Three topographical approaches to survey soil erosion on a mountain trail affected by a forest fire. Barranc de la Manesa, Llutxent, Eastern Iberian Peninsula.

Soil erosion on mountain trails threaten the sustainability of soils and vegetation. There is a wide theoretical knowledge about the effects produced by mountain recreational activities, but particularly for soil erosion there is a shortage of field data. This is why it is necessary to properly survey the soil losses on mountain trails. The most widely applied method in scientific literature is the Cross-Section field survey as is easy-to-apply and low-cost. However, there is a doubt about its accuracy and the development of the new technologies may improve the quality and accuracy of the measurements. Aerial and terrestrial photogrammetric methods are difficult to apply when vegetation is present but, an opportunity arises to apply this method when fire takes place. This paper analyses the soil losses in a recently fire-affected land to check the accuracy of the three methodologies to assess soil loss on mountain trails. The results obtained show an average soil loss between 1287 and 1404 Mg ha-1 of trail erosion for the three methodologies applied, which implies that the Cross-Sectional-Area method, aerial photography and terrestrial photography provide very similar values. Therefore, the conventional Cross-Section field surveys method is useful and adequate to evaluate the impacts generated on mountain trails as it provides accurate measurement and can be repeated any time and below different vegetation covers. The terrestrial photogrammetric methods are accurate too, but they can only be used when there is very little vegetation cover such as in semiarid and arid landscapes or after forest fires. Moreover, they are more expensive and time consuming.

Soil erosion on the "El Portalet" mountain trails in the Eastern Iberian Peninsula.

Leisure activities in natural areas have experienced a large increase in popularity. In Mediterranean ecosystems, research on soil erosion in agriculture and forest fire affected land has been well developed but trail erosion has not been widely studied. In this work we evaluated two trails in the eastern Iberian Peninsula to assess soil erosion rates and provide new data. The study area is located in a semi-arid Mediterranean climate (around 400 mm y-1) and in limestone terrain with scarce soil development. The average erosion rates were 24.39 Mg ha-1 y-1 and 40.40 Mg ha-1 y-1 for the "Barranc de la Cova de la Hedra" and "Casa del Racó" study trails, respectively. These are non-sustainable rates due to the shallow soils and slow soil development in Mediterranean ecosystems. We found that the depth at the centre of the trail and the maximum depth measured could quickly and easily assess soil erosion rates in the mountain trails. Measuring the width and depth in the centre of the trail can assess 91% of the total erosion and reduces the time of the survey by 80%.

La seguridad del paciente: una estrategia prioritaria para el Sistema Nacional de Salud español / No disponible

No disponible

Resultados de la estrategia en seguridad del paciente del Sistema Nacional de Salud español, período 2005-2007 / The Spanish National Health System patient safety strategy, results for the period 2005-2007

La Agencia de Calidad del Sistema Nacional de Salud (SNS) viene desarrollando desde 2005 una estrategia dirigida a la mejora de la seguridad de los pacientes (SP) atendidos en los centros sanitarios, cuyos objetivos específicos son: promover el conocimiento y la cultura de SP entre profesionales y pacientes; diseñar y establecer sistemas de información y notificación de eventos adversos para el aprendizaje; implantar prácticas seguras recomendadas en los centros del SNS; promover la investigación en SP y la participación de pacientes y ciudadanos en la estrategia. Material y Método: Se constituyó una red estatal en SP en la que participa el Comité Técnico Institucional con representantes de todas las comunidades autónomas y otros organismos nacionales implicados en la calidad asistencial y en la SP. La estrategia se encuentra alineada con la Alianza Mundial para la Seguridad del Paciente de la Organización Mundial de la Salud (OMS) y las recomendaciones del Consejo de Europa. El presupuesto asignado durante el período 2005-2007 ha sido de alrededor de 35 millones de euros. Resultados: Se han formado en aspectos sobre SP alrededor de 5.000 profesionales. Se han realizado estudios sobre efectos adversos en hospitales y en atención primaria, así como otros dirigidos a conocer la percepción de seguridad de los profesionales, la utilización de medicamentos o la situación de la infección nosocomial. Se han implantado en todas las comunidades autónomas prácticas seguras recomendadas internacionalmente. Conclusiones: Esta estrategia se ha desplegado en todas las comunidades autónomas, y ha contado además con el apoyo explícito de las principales sociedades científicas y asociaciones de pacientes, así como de universidades, escuelas, agencias y otras organizaciones nacionales (AU)

Background and objectives: In 2005 the Spanish National Health System (SNHS) implemented a strategy aimed at improving patient safety in Spanish healthcare centres. Specific aims: Promote and develop knowledge of patient safety and a patient safety culture among health professionals and patients; design and implement adverse event information and reporting systems for learning purposes; introduce recommended safe practices in SNHS centres; promote patient safety research and public and patient involvement in patient safety policies. Material and method: An Institutional Technical Committee was created with representatives from all the Spanish regions. All national organizations involved in healthcare quality and patient safety took part in the project. The strategy follows the WHO World Alliance for Patient Safety and Council of Europe recommendations. Budget allocated in the period 2005-2007: approximately EUR35 million. Results: Around 5,000 health professionals were educated in PS concepts. Several studies were conducted on: adverse events in Hospitals and Primary Care, as well as studies to obtain information on health professionals’ perceptions on safety, the use of medications and the situation regarding hospital-acquired infections. All the regions have introduced safe clinical practices related with the strategy. Conclusions: The strategy has been implemented in all the Spanish regions. Awareness was raised among health professionals and the public. A network of alliances has been set up with the regions, universities, schools, agencies and other organizations supporting the strategy (AU)

Percepción de los pacientes sobre la seguridad de la asistencia sanitaria / Patient perceptions on healthcare safety

Fundamento y Objetivo: La seguridad del paciente es un tema de creciente interés en las políticas sanitarias y la bibliografía especializada actual, sin que haya muchas investigaciones que incluyan la perspectiva de la ciudadanía sobre la seguridad clínica. Material y Método: Estudio cualitativo realizado en 4 comunidades autónomas españolas, a través de grupos focales y entrevistas semiestructuradas con pacientes y representantes de asociaciones. Análisis de discurso y triangulación de resultados. Resultados: Para los pacientes entrevistados, el concepto de seguridad no se limita a la ausencia de errores, sino que comprende aspectos como confianza, comunicación, información y participación. En la resolución de los eventos adversos, la actitud de disculpa por parte del profesional se considera un elemento clave. Se evalúan positivamente actuaciones existentes como los protocolos y sistemas de notificación, a la vez de señalarse las dificultades en el proceso de implantación. Respecto a la información, los pacientes demandan una formación de los profesionales en habilidades de comunicación. Una mayor participación en el propio proceso asistencial y en la gestión clínica se considera oportuna, a la vez de constatarse la escasez de posibilidades de participación ciudadana en las políticas de seguridad actuales. Conclusiones: Los pacientes y sus representantes en las asociaciones señalan la importancia de avanzar desde la cultura punitiva actual en el tema de la seguridad hacia una cultura de la confianza (AU)

Background and objective: Patient Safety is an issue of growing interest in healthcare politics and specialized bibliography, but there are limited studies that include the perspective of the public on healthcare safety. Material and method: Qualitative research performed in 4 Spanish Autonomous Regions, using focus groups and semi-structured interviews with patients and representatives of associations. Discourse analysis and result triangulation. Results: For the patients interviewed, the concept of safety is not limited to absence of error, but includes aspects such as confidence, communication, information and participation. In the process of resolving of adverse events, an apologetic attitude by the professionals is considered a key element. Existing interventions such as protocols and notification systems are positively valued, at same time pointing out difficulties in the implementation process. As regards information, the patients demand that the professional is trained in communication skills. More participation in their own healthcare process and clinical management is considered appropriate, at same time, it was stated that few members of the public have the opportunity to participate in current safety policies. Conclusions: Regarding healthcare safety, patients and key agents indicate the importance of moving from a blame culture to a confidence culture (AU)

Acciones estratégicas en seguridad del paciente para el Sistema Nacional de Salud. Recursos on-line en formación y acceso al conocimiento científico / Strategic measures for patient safety in the National Health System: on-line training resources and access to scientific knowledge

Introducción: La seguridad del paciente (SP) es una estrategia prioritaria del Plan de Calidad para el Sistema Nacional de Salud español, cuyo primer objetivo es fomentar la cultura en SP entre los profesionales y pacientes. Las tecnologías de la información están desempe- ñando un papel fundamental en la formación de los profesionales y en el acceso al conocimiento científico. Material y Método: Se creó un grupo de trabajo multidisciplinario para definir los criterios a tener en cuenta para contribuir a la disponibilidad y el uso de información y recursos formativos vía Internet enfocados a la SP. Resultados: Se desarrollaron dos tutoriales de autoformación on-line relacionados con la gestión de riesgos, la seguridad del paciente y la prevención de efectos adversos. Se puso en marcha un boletín de noticias junto a dos suplementos de información específicos en seguridad del paciente. Para mejorar la difusión, se creó una página electrónica y un blog sobre seguridad del paciente, además de una herramienta colaborativa de trabajo en grupo (a nivel interno). Para facilitar el acceso a información fiable y de calidad, se desarrolló excelenciaclinica.net, un metabuscador especializado en información basada en la evidencia para profesionales sanitarios que además facilita la consulta gratuita de recursos de información sanitaria fiables. Conclusiones: Se destaca la implicación de los profesionales sanitarios en estas actuaciones y el papel que cabe esperar que estas acciones desempeñen en el desarrollo de unos servicios sanitarios de excelencia (AU)

Introduction: Patient safety (PS) is a priority strategy included in the Quality Plan for the Spanish National Health System and its first objective is to promote PS culture among professionals and patients. The Internet is playing a key role in the access to clinical evidence and in the training of health professionals. Material and method: A multidisciplinary working group was created, who defined the criteria to help improve clinical practice in the field of patient safety, by making available and using web-based patient safety training resources and information. Results: Taking advantage of the possibilities offered by the Internet in terms of training, two online self-training tutorials were developed on risk management, patient safety and adverse event prevention. A Newsletter was also launched, together with two specific patient safety Supplements. Moreover, to extend the reach of the PS Strategy, a patient safety web page and weblog were created, in addition to a collaborative (internal) working group tool. Excelenciaclinica.net was also developed; a meta-search engine specialized in evidence-based information for health professionals, to make it easier to access reliable and valuable information. Health professionals were also allowed to consult, free of charge, reliable health information resources, such as the GuiaSalud platform, the Cochrane Library Plus and the resources of the Joanna Briggs Institute. Conclusions: The involvement of health professionals in these measures and the role that these measures may be expected to play in the development of a premium-quality health service (AU)

[The Spanish National Health System patient safety strategy, results for the period 2005-2007]. / Resultados de la estrategia en seguridad del paciente del Sistema Nacional de Salud español, período 2005-2007.

BACKGROUND AND OBJECTIVES: In 2005 the Spanish National Health System (SNHS) implemented a strategy aimed at improving patient safety in Spanish healthcare centres. SPECIFIC AIMS: Promote and develop knowledge of patient safety and a patient safety culture among health professionals and patients; design and implement adverse event information and reporting systems for learning purposes; introduce recommended safe practices in SNHS centres; promote patient safety research and public and patient involvement in patient safety policies. MATERIAL AND METHOD: An Institutional Technical Committee was created with representatives from all the Spanish regions. All national organizations involved in healthcare quality and patient safety took part in the project. The strategy follows the WHO World Alliance for Patient Safety and Council of Europe recommendations. Budget allocated in the period 2005-2007: approximately EUR35 million. RESULTS: Around 5,000 health professionals were educated in PS concepts. Several studies were conducted on: adverse events in Hospitals and Primary Care, as well as studies to obtain information on health professionals' perceptions on safety, the use of medications and the situation regarding hospital-acquired infections. All the regions have introduced safe clinical practices related with the strategy. CONCLUSIONS: The strategy has been implemented in all the Spanish regions. Awareness was raised among health professionals and the public. A network of alliances has been set up with the regions, universities, schools, agencies and other organizations supporting the strategy.

[Patient perceptions on healthcare safety]. / Percepción de los pacientes sobre la seguridad de la asistencia sanitaria.

BACKGROUND AND OBJECTIVE: Patient Safety is an issue of growing interest in healthcare politics and specialized bibliography, but there are limited studies that include the perspective of the public on healthcare safety. MATERIAL AND METHOD: Qualitative research performed in 4 Spanish Autonomous Regions, using focus groups and semi-structured interviews with patients and representatives of associations. Discourse analysis and result triangulation. RESULTS: For the patients interviewed, the concept of safety is not limited to absence of error, but includes aspects such as confidence, communication, information and participation. In the process of resolving of adverse events, an apologetic attitude by the professionals is considered a key element. Existing interventions such as protocols and notification systems are positively valued, at same time pointing out difficulties in the implementation process. As regards information, the patients demand that the professional is trained in communication skills. More participation in their own healthcare process and clinical management is considered appropriate, at same time, it was stated that few members of the public have the opportunity to participate in current safety policies. CONCLUSIONS: Regarding healthcare safety, patients and key agents indicate the importance of moving from a blame culture to a confidence culture.

[Strategic measures for patient safety in the National Health System: on-line training resources and access to scientific knowledge]. / Acciones estratégicas en seguridad del paciente para el Sistema Nacional de Salud. Recursos on-line en formación y acceso al conocimiento científico.

INTRODUCTION: Patient safety (PS) is a priority strategy included in the Quality Plan for the Spanish National Health System and its first objective is to promote PS culture among professionals and patients. The Internet is playing a key role in the access to clinical evidence and in the training of health professionals. MATERIAL AND METHOD: A multidisciplinary working group was created, who defined the criteria to help improve clinical practice in the field of patient safety, by making available and using web-based patient safety training resources and information. RESULTS: Taking advantage of the possibilities offered by the Internet in terms of training, two online self-training tutorials were developed on risk management, patient safety and adverse event prevention. A Newsletter was also launched, together with two specific patient safety Supplements. Moreover, to extend the reach of the PS Strategy, a patient safety web page and weblog were created, in addition to a collaborative (internal) working group tool. Excelenciaclinica.net was also developed; a meta-search engine specialized in evidence-based information for health professionals, to make it easier to access reliable and valuable information. Health professionals were also allowed to consult, free of charge, reliable health information resources, such as the GuiaSalud platform, the Cochrane Library Plus and the resources of the Joanna Briggs Institute. CONCLUSIONS: The involvement of health professionals in these measures and the role that these measures may be expected to play in the development of a premium-quality health service.

Seguridad del paciente y práctica clínica / No disponible

No disponible

La seguridad del paciente: una estrategia del Sistema Nacional de Salud / The safety of the patient: a strategy of the National Health System

No disponible

No disponible

An organizational model for a primary care program of home health care in Spain: a description of the program.

The National Institute of Health (INSALUD) in Spain has successfully used a model of home care that has two major components, each using the physician as part of the team that provides care at home. The first component is home health care that is provided to chronically ill, terminally ill and homebound patients, whereby professionals of primary care provide care for the patient at home, along with other professionals who provide specialized care as support elements. The second component is hospitalization at home, whereby care is provided to acutely ill patients or patients with a precocious medical or surgical discharge from the hospital. The professionals from the hospital provide the basis of care. and the primary health care professionals are the support elements. Both components incorporate a team of support.

Mantener la temperatura del recién nacido sano: medios artificiales frente a calor materno / Maintain the temperature of a healthy newborn infant

Se ha mostrado en numerosos estudios que la temperatura cutánea de los recién nacidos de muy bajo peso al nacer sometidos al método canguro (piel con piel) aumenta significativamente. Este método tiene además las ventajas del establecimiento precoz del vínculo afectivo madre-hijo y de la lactancia materna. En este estudio se compararon las temperaturas obtenidas en una muestra de 24 recién nacidos sanos a término a los 5, 30 y 90 minutos tras el nacimiento. El grupo control fue puesto en la mesa dé calor y el grupo experimental en contacto piel con piel con su madre. Se midieron además las variables temperatura del paritorio y temperatura materna. No se encontraron diferencias estadísticamente significativas entre los dos grupos en los tres momentos de medición (U1= 69,5; U2 = 50; U3 = 40,5). Tampoco se halló correlación entre las variables temperatura materna y temperatura del paritorio con la de los recién nacidos. El método piel con piel es el más aconsejable para el mantenimiento de la temperatura de los recién nacidos sanos a término (AU)