The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.

Purpose: To determine whether patients assigned to primary care nurses who use the nursing process (use of NANDA-I, NIC, and NOC) achieve better intermediate health outcomes than the population assigned to nurses who do not use the nursing process. Methods: This is a retrospective cross-sectional study conducted in 34 primary healthcare centers of Area 11 of the Community of Madrid (Spain) based on electronic health records. Findings: The extension of health care provided was greater in nurses who used the nursing process. Patients assigned to these nurses have better control of their chronic diseases and incur lower drug costs. Conclusions: The use of the nursing process can lead to improved health of populations. Implications: The development of strategies is necessary to ensure greater use of the nursing process among nurses in primary care.

The economic value attributed by users of health services in public health systems can be useful in planning and evaluation. This value can differ from the perspectives of Willingness to Pay (WTP) and Willingness to Accept [Compensation] (WTA).

Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. ClinicalTrials.gov , NCT02757781 . Registered on 25 April 2016.

Background: Health literacy enhances a population’s self-care capacity and helps to reduce health inequalities. This work examines the health literacy of a population attending primary care services and explores its relationship with sociodemographic factors. Methods: This cross-sectional study, conducted at a healthcare center in the Madrid region (Spain), involved adult patients requiring primary care nursing services. One hundred and sixty-six participants were recruited via systematic random sampling. Health literacy was measured using the Health Literacy Questionnaire (HLQ). Results: The studied population showed higher health literacy scores for literacy dimensions 1 (feeling understood and supported by healthcare providers) and 4 (social support for health); the lowest scores were recorded for dimensions 5 (appraisal of health information) and 8 (ability to find good health information). People with a better perceived health status showed a higher level of health literacy. People over 65 years of age, those with an incomplete secondary education, and those who were unemployed returned lower scores for several literacy dimensions. Conclusions: The results contribute to our understanding of the factors that influence health literacy. Identifying the areas in which patients show the poorest health literacy may help us comprehend their needs and better support them.

PURPOSE.  The purpose of this study is to publicize the experience of implementing and developing the nursing process in a sanitary area of primary health care (PHC), and to assess the outcomes reached during the past 9 years. METHODS.  This descriptive longitudinal study was carried out in the 42 PHC centers in the 11th Primary Care Area of Madrid, Spain. FINDINGS.  Between 2001 and 2009, 243,838 new nursing diagnoses were performed. The indicator of resolution capacity ranged from 75% to 80% for the attended problems. CONCLUSIONS.  Nurses in the 11th PHC Area have effectively incorporated the nursing process as a work methodology in their caregiving practices. IMPLICATIONS FOR NURSING PRACTICE.  The nursing process can be used to identify nursing care issues and assess the capacity for resolution. OBJETIVO.  El objetivo de este estudio es dar a conocer la experiencia de implantación y desarrollo del proceso enfermero en un Área Sanitaria de Atención Primaria (AP) y evaluar los resultados alcanzados en los últimos nueve años. MÉTODOS.  Estudio descriptivo longitudinal, realizado en los 42 centros de AP del Área 11 de Madrid (España). RESULTADOS.  Entre 2001 y 2009 se han realizado 243838 diagnósticos de enfermería. El indicador de capacidad de resolución se ha situado entre el 75 y el 80% de los problemas atendidos. CONCLUSIONES.  Las enfermeras de AP del Área 11 han integrado el proceso enfermero como metodología de trabajo en su práctica asistencial. IMPLICACIONES.  El proceso enfermero permite identificar problemas de cuidados y evaluar la capacidad de las enfermeras para su resolución. PALABRAS CLAVE.  Proceso Enfermero, Diagnósticos de Enfermería, Atención Primaria, Investigación en Enfermería, Efectividad.