INTRODUCTION: Specialized Health Training is a postgraduate training pathway in which physicians and nurses can choose to continue their learning and obtain the qualification of specialist professional in a specific field. The training is eminently practical with different clinical tracks in which nurses and physicians are tutored by clinician tutors. Our research aims to describe the experiences and perceptions of clinician tutors related to their own teaching performance and training needs. METHODS: We conducted a descriptive qualitative study. The sample consisted of active clinician tutors of specialized health training of family and community nursing and medicine, this being the main inclusion criterion, regardless of the number of years of experience as a tutor. Data were analyzed following a content analysis method. RESULTS: Four focus groups were held with 25 participants: 32% nursing tutors (8) and 68% tutors of medicine (17). The main categories identified were: (1) teaching performance; (2) training needs; and (3) characteristics of an ideal training program. The sample consisted of a majority of tutors of medicine compared to nursing. CONCLUSION: Clinician tutors of Specialized Health Training of Family and Community nursing and medicine express the need to acquire pedagogical tools, to develop communication skills and to create a tutor network in order to improve their mentorship practice. Furthermore, more institutional recognition and protected time are also highlighted as important elements for their mentorship role. The findings of our research can serve as a guideline to start designing a training plan that meets the real needs of clinician tutors.

ObjectiveThe LungFlag risk prediction model uses individualized clinical variables to identify individuals at high-risk of non-small cell lung cancer (NSCLC) for screening with low-dose computed tomography (LDCT). This study evaluates the cost-effectiveness of LungFlag implementation in the Spanish setting for the identification of individuals at high-risk of NSCLC.MethodsA model combining a decision-tree with a Markov model was adapted to the Spanish setting to calculate health outcomes and costs over a lifetime horizon, comparing two hypothetical scenarios: screening with LungFlag versus non-screening, and screening with LungFlag versus screening the entire population meeting 2013 US Preventive Services Task Force (USPSTF) criteria. Model inputs were obtained from the literature and the clinical practice of a multidisciplinary expert panel. Only direct costs (of 2023), obtained from local sources, were considered. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of our results.ResultsA cohort of 3,835,128 individuals meeting 2013 USPSTF criteria would require 2,147,672 LDCTs scans. However, using LungFlag would only require 232,120 LDCTs scans. Cost-effectiveness results showed that LungFlag was dominant versus non-screening scenario, and outperformed the scenario where the entire population were screened since the observed loss of effectiveness (-224,031 life years [LYs] and -97,612 quality-adjusted life years [QALYs]) was largely offset by the significant cost savings provided (7,053 million). The resulting incremental cost-effectiveness ratio (ICER) for this strategy of screening the whole population versus using LungFlag was 72,000/QALY, showing that LungFlag is cost-effective. Various were described, such as the source of the efficacy or adherence rates, and other limitations inherent to cost-effectiveness analyses.ConclusionsUsing LungFlag for the selection of high-risk individuals for NSCLC screening in Spain would be a cost-effective strategy over screening the entire population meeting USPSTF 2013 criteria and is dominant over non-screening.

BACKGROUND: The relative efficacy of information provision versus financial incentives in improving primary care quality remains a critical, unresolved question. We investigated these two strategies in Catalonia’s public primary care system from 2010 to 2019: an innovative online platform providing real-time quality indicator information and targeted economic incentives for achieving indicator goals. METHODS: We conducted a comprehensive interrupted time series regression analysis on data from 272 primary care practices (5,628,080 patients). This analysis used linear regression models with Newey-West standard errors, and a sensitivity analysis including logit transformations to address ceiling effects. We evaluated 1) immediate post-intervention changes (step changes) in indicator results and inter-practice variability (coefficient of variation, CV), and 2) shifts in pre-intervention trends (slopes). We scrutinized 39 indicators after rigorous quality control: 23 novel (12 informed, 11 incentivized) and 16 derived from existing incentivized indicators. Robustness checks included 14 consistently incentivized and 10 non-intervened indicators. Overall, we assessed 63 indicators: 18 control, 13 follow-up, 9 quaternary prevention, 7 treatment, 7 diagnosis, 6 screening and 3 vaccination indicators. FINDINGS: Informed indicators showed positive impacts in 75% (9/12) of cases, and incentivized indicators in 64% (7/11) of cases. Incentivized indicators displayed improvements in annual trends ranging from 6.66 to 1.25 percentage points, with step changes up to 8.87 percentage points. Information led to step changes ranging from 19.67 to 1.07 percentage points, along with trend improvements between 1.09 and 0.34 percentage points annually. Both interventions were associated with step reductions in variability (up to -0.18 CV reduction) and significant trend improvements. Derived indicators showed limited improvements in results or variability (31%, 5/16), with minor step increases up to 2.22 percentage points. INTERPRETATION: Our findings reveal that information provision alone can match or even surpass the impact of financial incentives in improving care quality and reducing practice variability. This challenges conventional wisdom and offers a cost-effective, scalable approach to primary care quality enhancement, with far-reaching implications for global health policy. FUNDING: European Union, Horizon Europe.

Objectives: Assess the prevalence of physical inactivity and risk of sarcopenia in primary care patients and their companions. Design: Cross-sectional study. We carried out an anonymous survey of primary care users (patients and companions) in primary care consultations and stands coinciding with a community health activity for World Physical Activity Day. Site: Five primary care centers (CAPs) of the South Metropolitan health region: in Cornell & agrave; de Llobregat (CAP Jaume Soler), in l’Hospitalet de Llobregat (CAP Florida Nord, CAP Florida Sud and CAP Bellvitge) and in Viladecans (CAP Maria Bernades) between 27 March to April 6, 2023 (coinciding with World Physical Activity Day). Participants: Primary care population consists of patients and their companions over 18 years of age. Interventions: The health workers administered questionnaires to users and companions. Main measurements: We evaluated physical inactivity with the BPAAT questionnaire, risk of sarcopenia with SARC-F screening test, sex and age range. We performed an univariate descriptive analysis to report prevalence. Results: Nine hundred ninety-eight participants were surveyed. Physical inactivity was present in 38.9% of the participants. Among those over 50 years (665 participants), 15.4% were at risk of sarcopenia (9.58% men, 19.2% women). Conclusions: The prevalence of physical inactivity and risk of sarcopenia (in individuals over 50 years old) in the studied population is high. Women have greater physical inactivity and a greater risk of sarcopenia than men. (c) 2024 The Authors. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Cancer is one of the main causes of morbidity and mortality. Environmental factors along with lifestyle: tobacco and alcohol consumption, unhealthy diet and sedentary lifestyle and lack of physical activity, are some of the risk factors that have caused an increase in cancer. This article updates the evidence and recommendations for cancer prevention strategies through screening in asymptomatic patients, as well as early detection of signs and symptoms in medium-risk and high-risk populations. (c) 2024The Author(s).Published by Elsevier Espana,S.L.U. This is an open access article under the CCBY-NC-ND license