National Level In Spain Research Articles

Assessment, Treatment, and Follow-Up of Phlebitis Related to Peripheral Venous Catheterisation: A Delphi Study in Spain

Background: Phlebitis related to peripheral venous catheters (PVCs) is a common complication in patients who require these devices and can have important consequences for the patients and the healthcare system. The management and control of the PVC-associated complications is related to nursing competency. The present study aims to determine, at the national level in Spain, the consensus on the assessment, treatment, and follow-up of PVC-related phlebitis and the importance of the actions taken. Method: A three-round Delphi technique was used with clinical care nurses who are experts in the field of in-hospital intravenous treatment in Spain. For this, an online questionnaire was developed with three open-ended questions on the dimensions of phlebitis assessment, treatment, and follow-up. For the statistical analysis of the results, frequencies and percentages were used to determine consensus, and the measures of central tendency (mean, standard deviation, and the coefficient of variation) were used to rank importance. The coefficient of variation was set as acceptable at ≤30%. Results: The final sample was 27 expert nurses. At the conclusion of round 3, actions were ranked according to their importance, with six items included in the PVC-related phlebitis assessment (symptomatology/observation, redness, the Maddox scale, induration, temperature, and pain), two in treatment (catheter removal, pentosan polysulphate sodium ointment + application of cold), and just one in follow-up (general monitoring + temperature control). Conclusions: There is a major disparity in relation to the PVC-related phlebitis assessment, treatment, and follow-up actions. More clinical studies are therefore needed to minimise the complications associated with the use of PVCs, given their impact on the quality of care and patient safety and their economic cost.

Identification and comparison of the main variables affecting early university dropout rates according to knowledge area and institution

The dropout rate in universities is a widely studied issue that concerns both universities and public organizations. Most studies focus on quantifying the phenomenon and identifying the variables involved. This paper uses a multidisciplinary approach to parameterize the factors that define the entry profile of undergraduates at the national level in Spain in collaboration with three universities in different regions and with different disciplines. The aim is to reduce the dropout rate in the first year of study towards a degree. The research questions focus on the weighting of personal variables about students by tutors and whether there are differences in the weighting systems for the main variables as differentiated by discipline, university and/or region. The document is organized to describe the method and context of the study, present the main results, show the application of the survey instrument in a case study, and provide conclusions. The method is based on the two fundamental factors, including the influence of certain student characteristics at matriculation and the importance of a positive experience in the first year of the degree. The study is focused on two elements that inspire the current proposal: the need to identify and rapidly detect students who, due to their entry characteristics, are at a greater risk of dropout and the importance of guaranteeing a good start in the first year of the degree. The study uses a multidisciplinary approach and combines qualitative and quantitative methods to gather data. The study also uses a survey instrument that measures the risk of student dropout based on the weighting of personal variables by tutors. The results of the study have allowed us to categorize the main variables of the student profile that affect the risk of dropout and establish them as aspects to be monitored by the tutors in the first weeks. Furthermore, it has been shown that although there are no significant differences in the averages of dropout risk calculated with either global or specific weighting systems (by centre or studies), there is a tendency observed by the tutors that the weighted averages generated by disciplinary focus are closer to identifying the student's real risk of dropping out.

Implementation of dual vocational education and training in Spain: the case of the Basque Country

ABSTRACT School-based vocational education and training (VET) systems are undergoing important changes with a view to strengthening their work-based learning component and, overall, their relationships with the local production environment. This paper looks at the introduction of dual VET in the Basque Country within the Spanish and European contexts. Based on an analysis of existing official information and literature as well as qualitative research carried out by the authors, the distinctive characteristics of the Basque system are documented and studied. It is shown that there has been a continuity in the ideas and relationships which have configured its trajectory from the early 1980s onwards, and that new instruments and elements of the system have been developed in the region even before those elements were fully formalised at national level in Spain.

Nurses’ perception on competency requirement and training demand for intensive care nurses

ObjectivesVarious authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units (ICUs). Nurses’ perception of training is an element that must be studied in order to adopt appropriate educational measures. This study aimed to evaluate nurses’ perception of the importance of intensive care training in Spain. MethodsA descriptive, cross-sectional, multicentre study was conducted on a national level in Spain. Totally 85 ICUs took part in the study. The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’ perception on competency requirements and training needs. The evaluation was conducted by a 10-point Likert scale. ResultsThe sample was 568 Spanish nurses. Significant differences were found on an academic level, in terms of gender and hospital type, and in the professional experience of the nurse when it comes to evaluating the different training items; the differences in overall questionnaire scores among these groups were statistically significant (P < 0.05). The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU. ConclusionImplementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system. Nurses benefited from training focused on the skills and knowledge of each moment of their working life. Nurses have a different evaluation of their training needs throughout their professional cycle. Therefore, their training must be adapted to the professional stage of each nurse.

Can unemployment forecasts based on Google Trends help government design better policies? An investigation based on Spain and Portugal

The Covid-19 pandemic has increased the unemployment issue and accelerated the digital transformation. Real-time data specific to ongoing revolution in applied economic analysis are increasingly demanded to anticipate changes in unemployment to improve decision-making. The aim of this paper is to test whether unemployment rate forecasts based on Google Trends data improve the predictions based only on macroeconomic indicators published with a longer time lag. The research has been carried out at the national level for Spain and Portugal, and the main novelty is the analysis of unemployment rate forecasts at the regional level for Spain using dynamic panel data models to implement the best policies to reduce unemployment. The keywords unemployment and job offers have been used in each language. The results obtained demonstrate the capacity of Google Trends data associated with unemployment to improve the predictions of unemployment rates in Spanish regions. Moreover, predictions based on Google Trends data at national level in Spain and Portugal are significantly more accurate than those based on autoregressive models for both countries.

Litigability and defensibility in neurology and neurosurgery. A “therapeutic” model for handling claims for malpractice care

Despite its indisputable importance, there are not many official data on claims for malpractice at the national level in Spain, mainly due to transfers from Health to the Autonomous Communities. This lack of unified information, together with other variables related to modern Healthcare Medicine (type of healthcare system, ethical aspects, consent, patients' rights, new technologies, etc.), complicates the healthcare professional's response to claims, and could not guarantee adequate protection of this against possible liability.This article analyzes the current situation in Spain and emphasizes aspects such as defensibility and liability in malpractice claims, taking as a model the Neurosurgery Specialty, one of the most prone to this type of situation.Prevention and action guidelines are offered, through a model aimed at reinforcing defensibility and reducing liability. This approach, which we call a “therapeutic model”, considers the problem analogously to a disease, providing the basis for its prevention and management.We believe that this approach can be useful both to the Neurosurgeon and to any healthcare provider at a time, such as today, when there is some confusion on these issues and some reluctance of insurance companies to provide coverage in some cases.

Perception survey on the relevance of main categories of health determinants for conducting health impact assessment

Addressing the characterization of social and economic determinants of health (SDH) properly is a key aspect in conducting a Health Impact Assessment (HIA). This article explores the level of knowledge on HIA environmental and public health professionals have as well as their perception regarding key concepts such as the definition of ‘health’ and the relevance of SDH. With this purpose in mind, a survey was conducted among experts (n = 41) who attended a technical session on HIA within the framework of the most important conference on the Environment on a national level in Spain. A hierarchical cluster analysis was conducted to categorize groups of respondents depending on their working profile and professional expertise and a Friedman test was used to compare mean ranks so as to assess the importance given to SDH according to the target respondents' perception. Strong differences were found in the relevance given to diverse SDH according to their contribution to a good state of health, the block referring to ‘Habits and lifestyle’ being the one perceived as more significant. SDH were ranked in a diverging order from that reported in the scientific evidence regarding the association between SDH and a wide range of health outcomes. Also, some diverging trends were illustrated between groups of respondents according to the relevance given to each block of SDH. However, differences in responses between groups of respondents were not statistically significant. A self-appraisal by respondents also revealed that the practitioner's level of knowledge on HIA ranged between low to medium. Therefore, it is recommended to improve their capacity.

Non-Typhi, non-Paratyphi Salmonella-related hospitalisations in Spain: trends, clinical aspects, risk factors for worse prognosis and hospital costs.

This study reviews non-typhoid Salmonella (NTS)-related hospitalisations at National level in Spain between 2010 and 2015. NTS hospitalisations were obtained from the National Registry of Hospitalisations. A descriptive analysis of the hospitalisations was performed, including hospitalisation rates (HR) and case-fatality rates (CFR%) calculation. For those with NTS as Main Diagnosis logistic regression were used to estimate the relationship between the different factors and death outcome. 21,660 registered NTS-related hospitalisations were described (88.8% with Salmonella coded as Main Diagnosis). Average HR2010-2015 was 7.7 (range, 7.3 to 8.1) hospitalisations/100,000 population. Those with NTS infections as Secondary Diagnosis were on average (p < 0.001) older (47.9 vs. 36.5years), presented worse Charlson Comorbidity Index (2.1 vs. 1.2), higher CFR% (4.8% vs. 0.7%), spent more days hospitalised (15.1 vs. 5.8days), and generated more costs (6173 vs. 4272 euros/per hospitalisation) than those with NTS as Main Diagnosis. For those with NTS as Main Diagnosis increased risk of death was related to being > 64years old (OR= 20.99; p < 0.001); presenting septicaemia (OR= 15.82; p < 0.001) or localised infections (OR= 3.98; p = 0.061); Charlson Comorbidity Index > 3 (OR= 4.57; p < 0.001); a non-HIV co-infection (OR= 1.80; p = 0.013); other risk factors (OR= 5.70; p < 0.001); bowel perforation (OR= 70.30; p < 0.001); or acute renal failure (OR= 1.95; p = 0.001). In those with Salmonella as Main Diagnosis, among all complications, bowel perforation presented the strongest association with death outcome. Clinical practice guidelines can help to identify patients at risk of bowel perforation to reduce the fatality of the disease.

Pediatric Catheter Ablation: Characteristics and Results of a Series in a Tertiary Referral Hospital

Introduction and objectivesCatheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. MethodsRetrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure. ResultsA total of 291 procedures in 224 patients were included. Median age was 12.2 years, 60% male. Overall, 46% patients were referred from other autonomous communities. The most frequent substrates were accessory pathways (AP) (70.2%,>50% septal AP localization) and atrioventricular nodal reentrant tachycardia (AVNRT) (15.8%). Congenital and acquired heart disease was frequent (16.8%). Cryoablation was used in 35.5% of the cases. Overall acute success of the primary procedure was 93.5% (AP 93.8%; AVNRT 100%). Redo procedures after recurrence were performed in 18.9% of all substrates, with a long-term cumulative efficacy of 98.4% (AP 99.3%; AVNRT 100%). One (0.37%) serious complication occurred, a case of complete atrioventricular block. ConclusionsOur study replicated previous international reports of high success rates with scarce complications in a high complexity series, confirming the safety and efficacy of pediatric catheter ablation in our environment performed at highly experienced referral centers.

Ablación pediátrica con catéter: características y resultados del procedimiento en un centro terciario de referencia

Introduction and objectivesCatheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. MethodsRetrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure. ResultsA total of 291 procedures in 224 patients were included. Median age was 12.2 years, 60% male. Overall, 46% patients were referred from other autonomous communities. The most frequent substrates were accessory pathways (AP) (70.2%,>50% septal AP localization) and atrioventricular nodal reentrant tachycardia (AVNRT) (15.8%). Congenital and acquired heart disease was frequent (16.8%). Cryoablation was used in 35.5% of the cases. Overall acute success of the primary procedure was 93.5% (AP 93.8%; AVNRT 100%). Redo procedures after recurrence were performed in 18.9% of all substrates, with a long-term cumulative efficacy of 98.4% (AP 99.3%; AVNRT 100%). One (0.37%) serious complication occurred, a case of complete atrioventricular block. ConclusionsOur study replicated previous international reports of high success rates with scarce complications in a high complexity series, confirming the safety and efficacy of pediatric catheter ablation in our environment performed at highly experienced referral centers.Full English text available from:www.revespcardiol.org/en

Climate change policy and water resources in the EU and Spain. A closer look into the Water Framework Directive

Climate change effects are becoming evident worldwide, with serious regional and local impacts. The European Union (EU) has launched and developed initiatives and policies that scratch the surface of water resources impacts. This article presents an introduction of the existing environmental policy and more concisely in the areas of climate change and the interactions with water resources. It also addresses main management tools, and plans linked to policies, recent updates on the Science–Policy Interface, highlighting major results from research and development projects. Establishing appropriate policies to tackle climate change impacts on water is essential given the cross-sectorial and flowing nature and the importance of water in all environmental, social and economic sectors. There are still some pending reviews and updates in the current EU policy and its implementation, as well as at the national level in Spain. This article identifies existing gaps, and provides recommendations on how and where reforms could take place and be applied by decision makers in the water policy sector.

How is Desertification Research Addressed in Spain? Land Versus Soil Approaches

AbstractThis study intends to understand how desertification research is organised in Spain. We assume that a strong communication between scientific knowledge and stakeholders is needed to slow down and reverse the impacts of land degradation on drylands. With this purpose, we conducted an in‐depth study at a national level in Spain. The work focused on a sample of published references on desertification in scientific journals indexed in the Web of Science (WoS). The keywords were related to ‘desertification’, ‘drylands’, ‘land’, ‘soil’, ‘development’ and ‘Spain’. Multivariate analysis, bibliometric techniques and network analysis were used in order to (i) identify research categories and their temporal evolution throughout the period under consideration (1989–2012), (ii) determine if there were different approaches amongst different regions affected by desertification in Spain, (iii) establish the relationships between research categories, (iv) characterise types of co‐authorship and (v) map out the Spanish network on the science of desertification. Erosion‐soil degradation and soil analysis are the most important research categories, whereas climatic issues are subsidiary and quite isolated from the rest of topics. Very few articles consider ‘desertification’ as the main theme. Socio‐economic issues have scant links with the core of biophysical science. The Spanish network on the science of desertification shows a low density. Moreover, the relationships between universities/research centres with other stakeholders are marginal. This is not the best scenario for transforming scientific knowledge into practical tools for policy makers and land users. Knowledge transfer should be a priority for national desertification programmes. Copyright © 2014 John Wiley &amp; Sons, Ltd.

Economic crisis and strengthening of the regulatory powers of the Executive

El contexto de crisis económica se ha traducido en las fuentes del Derecho en un reforzamiento de los poderes normativos de los Ejecutivos en detrimento de la ley parlamentaria. En España, a nivel nacional prolifera la regulación por decreto-ley, que se transforma después en proyecto de ley a tramitar por el procedimiento de urgencia. Y es que la urgencia se ha impuesto en la adopción de medidas normativas. Esto mismo se aprecia también en el ámbito de las Comunidades Autónomas, donde una de las novedades del último proceso de reformas estatutarias ha sido la incorporación de los decretos-leyes autonómicos (de momento presentes en ocho de las diecisiete Comunidades Autónomas). El objeto es el análisis, es poner manifiesto la dilatación del uso expansivo del decreto-ley, tanto a nivel nacional como autonómico, y apuntar los principales problemas que de esto se derivan

Conceptions of ability and self-determined motivation in young Spanish athletes

This investigation examined the relationship between implicit ability beliefs and self-determined motivation. The sample was comprised of 775 young athletes between the ages of 12 and 17 competing at national level in Spain. The participants completed the Spanish version of the Conceptions of the Nature of Athletic Ability Questionnaire (CNAAQ-2) and the Sport Motivation Scale (SMS). The results revealed a positive and significant correlation between stable ability beliefs and learning ability, and between self-determined motivation and perceived sports ability. To the contrary, stable entity beliefs were negatively correlated with self-determined motivation. Competitiveness in sports was significantly predicted by self-determined motivation, and the latter, in its turn, was positively predicted by learning belief and negatively by stable entity beliefs.

Stillbirth risk by maternal socio-economic status and country of origin: a population-based observational study in Spain, 2007–08

Socio-economic differences are a major determinant of perinatal outcomes. The impact of low socio-economic status on the risk of stillbirth, and the association between socio-economic status and stillbirth by maternal country of origin at a national level in Spain are unknown. We aimed to analyse the effect of maternal socio-economic status on the risk of stillbirth by maternal country of origin in Spain for the years 2007 and 2008. We designed a population-based observational study that included 970,740 live births and 2464 stillbirths from 2007 to 2008. Univariate risk ratios (RRs) of stillbirth were calculated by maternal education, country of origin, age, parity, and gestational age. Adjusted stillbirth RRs were calculated using a generalized linear model with the Poisson family. Then, adjusted attributable risks and aetiological fractions in the population were calculated as measures of impact. Stillbirth rate ranged from 1.0 to 4.7 deaths per 1000 births. The stillbirth risk among mothers having secondary or lower education was double than that of mothers with a tertiary education with an adjusted RR of 2.13 [95% confidence interval (CI): 1.74-2.60]. African mothers, compared with mothers from Spain, showed an adjusted stillbirth RR of 1.75 (95% CI: 1.54-2.00). This study confirms the differences of stillbirth risk by maternal socio-economic status. Regardless of socio-economic status, African mothers had the highest risk of stillbirth. These results point out the necessity to reduce factors related to social and health inequalities in perinatal mortality in Spain, and more specifically, to take into consideration the special vulnerability of African mothers.

Differences in the reproductive pattern and low birthweight by maternal country of origin in Spain, 1996-2006

Numerous studies have highlighted poorer reproductive and perinatal health outcomes among migrant mothers in developed countries. Due to the fact that no conclusive data is currently available at national level in Spain, this study aimed to explore potential differences by comparing the prevalence of low and multiple live births and the proportion of live births by maternal age and country of origin during 1996-2006. A cross-sectional study was conducted using data from the National Statistics Institute. Low birthweight (LBW) was compared by mothers' country of origin using a logistic regression model. Odds ratios (ORs) and their respective 95% confidence intervals (CIs) are stratified by multiplicity and maternal age. LBW was associated with a combination of older maternal age and multiple pregnancies in the case of women who had been born in Europe (EU15). However, this association was not found in women who originated from outside the EU15, mostly from countries who have shown significant emigration to Spain during the last decade. LBW was present among all age groups, in both singleton and multiple births, and in particular Romanian mothers showed the highest OR 2.34 (95% CI 1.20-4.80). This study confirms differences in the reproductive pattern and LBW depending on maternal country of origin. These results allow a better understanding of the reproductive pattern and the implications of mothers' country of origin in LBW. Thus, helping health decisions makers to plan future health interventions aimed at reducing the LBW prevalence in Spain.

Monitoring and managing sediment quality and impact assessment in Spain in the past 10 years

Members of the INTERSED network initiated several efforts to coordinate management activities, information, priorities and approaches in research and technological development (RTD) with respect to sediments at a national level in Spain. The present work summarizes the results of a database search (1995–2005) carried out within the INTERSED framework; we found 250 international and national publications of Spanish groups related to the study of sediments located in the Spanish coast and river basins using different approaches. The results show the statistics of RTD groups involved, the main objectives of the publications, the types of sediment and their location, and the analytical method and parameters. We describe the state of the art on the field of research in sediments at the national level in Spain over a period of 10 years.