Determinantes sociales de la salud. Estatus socioeconómico, neurodesarrollo y funciones ejecutivas en la infancia / Social determinants of health. Socioeconomic status, neurodevelopment and executive functions in childhood

Objetivo principal: El objetivo principal de esta revisión ha sido analizar las relaciones entre el estatus socioeconómico (SES) y el desarrollo de las funciones ejecutivas (FE) durante la infancia, partiendo del conocimiento de que los niveles bajos de SES afectan al neurodesarrollo. Metodología: Se ha realizado una búsqueda en diferentes bases de datos seleccionándose 15 artículos de interés. Resultados principales: Tras su lectura, se ha encontrado una clara relación entre SES y FE. Conclusión principal: Se ha apreciado que niveles bajos de SES afectan de forma negativa al desarrollo de las FE. Asimismo, en los estudios se han tenido en cuenta qué variables del SES podrían influir en esta relación, qué componentes de las FE se ven afectadas y qué factores pueden servir como mediadores

Objective: The main purpose of this review has been to analyse the relationship between socioeconomic status (SES) and the development of the executive functions (EF) during childhood, based on the knowledge that low levels of SES affect neurodevelopment. Methods: A search in different data bases has been made shortlisting 15 articles of interest. Results: After their analysis, a clear relationship has been found between SES and EF. Conclusions: It has been noted that low levels of SES negatively affect the development of the EF. Also, research has taken into account which SES variables could influence this relationship, which EF components can be affected, and which factors can be used as mediators

Bad news for the patient and the family? The worst part of being a health care professional.

In Spain, there is a general tendency to conceal the prognosis from a terminally ill patient. We conducted grounded-theory-based, phenomenological, qualitative research on this using a final sample of 42 in-depth interviews with doctors and nurses from different fields. We found that most health professionals believe that although patients don't ask questions, they know what is happening to them. Many professionals feel bad when communicating bad news. In hospitals, doctors take responsibility for doing so. The attitudes of professionals are influenced by their sense of responsibility and commitment to the principle of patient autonomy, as well as to the level of their agreement with the cultural context. The tacit agreement of silence makes communication impossible: the patient does not ask questions, the health professional does not want to be interrogated, and family members don't talk about the disease and want health professionals to follow their example. This situation is detrimental to patients and their families and leads to suffering, low levels of satisfaction, and feelings of guilt and helplessness. Health care professionals must acquire the means and the skills for communicating bad news.