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This study aims to analyse the use of an instant messaging app (WhatsApp®) as a means of communication for reaching people who inject drugs. An eight-week prospective longitudinal and observational study with three observations was designed for five addiction centres in Catalonia. The participants were 105 people who inject drugs, distributed in five intervention groups. The results of the Risk Assessment Battery (RAB) were compared in the three levels of analysis pre-test, post intervention and one month after the intervention. The main results indicate a significative reduction in RAB scores after the intervention. The main conclusion was that the WhatsApp® intervention has great potential for developing harm reduction interventions and to reduce the HIV contagion risk El presente estudio analiza el uso de una aplicación de mensajería instantánea (WhatsApp®) como canal de acceso a personas que se inyectan drogas. Se diseñó un estudio observacional longitudinal prospectivo de ocho semanas y tres observaciones en cinco centros de adicciones en Cataluña. Participaron 105 personas que consumían drogas por vía parenteral, distribuidas en cinco grupos de intervención grupal. Se compararon los resultados de la escala Risk Assessment Battery (RAB) (después de ser traducida al español y analizada su consistencia interna) en las tres fases de análisis pre test, post intervención y un mes después de la intervención. Los resultados indican una disminución significativa de las puntuaciones RAB tras la intervención a través de WhatsApp®. Se concluye que la intervención grupal a través de WhatsApp presenta grandes potencialidades para realizar intervenciones en reducción de daños y reducir el riesgo de contagio del VIH

Hundreds of minors born in the Maghreb come to Spain every year in search of a better future. The reality of these young people after taking the decision to migrate to a country that might fulfil these hopes often entails a descent into ex-clusion, a trajectory of personal suffering in all areas (social, psychological, physical, spiritual and cultural). This article discusses several re-levant topics for describing the elements that constitute risk factors for mental health pro-blems: from the unrecognised risk to life of the journey to our country to contact with a system of protection that will leave many of these boys on the street. Once they are in a situation of ho-melessness, pre- and post-stressors accumulate in each young person and generate a situation of such stress that there is a high risk of damage to their mental health, with consequences that they may have to live with for the rest of their lives Centenares de jóvenes menores de edad nacidos en el Magreb llegan cada año a España en busca de un futuro mejor. La realidad de estos jóvenes desde que toman la decisión de emigrar hacia un país que pueda dar respuesta a sus esperanzas se torna en muchos casos un descenso hacia la exclusión, por el camino del padecimiento personal en todas sus áreas (social, psicológica, física, espiritual y cultural). El objetivo de este artículo es hacer confluir varios tópicos relevantes para la descripción de aquellos elementos que constitu-yen factores de riesgo de padecer problemas de salud mental: desde el riesgo mortal no reconocido de un viaje hacia nuestro país, hasta el contacto con el sistema de protección que dejará a muchos de estos chicos fuera, en la calle. Una vez están en situación de sin-hogarismo, los estresores previos y posteriores se acumulan en cada joven generando una situación de tal estrés que provoca un alto riesgo de que tengan un perjuicio en su salud mental con consecuencias que podrían acompañarlo de por vida Centenars de joves menors d’edat nascuts al Magrib arriben cada any a Espanya a la recerca d’un futur millor. La realitat d’aquests joves des que prenen la decisió d’emigrar cap a un país que pugui donar resposta a les seves esperan-ces sovint esdevé un descens cap a l’exclusió, pel camí del patiment personal en totes les seves àrees (social, psicològica, física, espiritual i cul-tural). L’objectiu d’aquest article és fer confluir diversos tòpics rellevants per a la descripció dels elements que constitueixen factors de risc de pa-tir problemes de salut mental: des del risc mor-tal no reconegut d’un viatge cap al nostre país, fins al contacte amb el sistema de protecció que deixarà molts d’aquests nois fora, al carrer. Un cop són en situació de sensellarisme, els estres-sors previs i posteriors s’acumulen en cada jove i generen una situació de tant estrès que provoca un alt risc que tinguin un perjudici en la seva salut mental amb conseqüències que podrien acompanyar-los tota la vida

Objetivo principal: Determinar la prevalencia de tuberculosis, Virus de la Inmunodeficiencia Humana y Virus de la Hepatitis C en una muestra representativa de personas sin-hogar de Girona y establecer relaciones con los principales factores sociodemográficos y hábitos de salud. Metodología: Estudio transversal, observacional y analítico, Chi cuadrado y regresiones logísticas multivariadas. Resultados principales: Se establece una prevalencia de infección tuberculosa del 40'2% y de tuberculosis del 5,2%, relacionándose ambas con factores socioeconómicos. La tasa de VIH fue del 7,2% y del VHC del 11,7%, siendo las personas que se han consumido drogas por vía parenteral el principal factor de riesgo de infección tanto de VIH (p=0'002) como de VHC (p

With the start of the great economic recession in 2007, homelessness increased five- fold in some regions of southern Europe. Larger numbers of people experiencing homelessness, compounded by a lowered capacity for social and health services to respond to their needs, precipitated an increase in so-called 'chronic homelessness'. The aim of this study was to establish the presence of chronic homelessness in a defined geographical area of Spain, and to determine the prevalence of diagnosed mental disorders within both the chronic and non-chronic homeless population. A prospective and descriptive study was designed to monitor a cohort of 826 indi- viduals experiencing homelessness who constituted the entire identified homeless population in the relevant territory in 2006. This sample was followed until 2016 and sociodemographic as well as clinical information was collected, including the time spent homeless. The results obtained indicated that one in 10 participants met the criteria for chronic homelessness, a rate that is lower than in the US, where the definition of chronicity that was applied originates from. Alcohol use disorder was the most common mental health disorder that contributed to the chronicity asso- ciated with homelessness. Being born in the country (Spain) where the study was conducted and being older were the main other variables associated with chronicity. People defined as chronically homeless in Spain were on average younger than in the US, but women were present in the chronic subgroup at a similar rate. We also reflect on the limitations of the study and in particular the appropriateness of the concept of chronicity as applied to homelessness

A bibliometric review was conducted to assess the available scientific knowledge regarding the use of Information and Communication Technologies (ICT) by Individuals Experiencing Homelessness (IEH) and reflect on the existing evidence that ICT use has on their health. A total of 50 published articles were selected after a process of systematic review from five databases containing record of publications up until 2016. All the studies were published in English, half of the works were published in the last three years and 48% of them included the description of ICT use as an objective. Despite the fact that experimental studies were rare, and sample sizes typically small, it was concluded that the studies analyzing the effect of ICT on health display benefits. ndeed, the use of such technology offers promising opportunities to explore new ways of intervention in prevention, harm reduction and health treatment of IEH.

Summary. The universalisation of Social Networking Sites has prompted a debate about whether contact with relatives and friends online has a positive effect on psychological well-being, as it has on direct relationships with primary groups. The aim of this study is to analyze the use of social network sites in a sample of 164 individuals experiencing homelessness (IEH), and to establish the relationship between this usage and their levels of self-esteem and satisfaction with life, using a multiple linear regression model for each dependent variable. The main results show a high prevalence of Internet and social network sites usage amongst IEH, even slightly higher than in the population overall. The variables predicting a higher degree of well-being are related to the use of social network sites, especially keeping in touch with friends. The chronicity associated with length of time on the street is also a key factor. A debate exists regarding the benefits of social network sites on health, and the importance which education may have in improving access to specialized services.Resum. La universalització de les xarxes socials en línia ha provocat un debat sobre si el contacte amb familiars i amics en línia té un efecte positiu en el benestar psicològic, com ho ha fet en les relacions directes amb grups primaris. L’objectiu d’aquest estudi és analitzar l’ús que es fa de les xarxes socials en línia en una mostra de 164 persones que experimenten una situació de sense llar (PES), i establir la relació amb els seus nivells d’autoestima i satisfacció amb la vida, a partir d’un model de regressió lineal múltiple per a cada variable dependent. Els principals resultats mostren una alta prevalença d’ús de llocs d’Internet i xarxes socials entre PES, fins i tot lleugerament més alt que la població general. Les variables predictores d’un major grau de benestar estan relacionades amb l’ús de llocs de xarxes socials, especialment a l’estar en contacte amb amics. La cronicitat associada amb la permanència al carrer és també un factor clau. Hi ha un debat sobre els beneficis de les xarxes socials en línia sobre la salut i la importància que la formació pot tenir per millorar l’accés als serveis especialitzats.

All the policies, services, programmes and actions aimed at reducing the negative effects of drug consumption when the consumer does not wish to quit consumption, are called harm reduction. Historically, most of these interventions have been aimed at parenteral drug users. This is due to the epidemic nature of illnesses such as Acquired Immune Deficiency Syndrome, or the Hepatitis C Syndrome, whose main contagion mechanism is sharing injecting material, and also the risk of overdose associated to this type of consumption. The groups which are more vulnerable to suffering addiction issues and their related harm are the people experiencing homelessness. In the investigation conducted in order to design more efficient preventive interventions, it has been observed that there exist great opportunities to use Smartphones to develop distance interventions among homeless people with mental disorders, including those related to substance abuse. This work explores the possibilities of developing an on line intervention to reduce the principal harm associated to injected drug consumption among homeless people, in particular through the Whatsapp application for mobile phones. The reading of scientific literature indicates that the main advantages associated to this type of intervention are the improvement in the access to services, due to the inherent barriers to institutions and also to those associated to users, and the possibilities in the management of communication with intervention agents. There exist great possibilities to develop this proposal of intervention from specialised public services El conjunto de políticas, servicios, programas y acciones cuyos objetivos tratan de reducir los efectos nocivos de los consumos de drogas cuando la persona que las consume no desea o no consigue abandonarlos, se denominan reducción de daños. La mayor parte de este tipo de intervenciones se ha dirigido históricamente a usuarios de drogas por vía parenteral. Esto se debe tanto al carácter epidémico de enfermedades como el Virus de la Inmunodeficiencia Humana o el virus de la Hepatitis C, cuyo principal mecanismo de contagio es el compartir material de inyección, como al riesgo de muerte por sobredosis que se asocia a este tipo de consumo. Uno de los colectivos más vulnerables de padecer adicciones y los daños que se les asocian, son las personas que experimentan una situación de sinhogarismo. En la investigación para diseñar intervenciones preventivas más eficaces, se ha descubierto que existen grandes oportunidades en el uso del teléfono inteligente para desarrollar intervenciones a distancia con población sin hogar con patología mental, incluidas las relacionadas con el abuso de sustancias. Este trabajo explora las posibilidades de desarrollar una intervención en línea para reducir los principales daños asociados al consumo de drogas inyectado en población sin hogar, concretamente a través de la aplicación WhatsApp para dispositivos móviles. La revisión realizada de la literatura científica indica que las principales ventajas que se asocian a este tipo de intervención son la mejora en el acceso a los servicios, debido tanto a las barreras inherentes a las instituciones como las que se asocian a los usuarios, y las posibilidades en la gestión de la comunicación con los agentes de la intervención. Existen grandes posibilidades para desarrollar esta propuesta de intervención desde los servicios públicos especializados

The difficulties involved in continuing with the drug treatment offered by specialised public services lead to a considerable rate of premature abandon. Objective: the aim of this work is to learn the patients' reasons for abandoning their addiction treatment prematurely, and to establish relations with sociodemographic, administrative and clinical factors. Method: a transversal, observational and descriptive study, in a pubic therapeutic centre, via a phone interview of a sample of 92 patients selected with an intentional sampling method. The patients' clinical records were consulted in order to compile data on independent variables. Contingency tables were used for qualitative variables and t student or U Mann-Whitney tests for the comparison of averages. Results: the principal factors for abandoning treatment were related to the fact that patients considered that they had improved. Incompatibilities for personal reasons and not considering the existence of a problem were also frequently put forward as reasons for giving up treatment. Discussion: there is a gap between certain patients' expectations and the type of treatment offered. There is less adherence when patients are referred from health services. It is important to adapt initial visits to the patients' expectations in order to attempt to improve their adherence, and consequently, the success of their treatment. In conclusion, the results show the need to reflect on how to improve the process of therapeutic assistance until the initiation of the treatment Las dificultades de adherencia al tratamiento de las adicciones que se oferta desde los servicios públicos especializados, ocasionan una tasa de abandono temprano considerable. Objetivo: El objetivo de este trabajo es el de conocer los motivos de pacientes para abandonar prematuramente el tratamiento de su adicción y establecer relaciones con factores sociodemográficos, administrativos y clínicos. Método: Estudio transversal, observacional y descriptivo en un centro terapéutico público, a través de una entrevista telefónica aplicada a una muestra de 92 pacientes seleccionados con un método de muestreo intencional. Se consultaron las historias clínicas para recopilar los datos correspondientes a las variables independientes. Se usaron tablas de contingencia para variables cualitativas y pruebas t de Student para la comparación de medias. Resultados: Los principales motivos de abandono referidos estaban relacionados con la consideración propia de mejora. Las incompatibilidades por motivos personales y la no consideración de problema también fueron aducidas especialmente. Discusión: Existe una distancia entre las expectativas de determinados pacientes y el tipo de tratamiento que se oferta. Cuando la derivación procede de servicios sanitarios existe menos adherencia. Es importante adaptar las visitas iniciales a las expectativas de los pacientes para tratar de mejorar su adherencia y, por tanto, el éxito del tratamiento. En conclusión, los resultados indican la necesidad de reflexionar sobre cómo mejorar el proceso de acompañamiento terapéutico hasta el inicio del tratamiento

Objective: To determine the prevalence of tuberculosis, AIDS and Hepatitis C in a representative sample of homeless people in Girona, and set the connections with the main factors related to sociodemographic and health habit aspects. Methods: Transversal, observational and analytic study, CHI square, and multivariate regressive logistics. Results: There is a prevalence of tuberculosis infection of 40.2% and tuberculosis of 5.2%, both factors related to socioeconomic factors. The rate of VIH was 7.2% and VHC was 11.7%. Those people who had consumed drugs through parenteral ways were the ones with the highest infection risk of both VIH (p=0.002) and VHC (p

The number of homeless has increased in the last years, being an especially vulnerable group of suffering problems of mental Health and drug abuse. In the occasions in which the symptomatology of the patient prevents his follow-up in the ambulatory specialized services is possible to request the psychiatric involuntary valuation to diagnosis and the treat said problematic, being in many cases necessarily the admission. In the present study of observational methodology with direct intervention and from a perspective psycho-educative and social it will be thought over, from the exhibition of two practical cases, on the process that takes the interdisciplinary and community teams of Girona (Catalonia) to motivating the involuntary movement to the hospitable services of urgencies