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Bibliographic Details
Main Author:	José R. Repullo Labrador
Format:	Artículo científico
Language:	es
Published:	Ministerio de Sanidad 2006
Subjects:	Salud Salud pública Políticas públicas Asistencia sanitaria
Online Access:	https://www.redalyc.org/articulo.oa?id=17080506
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Salud pública y sostenibilidad de los sistemas públicos de salud José R. Repullo Labrador Andreu Segura Benedicto Salud Salud pública Políticas públicas Asistencia sanitaria La salud pública y la asistencia sanitaria tienen orígenes históricosdiferenciados, y desde su despliegue moderno han seguido trayectoriasbastante separadas. El gran desarrollo de los sistemas desalud en la segunda mitad del Siglo XX potencia la perspectiva individualy supone una divergencia de las dos orientaciones, a pesar delos intentos de aproximación realizados a partir de la Conferencia deAlma Atá de la OMS. El declive del racionalismo y otros fenómenossociales colaboran a una mayor desatención al enfoque colectivo opoblacional de la Salud Pública; pero estas tendencias crean tambiénun problema creciente de racionalidad en la atención sanitaria individual,y de sostenibilidad a los sistemas públicos de salud. El debatesobre el escenario actual, lleva a enunciar los problemas de sostenibilidadmediados por agentes internos y externos, y a revisar laposible contribución de la Salud Pública a su mejora, propugnandoun nuevo intento de convergencia e integración de ambas perspectivas. 2006 artículo científico 1135-5727 https://www.redalyc.org/articulo.oa?id=17080506 es http://www.redalyc.org/revista.oa?id=170 Revista Española de Salud Pública application/pdf Ministerio de Sanidad Revista Española de Salud Pública (España) Num.5 Vol.80

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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