Problem In Spain Research Articles

The Air Traffic Controller Work-Shift Scheduling Problem in Spain from a Multiobjective Perspective: A Metaheuristic and Regular Expression-Based Approach

We address an air traffic control operator (ATCo) work-shift scheduling problem. We consider a multiple objective perspective where the number of ATCos is fixed in advance and a set of ATCo labor conditions have to be satisfied. The objectives deal with the ATCo work and rest periods and positions, the structure of the solution, the number of control center changes, or the distribution of the ATCo workloads. We propose a three-phase problem-solving methodology. In the first phase, a heuristic is used to derive infeasible initial solutions on the basis of templates. Then, a multiple independent run of the simulated annealing metaheuristic is conducted aimed at reaching feasible solutions in the second phase. Finally, a multiple independent simulated annealing run is again conducted from the initial feasible solutions to optimize the objective functions. To do this, we transform the multiple to single optimization problem by using the rank-order centroid function. In the search processes in phases 2 and 3, we use regular expressions to check the ATCo labor conditions in the visited solutions. This provides high testing speed. The proposed approach is illustrated using a real example, and the optimal solution which is reached outperforms an existing template-based reference solution.

Tuberculosis e inmigración

Tuberculosis continues to be a major public health problem in Spain. The incidence of tuberculosis in the native population has declined steadily in recent years. Migration flows have changed drastically since the beginning of the 21st century, with Spain becoming a recipient country for immigrants. Because most of the immigrants comes from countries with high incidence of tuberculosis, the contribution of the migrant population to new cases of tuberculosis is higher in relative terms than its weight in the total population. Tuberculosis programs must address the cultural, economic and medical aspects of the disease, and particularly target groups at risk, including the migrant population. In this paper, we will review the epidemiology and dynamics of tuberculosis in the migrant population, their differentiating clinical characteristics and the programmatic actions to address the problem.

Modelling bullying propagation in Spain: a quantitative and qualitative approach

Bullying in schools can be defined as a category of aggressive behaviour with an imbalance of power, and aggression event is repeated over time. Bullying occurs as a social process in nature, and takes place in groups. Attacks are mostly unprovoked, and can be physical or verbal, direct or indirect. This paper focuses on modelling the propagation of bullying in the Spanish school population aged [12, 18] during the period July 2015–January 2020, and on identifying and quantifying its main drivers. Thus, a population dynamics model is built to forecast and quantify the magnitude of the bullying problem in Spain over the July 2015–January 2020 period by taking into account qualitative and quantitative factors; e.g., demography, economy, socio-cultural behaviour, consumption of drugs and alcohol, social contagion and technology. The study provides recommendations to reduce and prevent the growth of this social problem, but to also mitigate a correlated problem, such as intimate partner violence among adults. In fact one of the main utilities of the built model is that new policies can be simulated and allow their effects to be seen.

Hyponatraemia and congestive heart failure refractory to diuretic treatment. Utility of tolvaptan

Heart failure (HF) is currently one of the most significant healthcare problems in Spain and has a continuously increasing prevalence. Advances in our understanding of the various biological responses that promote cardiac remodeling and pulmonary venous congestion constitute the basis of current treatment.This article, prepared by members of the HF groups of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine, discusses the current therapeutic strategies for patients with congestion refractory to diuretic treatment. The article includes our clinical experience with the use of tolvaptan as an additional treatment for congestion associated with hyponatraemia. To this end, we propose an algorithm for the use of tolvaptan in patients with congestive HF, natraemia <130mEq/L and poor response to conventional diuretic treatment.

Use of YouTube for Business Communication. Analysis of the Content Management and Level of Participation of Spanish Best Reputed Companies Youtube Channels

Companies have incorporated new social media in their relations with the citizens. This article discusses the use of YouTube, the audiovisual contents and the involvement of users in the channels of best reputed companies in Spain according to Merco ranking (Business Monitor of Corporate Reputation). A total of 454 videos from 20 Youtube channels were analysed. The paper concludes that the use of YouTube is more promotional than informative, as well as unidirectional. Strategies vary according to business sectors, but low interaction and publics participation points to a lack of interest in the contents. Corporate Social Responsibility videos obtain interesting rates of viewing and can contribute to reputation perception in a context of socioeconomic problems in Spain. For the moment, the conservative and unidirectional attitude is the main trend of business communication on YouTube.

Hiponatremia e insuficiencia cardiaca congestiva refractaria a tratamiento diurético. Utilidad del tolvaptán

Heart failure (HF) is currently one of the most significant healthcare problems in Spain and has a continuously increasing prevalence. Advances in our understanding of the various biological responses that promote cardiac remodelling and pulmonary venous congestion constitute the basis of current treatment.This article, prepared by members of the HF groups of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine, discusses the current therapeutic strategies for patients with congestion refractory to diuretic treatment. The article includes our clinical experience with the use of tolvaptan as an additional treatment for congestion associated with hyponatraemia. To this end, we propose an algorithm for the use of tolvaptan in patients with congestive HF, natraemia <130mEq/l and poor response to conventional diuretic treatment.

Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients.

Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement.

Jaydess®, una nueva opción anticonceptiva a largo plazo y reversible adecuada para mujeres jóvenes

Unintended pregnancies remain a serious problem in Spain, especially among young women. Contraceptive patterns of young women include methods that are highly dependent of the user, with low effectiveness. Methods of long-acting reversible contraception (LARC), among which copper and levonorgestrel-releasing intrauterine devices are the most common, have been widely recommended to all women wishing a highly effective protection, at any age, when no specific contraindication exists. Despite this, the use of these devices in Spain is very limited. This is thought to be due to the existence of barriers arising from lack of information and wrong beliefs, which specially affect a higher use by young and nulliparous women. A new levonorgestrel-releasing intrauterine device (Jaydess®, Bayer HealthCare) has been recently marketed. Its smaller size, hormone content, and release rate compared to Mirena®, along with a similar efficacy and better safety profile, as well as other non-contraceptive benefits, may help overcome the barriers hindering a wider use of LARC (and particularly intrauterine devices) among young and nulliparous women. All these aspects are analysed in this review.

Molecular Genotyping of Giardia duodenalis Isolates from Symptomatic Individuals Attending Two Major Public Hospitals in Madrid, Spain.

BackgroundThe flagellate protozoan Giardia duodenalis is an enteric parasite causing human giardiasis, a major gastrointestinal disease of global distribution affecting both developing and industrialised countries. In Spain, sporadic cases of giardiasis have been regularly identified, particularly in pediatric and immigrant populations. However, there is limited information on the genetic variability of circulating G. duodenalis isolates in the country.MethodsIn this longitudinal molecular epidemiological study we report the diversity and frequency of the G. duodenalis assemblages and sub-assemblages identified in 199 stool samples collected from 184 individual with symptoms compatible with giardiasis presenting to two major public hospitals in Madrid for the period December 2013–January 2015. G. duodenalis cysts were initially detected by conventional microscopy and/or immunochomatography on stool samples. Confirmation of the infection was performed by direct immunofluorescence and real-time PCR methods. G. duodenalis assemblages and sub-assemblages were determined by multi-locus genotyping of the glutamate dehydrogenase (GDH) and β-giardin (BG) genes of the parasite. Sociodemographic and clinical features of patients infected with G. duodenalis were also analysed.Principal findingsOf 188 confirmed positive samples from 178 giardiasis cases a total of 124 G. duodenalis isolates were successfully typed at the GDH and/or the BG loci, revealing the presence of sub-assemblages BIV (62.1%), AII (15.3%), BIII (4.0%), AI (0.8%), and AIII (0.8%). Additionally, 6.5% of the isolates were only characterised at the assemblage level, being all of them assigned to assemblage B. Discordant genotype results AII/AIII or BIII/BIV were also observed in 10.5% of DNA isolates. A large number of multi-locus genotypes were identified in G. duodenalis assemblage B, but not assemblage A, isolates at both the GDH and BG loci, confirming the high degree of genetic variability observed in other molecular surveys. BIV was the most prevalent genetic variant of G. duodenalis found in individuals with symptomatic giardiasis in the population under study.ConclusionsHuman giardiasis is an ongoing public health problem in Spain affecting primarily young children under four years of age but also individuals of all age groups. Our typing and sub-typing results demonstrate that assemblage B is the most prevalent G. duodenalis assemblage circulating in patients with clinical giardiasis in Central Spain. Our analyses also revealed a large genetic variability in assemblage B (but not assemblage A) isolates of the parasite, corroborating the information obtained in similar studies in other geographical regions. We believe that molecular data presented here provide epidemiological evidence at the population level in support of the existence of genetic exchange within assemblages of G. duodenalis.

Second-hand smoke exposure in 4-year-old children in Spain: Sources, associated factors and urinary cotinine

IntroductionSecond-hand smoke exposure (SHS) in children remains as a major pollution problem, with important consequences for children's health. This study aimed to identify the sources of exposure to SHS among 4-year-old children, comparing self-reports to a urinary biomarker of exposure, and characterize the most important variables related to SHS exposure in this population. Methods4-year-old children's exposure to SHS was assessed by a parental-reported questionnaire and by urinary cotinine (UC) measurements in 1757 participants from 4 different areas of the Spanish INMA (INfancia y Medio Ambiente – Environment and Childhood) Project. The questionnaire about SHS included information about smoking habits at home by household members, and about exposure to SHS in other places including other homes, bars, restaurants or transportation. The association between quantified UC levels (>4ng/ml) and sociodemographic variables and the different sources of SHS exposure was examined using logistic regression. ResultsBased on parental reports, 21.6% of the children were exposed to SHS at home and 47.1% elsewhere; making a total 55.9% of the children exposed to SHS. In addition, 28.2% of the children whose parents reported being not regularly exposed to SHS had quantified UC values. Children from younger mothers (<34 vs. ≥39.4 y) had a higher odds of exposure to SHS [OR (95% CI): 2.28 (1.70–3.05) per year], as well as from families with a lower educational level [OR secondary: 2.12 (1.69–2.65); primary or less: 2.91 (2.19–3.88)]. The odds of quantifiable UC in children dropped after the smoking ban in public places [OR=0.59 (0.42–0.83)]. Regarding the sources of SHS exposure we observed that quantifiable UC odds was increased in children whose parents smoked at home in their presence [OR mother occasionally: 13.39 (7.03–25.50); mother often: 18.48 (8.40–40.66); father occasionally: 10.98 (6.52–18.49); father often: 11.50 (5.96–22.20)] or in children attending other confined places, mainly other houses where people smoked [OR: 2.23 (1.78–2.80)]. ConclusionsChildren's SHS exposure is nowadays an unresolved major public health problem in Spain. After the ban of smoking in public places health care professionals should put more emphasis to the parents on the importance of controlling the exposure of their children in private spaces.

El trasfondo weimariano de la filosofía política de José Ortega y Gasset: España invertebrada (1922)

This paper deals with the political philosophy of Jose Ortega y Gasset (1883-1955). Through discourse analysis it deepens investigations of the origins of Ortega´s political key concepts. Based on recent biographical research, the analysis illustrates and explains how the drastic sociopolitical changes experienced in Germany and Italy between 1918 and 1922 came to have major significance for Ortega´s political thinking. In fact, the tremendous transformations undergone in both countries had a direct and decisive impact on Ortega´s early, and fundamental, essay Espana invertebrada (1922). The results of the current study allow us to reevaluate Ortega´s political philosophy critically and in context, not only with regard to its origin and range, but also its systematic relevance with respect to current political and social problems in Spain.

Complications Associated With Liver Transplantation in Recipients With Body Mass Index >35 kg/m2: Would It Be a Poor Prognosis Predictive Factor?

BackgroundObesity is a global epidemic that continues to increase in a great number of countries, and it has become a major public health problem in Spain. Unfortunately, the impact of obesity on survival in liver transplantation (LT) recipients is underestimated and controversial. The aim of this study was to determine if obesity is a risk factor for morbidity and mortality after LT. MethodsIn a retrospective cohort study of the records of 180 consecutive patients who had undergone to LT from 2007 to 2013, 11 obese patients with body mass index (BMI) >35 kg/m2 were identified. Their data have been compared with recipients with BMI 20–25 kg/m2. ResultsThere were no differences in demographic data, Child-Pugh score, Model for End-Stage Liver Disease score, or cause of liver failure. BMI >35 kg/m2 recipients had a significantly higher rate of portal vein thrombosis before LT, compared with the BMI 20–25 kg/m2 group (36.5% vs 13.9%; P = .041). There were also no differences in development of post-reperfusion syndrome. The groups were also comparable concerning morbidity rate after LT, stay in the intensive care unit, and global hospital stay. However, the mortality rate was significantly higher in the obese group compared with the nonobese group (72.7% vs 38.9%; P = .032). ConclusionsThe results of the study clearly demonstrate higher mortality rates in obese patients undergoing LT; thus, it is fair to consider obesity as a poor prognosis predictive factor concerning mortality rate.

El concepto social de la violencia contra las mujeres en España: Aproximaciones a los imaginarios de jóvenes estudiantes

La violencia contra las mujeres es todavía un problema por resolver en España y su incidencia en la juventud (desde el prisma tanto de la prevención como del abordaje de los casos) es uno de los grandes retos actuales. Diferentes actuaciones gubernamentales se han dirigido en este sentido, sin embargo aún subsiste un concepto social reduccionista en el que la violencia es presentada públicamente como de tipo físico y que acontece sólo en parejas con cierta madurez, dificultando a los jóvenes identificarla en sus relaciones. En este trabajo se ha abordado, mediante la técnica de la encuesta, de qué manera desarrollan conceptualmente los jóvenes estudiantes el problema de la violencia contra las mujeres. Los resultados indican que frente a una gran identificación de la violencia física como forma de violencia generalizada, algunas prácticas culturales —como el acoso sexual en la calle— no son reconocidas como agresiones de género, o algunas formas de violencia como la económica. Además, los jóvenes presentan unas percepciones negativas con respecto a la posible erradicación de la violencia contra las mujeres en la sociedad.

El cáncer de mama

The high incidence of breast cancer makes it a major social-health problem in Spain. Over the last three decades, survival rates have improved markedly thanks to the introduction of mammographic screening campaigns and new treatments. Despite the optimistic data, we should not forget that there some patients still relapse after their breast cancer treatment (about 20%), some of whom die from the disease. It is therefore important to continue breast cancer research efforts until a relapse rate of zero is achieved. In this article, we review various aspects of this disease such as its signs and symptoms, diagnosis, chemoprevention, as well as the treatment of localised and metastatic breast cancer.

The Spanish Party System and the Issue of Assigning Responsibility

The article addresses the dependency between the level of institutionalization present in the Spanish party system, electoral accountability and assigning responsibility. The primary research objective of this article is to determine the extent to which electoral volatility is present in Spain, both at the aggregate and individual level, which is a measure of the degree of institutionalization reached by a party system. Next, the dependency between electoral volatility and fluidity of elites at the electoral and parliamentary level is analysed. This allows for an answer to the question of whether there is a problem in Spain with assigning responsibility, having regard to the fact that the presence of extensive electoral volatility among both voters and political elites makes it difficult to speak of effective accountability. Key words: party system, Spanish party system, assigning responsibility, electoral accountability

Percepción de la victimización en el noviazgo de adolescentes y jóvenes españoles

Dating violence, as a widespread social problem in Spain, has given rise to the creation of several victims’ assistance services. Nonetheless, previous research has shown that experiencing violence does not necessary lead the subject to be self-labelled as a victim. This dissociation between victimization and self-labelling might be hindering their access to these resources. This study analyses the relationship between dating violence, measured behavioural indicators, and the use of various labels (i.e., abuse, fear, being trapped) to describe aforementioned relationships. The sample was composed by 6,731 students, aged between 15 and 26 years (M=18.2; SD=2.1), 39% males and 61% females. The majority of the sample (70%) reported not having felt abused, frightened or trapped. Only 1.1% of males and 3.1% of females responded positively to the three questions, and 25% answered affirmative, at least, one of the issues. Regarding the victimization experience, it was confirmed that fear and feeling trapped were associated with lower abuse levels than those found in subjects self-labelled as abused, but they were statistically higher than those participants who responded negatively to the three questions (p<0,001). Besides, different types of violence were differently associated to fear and being trapped, with a linear upward trend for the different forms of violence assessed by Dating Violence Questionnaire, in both males and females. Thus, results are discussed in respect to the ease that being properly labelled as a victim of dating violence may suppose in help seeking behaviour.

Is Over-Education a Problem in Spain? Empirical Evidence Based on the EU-SILC

Spain is suffering an important economic slowdown which affects significantly to unemployment rises. For this reason, many individuals are considering to increase their educational level. However, this decision can lead to get worse labor market indicators. In this paper, we analyze the problem of over-education in Spain and its effect on earnings. Using the last four waves (2009–2012) of the European Union Statistics on Income and Living Conditions (EU-SILC, 2009–2012) this study analyses over-education situation of employed people and compares over-education rates and earnings of these individuals. Cross-sectional analysis (focused on a recent period of time) is performed. We apply different matching techniques based on propensity score methods to evaluate the impact of over-education on personal earnings. The results obtained in this paper add more empirical evidence supporting the effect of education on earnings together with occupational placement because over-education could be a great problem for many countries. In Spain, there exists a problem of over-education which varies among occupations. Overeducated workers are most likely to be found among “Service workers and shop and market sales workers” and “Elementary occupations”. Also, the majority of individuals working as “Professionals” are adequately educated. Besides, over-education has a significant negative impact on earnings. Although the results depend on the way we define over-education (interval or modal method), those individuals over-educated receive less earnings than they correspond to. In fact, the decrease can reach about 5000 euro per year.

Too much to pay: an estimation through microsimulation techniques of the monetary costs of early school leaving in Spain

Simulation techniques are nowadays widely applied in many areas of knowledge, as a means to provide tools for predicting future behaviour and reactions. In the last few years, public economy is one of the areas where there has been an increasing interest in simulation techniques in order to evaluate the achievement of different public policies, though these techniques are not as developed as in other subject areas. In this context, this paper provides empirical evidence for simulation literature, addressing two main aspects: first, an extended and alarming problem in Spain, the monetary costs associated with early school leaving (ESL) (Spain’s ESL rate is one of the highest in the EU); and, second, a not very common methodology to investigate this phenomenon: microsimulation techniques. More specifically, a behavioural microsimulation model is proposed in order to study the effects on employment and wages of eradicating ESL in Spain over a 20-year time horizon. Our results, under various scenarios, indicate that an increase in GDP of between 4 and 17% could be achieved.

Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial.

BackgroundColorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population’s reasons for refusing to take part in the screening programme and to find out the health professionals’ opinion about the official programme implementation and on the new computerised tool.Methods/DesignThis is a parallel randomised trial with a cross-sectional second stage. Participants: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50–69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient’s electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach.DiscussionWe expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals.Trial registrationClinical Trials.gov identifier NCT01877018

La medicalización de la violencia de género [The medicalization of gender violence

En las páginas siguientes se describirá el fenómeno de la violencia de género, como una problemática con gran prevalencia en España y sin embargo cabe señalar una invisibilidad del fenómeno en el sistema sanitario, debido fundamentalmente al proceso histórico de la medicalización que aún afecta en nuestros días. Comenzamos realizando una conceptualización breve de la violencia de género para contextualizar histórica y culturalmente este fenómeno, como premisa fundamental para comprender, en sentido amplio, los factores causales de la violencia. Posteriormente se realiza un contrapunto entre: la visibilidad del fenómeno en su dimensión social por una parte y la invisibilidad de la violencia en su individualidad, exponiendo, de forma breve, las consecuencias que el maltrato produce en las mujeres para comprender posteriormente la medicalización del fenómeno, teniendo presente como guía los argumentos de Foucault (1980). Aunque la crítica en las fundamentaciones expuestas acerca del abordaje de la violencia de género es manifiesta, la intención última es exponer una problemática social muy grave y los efectos de la medicalización y sus resquicios históricos sobre ella. Con esperanzas de que el cambio que ya se está produciendo continúe y otros cambios que serán venideros.