ORCID Profile
0000-0003-3378-5038
Current Organisations
University of Cadiz
,
University of Sevilla
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Nanomaterials | Nanotechnology | Composite and hybrid materials
Publisher: Cambridge University Press (CUP)
Date: 17-10-2018
DOI: 10.1017/S2045796018000574
Abstract: Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services. The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system. In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas. The functional distinction between core health and other care overcomes the traditional ision between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
Publisher: JMIR Publications Inc.
Date: 10-10-2020
Abstract: ESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in Andalucia, Spain. he aim of this study was to evaluate the maturity of DESDE-AND. A secondary objective of this study is to show the practicality of a new combined set of standard evaluation tools for measuring the maturity of health technology products. system for semiautomated coding of service provision has been co-designed. A panel of 23 domain experts and a group of 68 end users participated in its maturity assessment that included its technology readiness level (TRL), usability, validity, adoption (Adoption Impact Ladder [AIL]), and overall degree of maturity [implementation maturity model [IMM]). We piloted the prototype in an urban environment (Seville, Spain). he prototype was demonstrated in an operational environment (TRL 7). Sixty-eight different care services were coded, generating fact sheets for each service and its geolocation map. The observed agreement was 90%, with moderate reliability. The tool was partially adopted by the regional government of Andalucia (Spain), reaching a level 5 in adoption (AIL) and a level 4 in maturity (IMM) and is ready for full implementation. ESDE-AND is a usable and manageable system for coding and compiling service directories and it can be used as a core module of decision support systems to guide planning in complex cross-sectoral areas such as combined social and health care.
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00916.X
Abstract: Mental health research has made significant progress in international comparison and instrument development. This study reports the adaptation of the European Service Mapping Schedule (ESMS) to the assessment of services for persons with disabilities. Qualitative groups were used to develop the Description and Evaluation of Services for Disabilities in Europe (DESDE). The psychometric analysis of DESDE covered: feasibility, inter-rater reliability, descriptive validity and internal validity. A demonstration study was also carried out. Compared to the original ESMS, a new main branch and several sub-branches were added. We identified 826 services for persons with disabilities, which provided 1284 main types of care. The feasibility and reliability was good for the majority of codes. Only 6% of services were not properly classified. The Boolean factor analysis supported the internal validity of DESDE. DESDE is a useful and reliable instrument for the assessment of services for persons with disabilities.
Publisher: Elsevier BV
Date: 11-2020
DOI: 10.1016/J.GACETA.2019.01.001
Abstract: To evaluate the impact of the Plan for the promotion of personal autonomy and prevention of disability in Andalusia (2016-2020) in 13 public administrations during the first year of its implementation and to analyse the usability and feasibility of the impact assessment ladder used. The Plan addresses the promotion of personal autonomy and the prevention of disabilities and dependencies through a multisectoral approach. It is structured in strands or lines of work, objectives and actions that have been assessed through the Adoption Impact Ladder (AIL). The analysis of the face validity, feasibility and inter-rater reliability of the impact assessment ladder was carried out in 30 actions of the Plan that were rated by 20 experts from the 13 ministries and public agencies involved in the Plan, and an external rater. 176 actions and programmes were launched in 2017. Of these, 67.2% were implemented during the first year. Only one of the 16 objectives had no action initiated during the first year. Moreover, 7 out of 15 objectives implemented were fully multisectoral involving more than three Regional Ministries. The face validity, feasibility and inter-rater reliability of the AIL were good (κ: 0.72). This Plan has provided a novel framework to coordinate a broad range of proposed policies and actions within the public administration of Andalusia. For the first time, a multisectoral impact analysis has been conducted providing an effective guide for monitoring, planning and setting public priorities in health, social services, ageing and disabilities.
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00915.X
Abstract: The objective is to describe and characterize patterns of service use by out-patients with schizophrenia in Spain. A representative treated prevalence s le of cases with schizophrenia was selected from four Spanish health areas. The evaluation included health service use, clinical severity, functioning and disability. Statistical analysis was based on hierarchical clustering methods. A total of 356 patients were included in the analysis. Five patterns of health service use were defined: heavy out-patient mental health users mental health and general health service users heavy hospital service users nursing service users low users of mental health services. Patients in each group showed differences in clinical and disability status. Patterns of health service use showed consistency, but also variability, among the geographical areas. Development and organization of mental health services should take into account the combinations of services patients most frequently use.
Publisher: Cambridge University Press (CUP)
Date: 18-09-2017
DOI: 10.1017/S2045796017000415
Abstract: There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services h er like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project. A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, ersity and capacity were compared across these eight local MHS. The comparison of MHS revealed more community-oriented delivery systems in the areas of England (H shire) and Southern European countries (Verona – Italy and Girona – Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care. There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.
Publisher: Wiley
Date: 02-03-2022
DOI: 10.1111/ACPS.13417
Abstract: We report the psychometric properties of the Patient‐Reported Impact of Symptoms in Schizophrenia Scale (PRISS), which assesses the impact of subjective experiences or qualia in outpatients with this condition. A cross‐sectional study was carried out in 162 patients diagnosed with schizophrenia in Spain. The PRISS measures the presence, frequency, concern and interference with daily life of self‐reported experiences related to the main symptoms observed in these patients. The psychometric analysis included test‐retest reliability, internal consistency and structural and convergent validity. The 28‐item PRISS showed good test‐retest reliability as 64.3% of the intraclass correlation coefficient values were between 0.40 and 0.79, which were statistically significant ( p 0.01). Analysis of the structural validity revealed a three‐factor structure, (1) productive subjective experiences, (2) affective‐negative subjective experiences and (3) excitation, which accounted for 56.11% of the variance. Of the Pearson's correlation coefficients analysed between the PRISS and the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS) and World Health Organization Disability Assessment Schedule (WHO‐DAS), 72.2% were statistically significant ( p 0.05) and ranged from 0.38–0.42, 0.32–0.42 and 0.40–0.42, respectively. Our results indicate that the PRISS appears to be a brief, reliable and valid scale to measure subjective experiences in schizophrenia and provides valuable information complementary to clinical evaluation.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.JAD.2016.04.024
Abstract: Previous research identified high/low clusters of prevalence of outpatient-treated depression at municipal level in Catalonia (Spain). This study aims to analyse potential risk factors, both socioeconomic and related to the mental health service planning, which could influence the occurrence of hot/cold spots of depressed outpatients at two geographical levels: municipalities and service catchment areas. Hot/cold spots were examined in relation to socioeconomic indicators at municipal level, such as population density, unemployment, university education, personal income, and also those related to service planning at catchment area level, such as adequacy of healthcare, urbanicity, accessibility and the availability of mental health community centres. The analysis has been carried out through multilevel logistic regression models in order to consider the two different scales. Hot spots are related to high population density, unemployment, urbanicity, the adequacy of provision of mental health services, and accessibility to mental health community centres at both study levels. On the other hand, the multilevel model weakly explains cold spots, associating them with high personal incomes. The dependent variables of the multi-level models are binary. This limits the interpretation of the results, since they cannot provide information about the variance of the dependent variables explained by the models. The results described erse risk factors at two levels which are related to a high likelihood of hot and cold spots of depression. The findings show the relevance of health planning in the distribution of diseases and the utilisation of healthcare services.
Publisher: JMIR Publications Inc.
Date: 05-10-2023
DOI: 10.2196/51096
Publisher: Springer International Publishing
Date: 2014
Publisher: JMIR Publications Inc.
Date: 24-07-2023
Abstract: hildren's mental health is a public health priority. In Europe, 1 child in 5 under the age of 12 suffers from a behavioral, developmental or psychological disorder. Mental Health Literacy (MHL) is a modifiable determinant of mental health. The “Child Focused Mental Health Literacy Model” describes the six dimensions of MHL in children: (1) understanding of mental health and recognition of its fluctuations (2) help-seeking actions (3) supports available (4) influences on mental health (5) coping and resilience and (6) stigma. Very few interventions exist to promote MHL in children. Moreover, these interventions have not been evaluated using a rigorous design. Indeed, a validated scale measuring children’s MHL does not exist. his study has the dual objective of (1) co-creating and evaluating an intervention on children's MHL and (2) developing and validating a scale that measures children's MHL. e study he population of children 8-11-year old in primary school classes in urban and rural areas, private and public, in priority education areas. Through a participatory research approach, we will organize several meetings and focus groups with members of the project teams, children, parents, teachers, and two artists. We will co-create a program composed of several objects (educational kit, videos, etc.). In parallel, the artists will draw with children the items of a first version of the scale. The program will be evaluated in 5 classes by observations, interviews and satisfaction questionnaires with the aim of testing its viability. The scale will be administered to 300 children and psychometric analyzes will be carried out to validate the scale. A cluster randomized controlled trial will be conducted in a minimum of 20 classes to evaluate the program. As the primary endpoint, we will use the score of the CHILD-MHL scale. Additional interviews will complete the mixed-methods evaluation. he first part of the intervention is the pedagogical kit Le Jardin du Dedans®. We also have a handbook which is addressed to teachers in order to sensitize them to children’s mental health problems. In a supplementary leaflet of 5 pages, children acquaint with the notion of MHL. Finally, 56 items of the MHL scales as well as the list of existing education policies for children’s mental health have been already identified. he intervention could be extended to several schools in France and elsewhere. The participation of foreign partners will provide the possibility of translating the intervention. The scale will be the first in the world to measure children's MHL. It will be used to evaluate interventions, but also to provide data for decision-makers for including MHL in all educational policies.
Publisher: JMIR Publications Inc.
Date: 15-03-2021
DOI: 10.2196/24930
Abstract: DESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in Andalucia, Spain. The aim of this study was to evaluate the maturity of DESDE-AND. A secondary objective of this study is to show the practicality of a new combined set of standard evaluation tools for measuring the maturity of health technology products. A system for semiautomated coding of service provision has been co-designed. A panel of 23 domain experts and a group of 68 end users participated in its maturity assessment that included its technology readiness level (TRL), usability, validity, adoption (Adoption Impact Ladder [AIL]), and overall degree of maturity [implementation maturity model [IMM]). We piloted the prototype in an urban environment (Seville, Spain). The prototype was demonstrated in an operational environment (TRL 7). Sixty-eight different care services were coded, generating fact sheets for each service and its geolocation map. The observed agreement was 90%, with moderate reliability. The tool was partially adopted by the regional government of Andalucia (Spain), reaching a level 5 in adoption (AIL) and a level 4 in maturity (IMM) and is ready for full implementation. DESDE-AND is a usable and manageable system for coding and compiling service directories and it can be used as a core module of decision support systems to guide planning in complex cross-sectoral areas such as combined social and health care.
Start Date: 2023
End Date: 12-2025
Amount: $431,318.00
Funder: Australian Research Council
View Funded Activity