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Objective: To measure the benefits of a physical exercise program in a community, through the modifications in quality of life, and perimenopausal-menopausal women physical condition., Setting: The participants were recruited in PC consultations from two health centers in Molina de Segura (Murcia)., Participants: Women between 40 and 70 years old, or under 40 of age diagnosed with early menopause., Design: Quasi-experimental study, non-randomized, controlled, open and single-center with 2 parallel branches to study., Intervention: Experimental group: ACTIVA Bone Health Program for six months., Control: inactive., Main Measurements in Both Groups: The SF 36 questionnaire was used to measure the Quality of life., Physical Condition: Aerobic condition, flexibility, balance and strength measured with the mile, flamenco, flexibility box tests, and throwing the medicine ball, respectively. Physical activity level through the GPPAQ Questionnaire. Sociodemographic variables were collected and the adherence to the program was measured., Results: The quality of life improved in the intervention group compared to the control group, except «Body Pain» dimension (p = 0.412). As regards the intragroup level, all dimensions showed significant improvement except both «Physical Function» (p = 0.263) and «Body Pain» (p = 0.136). The physical capacities that benefited most were aerobic fitness, strength and balance., Conclusions: The Active Bone Health Physical Exercise Program piloting showed benefits on participants' physical and mental quality of life. In addition, it has been shown that performing a specific physical exercise for premenopausal-menopausal women improves their physical condition., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The European Commission Initiative on Breast Cancer (ECIBC) has developed new recommendations on breast cancer screening and diagnosis. The objective of this work was to adapt these recommendations to Spanish in order to implement and guarantee the quality and success of breast cancer screening programmes (PCCM) throughout the Spanish territory., Methods: The new European Guidelines on Screening and Diagnosis of Breast Cancer have been prepared by a multidisciplinary panel of experts and patients (Guidelines Development Group, GDG). The recommendations inclu-ded are supported by systematic reviews of the evidence conducted by a team of researchers from the Ibero-American Cochrane Center. For its preparation, the European Commission's conflict of interest management rules were applied and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used. The GRADE evidence-to-decision (EtD) frameworks were used to minimize potential influence of interests on the recommendations., Results: As a result of the systematic reviews carried out, the GDG published on the ECIBC website a list of recommendations as part of the guidelines for the screening and diagnosis of breast cancer, which were translated into Spanish in this work., Conclusions: The adaptation to Spanish of the new recommendations helps their implementation and the creation of a uniform PCCM throughout the Spanish territory. All of this improves informed decision making and the success of PCCM.

Objective: The delay caused to provide an appointment and the uncertainty of the expected waiting time, are cause for discontent in the patients. The object of this work was to improve the accessibility to the consultation of specialized attention in our health area, decreasing the average waiting time and reduce the number of claims for this reason., Methods: To measure the quality of the service provided, 5 criteria were developed and evaluated, by means of a cross section, in December 2015 for all patients pending appointment in the Area. Likewise, the complaints and claims collected during the 6 months prior to this date were quantified. As an intervention, a new circuit was designed and implemented in the interconsultation process, protocolizing a direct and automatic citation system. This system also eliminated patients without an appointment, allowing prioritization in preferred cases. At the end of 2016, a new evaluation was made with the same methodology. For the statistical analysis, Student's t and Chisquare were used., Results: In six months the number of patients without appointment was reduced from 4726 to 0. The average waiting time for external consultations improved from 63 to 44.2 days. Patients waiting more than 50 days increased from 41.5% to 74.8%. The number of complaints and claims due to appointment in external consultations decreased from 161 to 80., Conclusions: Accessibility has improved by reducing the average waiting time and eliminating the list of patients without an appointment, although the number of patients pending appointments for more than 50 days has increased. The number of complaints and claims has been halved., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objectives: To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies., Methods: A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009., Results: The adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R(2)). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses' and porters' professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028)., Conclusions: The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care., (Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.)

Objective: To evaluate the quality of referral from Primary Care to Mental Health and its relationship to the illness referred., Design: A descriptive retrospective study over 4 years on the quality of the process., Setting: Mental Health Centre II in the Autonomous Community of Murcia., Patients: 209 patients referred by three Primary Care teams., Measurements and Main Results: 91.4% of patients (C.I. 95%: 100%, 81.1%) were accepted with a referral report. 97.9% (C.I. 95%: 100%, 87.8%) presented a reason for psychiatric consultation. The report included the clinical history of the illness in 58.1% of cases (C.I. 95%: 70.3%, 45.9%); a diagnostic opinion was given in 79.6% (C.I. 95%: 91.1%, 68%); and 37.2% (C.I. 95%: 49.3%, 25%) were referred with a request for a specific consultation. 68.4% of the referrals (C.I. 95%: 81.8%, 54.9%) coincided with the Mental Health diagnosis. It was observed that among the most commonly referred pathologies: anxiety disorders (31.6%), affective (28.8%), personality (7.7%), psychotic (5.3%), and adaptive disorders (5.3%); diagnoses were commonly made for affective or anxiety disorders (p < 0.0001); the specific cause of referral of anxiety disorders was recorded (p < 0.01); and in cases of psychotic and personality disorders, the diagnoses did not coincide (p < 0.001)., Conclusions: Referral to Mental Health can be improved, fundamentally by sending a report which includes the clinical history and the reason for referral. It is common to express a diagnostic opinion on affective and anxiety disorders, to note a specific reason for referral in the case of anxiety disorders and not to specify personality and psychotic disorders.