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Objective: To decide if Primary Care (PC) professionals know the European Code against Cancer (CECC) and if this relates to practice the recommendations with themselves and with their patients. Design: descriptive, observational study. Setting: Spanish Health Centers. Participants: Health professionals. Interventions: self-administered questionnaire. Main measurements: cancer protective and risk factors, screening for colorectal, breast, cervix and prostate cancer, level of knowledge of the ECAC. Results: 1734 participants (10.5%), mean age 47.4 years (SD: 8.6), 71.5% female. 50.0% do not know the CECC; tutors (OR = 1.61), assigned to the PAPPS (OR = 1.51) and who have been working in AP for more time (OR = 2.62) are the ones who know it most. 7.2% smoke and 79.1% drink alcohol. 64.1% presented normal weight and 19% performed physical activity. They avoid exposing themselves to the sun 52.7% and use protectors 53.8%. 85.2% have never had a colorectal screening, 11% never had a cytology, and 12% had a mammogram. There is a relationship between knowing the CECC and smoking (P

Objective: this study will present insights on the situation in the surveyed sample as it relates to attitudes towards persons who abuse alcohol by age and gender and would constitute a platform upon which further research can be conducted by researchers in the drug field. Method: this cross-sectional study examines the profile of a sample of residents in the Electoral District of Woodbrook, Port-of-Spain, Trinidad and Tobago. The sample consisted of 121 respondents. Results: alcohol was the most abused drug (85.2%), followed by marijuana (86%), cocaine (69%) and cocaine derivative (41.8%). The prevailing attitude towards persons who abused alcohol was ambivalence (64.8%); this was followed to a lesser extent by an attitude of negativity (34.4%), and the least significant attitude among respondents was premised on positivity (.8%). Respondents also held a negative attitude towards those who abused cocaine and marijuana. Conclusion: the high level of ambivalence towards alcohol use may be intertwined with the social acceptability and high usage of this drug reported from among those surveyed in the Electoral District of Woodbrook. RESUMO Objetivo: este estudo apresentará insights sobre a situação na amostra pesquisada no que se refere a atitudes em relação às pessoas que abusam de álcool por idade e sexo e que constituiria uma plataforma sobre a qual mais pesquisas podem ser conduzidas por pesquisadores no campo das drogas. Método: transversal que examina o perfil de uma amostra de residentes no Distrito Eleitoral de Woodbrook, Port of Spain, Trinidad e Tobago. A amostra foi composta por 121 respondentes. Resultados: o álcool foi a droga mais utilizada (85,2%), seguido pela maconha (86%), cocaína (69%) e derivado de cocaína (41,8%). A atitude predominante em relação às pessoas que abusaram do álcool foi a ambivalência (64,8%); isso foi seguido em menor medida por uma atitude de negatividade (34,4%), e a atitude menos significativa entre os entrevistados foi baseada na positividade (0,8%). Os entrevistados também mantiveram uma atitude negativa em relação àqueles que abusaram de cocaína e maconha. Conclusão: o alto nível de ambivalência em relação ao uso de álcool pode estar interligado com a aceitabilidade social e alto uso dessa droga relatada entre os entrevistados no Distrito Eleitoral de Woodbrook. RESUMEN Objetivo: este estudio presentará un informe sobre la situación en la muestra investigada en lo que se refiere a actitudes hacia las personas que hacen uso excesivo de alcohol por edad y sexo, y que constituiría una plataforma sobre la cual los investigadores pueden conducir más investigaciones en el campo de las drogas. Método: transversal que examina el perfil de una muestra de residentes en el Distrito Electoral de Woodbrook, Puerto de España, Trinidad y Tobago. La muestra estuvo compuesta por 121 participantes. Resultados: el alcohol fue la droga más utilizada (85,2%), seguida por la marihuana (86%), cocaína (69%) y derivado de la cocaína (41,8%). La actitud predominante en relación a las personas que hicieron uso excesivo de alcohol fue la ambivalencia (64,8%), seguido en menor medida por una actitud negativa (34,4%), y la actitud menos significativa entre los entrevistados se basó en la positividad (0,8%). Los entrevistados también mantuvieron una actitud negativa hacia los que hacen uso excesivo de la cocaína y marihuana. Conclusión: el alto nivel de ambivalencia en relación al uso de alcohol puede estar interconectado con la aceptabilidad social y el uso excesivo de esta droga mencionada entre los entrevistados en el Distrito Electoral de Woodbrook.

Com o objetivo de analisar a literatura acadêmica de abordagem sociocultural acerca da relação entre os temas homossexualidade masculina, homem jovem e saúde, realizou-se uma revisão baseada na análise de conteúdo temática de 37 artigos selecionados, nas bases de dados Medline e Lilacs, entre 2004 e 2013. A escassez de literatura na perspectiva sociocultural apontou para obstáculos e desafios, relacionados à promoção de saúde, que vão desde a qualidade da informação, passando por valores simbólicos inconscientes, até a efetivação de propostas de gestores de saúde. Concluiu-se que a hegemonia heterossexual encontra-se presente nas estruturas inconscientes da construção da homossexualidade, contribuindo para a perpetuação do habitus heteronormativo. Estudos que valorizam o encontro do saber técnico com o conhecimento que cada um produz, referido a seus valores pessoais e culturais, podem servir de subsídio para o maior aprofundamento dessa discussão. This review aimed to analyze the academic literature with a sociocultural approach regarding the relationship between topics of male homosexuality, young men and health. It was based on thematic content analysis on 37 articles published between 2004 and 2013 that were selected from the Medline and Lilacs databases. The scarcity of literature on the sociocultural perspective showed that there were obstacles and challenges relating to health promotion, ranging from the quality of information to unconscious symbolic values and how proposals from healthcare managers are put into effect. It was concluded that heterosexual hegemony is present in the unconscious structures of the construct of homosexuality, thereby contributing towards perpetuation of the heteronormative habitus. Studies valuing the meeting point of technical knowledge with the knowledge that each individual produces, relating to personal and cultural values, may serve as a basis for deepening this discussion. Con el objetivo de analizar la literatura académica de abordaje sociocultural sobre la relación entre homosexualidad masculina, hombre joven y salud, se realizó una revisión basada en el análisis de contenido temático de 37 artículos seleccionados en Medline y Lilacs, entre 2004 y 2013. La escasez de literatura en la perspectiva sociocultural señaló obstáculos y desafíos relacionados con la promoción de la salud que van desde la calidad de la información, pasando por valores simbólicos inconscientes, hasta la efectuación de propuestas de gestores de salud. Se concluyó que la hegemonía heterosexual se encuentra presente en las estructuras inconscientes de la construcción de la homosexualidad, contribuyendo para la perpetuación del habitus heteronormativo. Estudios que valorizan el encuentro del saber técnico con el conocimiento que cada uno produce, referido a sus valores personales y culturales, pueden servir de subsidio para una mayor profundización de esa discusión.

Background In the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals’ attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects. Methods A parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed. Discussion Knowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.

Background Colorectal cancer (CRC) is the second most frequent tumor in developed countries. Since survival from CRC depends mostly on disease stage at the time of diagnosis, individuals with symptoms or signs suspicious of CRC should be examined without delay. Many factors, however, intervene between symptom onset and diagnosis. This study was designed to: 1) Describe the diagnostic process of CRC from the onset of first symptoms to diagnosis and treatment. 2) Establish the time interval from initial symptoms to diagnosis and treatment, globally and considering patient's and doctors' delay, with the latter due to family physician and/or hospital services. 3) Identify the factors related to defined types of delay. 4) Assess the concordance between information included in primary health care and hospital clinical records regarding onset of first symptoms. Methods/Design Descriptive study, coordinated, with 5 participant groups of 5 different Spanish regions (Balearic Islands, Galicia, Catalunya, Aragón and Valencia Health Districts), with a total of 8 acute public hospitals and 140 primary care centers. Incident cases of CRC during the study period, as identified from pathology services at the involved hospitals. A sample size of 896 subjects has been estimated, 150 subjects for each participant group. Information will be collected through patient interviews and primary health care and hospital clinical records. Patient variables will include sociodemographic variables, family history of cancer, symptom perception, and confidence in the family physician; tumor variables will include tumor site, histological type, grade and stage; symptom variables will include date of onset, type and number of symptoms; health system variables will include number of patient contacts with family physician, type and content of the referral, hospital services attending the patient, diagnostic modalities and results; and delay intervals, including global delays and delays attributed to the patient, family physician and hospital. Discussion To obtain a nonrestricted sample of patients with CRC we have minimized selection risk by identifying the patients from pathology services. A greater constraint may be associated with information sources based on clinical records. Due to inherent features of coordinated studies, it is important to standardize the collection of information.

Fatigue is a symptom with a relevant impact on the daily lives of cancer patients and is gaining importance as an outcome measure. The Perform Questionnaire (PQ) is a new scale originally developed among Spanish-speaking patients for the assessment of perception and beliefs about fatigue in cancer patients. An observational longitudinal multicenter study was carried out on cancer patients with fatigue. Fatigue-specific measures (FACT-F), generic health-related quality-of-life measures (NHP), and PQ were gathered at baseline and 3 months later. Feasibility, reliability (internal consistency and test-retest), validity, sensitivity to change, and minimally important differences were analysed. Four hundred thirty-seven patients were included in the study: 60.5% were women, the mean age was 59.1 years, the mean time from diagnosis was 2.2 years, 33.6% of patients had breast cancer, and 29.1% had anaemia (haemoglobin (Hb) < 11 g/dL). Low levels of missing items and ceiling/floor effects (< 10%) were found. The overall Cronbach's alpha and intraclass correlation coefficient were 0.94 and 0.83, respectively. The PQ score was associated with fatigue intensity, the need for a caregiver, and the Hb level. Its association was stronger with the FACT-F than with non-specific health measures (NHP). The PQ showed good sensitivity to change for improved and worsening health status. A minimally important difference of 3.5 was estimated in patients whose Hb level had improved by at least 1 g/dL. The PQ measured the attitudes and beliefs about fatigue among cancer patients in clinical practice and showed good psychometric properties among Spanish-speaking patients., This study was funded by Amgem S.A. Jose Antonio Gasquet is an employee of Amgen S.A.

Background: Knowledge about trends in the socioeconomic patterning of overweight and obesity in women provides insights into the nature of the obesity epidemic. Therefore the aim was to assess a ten-year trend (2000-2010) in the prevalence of excessive weight in Balearic Islands' women and its association with socioeconomic factors. Method: Young (18-35 year-old) and middle-aged (36-55 year-old) women were selected from two population-based cross-sectional nutritional surveys carried out in the Balearic Islands, Spain. The participation rate was 80 % during 1999-2000 and 92.5 % during 2009-2010. Measured weight and height was obtained, and body mass index (kg/m(2)) was classified as follows: overweight (25.0 < 30), obese (>= 30) and excessive weight (>= 25). In both surveys, a general questionnaire including questions relating to socioeconomic status factors was used. Logistic regression was used to examine the association of excessive weight with socioeconomic variables and to test the interaction between the survey period and the socioeconomic factors. Results: Overall, while the prevalence of obesity mainly remained stable over the study period, the prevalence of overweight increased from 21.0 to 24.8 %. Young women showed an increased prevalence of overweight and excessive weight, from 14.1 to 20.9 % and from 20.9 to 28.6 %, respectively. Significant differences were not found in middle-aged women. Over the whole period, the incidence of excessive weight was higher among middle-aged and foreign women, but lower in women with a high educational profile and in employment. The prevalence of excessive weight in young women was also around 2.5 times higher in women who were living with at least one child at home. The tendency towards excessive weight in employed women decreased significantly between 2000 and 2010 in the younger age group (OR: 0.42; 95 % CI: 0.22-0.82). Conclusions: No significant increase in the prevalence of overweight/obesity was observed in middle-aged women, with a low level of education being the single socioeconomic variable associated with excessive weight in this target group. Overweight/obesity increased in young women with unemployment being the distinguishing socioeconomic factor associated with this increase., Spanish Ministry of Health and Consumption Affairs (Projects 05/1276, 08/1259, 11/01791, 14/00636, Red Predimed-RETIC RD06/0045/1004, and CIBEROBN CB12/03/30038), Grant of support to research groups no. 35/2011 (BI Gov.) and EU FEDER funds. Spanish Ministry of Education and Science (FPU Programme, PhD fellowship to M.M.B.). The Research Group on Community Nutrition and Oxidative Stress belongs to the Centre Catala de la Nutricio and Exernet Network.