[Singularization processes: a proposal for continuity between clinical activity and health policy objectives]. / Singularizar procesos: una propuesta de continuidad entre la actividad clínica y los objetivos de salud de las políticas sanitarias.

BACKGROUNDS AND OBJECTIVES: In 1996 the Gipuzkoa Territorial Health Agency (Basque Country, Spain) created the Health Plan Service. The aim was to transform the health objectives prioritized by the Health Department into intervention strategies to be incorporated into the local contract services. PROCESS AND RESULTS: One of the procedures the service uses for this purpose, known as <>, involves selecting a process linked to a prioritized health problem, and analyzing and reconstructing it so that the related activity, expected results, financial costs and its impact on the population's health can be identified. After this process the service provides the Territorial Health Agency, which is responsible for service purchase for the public and private sectors, with information about contract conditions for the process reviewed. Annual assessment of contract services monitors the extent to which the agreements made have been carried out and their consequences on the population's health. The present article deals with the process through which this <> is carried out.

Singularizar procesos: una propuesta de continuidad entre la actividad clínica y los objetivos de salud de las políticas sanitarias / Singularization processes: a proposal for continuity between clinical activity and health policy objectives

Antecedentes y objetivos: La Dirección Territorial de Sanidad de Gipuzkoa creó en 1996 el servicio del Plan de Salud con la finalidad de transformar los objetivos de salud priorizados por el Departamento de Sanidad en estrategias de intervención a incorporar a los contratos programa. Proceso y resultados: el procedimiento que el servicio está utilizando para cumplir este objetivo se denomina singularización y consiste en seleccionar un proceso vinculado a un problema de salud prioritario, analizarlo y reconstruirlo de forma que se conozca la actividad relacionada con él, los resultados, el coste económico y su impacto en la salud de la población. El procedimiento permite a la Dirección Territorial de Sanidad, responsable de la compra de servicios al sector público y privado, disponer de información sobre las condiciones de contratación para el proceso revisado. La evaluación anual de los Contratos programa y Conciertos controla el grado de consecución de los pactos realizados y de sus consecuencias sobre la salud de la población. El artículo que se presenta recoge la forma en la que se realiza esta singularización

Backgrounds and objectives: In 1996 the Gipuzkoa Territorial Health Agency (Basque Country, Spain) created the Health Plan Service. The aim was to transform the health objectives prioritized by the Health Department into intervention strategies to be incorporated into the local contract services. Process and results: One of the procedures the service uses for this purpose, known as «singularization», involves selecting a process linked to a prioritized health problem, and analyzing and reconstructing it so that the related activity, expected results, financial costs and its impact on the population's health can be identified. After this process the service provides the Territorial Health Agency, which is responsible for service purchase for the public and private sectors, with information about contract conditions for the process reviewed. Annual assessment of contract services monitors the extent to which the agreements made have been carried out and their consequences on the population's health. The present article deals with the process through which this «singularization» is carried out

Physical sports activity during leisure time and dietary intake of foods and nutrients in a large Spanish cohort.

This study evaluated the dietary pattern of foods and nutrients according to levels of vigorous leisure time physical activity (PA) assessed at recruitment within the Spanish cohort of the European Prospective Investigation on Cancer (EPIC) study (37,287 healthy volunteers with complete information). We used a validated PA questionnaire (PAQ) to measure the weekly frequency and duration of different kinds of sport activities. For dietary assessment, we used a validated diet history questionnaire that included all items consumed with a frequency of at least twice a month. We tested differences in food and nutrient intake according to PA duration by means of both an analysis of variance and an analysis of covariance adjusted for confounding factors. Linear increases or decreases in food and nutrient intake across PA levels were tested by means of a regression analysis. Only 11% of men and 6% of women performed at least 3 hours/week of intense PA, which is similar to current recommendations. Overall, main nutrient and total energy intakes were similar across different PA levels (<2% change in total energy intake between extreme PA categories). However, the intake of some foods and vitamins did significantly (p .05) increase as PA increased. The average gender-weighted percentage change in the intake of food and vitamins increased when moving from the lowest levels of PA to the highest. There was an increase in the intake of the following: 15.9% in vegetables, 6.7% in fruit, 9% in fish, 5.6% in dairy products, 10% in vitamin C, 5.9% in vitamin E, 7.2% in retinol, 19.7% in total carotene, 40.1% in alpha-carotene, 20.4% in beta-carotene, 11.2% in licopene, and 26.1% in lutein. BMI, which was above average for the cohort (mean +/- SD: 28.4 +/- 4.2), decreased steadily when PA increased. To sum up, in this large Spanish cohort, the differences in dietary intake relative to levels of PA were not found either in the amount of total energy consumed nor in the number of main macronutrients but rather in the intake of certain foods which, while having very little or moderate caloric content, are very rich in highly bioactive elements such as vitamins and provitamins.