Autonomous Regions Of Spain Research Articles

Violencia de género en mujeres inmigrantes y españolas: magnitud, respuestas ante el problema y políticas existentes

Objective To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. Methods We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. Results The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61–2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. Conclusions Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women.

Unidades de dolor en España. Encuesta SED Día del Dolor 2007

Objective To determine the real situation of pain units in the hospitals of all the autonomous regions of Spain, Ceuta and Melilla, concerning their staffing, facilities, and the clinical work carried out in 2006. Material and methods We performed an observational cross-sectional study through hand delivery and collection of a questionnaire to the heads or coordinators of pain units. The questionnaires consisted of three sections. The first contained items on the staff working in the units and their hours of work. The second set of items concerned the facilities available and the third concerned the clinical work performed in 2006. Two final items were related to whether the units held clinical sessions or not and the waiting time for consultations. Results Completed questionnaires were received by 95 hospitals. Of these, 94 had a pain unit, while one did not. There were 356 physicians working in pain units: most were anesthesiologists, followed by a much smaller number of neurosurgeons and family physicians. Most staff worked part-time in the units. There were few clinical psychologists, working very few hours. Staffing levels for nurses, auxiliaries and secretaries were acceptable. The results on the available facilities were discouraging. Most units lacked spaces of their own and used the hospital's general consulting rooms and operating rooms. A not inconsiderable percentage was unable to use any operating room. Despite these limitations, substantial clinical work was performed in terms of the number of both first and follow-up consultations. Conclusions Despite the difficulties and lack of resources encountered, pain units perform considerable clinical work and a fair number also carry out teaching and research. National and regional health authorities should take a census, which should then be used to provide all the hospitals in the country with a pain unit suitable to each type of hospital. Level IV pain units should be created in level I and regional hospitals. Some family physicians should receive training in pain in order to improve coordination and provide optimal patient care . Equally, closer links with palliative care units are also desirable, since a not inconsiderable percentage of cancer patients could benefit from such a collaboration. The Comprehensive National Plan for the Treatment of Pain, much heralded by the Ministry of Health, should urgently be implemented, as has occurred with other prevalent disorders.

Prevención secundaria en traumatizados relacionados con alcohol y drogas. Resultados de una encuesta nacional

Objective To determine the degree of activity in the field of secondary prevention of alcohol and/or drug abuse in trauma patients in Spain. Material and methods We surveyed 76 hospitals located in all the autonomous regions of Spain. We collected information about the number of severe trauma patients admitted to the ICU per year, the detection of alcohol and drugs in these patients, and the activity for secondary prevention through motivational intervention among other approaches. Results Of the 76 hospitals surveyed, 66 responded and only one carried out any secondary prevention activity through motivational intervention. Most of the hospitals surveyed (64.5%, 40/62) did not know of the possibility of secondary prevention through motivational intervention and (29%, 18/62) did not have the resources to carry it out. Asked whether they screened trauma patients for drugs and/or alcohol, 15.6% of centers responded “always” 37.5% (24/64) “usually”, and 40.6% only “sometimes”. Conclusion Most centers surveyed are unaware of the usefulness of secondary prevention in trauma patients. This lack of awareness may be responsible for the lack of activity in this field in Spain. A plan to increase awareness, including educational interventions, is necessary to promote secondary prevention of alcohol and drug abuse among trauma patients.

Developments in Retail Trade Regulation in Spain and Their Macroeconomic Implications

The literature points out that retail trade regulations may have a significant impact on prices, employment and productivity. In the case of Spain, the retail trade sector is subject to a rich set of regional regulations. This paper provides a database and a set of indicators on the main restrictions to retail trade in place in Spain's Autonomous Regions (Comunidades Autonomas) between 1997 and 2007. Those restrictions bear on the following regulatory aspects: shopping hours, blue laws, seasonal discounts, definitions of big stores, licensing of discount stores, moratoria in retail trade licence issuing and taxes on big stores. The paper presents then an aggregate indicator constructed on the basis of these restrictions using factor analysis. Finally, this research estimates the effect of the commercial restrictiveness (using the aggregate indicator) among the regions on the commercial density, the number of employees of the sector and the rate of inflation. For that, panel data techniques are applied to the analysis. On the one hand, the results of this research point to an increase in the level of regulation throughout the period. On the other hand the estimates show that an increase in the level of restrictiveness increases commercial density and inflation among the regions but diminishes the number of persons employed in the sector. In either case, the results of this research must be taken with care due to the limitations of the regulation indicator studied and the limited availability of data for the period under study.

The Politics of Adjustment and Coordination at the Regional Level: The Basque Country

Is globalization forcing economies that are not coordinated market economies, such as Spain's, to converge on a British-American model? This essay seeks to build on the hypotheses generated by the literature on varieties of capitalism to analyze the challenges of developing and sustaining coordination while adjusting for economic change. In particular, it seeks to explore ways in which subnational factors promote the ability of socioeconomic actors to develop public-private institutions. By focusing on a particular autonomous region of Spain, the Basque Country, this article explores the role of institutional arrangements at the regional level in determining national adjustment. In the Basque Country the relative power and the particular interests of the regional state have been central factors in promoting distinctive patterns of coordination. At the same time, actors' preferences and policy outcomes have been constrained by the differences in the quality and configuration of institutional frameworks, political deals, and the existing economic structure.

Infección por virus de la inmunodeficiencia humana en inmigrantes en España: características epidemiológicas y presentación clínica en la cohorte CoRIS, 2004–2006

A growing number of immigrants are using the public health services for HIV in Spain. We describe the sociodemographic, epidemiological, and clinical characteristics of a cohort of naïve HIV-infected subjects (CoRIS cohort) according to their place of origin. CoRIS is an open, hospital-based cohort of naïve, HIV-infected persons attended in 19 hospitals from 9 of the 19 autonomous regions in Spain. We describe the characteristics of the cohort members by place of origin, and compare them with the Spanish cases identified from January 2004 to October 2006, using the chi-square and Fisher exact tests. Of 2507 patients, 76.3% were men and median age was 36 years. By origin, 71.5% were Spanish, 16.0% Latin Americans (LA), 5.8% sub-Saharan Africans (SSA), 3.7% Western Europeans (WE), 1.7% Eastern Europeans (EE) and 1.4% North Africans (NA). Compared to Spaniards, there were significant differences by origin in sex, age, and transmission category. Median CD4 count at cohort entry was 352 cell/microL, with no differences according to origin. Median viral load was 48 962 copies/mL and was significantly lower for SSA. Over 11.4 months of follow-up, 57.9% initiated HAART with no differences by origin. Hepatitis C prevalence was 29.9% in Spaniards, 7.3% in Latin Americans, 11.7% in SSA, and 45.7% in EE (P<0.05). Overall, 13.4% were Mantoux-positive (28.6% in SSA and 30.8% in NA). Tuberculosis was more common among cases from EE (9.5%) and SSA (8.3%) compared to Spaniards (4.8%) (P<0.05). Almost one third of naïve HIV-infected patients in CoRIS are foreign-born. Their sociodemographic, epidemiological and clinical characteristics reflect the epidemic in their places of origin. However, their immunological status at cohort entry and initiation of HAART is no different from that of Spaniards.

Mortality in Catalonia in the context of the third, fourth and future phases of the epidemiological transition theory

Abstract In the period 1960-2000, male and female life expectancy in Spain's Autonomous Region of Catalonia increased by 8.2 and 10.5 years, respectively, thus raising it to among one of the highest in the world. Initially, most gains were due to lower infant mortality, but as cardiovascular diseases declined, this later shifted to advanced ages. Between the mid-1980s and early 1990s life expectancy improvements stagnated as the mortality risk from traffic accidents and HIV/AIDS in young adults increased. Both the age-delay in old age mortality and the simultaneous influence of behavior and lifestyle reflect distinct aspects of the fourth stage of the epidemiological transition. This analysis quantifies the age and cause-of-death contributions to changes and sex-differences in life expectancy in Catalonia. We then compare the most recent life table for women with the Duchene-Wunsch limited life table to estimate the potential gain in life expectancy if all deaths were aging-related and in which ages these improvements would fall. 1. Introduction The decline of mortality constitutes one of the basic, perhaps most fundamental, aspects of demographic change in the 20th century. Its history shows a large heterogeneity between countries, with a variety of traditional models that have been defined in function of its timing, intensity, extent, and underlying causes. Catalonia is one of Spain's Autonomous Regions, but with a larger population than for example Denmark, and is an example of the accelerated transition within the western model, as changes were similar but occurred over a shorter period of time (and later). During the last century, male and female life expectancy increased by 40 and 45 years, respectively, during which time Catalonia consistently enjoyed a higher life expectancy than Spain as a whole. While their current levels are among the highest in the world, the impact of HIV/AIDS and an increased number of motor vehicle accidents caused male life expectancy to actually drop in Catalonia during the second half of the 1980s. This did not occur in Spain as a whole, hence the accelerated mortality transition and the influence of behavior and lifestyle on the mortality trends of young adults merit studying Catalonia on its own. The objective of this article is to describe and analyze mortality trends in Catalonia during the last four decades, starting with the beginning of the 1960s. At that time life expectancy at birth was still slightly lower than the average for the 15 Western European countries of the European Union (former EU15): 68.0 vs. 68.3 years for men and 72.8 vs. 73.8 years for women. Analysis is set within the conceptual framework of the epidemiological transition, whereby the evolution of Catalonian survival and mortality patterns is analyzed based on the features that define the last phases of the transition. Our study therefore links up well with similar studies on the evolution of Canadian mortality during the latter half of the 20th century (e.g. Bah and Rajulton 1991; Lussier et al. 2008). In order to attain our objective, life tables have been reconstructed, making it possible to analyze mortality by age and sex. First, the effects of changes in the age- and sex-specific mortality risk on the change in life expectancy over time are quantified. Subsequently, from 1980, causes of death are introduced. This permits a more detailed study of the characteristics of the current pattern of mortality in Catalonia, and can therefore be seen as an extension of recent research by Gomez- Redondo and Boe (2005) on the contributions of age and sex to changes in life expectancy at birth in Spain. The theory of the epidemiological transition, formulated by Omran (1971, 1983), establishes a general framework to describe and interpret the changes in mortality and health patterns during the broad decline of mortality, as well as its determinants and consequences. Until the second half of the 19th century, mortality was still partly subjected to plagues and famines (first phase). …

Introduction

3 Catalan Literature Introduction by Lawrence Venuti How should a reader approach a sampling of a foreign literaturein translation? With what expectations, what ways of reading? Should we allow our previous experiences with a foreign language or culture towell up and saturate our responses, regardless ofwhether those experiences are purely personal (gained through actual or armchair travel) or academic (accumulated through a course of study)? This approach won't be much effectivewith Catalan literature,unfor tunately,since themere word "Catalan" remains unfamiliar tomany anglophone readers. The Catalan language isnotwidely taught inanglophone countries, and too littleof the literature has been translated, most of ittucked away in thebacklists of small and university presses. Should we then allow our immersion inour native language and literatureto influencehow we read a selecti?n of trans lations?This influence seems virtually impossible to avoid, insofar as our knowledge of Catalan contexts is limited and the translations presented here are written in English. What the reader knows of the literary traditions inhis native tongue instantly fills the gaps inhis knowledge of the foreign literature, just tomake sense of the texts. Yet this reaction casts doubt on any notion of impartial reading, any possibility of understanding and judging theCatalan poems and stories in terms that are distinctly Catalan rather than anglophone. And the translated status of the texts is all too likely tovanish, made invis ible by the sheer familiarityof the language. The most promising course may well be to gravitate towardwhat isdifferent in thewriting?different from what we know, from what we usually prefer inworks written originally inEnglish, staving off a too quick dismissal of the foreignor a too quick assimilation to native traditions. The very idea of "sampling" a foreign lit erature should likewise give us pause. How rep resentative can the selection be when defined by exclusions as well as inclusions, when constrained by arbitrary factors like the availability of books and space limitations? Frank O'Hara's poem "The Day Lady Died" (1964) displays a remarkable sophistication and catholicity of taste, embracing themost selectively elite (Hesiod and Verlaine, Strega and Gauloises) as well as the most mun danely popular (theNew YorkPost and jazz, ham burgers and malteds). But when O'Hara mentions buying themagazine New World Writing "to see what thepoets / inGhana are doing these days," he isblithely oblivious of editorial constraints, too ready to readmetonymically, toowilling to take a part of theGhanaian literaryscene forthe whole. O'Hara's cosmopolitanism is resolutely mod ernist, driven by what is attracting attention in his moment, by thenew and the famous (he also mentions Genet, Brendan Behan, Richmond Lat timore). He values an immediacy of response, even iffleeting. Yet shouldn't the reader of any foreign sampling be concerned about why the writers are presented?that is, the editor's selec tion criteria? Shouldn't we consider the crucial mediation of translating? (Would O'Hara have noticed theHesiod ifLattimore hadn't rendered it?)And shouldn't we expect a historical perspec tive, however truncated, so as to grasp the tradi tions fromwhich individual texts emerged and perhaps departed? Catalan: a Romance language currently spo ken by approximately ten million people in an area stretching from Roussillon in south ern France and the country of Andorra, through Catalonia in northeastern Spain to Valencia and Alicante along the eastern Spanish coast, and including the Balearic Islands, principally Ma llorca, Menorca, and Ibiza. Although the language of autonomous regions in Spain, although taught in schools and used inprint and electronicmedia, Catalan occupies a minor position in relation to Castilian, the language of the central government inMadrid, universally known as Spanish. Here theminority is a community whose language is not just spoken by fewer people but carries less political power and cultural prestige than the major language. Every speaker ofCatalan speaks Castilian, but not vice versa. In 2007 Catalonian publishers brought out 8340 new Catalan titles,1742 ofwhich were trans lations (21%). Among the translated languages, Castilian ranks first with 794 books, English sec ond with 499, and French thirdwith 154. Since the year 2000, Catalan translations of English language books have averaged 500 per year. In 2007, DV contrast, British and American publishers togetherbrought out 6 translations fromCatalan in the...

P02-272 The catalan healthcare intercultural mediation training project of “la Caixa” social and cultural outreach projects

Known by many different names-culture broker, community interpreter, medical interpreter, and communication facilitator-the intercultural mediator has as a primary task the facilitation of communication and the therapeutic relationship in the presence of linguistic and/or cultural difference. The Immigration Plan of “la Caixa” Social and Cultural Outreach Projects has undertaken an ambitious project to train all of the cultural mediators in Spain, including both those currently working and those newly entering the field, to meet existing needs. In the first phase of the project, the training was developed in Catalunya, in collaboration with the the Catalan Department of Health, executed by the Psychiatry Department of the Vall d'Hebron University Hospital (Autonomous University of Barcelona) and certified by the Health Studies Institute of the Department of Health. Drawing from the four years experience of the NGO SURT and the Department of Psychiatry of the Vall d'Hebron University Hospital, the program provides 200 hours of theoretical and 1200 hours of practical training. 50 currently employed intercultural mediators and 30 novices are being trained. In subsequent phases the training will be adapted to needs of other autonomous regions of Spain. Modules include medical anthropology, Western biomedicine, community health, linguistic interpretation, cultural competence, professional identity, and ethics. Small group supervision provides a supportive environment to facilitate the application of theory to practice. Finally, high quality training materials were developed specifically for the course. Preliminary evaluations of the project are positive despite some unanticipated complications.

Epidemiology and Costs of Screening and Management of Precancerous Lesions of the Cervix in Spain

Oncogenic human papillomaviruses (HPVs) are essential causes of cervical cancer. Screening prevents cancer by detecting precancerous lesions (cervical intraepithelial neoplasia, CIN). Our aim was to assess the annual number of Pap smears and CIN diagnoses in Spain and to estimate associated management costs. A 1-year retrospective cross-sectional study was conducted among 65 gynecologists from public primary health care centers in 6 autonomous regions in Spain. We documented the total number of Pap smears performed and the management of women with CIN. Data on health care resource use related to CIN management for 2 years after diagnosis were collected and combined with unit costs to assess the mean cost per patient. We extrapolated to the general female Spanish population to estimate the total cost of screening and CIN management from the third-party payer's perspective. In our study sample, 3.5% of routine Pap smears were abnormal. We estimated that 7.6 million Pap smears are performed annually in Spain, at a cost of 622 million euro (US$987). Furthermore, 40,530 women are annually diagnosed with CIN 1, 26,243 with CIN 2, and 28,423 with CIN 3. The mean cost of CIN management per patient was 1,115 euro for CIN 1, 1,626 euro for CIN 2, and 2,090 euro for CIN 3. The total cost of CIN management was estimated at 147 million euro (US$233). This study shows that the costs of screening and management of CIN represent a heavy burden to the public health system in Spain.

A Drug Consumption Room in the Spanish Basque country

A professional interest in substance misuse coupled with a love of the people, culture, and language of Spain led me to investigate Bilbao's Sala de Consumo Supervisado or Drug Consumption Room (DCR) last February. Bilbao, capital of the Spanish Basque Country (Pais Vasco) is Spain's largest port. It flanks the green and winding Rio Nirvion, a back drop of hills on both sides completes the scene. The streets are clean, sunny, and welcoming. The small 16th century shops and bars of the old town (Casco Viejo) buzz with tourist activity. Bilbao, like many European cities has undergone much regeneration in recent years. The spectacular and surreal Guggenheim Museum is its most famous achievement. ‘El Gugg’, as its known to the locals, is a pleasant half hour riverside walk from our hotel in Casco Viejo. In common with many thriving European cities, Bilbao has a darker side. The revitalisation strategies tended to focus mainly on the physical regeneration of the city, while ignoring socioeconomic aspects.1 Social exclusion persists; directly below our walk the riverside arches provide shelter for the city's homeless. Although Pais Vasco is the most prosperous of Spain's autonomous regions, the more disadvantaged neighbourhoods of Bilbao have unemployment levels at around 14%. This is inevitably linked with the related social …

Bayesian Markov switching models for the early detection of influenza epidemics

The early detection of outbreaks of diseases is one of the most challenging objectives of epidemiological surveillance systems. In this paper, a Markov switching model is introduced to determine the epidemic and non-epidemic periods from influenza surveillance data: the process of differenced incidence rates is modelled either with a first-order autoregressive process or with a Gaussian white-noise process depending on whether the system is in an epidemic or in a non-epidemic phase. The transition between phases of the disease is modelled as a Markovian process. Bayesian inference is carried out on the former model to detect influenza epidemics at the very moment of their onset. Moreover, the proposal provides the probability of being in an epidemic state at any given moment. In order to validate the methodology, a comparison of its performance with other alternatives has been made using influenza illness data obtained from the Sanitary Sentinel Network of the Comunitat Valenciana, one of the 17 autonomous regions in Spain.

Amenazas para la salud y crisis sanitarias. Aproximación a la alerta y respuesta. Informe SESPAS 2008

The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The “International Health Regulations (2005)” reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the development of surveillance methods and operational research in public health.

Epidemiology of hip fracture in the elderly in Spain

Objective To describe the incidence and epidemiological characteristics of hip fracture (HF) in patients aged 65 years or over in the various autonomous regions (AR) of Spain from the year 2000 to 2002 and to determine which factors affect in-hospital mortality. Methods Retrospective, observational study including all patients aged > 65 years with acute hip fracture in the 19 AR of Spain from 2000 to 2002. Data were obtained from the National Record of the Minimum Basic Data Set of the Ministry of Health. We analyzed the following: incidence rates (crude and age- and gender-adjusted rates) and incidence of hospital admission by season, length of hospital stay and in-hospital mortality. We used regression analysis to identify the factors that influenced in-hospital mortality. Results There were 107,718 cases of HF in patients aged > 65 years; of these, 74% were women, with a mean age of 79 years (SD 14). The crude incidence rate for HF was 511 cases per 100,000 > 65-year-old patients per year (265 cases per 100,000 men and 688 per 100,000 women and year). Incidence adjusted for age and gender was 503 cases per 100,000 inhabitants per year. Catalonia had the highest age-adjusted incidence and Galicia the lowest (623 and 317 cases per 100,000 inhabitants per year, respectively). Incidence rates increased from spring (24.1%) to winter (25.8%). The mean length of hospital stay was 15 days (SD 13). Seasonal influence and length of stay varied greatly between autonomous regions. While the overall in-hospital mortality rate was 5.3%, the rate for males was double that of females (8.9% and 4.8%, respectively), and in-hospital mortality increased with comorbidity (each point on the Charlson index increased mortality by 34.5%) was higher in winter (11% more risk compared to warmer seasons) and in cold climate regions (15% more risk compared to regions with a warm climate, i.e.: Catalonia, Valencia, Murcia, Andalusia, Balearic Islands and Canary Islands). Conclusions Hip fracture mainly affects elderly women and presents great variability in incidence, seasonality, length of hospital stay and mortality between the different autonomous regions in Spain. Elderly male patients with severe comorbid conditions, who are admitted in winter and in cold climate regions are more at risk of in-hospital mortality.

Prescripción inadecuada de estatinas y factores clínicos asociados

The aim of this study was to determine the percentage of subjects receiving statin treatment that was inappropriate and to evaluate the associated clinical factors. A cross-sectional multi-centred study conducted across the Autonomous Regions of Spain. The appropriateness of prescription was based on the guidelines of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and the European Guidelines on Cardiovascular Disease Prevention. Of the 1,817 patients studied, 52.9% were male, the overall mean age was 59.4 years, 36% had cardiovascular disease and 32.7% had diabetes. In 90.8% of the population the prescription was correct according to at least one of the two guides being used, with a low concordance between them (kappa = 0.279). Almost 100% of subjects with cardiovascular disease or diabetes had an appropriate prescription. In primary prevention, 82.7% had an appropriate prescription according to at least one of the two guides used, but this percentage decreased to 20.7% when based on the European Guidelines. In multivariate analysis, there was agreement with both guides. The inappropriate prescription was directly, and significantly, associated with primary prevention and female gender, while being inversely related to age, smoking habit and LDL-cholesterol concentration. Most of the patients receiving statin treatment have an appropriate prescription, but the percentage of inappropriate prescription increases significantly in patients in primary prevention following European Guidelines.

The Impact of the Madrid Bombing on Personal Emotions, Emotional Atmosphere and Emotional Climate

This article analyzes the personal emotions, emotional atmosphere, and emotional climate in Spain both one week and two months after the terrorist attacks that took place in Madrid on March 11, 2004. It also examines the relationship among these variables and their effect on various behaviors. Participants consisted of 1,807 people from seven autonomous regions in Spain with a mean age of 27.64 years. Personal emotions were significantly affected by degree of Spanish identification. These personal emotions and the general emotional atmosphere were characterized by high levels of sadness, disgust, anger, and contempt, as well as (to a lesser degree) fear. Personal emotions, emotional atmosphere, and the nation's emotional climate improved after two months, although a high degree of sadness persisted in the atmosphere. The emotional climate was relatively independent and stable. Personal emotions had a low but significant capacity for predicting avoidant and altruistic behaviors. Measures of emotional climate added to this ability to predict specific avoidant and altruistic behavior.

Prevalence of Antibodies against Rubella Virus in Spain

The importance acquired by the strategy of anticipating rubella revacunation needs no emphasis1. Recommendations by experts committees and actualization of the prevailing childhood immunization schedules are unanimous when it comes to including the above-mentioned strategy2. In this context, seroepidemiologic survey studies allow the assesment of humoral immunologic response against viral structural antigens3,4 despite the assumed potential bias attached to their design. Being aware of the importance of describing rubella seropositivity real status in our setting we decided to document such situation in children under theoretically proper immunization schedules. The present contribution relies on data from a cross-sectional study carried out between 1999 and 2000 in children from the autonomous region of Spain, Castilla y Leon, (the largest region in the European Economic Community). The chosen framework was restricted to serum samples received in a Microbiology Laboratory of a University Hospital with the request of analyzing infectious markers other than rubella antibodies. According to demographic features a double stratification was made and we evaluated 323 children whose age was between 1 and 5 years and 1166 from 6 to 14 years of age. All samples were alicuoted and frozen (-20oC) until the moment of processing. Antibodies to proteic antigens of rubella viral envelope were determined by means of an indirect enzymeimmunoassay (EIA) (Bio-Whittaker, USA). Results were validated according to manufacturer's instructions and samples that showed a neat absorbance greater the cut-off value plus 15% were considered positive. Our findings reveal that 309 of the investigated samples belonging to children from 1 to 5 years of age (95.7%) had antibodies to rubella virus (95% CI, 93.2% to 98.2%), being the rest of them seronegative at the moment of our study. In the age group ranging from 6 to 14 years the prevalence of antibodies was 90.5% (1055/1166) (95% CI, 88.6% to 92.5%) which resulted lower to that found in the previous group and the difference was statistically significant (p=0.003). This fact reflects a decrease of 5.2% in the seropositivity percentage of the second age group. An additional finding was that when we investigated the 6 to 14 years old group in terms of gender differences, girls (568) reached significantly higher percentages of seroprotection than boys (521) did (94.4 vs 87.1%, p=0.000). Conscious of the caution required in this kind of studies and assuming the internal validity for the evaluated population, our results point out to a age dependent loss of seroprotection. Among the potential causes that maintain this fact we may denote on the one hand the differences in vaccine coverage reached by both groups of children, just as Davidkina et al.5 have recently reported, and on the other hand limitations inherent in the vaccination itself6,7. Moreover, it is of course true that in our country, as well as in all developed countries, systematic vaccination of girls before puberty yields high efficiency, in order to prevent consequences derived from a potential primary infection during pregnancy8,9, all the same it is also certain that we still attend to the presence of small proportions of unprotected persons. The efficiency of new strategies of anticipating combined vaccines needs to be evaluated, and seroepidemiological studies seem to be a good tool for such

Cohorte RIS de pacientes con infección por VIH sin tratamiento antirretroviral previo (CoRIS): metodología y primeros resultados

To describe the methodology and baseline results of the Spanish cohort of naïve HIV-infected patients included in the Research Network on HIV/AIDS (CoRIS). CoRIS is a multicenter, hospital-based prospective cohort of HIV sero-prevalent, retroviral-naïve subjects, over 13 years old, and seen at 17 hospitals in 8 of the 17 Autonomous Regions in Spain from January 2004 to October 2005. The socio-demographic characteristics, as well as epidemiological, clinical, laboratory and treatment data were recorded, and biological samples were collected at baseline and during follow-up. A total of 1,591 subjects have been included in CoRIS; 24% are women, median age at cohort entry is 36 years, and 74% were diagnosed during 2004 or 2005. Twenty-seven percent came from countries other than Spain, mainly Latin-America (16%) and sub-Saharan Africa (5%). Thirty-two percent had completed secondary education and 16% university studies. The most frequent categories of transmission were men having sex with men (37%) and heterosexual sex (36%); only 21% were injection drug users. At cohort entry, median CD4 count was 317 cells/mm 3 and median viral load was 52,300 copies/mL; 18% were diagnosed with AIDS. Main AIDS-defining illnesses were Pneumocystis jiroveci pneumonia (6.1%), esophageal candidiasis (3.3%) and tuberculosis (extrapulmonary, 3.0% and pulmonary 2.7%). There were 35 deaths (2.2%). Thirty-three percent of patients gave a baseline sample to the BioBank. CoRIS offers relevant information about the current epidemiological profile of HIV infection in Spain, where sexual transmission has become predominant. The type and amount of information obtained from clinical and epidemiological data collection together with biological samples demonstrate the viability of the project, which offers many possibilities for future research.

Modelos de financiación pública de las residencias para personas mayores. Análisis comparativo por comunidades autónomas

Introduction this study presents a comparative analysis of models of public financing of rest homes based on the current regulations in the distinct Autonomous Regions in Spain. Material and methods the regulations for rest homes of the various Autonomous Regions were compiled and analysed. To do this, an exhaustive search of databases was performed and a survey was designed. The principal focus of this survey was on the specific legislation relating to the elderly, general data about rest homes, and regulations and quantifiable data about their financing. Information was also obtained from existing publications on this subject. Results the study shows that the intense efforts of the Autonomous Regions on social policies for the elderly and care of the elderly in the last decade have consolidated a model for the public financingof rest homes. This model focuses on 3 areas: investments, the running of rest homes and financial aid for the residents, and criteria that entitle residents to receive financial aid. It also shows the wide variety of proposals and procedures incorporated in the regulations of the Autonomous Regions, giving shape to a series of public financing models with distinct organization and procedures to access services and benefits for the elderly. Discussion the results indicate that residents and their families are the principal source of finance for rest homes. Public financing modelshave focused on guaranteeing the rights of the elderly (especially the rights of those in need of care) to be cared for in rest homes, and on fulfilling the social responsibility of public administrations. All of this is related to prolix regulations on financing the running of rest homes.

Pharma spending on the up in Europe. . .

Pharma spending on the up in Europe. . .