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Objective: We analyse how reproductive health strategies have been incorporated into the everyday activities of the services and the resulting transformation of professional and user practices., Method: Cartographic research taking a multi-sited ethnographic approach that seeks to reveal the processes of transformation. Data generation techniques featuring participant observation and situated interviews. Discourse analysis of the text corpus using three analytical axes based on three main lines of action promoted by the strategies., Results: We identified transformations in: 1) demedicalisation: an increase in midwives' know-how and autonomy, changes in episiotomy practice and the facilitation of bonding practices; 2) warmth of care: incorporation of women's needs and expectations and improvements in the comfortableness of birth settings, especially in assistance at physiological birth; and 3) participation: actions that foster shared decision-making and the involvement of the persons accompanying women in labour., Conclusions: Above all, transformation is visible in the incorporation of new attitudes, sensibilities and practices that have developed around the old structures, especially during physiological childbirth. The more technological areas have been less permeable to change. Risk management in decision-making and addressing diversity are identified as areas where transformation is less evident., (Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Intercultural Mediation is a strategy for quality health care aimed at reducing inequalities in immigrant population. The aim is to analyse main reasons consultation with the mediation service, women care profile and characteristics of intervention., Methods: Cross-sectional study of 339 episodes of care by two intercultural mediators (MI) from February 2008 to October 2011 in Valencia. Variables were analysed individual records of the consultations of the MI: reasons for referral to MI and professionals who refer, motives and problems identified by MI, kind of intervention, kind of derivation of MI and socio-economic variables. To evaluate the differences between countries, X2 test was used for qualitative variables and one-way ANOVA test for quantitative variables., Results: 123 women (36,3%), were referred to the MI by the Sexual and Reproductive Health Centre and 98 (28,9%) by the midwife. 272 women (80,24%) were referred for information and demand for contraception. The MI conducted health education and detected social problems in 67 women (19,7%) and gender violence in 38 (11,21%)., Conclusions: The women attending were Latin American immigrants (those of Bolivia showed more vulnerability) and were referred for contraception. The MI provided information, education and facilitated access to reproductive health services. Bolivian women showed more vulnerability factors: irregular situation, precarious work and low residence time.

Objective: To typify the episodes of early detection of cardiovascular risk factors (CRF) and to calculate their frequency by age and sex groups., Design: An observational, prospective and multi-centred study., Setting: Twenty health centres distributed in the three provinces of the Community of Valencia., Patients: Episodes of prevention of CRF in users of both sexes aged between 18 and 64 who, in the three years prior to the study, had undergone no CRF early diagnosis protocol. They were included by means of consecutive proposal with informed consent., Measurements and Results: The diagnostic protocol of the Plan for Prevention of Cardiovascular Diseases (PPCVD) was applied. The variables analysed were: age, sex, number and duration of consultations, CRF diagnosed previously, and CRF diagnosed at the intervention. 632 episodes were analysed, with a mean 1.44 (CI: 1.39-1.49) consultations per episode and a mean duration of 10 minutes 53 seconds. At the start of the study 60.3% of the population did not have CRF, but after the intervention only 17.2% had no CRF diagnosed. CRF frequency after the intervention was: diabetes 4.5% (CI: 3.2-12.2), alcohol consumption 5.5% (CI: 2.2-13.1), hypertension 14.9% (CI: 7.7-22.2), obesity 30.8% (CI: 24.3-37.3), tobacco habit 33.2% (CI: 26.8-39.6), lipaemia 42.5% (CI: 36.6-48.5), and sedentary life-style 54.9% (CI: 49.6-60.2)., Conclusions: CRF diagnosed most often after the intervention were: sedentary life-style, tobacco habit and obesity; and the least commonly diagnosed was alcohol consumption. The application of the PPCVD protocol was most effective in the youngest age-groups and women. The "episode" as a unit of analysis is a useful and feasible instrument for investigating the procedures and results of primary care preventive activities.