Suchergebnisse

La Comisión Europea adoptó el pasado 2 de julio una propuesta de directiva sobre la aplicación de los derechos de los pacientes en materia de asistencia sanitaria transfronteriza. Dicha propuesta forma parte de la Agenda Social Renovada y establece un marco comunitario para la asistencia sanitaria transfronteriza. Este marco se estructura en torno a tres ámbitos diferentes: Los principios comunes a todos los sistemas de salud de la UE, estableciendo qué Estado miembro será responsable de velar por los principios comunes de la asistencia sanitaria y cuáles son sus responsabilidades. Un marco especifico para la asistencia sanitaria transfronteriza: se aclararán los derechos de los pacientes a recibir asistencia sanitaria en otro Estado miembro, incluidos los límites que los Estados miembros pueden imponer a esta asistencia sanitaria en el extranjero, y el nivel de la cobertura financiera prevista para la asistencia sanitaria transfronteriza. La cooperación europea en materia de asistencia sanitaria: colaboración entre los países de la UE en las regiones fronterizas, el reconocimiento de las recetas emitidas en otros países, las redes europeas de referencia, la evaluación de las tecnologías sanitarias, la recopilación de datos, la calidad y la seguridad. ; The Commission's proposal for a directive on services in the internal market at the start of 2004 included provisions codifying the rulings of the Court of Justice in applying free movement principles to heath services. This approach, however, was not considered appropriate by Parliament and Council, which invited the Commission to develop specific proposals in this area. On 2 July 2008, part of the Renewed Social Agenda, the Commission adopted a draft Directive on the application of patients' rights in to cross-border healthcare, which provides a Community framework for safe, high quality an efficient cross-border healthcare, by reinforcing cooperation between Member States and providing legal certainty over the rights of patinglésients to seek healthcare in another Member State.

Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA). The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR) in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997–2007). IMR mean value is 92.2 (per 1000 live births) and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas) and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.

Diet is one of the key modifiable behaviors that can help to control and prevent non-communicable chronic diseases. Therefore, it is important to evaluate the overall diet composition of the population through non-invasive and independent indexes or scores as diet quality indexes (DQIs). The primary aim of the present work was to estimate the adequacy of the intake of critical nutrients in the Spanish "Anthropometry, Intake, and Energy Balance Study" (ANIBES) (n = 2285; 9–75 years), considering, as a reference, the European Food Scientific Authority (EFSA) values for nutrients for the European Union. We also assessed the quality of the diet for adults and older adults using four internationally accepted DQIs, namely the Healthy Diet Indicator (HDI), the Mediterranean Diet Score (MDS), the Mediterranean Diet Score-modified (MDS-mod), and the Mediterranean-Diet Quality Index (MED-DQI), as well as the ANIBES-DQI, stratified by education and income. The ANIBES-DQI was based on compliance with EFSA and Food and Agriculture Organization recommendations for a selected group of nutrients (i.e., total fat, saturated fatty acids (SFAs), simple sugars, fiber, calcium, vitamin C, and vitamin A), with a total range of 0–7. Misreporting was assessed according to the EFSA protocol, which allowed us to assess the DQIs for both the general population and plausible reporters. The majority of the Spanish population had high intakes of SFAs and sugars and low intakes of fiber, folate, and vitamins A and C. In addition, about half of the population had low DQI scores and exhibited low adherence to the Mediterranean diet pattern. Overall, older adults (>65–75 years) showed better DQIs than adults (18–64 years), without major differences between men and women. Moreover, primary education and low income were associated with low MDS and ANIBES-DQI scores. For the ANIBES-DQI, the percentage of the population with low scores was higher in the whole population (69.5%) compared with the plausible energy reporters (49.0%), whereas for ...

European biodiversity significantly depends on large-scale livestock systems with low input levels. In most countries forms of grazing are organized in permanent or seasonal cooperations (land-owner/land-user agents) and covers different landscape such as alpine areas, forest, grasslands, mires, and even arable land. Today, the existence of these structures is threatened due to changes in agricultural land use practices and erratic governmental policies. The present chapter investigates six low-input livestock systems of grassland management with varying degrees of arrangements in different European countries and landscapes. These large-scale grazing systems (LSGS) are reindeer husbandry in Northern Sapmi (Fennoscandia), sheep grazing in the Polish Tatra mountains, cattle grazing in the Swiss and German Alps, cattle, sheep, and pig grazing in Baixo Alentejo, Southern Portugal, and sedentary sheep grazing in Central Spain. These systems showed very heterogeneous organizational patterns in their way of exploiting the pastoral resources. At the same time, these LSGS showed at least some of the following weaknesses such as poor economic performance, social fragility, and structural shortcomings for proper grazing management. Lack of proper mobility of herds/flocks or accession to specific grazing grounds can be a cause of environmental hazards. The surveyed LSGS are mostly dependent on public handouts for survival, but successive policy schemes have only showed mixed effects and, in particular study areas, clear inconsistencies in their aim to stop the general declining trend of LSGS.

Polygenetic risk scores (pGRSs) consisting of adult body mass index (BMI) genetic variants have been widely associated with obesity in children populations. The implication of such obesity pGRSs in the development of cardio-metabolic alterations during childhood as well as their utility for the clinical prediction of pubertal obesity outcomes has been barely investigated otherwise. In the present study, we evaluated the utility of an adult BMI predisposing pGRS for the prediction and pharmacological management of obesity in Spanish children, further investigating its implication in the appearance of cardio-metabolic alterations. For that purpose, we counted on genetics data from three well-characterized children populations (composed of 574, 96 and 124 individuals), following both cross-sectional and longitudinal designs, expanding childhood and puberty. As a result, we demonstrated that the pGRS is strongly associated with childhood BMI Z-Score (B = 1.56, SE = 0.27 and p-value = 1.90 × 10−8), and that could be used as a good predictor of obesity longitudinal trajectories during puberty. On the other hand, we showed that the pGRS is not associated with cardio-metabolic comorbidities in children and that certain environmental factors interact with the genetic predisposition to the disease. Finally, according to the results derived from a weight-reduction metformin intervention in children with obesity, we discarded the utility of the pGRS as a pharmacogenetics marker of metformin response ; This research was supported by the Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I + D + I), Instituto de Salud Carlos III-Health Research Funding (FONDOS FEDER) (PI1102042, PI1102059, PI1601301 and PI1600871); by the Spanish Ministry of Health, Social and Equality, General Department for Pharmacy and Health Products (EC10-243, EC10-056, EC10-281 and EC10-227); by the Regional Government of Andalusia ("Plan Andaluz de investigación, desarrollo e innovación (2018), P18-RT-2248") and by the ...