perspective. CONCLUSIONS: Computer-tailored feedback is a cost-effective way to reduce BD and increase QALYs among adolescents. However, long-term follow-up is needed to evaluate more fully changes in both BD and health-related quality of life.

Economic evaluations of interventions aimed at the prevention, treatment and/or rehabilitation of alcohol-related disorders: A systematic review. / Evaluaciones económicas de intervenciones dirigidas a la prevención, tratamiento y/o rehabilitación de trastornos por consumo de alcohol: Una revisión sistemática.

The aim of this systematic literature review is to identify economic evaluations of programmes or interventions aimed at the prevention, treatment and rehabilitation of alcohol use disorders, as well as to determine those types of programmes, treatments or interventions that are efficient. The systematic literature review was conducted by searching the following databases: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. The search terms used were in English. No time restriction was applied. A data extraction form was used to draw information. The systematic review follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) on reporting systematic reviews. The interventions were classified into three categories: "A" treatments for people with alcohol use disorders (tertiary prevention); "B" treatments for people at risk for alcohol-related problems (secondary prevention); "C" policy legislation and enforcement interventions (primary prevention). Furthermore, the "A" interventions were subclassified into psychological, pharmacological and combined interventions. The review included 63 papers. In terms of treatments for people with alcohol use disorders, any psychosocial intervention compared to no intervention appeared to be a dominant strategy. In terms of treatments for people at risk of alcohol-related problems, brief intervention appears to be dominant or cost-effective when compared to no intervention. Advertising controls, tax increases, licensing, legal drinking age, and mass media campaigns seem to be dominant or cost-effective strategies compared to no intervention or random breath testing. Previous reviews have been extended by depicting alcohol programmes according to their efficiency. Despite this, the available studies in this regard have heterogeneous approaches and most do not adequately define the costs included in their analyses. Therefore, it is necessary to encourage the evaluation of the efficiency of these types of interventions to aid decision-making in public health.

El objetivo de esta revisión sistemática de la literatura es identificar evaluaciones económicas de programas o intervenciones dirigidas a la prevención, tratamiento y rehabilitación de trastornos por consumo de alcohol, así como determinar aquellos tipos de programas, tratamientos o intervenciones que son eficientes. Se realizó una revisión sistemática de la literatura mediante la búsqueda en las siguientes bases de datos: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. Los términos de búsqueda utilizados fueron en inglés. No se aplicó ninguna restricción de tiempo. Se utilizó un formulario de extracción de datos para resumir la información. La revisión sistemática siguió las recomendaciones (PRISMA-P) sobre la presentación de informes de revisiones sistemáticas. Las intervenciones fueron clasificadas en tres categorías: «A¼ tratamientos para personas con trastornos por consumo de alcohol (prevención terciaria); «B¼ tratamientos para personas en riesgo de problemas relacionados con el alcohol (prevención secundaria); «C¼ legislación sobre políticas e intervenciones de aplicación (prevención terciaria). Además, las intervenciones «A¼ fueron subclasificadas en intervenciones psicológicas, farmacológicas y combinadas. Se incluyeron 63 documentos. En términos de tratamientos para personas con trastornos por uso de alcohol, cualquier intervención psicosocial en comparación con ninguna intervención parece ser una estrategia dominante. En términos de tratamientos para personas en riesgo de problemas relacionados con el alcohol, la intervención breve parece ser dominante o rentable en comparación con no hacer nada. Los controles publicitarios, las subidas de impuestos, las licencias, la edad legal para consumir alcohol y las campañas en los medios de comunicación parecen ser una estrategia dominante o rentable en comparación con ninguna intervención o prueba aleatoria de alcoholemia. Se han ampliado las revisiones anteriores al mostrar los programas de alcohol según criterios de eficiencia. A pesar de ello, los estudios disponibles al respecto tienen enfoques heterogéneos y la mayoría no define adecuadamente los costes incluidos en su análisis. Por tanto, es necesario continuar evaluando en términos de eficiencia este tipo de intervenciones para informar mejor la toma de decisiones en salud pública.

Posttransplant Hepatocellular Carcinoma Surveillance: A Cost-effectiveness and Cost-utility Analysis.

OBJECTIVE: Assess cost-effectiveness and -utility associated with posttransplant HCC surveillance compared to standard follow-up. SUMMARY OF BACKGROUND DATA: Despite lack of prospective clinical data, expert consensus recommends posttransplant surveillance to detect HCC recurrence in a latent phase, while it might be amenable to curative-intent therapy. METHODS: A Markov-based transition model was created to estimate life expectancy and quality-of-life among liver transplant patients undergoing HCC surveillance. Models were built for 2 cohorts: 1 undergoing HCC surveillance with contrast-enhanced computed tomography of chest and abdomen and serum alpha-fetoprotein analysis and the other receiving standard posttransplant follow-up. Primary model outputs included LY and QALY gains, incremental cost-effectiveness ratio, and incremental cost-utility ratio. Willingness-to-pay for a QALY gain (cost-effectiveness threshold) was used to estimate efficiency. RESULTS: Surveillance was marginally more effective versus no surveillance, resulting in means of 0.069 LYs and 0.026 QALYs gained. Costs for surveillance were increased by an average of 988.32€, resulting in incremental cost-effectiveness ratio 14,410.15€/LY and incremental cost-utility ratio 37,547.97€/QALY. Surveillance did not seem cost-effective in our setting, considering willingness-to-pay threshold of 25,000€/QALY. Probabilistic sensitivity analysis indicated surveillance might be cost-effective in 42% of cases, but degree of uncertainty in the analysis was high. CONCLUSIONS: Performing posttransplant HCC surveillance offers marginal clinical benefits and increases costs. Although expert consensus supports surveillance, results of this decision analysis raise doubt regarding the utility of such recommendations and support ongoing need for prospective clinical trials.

Cost-effectiveness of Alzheimer's disease CSF biomarkers and amyloid-PET in early-onset cognitive impairment diagnosis.

This study aimed at determining the cost-effectiveness of amyloid-positron emission tomography (PET) compared to Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers (amyloid-ß42, total-Tau and phosphorylated-Tau) for the diagnosis of AD in patients with early-onset cognitive impairment. A decision tree model using a national health care perspective was developed to compare the costs and effectiveness associated with Amyloid-PET and AD CSF biomarkers. Available evidence from the literature and primary data from Hospital Clínic de Barcelona were used to inform the model and calculate the efficiency of these diagnostic alternatives. Medical visits and diagnostic procedures were considered and reported in €2020. We calculated the incremental cost-effectiveness ratio to measure the cost per % of correct diagnoses detected and we perform one-way deterministic and probabilistic sensitivity analyses to assess the uncertainty of these results. Compared with AD CSF biomarkers, Amyloid-PET resulted in 7.40% more correctly diagnosed cases of AD, with an incremental total mean cost of €146,854.80 per 100 cases. We found a 50% of probability that Amyloid-PET was cost-effective for a willingness to pay (WTP) of €19,840.39 per correct case detected. Using a WTP of €75,000, the probability that it is cost-effective reached a maximum of 76.9%, thus leading to a conclusion that Amyloid-PET is not a cost-effective technique compared to AD CSF biomarkers, unless the funder is willing to pay a minimum of €19,840.39 to detect one more correct case. Furthermore, obtaining CSF provides simultaneous information on amyloid ß and tau biomarkers and allows other biomarkers to be analyzed at a relatively low cost.

Evaluaciones económicas de intervenciones dirigidas a la prevención, tratamiento y/o rehabilitación de trastornos por consumo de alcohol: Una revisión sistemática / Economic evaluations of interventions aimed at the prevention, treatment and/or rehabilitation of alcohol-related disorders: A systematic review

El objetivo de esta revisión sistemática de la literatura es identificar evaluaciones económicas de programas o intervenciones dirigidas a la prevención, tratamiento y rehabilitación de trastornos por consumo de alcohol, así como determinar aquellos tipos de programas, tratamientos o intervenciones que son eficientes. Se realizó una revisión sistemática de la literatura mediante la búsqueda en las siguientes bases de datos: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. Los términos de búsqueda utilizados fueron en inglés. No se aplicó ninguna restricción de tiempo. Se utilizó un formulario de extracción de datos para resumir la información. La revisión sistemática siguió las recomendaciones (PRISMA-P) sobre la presentación de informes de revisiones sistemáticas. Las intervenciones fueron clasificadas en tres categorías: «A» tratamientos para personas con trastornos por consumo de alcohol (prevención terciaria); «B» tratamientos para personas en riesgo de problemas relacionados con el alcohol (prevención secundaria); «C» legislación sobre políticas e intervenciones de aplicación (prevención terciaria). Además, las intervenciones «A» fueron subclasificadas en intervenciones psicológicas, farmacológicas y combinadas. Se incluyeron 63 documentos. En términos de tratamientos para personas con trastornos por uso de alcohol, cualquier intervención psicosocial en comparación con ninguna intervención parece ser una estrategia dominante. En términos de tratamientos para personas en riesgo de problemas relacionados con el alcohol, la intervención breve parece ser dominante o rentable en comparación con no hacer nada. Los controles publicitarios, las subidas de impuestos, las licencias, la edad legal para consumir alcohol y las campañas en los medios de comunicación parecen ser una estrategia dominante o rentable en comparación con ninguna intervención o prueba aleatoria de alcoholemia. ... (AU)

The aim of this systematic literature review is to identify economic evaluations of programmes or interventions aimed at the prevention, treatment and rehabilitation of alcohol use disorders, as well as to determine those types of programmes, treatments or interventions that are efficient. The systematic literature review was conducted by searching the following databases: National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. The search terms used were in English. No time restriction was applied. A data extraction form was used to draw information. The systematic review follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) on reporting systematic reviews. The interventions were classified into three categories: “A” treatments for people with alcohol use disorders (tertiary prevention); “B” treatments for people at risk for alcohol-related problems (secondary prevention); “C” policy legislation and enforcement interventions (primary prevention). Furthermore, the “A” interventions were subclassified into psychological, pharmacological and combined interventions. The review included 63 papers. In terms of treatments for people with alcohol use disorders, any psychosocial intervention compared to no intervention appeared to be a dominant strategy. In terms of treatments for people at risk of alcohol-related problems, brief intervention appears to be dominant or cost-effective when compared to no intervention. Advertising controls, tax increases, licensing, legal drinking age, and mass media campaigns seem to be dominant or cost-effective strategies compared to no intervention or random breath testing. Previous reviews have been extended by depicting alcohol programmes according to their efficiency. ... (AU)

Effects of an educational intervention on nursing students' attitudes towards gypsy women: A non-randomized controlled trial.

BACKGROUND: The cultural differences between health professionals and patients, together with the ethnocentric opinions that some health professionals sometimes hold, generate prejudice and negatively influence the experiences of these groups, for example, the Gypsy population. METHODS: We set up a quasi-experimental study to test the efficacy of an educational intervention among 40 nursing students in Spain based on the use of positive references in order to improve the students' attitude towards gypsy women receiving health care. Analysis of comparison of means and correlation analysis were carried out according to the type of variable compared. RESULTS: The score in all the items that make up the Prejudicial Attitude Scale (PAT) decreased after the test, which demonstrated that their attitudes had become less prejudiced. The Stereotype Content Model (SCM), the perception of the outgroup and the stereotypes regarding the Roma population as "trustworthy" all improved showing a statistically significant difference between the periods (pre and post educational intervention). CONCLUSION: Nursing educators have the opportunity, through theoretical and practical exposure to positive references, to explore the students' experience and perceptions, analyze interventions and change their perceptions of threat, thus contributing to a more inclusive group identity.

Impact of the COVID-19 Pandemic and Psychosocial Coping Strategies in Health Sciences Students at the University of Seville: A Pilot Study.

The new infection by coronavirus has supposed a challenge to all health systems worldwide, affecting our psychosocial health. Education as we knew it has changed, which is why university students, attending Health Sciences courses in this case, have been affected by the pandemic. This study aimed to analyze the impact of the preventative measures and restrictions associated with COVID-19 on multiple mental health and psychological well-being indicators in Health Sciences students at the University of Seville. A descriptive and cross-sectional pilot study in the University of Seville by means of an online questionnaire elaborated was conducted. Of the final sample (n = 68), more than 60% of the students acknowledged having received specific training by their university and/or health institution where they perform practices on COVID-19 measures; however, they negatively emphasized not having received psychosocial aid or support in most of the cases (94.12%). As the health situation imposed by COVID-19 is considered long-lasting, the proposal is to plan short- and long-term strategies for promotion and intervention in the mental health of students and future health care workers.

Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level.

Ecuador assumed the commitment of including Palliative Care (PC) in its health policies. In 2014, the Ministry of Public Health (Ministerio de Salud Pública, MSP) approved the Clinical Practice Guide for Palliative Care (Guía de Práctica Clínica sobre Cuidados Paliativos, GPCCP), with application at the national level, as a mandatory internal regulation in all institutions belonging to the National Health System. In 2021, there is no evidence about the degree of implementation. The objective was to evaluate the implementation (I) of the GPCCP guide and the knowledge (C) of the health personnel working in the Zone 7 Health Centers (HCs). This is a cross-sectional, descriptive, and prospective study. A total of 292 professionals were interviewed: managers (38), physicians (150), and nurses (104). Three surveys based on the GPCCP guide were elaborated: one for the implementation, which was applied to the individuals in charge, and the others to assess the health professionals' knowledge. The SPSS program was used, version 25. In the three groups, more than half of the participants had no training in PC, 91.2% of the HCs have the GPCCP guide, there is PC medical history (MH) in 38.2%, and morphine is used in 14.7%. The implementation of the GPCCP guide was inadequate in 52.9% of the cases. Only 25% treat the agony symptoms and 30%, delirium; 4.4% acknowledge the use of morphine in dyspnea, and 13.3% identify the subcutaneous route as the first choice for hydration at the end-of-life phase. Strategies to implement the GPCCP guide and to improve the health personnel's knowledge must be implemented in Zone 7 centers.

The Suffering of Advanced Chronic Renal Patients and Their Relationship with Symptoms in Loja, Ecuador.

Advanced Chronic Kidney Disease (ACKD) supposes a public health problem in Ecuador that requires a comprehensive approach. In view of the scarcity of studies on the subject in this country, the objective of this research was to determine the signs and symptoms associated with the patients' physical, social and psychological spheres that allow properly developing palliative care. A longitudinal, prospective and observational study was conducted with ACKD patients. In order to assess the symptomatic burden and suffering of these patients, the Edmonton Symptom Assessment System Revised: renal (ESAS-r) for renal patients and the Distress Thermometer (DT) were used. The sample consisted of a total of 246 patients. The most common symptoms that affect them, causing them suffering in their daily lives, are those related to well-being, difficulty falling asleep and itching. It is necessary that health professionals adapt care measures and help patients undergoing renal treatment, especially those who have suffered the disease for a longer period of time, in order to alleviate the patients' suffering and therefore improve their daily lives. To such an end, a care plan could be designed that includes early palliative care.

The effectiveness of spiritual interventions in the workplace for work-related health outcomes: A systematic review and meta-analysis.

AIM: To investigate the effectiveness of spiritual interventions in the workplace for different health outcomes through the use of a meta-analysis of randomized controlled trials. BACKGROUND: Most studies including spirituality in the workplace investigated it at the organisational/business level, while giving a secondary value to the well-being and quality of life of the workers. METHODS: Systematic review and meta-analysis carried out on the following databases: SCOPUS, PubMed and Web of Science. Spiritual interventions investigating work-related health outcomes were included. Then, meta-analyses were conducted. RESULTS: From a total of 2,832 studies, 7 articles were included in the systematic review and 6 in the meta-analysis. Spiritual interventions, as compared to controls, improved the health outcomes of the workers (standard mean difference (SMD), -1.42; 95% CI, -1.98, -0.86; p < .001; I2  = 96%). Subanalyses revealed that yoga was an effective intervention and that stress was reduced by these interventions. CONCLUSION: Spiritual interventions in the workplace seem to be effective in improving workers' health. Nevertheless, the high heterogeneity and limited number of studies may hinder more robust conclusions at the moment. IMPLICATIONS FOR NURSING MANAGEMENT: The use of spiritual interventions should be considered in workplaces in order to reduce the stress and other negative outcomes.

Assessment of Ambivalent Sexism in University Students in Colombia and Spain: A Comparative Analysis.

(1) Background: Gender-based violence has no geographical, personal, or social boundaries. It constitutes a serious public health problem that affects the entire society. This research aims to identify and compare the level of ambivalent sexism in Spanish and Colombian university students and its relationship with sociodemographic factors. Ambivalent sexism, developed by Glick and Fiske (1996), is considered a new type of sexism since, for the first time, it combines negative and positive feelings that give rise to hostile and benevolent sexism, maintaining the subordination of women through punishment and rewards. (2) Methods: The methodology consisted of the application of the validated Spanish version of the Ambivalent Sexism Inventory (ASI) to a sample of 374 students in their final academic year of the Law program, of which 21.7% were students at the University of Santander (Bucaramanga, Colombia), 45.5% at the University Rey Juan Carlos (Madrid, Spain), and the remaining 32.9% at the University of Seville (Seville, Spain). (3) Results: A high level of ambivalent sexism is reported in Colombian students nowadays. In the two countries. there are similarities (e.g., the great weight of religion and the variation in attitudes towards sexism in people who identify themselves as women, compared to male or students consulted that prefer not to answer) and differences (e.g., absence in Colombia of gender-specific legislation, low number of students who have received gender education in Spain). (4) Conclusions: These findings may contribute to the construction of laws that take into account the particular problems of women and the development of educational programs on gender that are offered in a transversal and permanent way and that take into account cultural factors and equity between men and women as an essential element in the training of future judges who have the legal responsibility to protect those who report gender violence.

Compassionate Engagement and Action in the Education for Health Care Professions: A Cross-Sectional Study at an Ecuadorian University.

Objective: This study aimed at exploring the compassion attitudes and needs for awareness and training related to a compassionate approach for Medicine, Nursing, and Psychology students, as well as for the academic and administration personnel from the Universidad Técnica Particular de Loja (UTPL, Ecuador) Health Sciences area. Methods: A cross-sectional observational study, based on a self-administered questionnaire through a sample of 788 UPTL students. STROBE guidelines were followed and applied. Results: A positive correlation was found between life engagement and compassion for others, from others, and self-compassion. The Nursing students were those who reported having previous experiences of contact with people with an advanced disease or in an end-of-life situation and having received some type of training compared to Medicine and Psychology students and lecturers (faculty members). Differences were found on the "self-compassion" and "compassion for others" subscales, noting a higher level of compassion among Psychology students. Conclusions: To implement the philosophy of compassionate universities it is necessary to design trainings that include the students, the faculty members, and the administrative staff, centered on sensitization and training about assistance, care, and accompaniment at the end of life, as well as cultivating compassion in the workplace.

Chronic Diseases and Associated Factors among Older Adults in Loja, Ecuador.

(1) Background: This study aimed to explore the symptoms, functional status, and depression in patients with chronic diseases in Loja, Ecuador. (2) Methods: A cross-sectional study was carried out with patients over 60 years old having at least one chronic disease and cared for in healthcare centers of the Health Ministry of Ecuador or living in associated geriatric centers. (3) Results: The sample comprised 283 patients with a mean age of 76.56 (SD 7.76) years. The most prevalent chronic diseases were chronic obstructive pulmonary disease, followed by arterial hypertension and diabetes. Patients with a joint disease had the worst scores for the majority of the symptoms assessed with the Edmonton Scale. Cancer, dementia, and arterial hypertension contributed the most to the dependence levels assessed with the Barthel Index. Dementia contributed the most to the poor performance status evaluated with the Karnofsky Performance Status. Cancer and diabetes contributed the most to depression. Patients with a higher number of chronic diseases reported worse functional status. (4) Conclusions: Targeted interventions to address symptoms, functional status, and depression in patients with chronic diseases are needed.

Social, economic and family factors associated with binge drinking in Spanish adolescents.

BACKGROUND: The main aim of this study was to determine the socioeconomic and family factors associated with binge drinking (BD) in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known as Alerta Alcohol. METHODS: Longitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial with an intervention group (IG) who received the Alerta Alcohol programme and a control group (CG) who did not receive any active intervention. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. The endogenous variable in all models was the number of BD occasions in the last 30 days. A total of 1247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period (4 months later), were included in the analysis. RESULTS: In relation to findings, being older (≥ 17 years old), having more pocket money and higher family alcohol consumption were associated with greater BD. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of BD occasions. CONCLUSIONS: Our results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between BD and both family alcohol consumption and weekly pocket money or availability of money to adolescents. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent BD would be justified. TRIAL REGISTRATION: (ClinicalTrials.gov): NCT03288896. Registration date: September 20, 2017. "Retrospectively registered".

Measuring the effects on quality of life and alcohol consumption of a program to reduce binge drinking in Spanish adolescents.

AIM: To present a comparison between the effects on health due to a reduction in binge drinking (BD) and health-related quality of life (HRQoL), as a result of ALERTA ALCOHOL, an intervention aimed at reducing BD in Spanish adolescents. METHODS: A two-arm cluster randomized controlled trial was conducted with an intervention and a control group, randomized at the school level, following individuals over four months. The study population consisted of Andalusian adolescents aged 15 to 19 years who were enrolled in urban public high schools (n = 1247). Participants were assigned randomly to receive the intervention. The main outcomes studied were the number of occasions of BD in the last 30 days, which was directly obtained from the answers given by the adolescents, and HRQoL measured with the EQ-5D-5 L questionnaire. The model of estimation was the generalized estimating equations (GEE) approach. RESULTS: The program showed a BD reduction at the 4-month follow-up, although it was not shown to significantly increase the HRQoL in adolescents who reduced the number of occasions of BD and had received the intervention. However, it was shown that those who would predictably reduce the number of occasions of BD controlled by several sociodemographic variables perceived a higher HRQoL, as did those who had a greater adherence to the program. CONCLUSIONS: Higher adherence to a web-based computer-tailored intervention to prevent BD in adolescents has a positive effect on decreasing the number of occasions of BD in adolescents as well as on increasing participants' HRQoL, although this second effect is very small, which could be due to the short follow-up time. This fact is quite important and should be assessed extensively to corroborate the results and translate into health policy.

La docencia en enfermería comunitaria. ¿Teoría solamente? / Teaching in community nursing. Only theory?

Desde la Atención Primaria de Salud, la enfermera comunitaria atiende a personas, familias, grupos y comunidades, en todas sus circunstancias, poniendo los cuidados lo más cerca posible de los lugares donde las personas viven y trabajan, orientados a la promoción de la salud, la prevención, la atención y control de problemas de salud. La docencia en enfermería comunitaria debe fomentar el desarrollo de competencias para unos cuidados de calidad y basados en la evidencia científica. Pero, ¿cuál es la metodología docente más adecuada? En este trabajo debatimos la importancia de imbricar la teoría y la práctica en la docencia, aplicando metodologías innovadoras, poniendo de ejemplo las metodologías empleadas en las asignaturas de Enfermería del Adulto en el Ámbito Comunitario y Enfermería Familiar y Comunitaria del Grado de Enfermería de la Universidad de Sevilla. A través de las taxonomías enfermeras, el aprendizaje basado en problemas, el role-playing o la simulación, se abarcan los cuidados centrados en la persona; mediante la realización de una valoración enfermera, desde un modelo de atención familiar, y aplicando las taxonomías a la unidad familiar, se abarcan los cuidados centrados en la familia; y usando las prácticas de campo en colaboración con asociaciones y grupos de autoayuda y realizando mapeos de activos para la salud, se abarcan los cuidados centrados en la comunidad. Para concluir, a pesar de que se ha avanzado en la formación enfermera orientada al trabajo con personas, consideramos necesario seguir profundizando en la docencia orientada a las unidades familiares y grupos comunitarios

From the Primary Health Care, the community nurse attends to people, families, groups and communities, in all their circumstances, putting care as close as possible to the places where people live and work, oriented to the promotion of health, the prevention, attention and control of health problems. Teaching in community nursing should encourage the development of competencies for a quality and evidence based care. But, what is the most appropriate teaching methodology? In this work we discuss the importance of imbricating the theory and practice in teaching, applying innovative methodologies, setting the example of the methodologies used in the subjects of Nursing of Adult in the Community and Family and Community Nursing of the Degree of Nursing of the University of Sevilla. Through the nursing taxonomy, problem-based learning, role-playing or simulation, care centered on the person is covered; by carrying out a nursing assessment, from a model of family care, and applying the taxonomy to the family unit, care centered on the family is included; and using field practices in collaboration with associations and self-help groups and mapping assets for health, community-centered care is covered. To conclude, despite the fact that progress has been made in nurse education oriented to work with people, we consider it is necessary to continue deepening in teaching oriented to family units and community groups

Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo / Characteristics present in secondary school students who do not smoke and who have no intention to smoke

Objetivo: Conocer las variables presentes en escolares de primero y segundo de secundaria que no consumen tabaco o no tienen intención de fumar desde un modelo de salud positiva. Métodos: Estudio transversal con 482 estudiantes en Andalucía y Cataluña usando un cuestionario validado (proyecto ESFA y PASE). Se realizaron análisis de regresión logística binaria. Resultados: Quienes no tenían intención de fumar presentaron una actitud desfavorable al tabaco y una alta autoeficacia (p <0,001). En los/las no consumidores/as las variables más asociadas fueron la actitud, el modelo social (p <0,001) y la autoeficacia (p = 0,005). Conclusiones: Los resultados reflejan factores motivacionales presentes en escolares que no fuman ni pretenden hacerlo. La actitud y la autoeficacia se asocian fuertemente con la intención y con el comportamiento. Esta información puede ser útil para desarrollar estrategias positivas de promoción de la salud desde un modelo salutogénico

Objective: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. Methods: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. Results: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). Conclusions: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach

[Characteristics present in secondary school students who do not smoke and who have no intention to smoke]. / Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo.

OBJECTIVE: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. METHODS: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. RESULTS: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). CONCLUSIONS: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach.

Factores relacionados con la calidad de vida en la adolescencia / Quality-of-life-related factors in adolescents

Objetivo: Conocer la calidad de vida (CV) y su relación con estilos de vida en adolescentes de educación secundaria. Método: Estudio observacional transversal con 256 estudiantes de 12 a 17 años de edad, de la provincia de Sevilla (España). Se utilizaron modelos de regresión lineal múltiple (p <0,05). Resultados: Los chicos presentan mayor puntuación en diversas dimensiones de CV, relacionándose inversamente el ser chica y la CV física, psicológica, familiar y el índice general de CV (p <0,05). El funcionamiento familiar y la realización de actividad física se asociaron fuertemente a una mejor CV, en todas sus dimensiones. Los modelos multivariados fueron estadísticamente significativos y explicaron desde el 11% de variabilidad de la CV social hasta el 35% del Índice general de CV. Conclusiones: Los hallazgos podrían ser útiles para el desarrollo de intervenciones de promoción de la salud escolar dirigidas a promover estilos de vida saludables y CV (AU)

Objective: To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools. Methods: Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05). Results: The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index. Conclusions: The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL (AU)

Editorial. Impact of the Binge Drinking (BD) in Adolescence. Are we doing it right? Editorial. Impacto del consumo episódico excesivo de alcohol en la adolescencia. ¿Lo estamos haciendo bien? / Impacto del consumo episódico excesivo de alcohol en la adolescencia. ¿Lo estamos haciendo bien?

Nowadays, one of the most prevalent patterns of alcohol consumption is called binge drinking (BD). In 2015, the European School Survey Project on Alcohol and Drugs (ESPAD) Group estimated that about 35% of adolescents of 15-16 years old have had at least one BD occasion in the past 30 days while at national level, the series of surveys on the use of drugs in adolescents of secondary education (ESTUDES, 2014-2015) determined that 32.2% of adolescents stated having performed BD in the last month. The aim of this editorial was to update the context of adolescence drinking and analysing the impact of BD by ages, including health and social costs derived. Once the magnitude of the problem was set, some research and action lines have been established in order to guide future work for the prevention of alcohol misuse and for establishing future preventive policies on alcohol. Finally, the need for evaluating these interventions from the efficiency point of view was discussed and assessed.

Hoy en día, el consumo episódico excesivo de alcohol (BD, binge drinking) es uno de los patrones de consumo de alcohol más prevalentes. En el año 2015, se estimó que el 35% de los adolescentes europeos con edades entre los 15-16 años participó al menos una vez en BD en los últimos 30 días (The ESPAD Group, 2016). Es más, en España, según la serie de encuestas sobre el uso de drogas en enseñanzas secundarias, ESTUDES 2014-2015, el 32,2% han participado en BD al menos una vez en el último mes (Plan Nacional de Drogas, 2016), mientras que un estudio reciente de Golpe, Gómez, Braña, Varela y Rial (2017) llegó a la conclusión que el 33,1% de los adolescentes españoles consumieron alcohol de manera intensiva en el último año, y el 20% en el último mes (3 o más bebidas alcohólicas por ocasión de consumo y embriaguez). Además, el 19,8% de los adolescentes tenían un consumo de alcohol de riesgo, sin diferencias significativas por género. Romo-Avilés, Marcos-Marcos, Tarragona-Camacho, Gil-García y Marquina-Márquez (2016) encontraron diferencias menores entre niños y niñas respecto de la cantidad de alcohol consumida durante la participación en un botellón. Esto sugiere que ha aumentado el consumo intensivo de alcohol y el BD en las niñas.