Álvaro Alconada

To explore general practitioner (GP) training, continuing professional development, scope of practice, ethical issues and challenges in the working environment in three European countries. Qualitative study of 35 GPs from England, Germany and Spain working in urban primary care practices. Participants were recruited using convenience and snowball sampling techniques. Semi-structured interviews were recorded, transcribed and analysed by four independent researchers adopting a thematic approach. Entrance to and length of GP training differ between the three countries, while continuing professional development is required in all three, although with different characteristics. Key variations in the scope of practice include whether there is a gatekeeping role, whether GPs work in multidisciplinary teams or singlehandedly, the existence of appraisal processes, and the balance between administrative and clinical tasks. However, similar challenges, including the need to adapt to an ageing ...

A lo largo del presente articulo nos adentraremos en la vida de Ressano Garcia, una villa fronteriza marcada por el historico y constante movimiento entre el sur de Mozambique y el este de la Republica Sudafricana. Aqui la frontera se muestra como lugar de oportunidades y de explotacion, de suenos y frustraciones, division y de contacto, al que llegan personas de diferentes edades y condiciones persiguiendo diversos propositos. Ya sea su objetivo asentarse o cruzar la frontera, se integran en la dinamica que marca la vida local, que se conforma entorno a este movimiento, siendo Ressano un hito para las poblaciones ligadas al mismo.

Cervical cancer is a major public health problem. Even though readily preventable, it is the fourth leading cause of death in women globally. Women living with HIV are at increased risk of invasive cervical cancer, highlighting the need for access to screening and treatment for this population. Integration of services has been proposed as an effective way of improving access to cervical cancer screening especially in areas of high HIV prevalence as well as lower resourced settings. This paper presents the results of a systematic review of programs integrating cervical cancer and HIV services globally, including feasibility, acceptability, clinical outcomes and facilitators for service delivery. This is part of a larger systematic review on integration of services for HIV and non-communicable diseases. To be considered for inclusion studies had to report on programs to integrate cervical cancer and HIV services at the level of service delivery. We searched multiple databases includin...

espanolEl presente articulo tiene por objetivo centrar la reflexion desde las atribuciones y significados que genera la alimentacion en el continente africano a casos de alimentos especificos. Centrado especialmente en la region austral del continente, empieza haciendo referencia a estudios clasicos que se han llevado a cabo en la zona para vislumbrar algunas de sus conclusiones relacionadas con los significados y el interes en la alimentacion como elemento central de socializacion y motivacion grupal. Asimismo, busca la comparacion con referencias mas recientes que muestran abordajes y metodologias que contrastan con las primeras investigaciones etnograficas en la zona. Posteriormente ponemos el foco en la zona sur de Mozambique para profundizar en dos alimentos que tienen una especial relevancia para las aldeas changana que viven en ese territorio: xima y canhu, para ver a traves de los significados que rodean su obtencion y consumo, caracteristicas socioculturales de las poblacio...

BACKGROUND Supervisory effectiveness in long-term care facilities has been identified a key factor in staff satisfaction and quality of care. Determining its utility in Spanish speaking countries will assist with understanding different cultural and health service contexts. OBJECTIVES To develop and psychometrically test the Supervisory Support Scale in Spanish. The Spanish version of the Supportive Supervisory Scale could be useful for cross-cultural comparisons of supervisory support, which is a key factor to improving work relationships in long-term care facilities. METHODS Validation was carried out with 405 participants in 37 long-term care facilities. One-way analysis of variance was the test of significance performed to examine the differences among the facilities and Pearson product-moment correlations were used to assess construct validation of the scale. The mean and standard deviation were calculated for each supervisory score in each facility. Structural equation modelli...

Partiremos de explicar un lugar de origen o retorno en continua mudanza y con una historia migratoria comun. Es el lugar en el que se asienta y reproduce el grupo familiar y donde van intermitentemente los migrantes, siendo su regreso de manera definitiva cuando pasa el periodo vital de maxima productividad. Es una migracion fundamentalmente masculina a pesar de la creciente feminizacion. Esta caracteristica hace que las mujeres, en su papel asignado de productoras agricolas, reproductoras y educadoras permanezcan en gran numero y, en los casos en que sus movimientos se salgan de los roles establecidos, seran criticados, invisibilizados y muchas veces conlleven una innovacion y segregacion del grupo por la caracteristica patrilocal que, en ese caso, no cumpliria los requisitos de union familiar. Por lo tanto, dentro de las redes socio-familiares, la decision de migrar y el viaje se van fraguando desde la infancia en el caso masculino, paralelamente a la promocion de la misma desde e...

Las conexiones hoy vencen continuamente las fronteras físicas y humanas, y quizá sea en éstas donde consigamos materializar el trabajo etnográfico, viendo cómo se reinterpreta la vida cuando entendemos que cambia de contexto. Los conceptos de movimiento o de conexión son incomprensibles si no se entiende que hay más de un lugar o persona que además se transforman con el tiempo. Por tanto es a partir de esas dimensiones de globalidad y localidad, de identificación y adaptación, donde podemos aprehender la esencia de cualquier fenómeno social. El contexto de los movimientos de personas en África Austral ayudará a centrar estas reflexiones a través de un ejemplo que, por su constancia en el tiempo y la diversidad de circunstancias que lo han acompañado, nos ayudará a pensar el abordaje del estudio del movimiento, la presencia, el vínculo, la pertenencia o incluso los canales y vías de comunicación utilizados por poblaciones transnacionales conformando su forma de vida.

The long term care environment demands specific requirements of the staff, namely that they provide a holistic approach to care. Providing holistic care leads to complex decision-making processes which go beyond just finding a solution to a specific health problem. It requires that staff are able to respond to the diverse needs expressed by the residents and which, in many cases, are only identified through the relationship that professionals have with them. However, this relationship that staff establishes with the resident often leads to burden for these professionals. The researchers sought to identify characteristics of the nursing homes that lead to positive outcomes for staff. The study involves collecting questionnaires (n=132) and conducting semi structured interviews (n=35) in 9 Catalan nursing homes with number of staff, utilizing a quantitative questionnaire and semi-structured interviews. Practices in organisations that led to positive outcomes for staff included coordin...

This scoping review summarizes and analyzes relevant studies related to the evidence published on undocumented immigrant women's access to and utilization of health and social services in Spain. Scientific literature was identified by entering search terms in seven electronic databases which combined retrieved health sciences peer-reviewed articles (Pubmed, Embase, CINAHL Plus and Scopus) and grey literature databases (Europa OpenGrey, DART-Europe and Google Scholar) published between 2004 and 2014 and written in Spanish or in English presenting data about Spain. Those that fulfill the inclusion criteria were selected after a blind peer reviewed process when pertinence and quality was debated. A total of 16 publications were included, the main topics being socio-cultural differences in the access and utilization of social and health services and barriers faced by immigrant women. None of the studies focused exclusively on undocumented women, hence further research is needed in this area.

Nursing staff who provide care in the nursing homes of Catalonia have more precarious work conditions, including more demanding schedules and work overload, than those in other areas of care. This situation entails two major problems: Detrimental health results for nurses who face psychosocial and physical risks and a negative impact on the care provided to patients, with a decrease in the quality of care. This study aimed to describe the precarious employment situation of nursing staff in nursing homes. We carried out a descriptive study based on the employment precariousness scale (EPRES), which was administered to a sample of 239 nurses and nursing assistants working in public and private nursing homes in Catalonia. The highest level of job insecurity occurred among nursing assistants and in privately managed nursing homes. The precariousness of the working conditions of nursing staff poses a risk both to the workers themselves and to the people they tend to. For this reason, the...