[Core competencies for public health teaching: regional framework for the AmericasCompetências essenciais para a docência em saúde pública: um marco regional para as Américas]. / Competencias esenciales para la docencia en salud pública: marco regional para las Américas.

Objective: To present the Regional Core Competency Framework for Public Health (RCCFPH) and the methodology used for its development. Methods: A participatory methodology was used for this descriptive study, using techniques such as questionnaires, discussions, pair work, extreme cases, jigsaw, data evaluation matrices, iterative reviews, and comparative analyses. The study was carried out over nine stages, bringing together experts from public health institutions and schools, as well as primary health care professionals in the Americas. Results: The primary result is the RCCFPH, which is organized around 10 competency domains, all favoring comprehensive teaching. The primary focus is on the disciplinary domain, along with the educational domain. The remaining domains are common to the teaching of any discipline, but each competence was formulated for use within the field of public health, which is what differentiates this framework from others. It is proposed as a regional tool for use from multiple perspectives. Conclusion: The domains and competencies encourage a new perspective on comprehensive teacher training in public health. The RCCFPH can be used as a tool to assess teaching skills and improve the quality of teaching in the Region. It can foster cooperation among educational institutions and is proposed as a facilitator for a Latin American community of practice to address new challenges in public health.

Objetivo: Apresentar o Marco Regional de Competências Docentes em Saúde Pública (MRCDSP) e a metodologia utilizada em sua elaboração. Métodos: Este estudo descritivo empregou uma abordagem participativa, combinando técnicas como inquéritos por questionários, debates, método de pareamento, casos extremos, método jigsaw (quebra-cabeças), matriz de avaliação de dados, revisões iterativas e análise comparativa. O processo foi desenvolvido em nove etapas e reuniu especialistas ligados a instituições e escolas de saúde pública, juntamente com profissionais de atenção primária à saúde nas Américas. Resultados: O resultado principal é o MRCDSP, organizado em torno de 10 domínios cuja interseção promove uma abordagem integral para a docência. É dado um papel de destaque ao domínio disciplinar, e o domínio pedagógico atua como coprotagonista. Os demais domínios são transversais ao ensino de qualquer disciplina, mas a redação de cada competência foi complementada com finalidades situadas no campo da saúde pública, o que diferencia este marco de outros semelhantes. O marco é apresentado como uma ferramenta regional a ser utilizada a partir de múltiplas perspectivas. Conclusão: Os domínios e competências promovem uma nova perspectiva sobre a formação integral de docentes em saúde pública. O MRCDSP pode se tornar uma ferramenta para avaliar as capacidades e melhorar a qualidade do ensino na região. É proposto como um elemento para fomentar a cooperação entre instituições educacionais e a formação de uma comunidade de prática latino-americana, com o objetivo de enfrentar os novos desafios em saúde pública.

Competencias esenciales para la docencia en salud pública: marco regional para las Américas / Core competencies for public health teaching: regional framework for the Americas / Competências essenciais para a docência em saúde pública: um marco regional para as Américas

[RESUMEN]. Objetivo. Presentar el Marco Regional de Competencias Docentes en Salud Pública (MRCDSP) y la metodología utilizada para su construcción. Métodos. Se utilizó una metodología participativa para este estudio descriptivo, donde se combinaron técnicas como la encuesta por cuestionario, el debate, el método de pares, los casos extremos, el rompecabezas (jigsaw), la matriz de evaluación de datos, las revisiones iterativas y el análisis comparativo. Se desarrolló en nueve etapas y agrupó a expertos asociados a instituciones y escuelas de salud pública, junto a profesionales de la atención primaria de salud en las Américas. Resultados. El principal resultado es el MRCDSP, organizado alrededor de 10 dominios cuya intersección favorece la integralidad docente. Se le asigna centralidad al dominio disciplinar y, como coprotagonista, al dominio pedagógico. Los restantes dominios son transversales a la docencia de cualquier disciplina, pero la redacción de cada competencia se complementó con las finalidades situadas en el campo de la salud pública, hecho que diferencia este marco de otros. Se ofrece como una herramienta regional para utilizar desde múltiples perspectivas. Conclusión. Los dominios y las competencias promueven una perspectiva nueva sobre la formación integral docente en salud pública. El MRCDSP puede convertirse en una herramienta para evaluar capacidades y mejorar la calidad de la enseñanza en la Región. Puede fomentar la cooperación entre instituciones educativas y se propone que sea el promotor de una comunidad de práctica latinoamericana para abordar los desafíos nuevos en salud pública.

[ABSTRACT]. Objective. To present the Regional Core Competency Framework for Public Health (RCCFPH) and the methodology used for its development. Methods. A participatory methodology was used for this descriptive study, using techniques such as questionnaires, discussions, pair work, extreme cases, jigsaw, data evaluation matrices, iterative reviews, and comparative analyses. The study was carried out over nine stages, bringing together experts from public health institutions and schools, as well as primary health care professionals in the Americas. Results. The primary result is the RCCFPH, which is organized around 10 competency domains, all favoring comprehensive teaching. The primary focus is on the disciplinary domain, along with the educational domain. The remaining domains are common to the teaching of any discipline, but each competence was formulated for use within the field of public health, which is what differentiates this framework from others. It is proposed as a regional tool for use from multiple perspectives. Conclusion. The domains and competencies encourage a new perspective on comprehensive teacher training in public health. The RCCFPH can be used as a tool to assess teaching skills and improve the quality of teaching in the Region. It can foster cooperation among educational institutions and is proposed as a facilitator for a Latin American community of practice to address new challenges in public health.

[RESUMO]. Objetivo. Apresentar o Marco Regional de Competências Docentes em Saúde Pública (MRCDSP) e a metodologia utilizada em sua elaboração. Métodos. Este estudo descritivo empregou uma abordagem participativa, combinando técnicas como inquéritos por questionários, debates, método de pareamento, casos extremos, método jigsaw (quebra-cabeças), matriz de avaliação de dados, revisões iterativas e análise comparativa. O processo foi desenvolvido em nove etapas e reuniu especialistas ligados a instituições e escolas de saúde pública, juntamente com profissionais de atenção primária à saúde nas Américas. Resultados. O resultado principal é o MRCDSP, organizado em torno de 10 domínios cuja interseção pro- move uma abordagem integral para a docência. É dado um papel de destaque ao domínio disciplinar, e o domínio pedagógico atua como coprotagonista. Os demais domínios são transversais ao ensino de qualquer disciplina, mas a redação de cada competência foi complementada com finalidades situadas no campo da saúde pública, o que diferencia este marco de outros semelhantes. O marco é apresentado como uma ferramenta regional a ser utilizada a partir de múltiplas perspectivas. Conclusão. Os domínios e competências promovem uma nova perspectiva sobre a formação integral de docentes em saúde pública. O MRCDSP pode se tornar uma ferramenta para avaliar as capacidades e melhorar a qualidade do ensino na região. É proposto como um elemento para fomentar a cooperação entre instituições educacionais e a formação de uma comunidade de prática latino-americana, com o objetivo de enfrentar os novos desafios em saúde pública.

Competencias esenciales para la docencia en salud pública: marco regional para las Américas / Core competencies for public health teaching: regional framework for the Americas / Competências essenciais para a docência em saúde pública: um marco regional para as Américas

RESUMEN Objetivo. Presentar el Marco Regional de Competencias Docentes en Salud Pública (MRCDSP) y la metodología utilizada para su construcción. Métodos. Se utilizó una metodología participativa para este estudio descriptivo, donde se combinaron técnicas como la encuesta por cuestionario, el debate, el método de pares, los casos extremos, el rompecabezas (jigsaw), la matriz de evaluación de datos, las revisiones iterativas y el análisis comparativo. Se desarrolló en nueve etapas y agrupó a expertos asociados a instituciones y escuelas de salud pública, junto a profesionales de la atención primaria de salud en las Américas. Resultados. El principal resultado es el MRCDSP, organizado alrededor de 10 dominios cuya intersección favorece la integralidad docente. Se le asigna centralidad al dominio disciplinar y, como coprotagonista, al dominio pedagógico. Los restantes dominios son transversales a la docencia de cualquier disciplina, pero la redacción de cada competencia se complementó con las finalidades situadas en el campo de la salud pública, hecho que diferencia este marco de otros. Se ofrece como una herramienta regional para utilizar desde múltiples perspectivas. Conclusión. Los dominios y las competencias promueven una perspectiva nueva sobre la formación integral docente en salud pública. El MRCDSP puede convertirse en una herramienta para evaluar capacidades y mejorar la calidad de la enseñanza en la Región. Puede fomentar la cooperación entre instituciones educativas y se propone que sea el promotor de una comunidad de práctica latinoamericana para abordar los desafíos nuevos en salud pública.

ABSTRACT Objective. To present the Regional Core Competency Framework for Public Health (RCCFPH) and the methodology used for its development. Methods. A participatory methodology was used for this descriptive study, using techniques such as questionnaires, discussions, pair work, extreme cases, jigsaw, data evaluation matrices, iterative reviews, and comparative analyses. The study was carried out over nine stages, bringing together experts from public health institutions and schools, as well as primary health care professionals in the Americas. Results. The primary result is the RCCFPH, which is organized around 10 competency domains, all favoring comprehensive teaching. The primary focus is on the disciplinary domain, along with the educational domain. The remaining domains are common to the teaching of any discipline, but each competence was formulated for use within the field of public health, which is what differentiates this framework from others. It is proposed as a regional tool for use from multiple perspectives. Conclusion. The domains and competencies encourage a new perspective on comprehensive teacher training in public health. The RCCFPH can be used as a tool to assess teaching skills and improve the quality of teaching in the Region. It can foster cooperation among educational institutions and is proposed as a facilitator for a Latin American community of practice to address new challenges in public health.

RESUMO Objetivo. Apresentar o Marco Regional de Competências Docentes em Saúde Pública (MRCDSP) e a metodologia utilizada em sua elaboração. Métodos. Este estudo descritivo empregou uma abordagem participativa, combinando técnicas como inquéritos por questionários, debates, método de pareamento, casos extremos, método jigsaw (quebra-cabeças), matriz de avaliação de dados, revisões iterativas e análise comparativa. O processo foi desenvolvido em nove etapas e reuniu especialistas ligados a instituições e escolas de saúde pública, juntamente com profissionais de atenção primária à saúde nas Américas. Resultados. O resultado principal é o MRCDSP, organizado em torno de 10 domínios cuja interseção promove uma abordagem integral para a docência. É dado um papel de destaque ao domínio disciplinar, e o domínio pedagógico atua como coprotagonista. Os demais domínios são transversais ao ensino de qualquer disciplina, mas a redação de cada competência foi complementada com finalidades situadas no campo da saúde pública, o que diferencia este marco de outros semelhantes. O marco é apresentado como uma ferramenta regional a ser utilizada a partir de múltiplas perspectivas. Conclusão. Os domínios e competências promovem uma nova perspectiva sobre a formação integral de docentes em saúde pública. O MRCDSP pode se tornar uma ferramenta para avaliar as capacidades e melhorar a qualidade do ensino na região. É proposto como um elemento para fomentar a cooperação entre instituições educacionais e a formação de uma comunidade de prática latino-americana, com o objetivo de enfrentar os novos desafios em saúde pública.

Planificación y gestión de recursos humanos en salud en los países andinos. Evidencias para la toma de decisiones

[Prólogo]. Está finalizando el período 2006-2015, definido como la Década de los Recursos Humanos de Salud (RHUS), que se inició con el Llamado a la Acción de Toronto y la definición de las 20 Metas Regionales. La intensa acción desplegada por los países de la Región de las Américas durante esta década y el análisis de los avances logrados han permitido identificar con mayor precisión los problemas persistentes y emergentes en el campo de los RHUS, así como las prioridades de acción a futuro. En la actual coyuntura se suma además otro desafío que es lograr que el Acceso Universal y la Cobertura Universal de Salud (redefinidos como Salud Universal) sean una realidad en todos los países de la Región. Atender este reto supone contar con RHUS adecuadamente capacitados, distribuidos de acuerdo con las necesidades de la población y los sistemas de salud e identificados con los objetivos de la Salud Universal. Para contribuir a este objetivo desde la OPS y la OMS se están construyendo una nueva agenda post-2015 de RHUS para la Región de las Américas y una Estrategia Mundial de RHUS 2016-2030 [...] Un buen ejemplo de esta coordinación es la publicación de este libro en el que se presentan los resultados de cinco estudios realizados en los países andinos con la participación de sus técnicos nacionales. Deseamos que estas investigaciones contribuyan con la evidencia que aportan a fortalecer las políticas y planes nacionales y a facilitar la toma informada de decisiones en el complejo campo de los Recursos Humanos de Salud.

Information needs and Internet use in urological and breast cancer patients.

AIMS: This study aims to describe the information needs of urological and breast cancer patients and factors related to use of the Internet as a source of health information. METHODOLOGY: A cross-sectional descriptive study was carried out, using individual questionnaire-based interviews held during the oncology appointments of 169 patients with urological cancer and 100 with breast cancer at the Virgen de las Nieves University Hospital in Granada, Spain. The variables studied were use of the Internet as a source of health information, health status, patient's role in the decision-making process, information sources, satisfaction with the health-care system, type of information received, and Internet use. A multivariate logistic regression analysis was carried out. RESULTS: Breast cancer patients are more concerned with long-term results and the effects on their family and personal life. They are also interested in the experiences of other patients and support groups or staff who could help them to cope with their illness. The information needs of patients with urological cancer are linked to short-term alternative treatments, their sex life, keeping healthy, and exercise. More clinical aspects, such as tests and experiments linked to their treatment, are not a frequent information need. The factors linked to use of the Internet as a source of health information are younger age, high level of education, the patient's active role in the decision-making process, and undergoing more aggressive treatment. There is no link between using the Internet as a source of health information and level of satisfaction with the health-care system, or with Internet use in general. CONCLUSION: Patients need additional information about their illness on top of that given to them by health-care staff, and they often use the Internet to find it. The greatest information need is related to the effects of their illness on their day-to-day life. Health-care staff should provide patients with advice about reliable websites and how to search the Internet.

Adapting the content of cancer web sites to the information needs of patients: reliability and readability.

BACKGROUND: People who use the Internet to research health topics do not usually find all the information they need and do not trust what they read. This study was designed to assess the reliability, accessibility, readability, and popularity of cancer Web sites in Spanish and to analyze the suitability of Web site content in accordance with the specific information needs of cancer patients. MATERIALS AND METHODS: This was a two-phase, cross-sectional, descriptive study. The first phase involved data gathering through online searches and direct observation. The second phase involved individual structured interviews with 169 patients with breast, prostate, bladder, and kidney cancer. Spearman rank correlations were calculated between variables. RESULTS: Most sites belonged to nonprofit organizations, followed by universities or medical centers (14%). Thirty-one percent of the Web sites had quality seals, 59% provided details of authorship, 62% provided references to bibliographic sources, 38% identified their funding sources, and 54% showed the date of their last update. Twenty-one percent of the Web sites did not meet the minimum accessibility criteria. With regard to readability, 24% of the texts were considered to be "quite difficult." Patients' information needs vary depending on the type of cancer they have, although all patients want to know about the likelihood of a cure, survival rates, the side effects, and risks of treatment. CONCLUSIONS: The health information on cancer available on the Internet in Spanish is not very reliable, accessible, or readable and is not necessarily the information that breast, kidney, prostate, and bladder cancer patients require. The content of cancer Web sites needs to be assessed according to the information needs of patients.

Competencias esenciales en salud pública: un marco regional para las Américas / Core competencies in public health: a regional framework for the Americas

Se describe la respuesta a un llamado de la Organización Panamericana de la Salud, realizado en 2010, para conformar el Marco Regional de Competencias Esenciales en Salud Pública, con el propósito de apoyar a los Estados de las Américas en sus esfuerzos por fortalecer las capacidades de sus sistemas de salud pública, en tanto estrategia para el desempeño óptimo de las Funciones Esenciales de Salud Pública. El proceso metodológico de dicha respuesta se dividió en cuatro fases. En la primera se convocó a un equipo de expertos que definieron la metodología a seguir durante un taller en el Instituto Nacional de Salud Pública de México en 2010. La segunda fase fue la constitución de grupos de trabajo, utilizando dos criterios: experiencia y composición multidisciplinaria, lo cual derivó en un equipo regional con 225 integrantes de 12 países. Estos equipos elaboraron una propuesta inicial de 88 competencias. En la tercera fase se realizó una validación cruzada de las competencias, cuyo número se redujo a 64. Durante la cuarta fase, que incluyó dos talleres en marzo (Medellín, Colombia) y junio (Lima, Perú) de 2011, las discusiones se centraron en analizar la correspondencia de los resultados con la metodología.

The response is described to the 2010 call from the Pan American Health Organization to develop a Regional Framework on Core Competencies in Public Health, with a view to supporting the efforts of the countries in the Americas to build public health systems capacity as a strategy for optimal performance of the Essential Public Health Functions. The methodological process for the response was divided into four phases. In the first, a team of experts was convened who defined the methodology to be used during a workshop at the National Institute of Public Health of Mexico in 2010. The second phase involved formation of the working groups, using two criteria: experience and multidisciplinary membership, which resulted in a regional team with 225 members from 12 countries. This team prepared an initial proposal with 88 competencies. In the third phase, the competencies were cross-validated and their number reduced to 64. During the fourth phase, which included two workshops, in March 2011 (Medellín, Colombia) and June 2011 (Lima, Peru), discussions centered on analyzing the association between the results and the methodology.

Use of social media by Spanish hospitals: perceptions, difficulties, and success factors.

This exploratory study has two aims: (1) to find out if and how social media (SM) applications are used by hospitals in Spain and (2) to assess hospital managers' perception of these applications in terms of their evaluation of them, reasons for use, success factors, and difficulties encountered during their implementation. A cross-sectional survey has been carried out using Spanish hospitals as the unit of analysis. Geographical differences in the use of SM were found. Social networks are used most often by larger hospitals (30% by medium-size, 28% by large-size). They are also more frequently used by public hospitals (19%, p<0.01) than by private ones. Respondents with a negative perception of SM felt that there is a chance they may be abused by healthcare professionals, whereas those with a positive perception believed that they can be used to improve communication both within and outside the hospital. Reasons for the use of SM include the idea of maximizing exposure of the hospital. The results show that Spanish hospitals are only just beginning to use SM applications and that hospital type can influence their use. The perceptions, reasons for use, success factors, and difficulties encountered during the implementation of SM mean that it is very important for healthcare professionals to use SM correctly and adequately.

Factors related to use of the Internet as a source of health information by urological cancer patients.

AIMS: The aims of this study were to describe the profile of urological cancer patients who look for health information on the Internet and to analyse the factors related to use of the Internet as a source of health information. METHODOLOGY: A cross-sectional descriptive study using individual, semi-structured, questionnaire-based interviews was carried out in oncology clinics in a hospital in Granada (Spain) in a sample group of 169 patients with prostate, bladder and kidney cancer. The dependent variable was use of the Internet as a source of health information. The independent variables were sociodemographic variables, health status, relationship with healthcare services, patient's role in decision-making process, satisfaction with healthcare, Internet use, Internet skills and attitude. Data analyses include descriptive, bivariate and multivariate analyses. RESULTS: Of the patients in the sample group, 72.2 % had prostate cancer, 19.4 % had bladder cancer and 8.3 % had kidney cancer. Only 11.2 % of patients in the group used the Internet as a source of health information. These patients were typically men of an average age of 62 years, who live in urban areas, who have completed secondary or university education, with a high income and who usually share the role of decision maker with their doctor. Patients who use the Internet as a source of health information usually look for support from psychological support groups, have family members who also look for information on the Internet and prefer sources of information other than those provided by the health services. CONCLUSIONS: The study outlines the profile of urological cancer patients who use the Internet as a source of health information. Internet use is related to a patient's attitude towards decision making, level of education and whether or not they look for information from sources other than the health system itself.

Are the health messages in schoolbooks based on scientific evidence? A descriptive study.

BACKGROUND: Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. METHODS: The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. RESULTS: 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. CONCLUSION: Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.

Use of the internet as a source of health information by Spanish adolescents.

BACKGROUND: The Internet is a fundamental part of the daily life of adolescents, they consider it as a safe and confidential source of information on health matters. The aims is to describe the experience of Spanish adolescents searching for health information on the Internet. METHODS: A cross-sectional study of 811 school-age adolescents in Granada was carried out. An adapted and piloted questionnaire was used which was controlled by trained personnel. Sociodemographic and health variables were included together with those concerning the conditions governing access to and use of information and communication technologies (ICT). RESULTS: 811 adolescents were surveyed (99.38% response rate), mean age was 17 years old. Of these, 88% used the Internet; 57.5% used it on a daily or weekly basis and 38.7% used it occasionally. Nearly half the sample group (55.7%) stated that they used the Internet to search for health-related information. The main problems reported in the search for e-health were the ignorance of good web pages (54.8%) and the lack of confidence or search skills (23.2%). CONCLUSIONS: In conclusion, it seems plausible to claim that websites designed and managed by health services should have a predominant position among interventions specifically addressed to young people.

Sex differences in the use of the Internet as a source of health information among adolescents.

BACKGROUND: The Internet is a fundamental part of the day-to-day lives of adolescents. Faced with the difficulties of accessing conventional health services, adolescents use the Internet as a confidential and safe means of accessing information about health issues. OBJECTIVES: To describe sex differences in the way in which adolescents search for health information on the Internet. METHODS: Cross-sectional survey with a questionnaire administered by an interviewer. Sociodemographic and health variables and those related to the conditions of access and use of information and communication technologies were gathered (multivariate analysis). RESULTS: About 823 school-age youths were interviewed (21 questionnaires were discarded due to low quality), among whom 54.1% were girls and 46% were boys. The girls had a lower self-assessed level of health than the boys. About 86.5% of the girls used the Internet, compared with 89.9% of the boys (p = 0.155). About 21.7% and 48.3% of the boys used it daily/weekly and occasionally, respectively, compared with 17.9% and 59.1% of the girls who used it daily/weekly and occasionally, respectively. The multivariate analysis shows that girls (odds ratio [OR], 1.709; 95% confidence interval [CI], 1.277-2.287), those in their last year of secondary school (OR, 1.369; 95% CI, 1.025-1.830) and those who had visited the doctor most often the previous year (OR, 1.061; 95% CI, 1.017-1.107), were statistically significantly more likely to search for health information on the Internet. CONCLUSION: Adolescent girls tend to seek more information about health than boys and there are differences in the way in which these girls search for health information on the Internet. The Internet provides adolescents, especially adolescent girls, with an opportunity for relaying health recommendations.

Interventions to promote the use of advance directives: an overview of systematic reviews.

OBJECTIVE: To identify, appraise and synthesise the results of systematic reviews of the literature (SRLs) that examines the effectiveness of interventions to increase advance directive (AD) completion rate. METHODS: Narrative review of the literature-an overview of SRLs focused on interventions to improve patients' AD completion rate. RESULTS: Seven SRLs were located. A wide range of interventions was identified in order to determine their influence on the AD completion rate. CONCLUSION: The most effective method of increasing the use of ADs is the combination of informative material and repeated conversations over clinical visits. The use of passive informative material in isolation does not significantly increase AD completion rates. However, when interactive informative interventions are employed, the AD completion rate increases and the majority of the studies identify multiple sessions as the most effective method for direct interaction between patients and health care professionals. PRACTICE IMPLICATIONS: The progressive ageing of the population and the provision of quality care during the process of ageing and dying, have given rise to the Governments' interest in developing moral autonomy and regulating tools as ADs. In order to put legislation into practice it is necessary to set up successful interventions to expand ADs use.

Accesibilidad de sitios web sobre salud para mayores / Accessibility of web sites on health for the elderly

IntroducciónEl desarrollo y difusión de Internet ofrece nuevas posibilidades para atender las necesidades de las personas mayores. Para desarrollar este potencial debe garantizarse la accesibilidad a los recursos disponibles.En este trabajo nos proponemos1) Identificar sitios web en castellano con información sobre salud para personas mayores, y 2) evaluar la accesibilidad de los sitios web seleccionados.Material y métodosEstudio descriptivo del cumplimiento de los criterios de accesibilidad de sitios web sobre salud para mayores. Para seleccionar los sitios web con información sobre salud dirigida a personas mayores se adoptó una metodología de búsquedas con palabras clave en dos de los principales buscadores de Internet. Se realizó un estudio descriptivo a partir de un cuestionario diseñado para tal fin. Los sitios fueron evaluados independientemente por 3 evaluadores. Las dimensiones estudiadas fueron aspectos visuales, motrices, cognitivos, auditivos, otros aspectos y total general. Se calculó la accesibilidad A, AA y AAA mediante el test de accesibilidad a la web (TAW). Se realizó un análisis descriptivo del cumplimiento y se estimó el coeficiente kappa para valorar la concordancia entre evaluadores (criterios de Fleiss) y se calculó el número de errores según los criterios del TAW.ResultadosSe elaboró una lista de 35 sitios web. La mayoría de los sitios web tenía un proveedor español (74,3%), 2 sitios web provenían de Estados Unidos (5,7%) y el resto de Latinoamérica (1 de Cuba, 2 de Argentina, 2 de México y 1 de Uruguay)...(AU)

BackgroundThe development and dissemination of the Internet offers new opportunities to meet the needs of older people. To develop this potential, access to the available resources must be guaranteed.Our aims are(1) To identify web sites in Spanish with information on healthcare for older adults and (2) to assess the accessibility of the web sites selected.Instruments and methodsWe performed a descriptive study of compliance with accessibility criteria among web sites on healthcare for the elderly. To select the sites with health information aimed at older people, a search method with keywords was used in two of the major Internet search engines. The descriptive study was carried out by using a specially-designed questionnaire. The web sites were independently evaluated by three evaluators. The dimensions studied were visual, motor, cognitive, auditory and global factors. Accessibility A, AA and AAA was evaluated with the TAW test. A descriptive analysis of compliance was carried out and the kappa coefficient was estimated to evaluate the concordance between evaluators (Fleiss’ criteria), while the number of errors was calculated according to the TAW criteria.ResultsA list of 35 web sites was created. Most of the web sites had a Spanish web hosting provider (74.3%), two sites were from United States (5.7%) and the remainder were from Latin America (Cuba 1, Argentina 2, Mexico 2 and Uruguay 1)...(AU)

[Accessibility of web sites on health for the elderly]. / Accesibilidad de sitios web sobre salud para mayores.

BACKGROUND: The development and dissemination of the Internet offers new opportunities to meet the needs of older people. To develop this potential, access to the available resources must be guaranteed. Our aims are: (1) To identify web sites in Spanish with information on healthcare for older adults and (2) to assess the accessibility of the web sites selected. INSTRUMENTS AND METHODS: We performed a descriptive study of compliance with accessibility criteria among web sites on healthcare for the elderly. To select the sites with health information aimed at older people, a search method with keywords was used in two of the major Internet search engines. The descriptive study was carried out by using a specially-designed questionnaire. The web sites were independently evaluated by three evaluators. The dimensions studied were visual, motor, cognitive, auditory and global factors. Accessibility A, AA and AAA was evaluated with the TAW test. A descriptive analysis of compliance was carried out and the kappa coefficient was estimated to evaluate the concordance between evaluators (Fleiss' criteria), while the number of errors was calculated according to the TAW criteria. RESULTS: A list of 35 web sites was created. Most of the web sites had a Spanish web hosting provider (74.3%), two sites were from United States (5.7%) and the remainder were from Latin America (Cuba 1, Argentina 2, Mexico 2 and Uruguay 1). A high degree of accessibility was found for the IMSERSO Portal, the Disc@PNET portal, the section on public health protection of the Spanish Ministry of Health web site and the Community of Madrid web site. Fourteen web sites complied with more than 42% of the items evaluated. The dimension with the lowest compliance was cognitive features. When the TAW tool was applied, only the IMSERSO web site fulfilled all the criteria A, AA and AAA. CONCLUSIONS: The present study obtained a accessibility ranking of web sites with information on health for seniors. Accessibility level varied among these web sites.

Evaluación de sitios web con información sobre medicamentos / Assessment of websites with information on medicines

ObjetivoIdentificar sitios web con información sobre medicamentos a través de expertos y evaluar su adecuación a códigos de conducta y las recomendaciones de la Organización Mundial de la Salud.DiseñoEstudio transversal de la adecuación a los criterios, a partir de un cuestionario diseñado ad hoc (efectuado independientemente por dos evaluadores). Los sitios web fueron identificados a partir de la técnica Delphi (35 expertos).EmplazamientoSitios web con información sobre medicamentos.Unidad de análisis35 sitios web seleccionados por la técnica Delphi. En la tercera ronda se alcanzó un nivel de estabilidad (variabilidad intercuartílica) aceptable (< 0,05).Mediciones principalesResponsabilidad, transparencia y honestidad, autoría de la información, política editorial, protección de datos personales, actualización de la información y accesibilidad. Se realizó un análisis descriptivo del cumplimiento y se estimó el coeficiente kappa para valorar la concordancia entre evaluadores (criterios de Fleiss).ResultadosDestacan con cumplimiento general alto el National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra y National Institute for Health and Clinical Excellence. La dimensión de actualización de la información es la que presentó una menor valoración para los diferentes sitios web.ConclusionesLa calidad de los sitios web sobre medicamentos recomendada por expertos es variable. Sin embargo, hay diversos sitios web de cumplimiento alto, que se detallan en el informe(AU)

AimsTo identify websites with information on medicines and assess, using experts, their adherence to codes of conduct and recommendations by the WHO.DesignCross-sectional study based on an ad hoc designed questionnaire (performed independently by 2 reviewers). The websites were identified by the Delphi technique (35 experts).SettingWebsites with information on medicines.ParticipantsA total of 35 websites selected by the Delphi technique. An acceptable level of stability was achieved in the third round (interquartile variability; <0.05).ResultsThe National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra and National Institute for Health and Clinical Excellence stood out with an overall high fulfilment of the questionnaire. The updated information dimension was the lowest evaluation for the different websites.ConclusionsThe quality of the web sites evaluated varied widely. Although there are several websites, which are detailed in the article, with high overall scores(AU)