Programs In Spain Research Articles

The leniency programme: obstacles on the way to collude

There is no honour among thieves. This aphorism concisely expresses why the leniency programmes in competition policy have become one of the most effective instruments in the fight against the cartels. In this work we describe the dissemination, evolution, and effects of the aforementioned programmes in the two decades since its implementation around the world, paying special attention to what is being done at the European Union level and in Spain. The empirical regularities obtained from the descriptive analysis of leniency decisions adopted by the European Commission and by the Spanish Competition Authority provide relevant information about the effectiveness of their corresponding programmes, as well as information about the underlying reasons why companies, in this context, submit applications for sanction exemption or reductions in the penalty amount. We conclude that still there is scope to increase substantially the dissemination and implementation of the leniency programme in Spain, and if the reforms are handled correctly, the programme is set to catch up and to be the main source of detecting and sanctioning of Spanish cartels in the next decade.

Meta-analysis of the effectiveness of school substance abuse prevention programs in Spain.

There has been an increase in adolescent substance use that has led to the development and implementation of prevention programs. New evidence is needed in order to improve them and optimize the resources. The aim of this paper is to use a meta-analysis to analyze the effectiveness of school drug prevention programs in Spain. Twenty-one studies that evaluated drug abuse prevention programs in schools, were published between 2002 and 2013, and that met the selection criteria were identified. Preventive program effectiveness was low ( d = 0.16), although it was higher at the follow-up ( d = 0.30). The programs were most effective in changing attitudes ( d = 0.44) towards drugs. The models of health education ( d = 0.48) and social learning ( d = 0.20) were also very effective, especially in combination with oral, written, and audiovisual support material ( d = 0.21) and the implementation of joint programs by health education professionals and faculty members ( d = 0.25). Is possible to determine the need for more rigorous evaluations of interventions to establish useful programs.

Undergraduate Geriatric Dentistry Programs in Spain

The increasing size of the elderly population in Spain underlines the need for the dental profession to pay particular attention to the oral health needs of older patients. The aim of this study was to perform a preliminary assessment of the Geriatric Dentistry education programs in Spanish dental schools and highlight the models being employed for the geriatric training programs in these schools. The assessment was designed to be a cross-sectional study, which involved all the dental schools (n = 19) in Spain. Using a simple, 12-item questionnaire, information regarding the geriatric dental education programs in the schools was collected from their official websites by researchers from the University of Seville. In the first instance, the information was collected from the dental schools' websites and included the history, frequency and characteristics of the geriatric dental program. The deans or their deputies from those schools with a geriatric dental education programme were then asked to validate the data obtained from the websites. Only eight (42%) of schools offered a specific geriatric dentistry course. Seven of these schools were public and only one was private. The other 11 Spanish dental schools (five public and six private) did not offer a specific geriatric dentistry course. Seven out of the eight schools taught the course using a didactic teaching method and none of these seven included a clinical component in the program. No school had a specific geriatric dentistry clinic within the school, neither did they run geriatric clinics at remote locations or operate mobile dental clinics for geriatric patients. This study has described the current provision of dental undergraduate education in geriatric dentistry in Spain. The results suggest that there is a need to develop the curriculum content, design, implementation and evaluation of geriatric dentistry programs. Research should also focus on assessing the access to and improvement in the oral care of the elderly population.

Approval and potential use of over-the-counter HIV self-tests: the opinion of participants in a street based HIV rapid testing program in Spain.

HIV self-testing, not yet available in Spain, is a strategy thought to be able to increase the number of people tested and testing frequency. 3,373 attenders of a street-based HIV rapid-testing program gave their opinion on authorizing over-the-counter self-tests and a potentially shorter lead time if self-tests were available. 88.0 % of participants were in favor of authorization, 9.2 % had no clear opinion and 2.8 % were against. 54.6 % of men who have sex with men (MSM), 38.4 % of men who have sex with women and 36.3 % of women acknowledged a potential for lead time reduction. Potential lead time was associated with being ≥35 years, having a university degree, never injected drugs, previous HIV tests and being concerned about an HIV positive result, and in MSM, also having ≥5 partners. Self-testing seems a promising strategy for Spain: its authorization is supported by nearly all potential users and almost three quarters of MSM would have opted to advance their current testing if self-tests were available.

Electricity load level detail in computational general equilibrium – part II – welfare impacts of a demand response program

Demand Response (DR) programs send time-based signals to electricity consumers so that they may shift or reduce their loads to better adjust to the system requirements, thus creating interesting benefits for power systems. However, the assessment of these benefits is quite challenging, since it requires combining features from bottom-up and computable general equilibrium (CGE) models. This paper assesses the impacts of a DR program in Spain using a CGE model which includes both technological and temporal disaggregation. The model is able to account for the indirect effects characteristic of CGE models while also mimicking the detailed behavior of the electricity operation and investment available before only in bottom-up detailed models. Our results show clearly the advantages of using this approach for this type of policies.

Reorganización de la especialización médica. Más allá de la Ley de Ordenación de Profesiones Sanitarias

More than 30 years after the creation of postgraduate medical training program in Spain supported by the MIR system, a thorough review of it becomes essential. This was the goal of the LOPS law enacted in 2003.The development of the LOPS is being slow and difficult to enforce, because master lines have to be achieved in order to develop the training of specialists in accordance with internationals standards and, simultaneously, with the reform that is taking place in the undergraduate education. The start up of the medical core will be the cornerstone of this project. The principles of the LOPS provide an opportunity for the training of competent physician in basic general medical practice followed by a progressive specialization supported on a solid foundation. And these principles have to prevail over corporate interests.

Sex-specific disease outcomes of HIV-positive and HIV-negative drug users admitted to an opioid substitution therapy program in Spain: a cohort study

BackgroundOpioid substitution therapy has improved the survival of heroin users with and without HIV infection. We aimed to analyze sex differences in mortality rates and predictors of death among those admitted to a methadone treatment program (MTP).MethodsLongitudinal study of patients enrolled in a MTP from 1992 to 2010. Socio-demographic and drug use characteristics, and markers of viral infections were assessed at entry. Vital status was ascertained by clinical charts and the mortality register. Four calendar periods were defined according to the introduction of preventive and treatment interventions in Spain. Predictors of death were analyzed by Cox regression models.Results1,678 patients (82.8% men) were included; age at first heroin use was 18.6 years (IQR: 16–23 years), and age at first entry into a MTP was 30.7 years (IQR: 26–36 years). A total of 441 (26.3%) deaths occurred during 15,124 person-years (p-y) of follow-up (median: 9.2 years, IQR: 4–13 years). HIV infection was the main predictor of death in men (HR = 3.5, 95% CI: 2.1-5.7) and women (HR = 3.2, 95% CI: 1.2-8.7 ) and main cause of death was HIV/AIDS. Overall mortality rate was 2.9 per 100 p-y (95% CI: 2.7-3.2 per 100 p-y) and death rates decreased over time: 7.4 per 100 p-y (95% CI: 6.3-8.8 per 100 p-y) for the 1992–1996 period to 1.9 per 100 p-y (95% CI: 1.6-2.4 per 100 p-y) for the 2007–2010 period. In women, a slightly increase in mortality was observed in recent periods specifically among HIV-positive women (3.7 per 100 p-y in period 2002–2006 and 4.5 per 100 p-y in 2007–2010).ConclusionsSignificant reductions in mortality of patients in MTP are observed after nineteen years of observation. However, HIV infection shows a great impact on survival, particularly among HIV-infected women.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-504) contains supplementary material, which is available to authorized users.

Learning leadership from teaching: emotional competences

During the last two decades, in our societies we have sought quality education. One way to achieve this goal is to promote educational leadership. The field of educational leadership is complex: administrative, instructional, school supervision, teacher supervision. Our focus is on instructional leadership and teacher leadership. There’s an extensive literature on this topic and we have selected recent publications that present a discussion of theoretical and practical implications. Our theoretical study is from an educative perspective. We highlight a theme: the emotional competences of academic leaders and teachers and their influence on effective teaching. Researchers insist that teachers’ emotions cannot be regarded only in their psychological aspects. They show the interconnections between teacher’s beliefs, identity, goals and emotions and teaching. The relevance of this topic drives our research on how it’s introduced in programmes of teacher education. Teacher education should incorporate this vision. In particular, we analyse the most representative and current programmes in Spain. We compare these programmes with the current tendency of teacher education in an international context.

Course content related to chronic wounds in nursing degree programs in Spain.

To analyze content related to chronic wounds in nursing degree programs in Spain. Cross-sectional descriptive study. Course descriptions available for online access during June and July of 2012 were reviewed for the 114 centers in Spain that offer a nursing degree, according to the official Registry of Universities, Centers, and Titles. Of the 114 centers with degree programs, 95 (83.3%) post course content online, which make it possible to analyze 2,258 courses. In 60 (63.1%) of these centers, none of the courses included the concept of pressure ulcer prevention, and the course content posted by 36 (37.9%) centers made no mention of their treatment. None of the course descriptions contained any reference to pain management in patients with chronic wounds. Of the 728 elective courses analyzed, only one was related to chronic wounds. This review of available information about nursing degree programs in Spain indicates that pain management in patients with chronic wounds is not addressed in any course, and more courses consider the treatment of pressure ulcers than their prevention. Degree programs responsible for the training of future nurses should be reviewed and revised as needed to ensure that graduates have acquired minimum basic competencies in the prevention and treatment of chronic wounds that help to decrease the theory-practice gap in this field.

A proposal of basic guidelines for training in psychosomatic and liaison psychiatry in Spanish psychiatry training programs

The Psychosomatic and Liaison Psychiatry is an emerging psychiatric subspecialty. This article is intended to summarize the philosophy supporting training programmes in Spain, and the recommended training guidelines. Methods: Review of the literature and teaching experience. Results: The increasing complexity of diagnosis and treatment, and the demand by patients and providers of resources for higher and more efficient quality of care, make skills training a key tool for achieving these goals. The human being is biology, feelings, thoughts, experiences and thus individuality when sick. Understanding all this is the core on which to base our competencies in this exciting crossroads between psychiatry and other medical specialties. We propose a set of competencies to achieve, and point learning spaces and evaluation mechanisms. Conclusions: Based on accumulated experiences in Spain, and the review of European and international literature, it is possible to summarize a realistic set of norms and directions for training in Psychosomatic and Liaison Psychiatry in residency programmes.

Safety and Efficacy of Vandetanib As Systemic Treatment for Patients with Advanced and Progressive Medullary Thyroid Cancer (Mtc)

ABSTRACT Aim: Vandetanib has demonstrated efficacy in advanced MTC in a large phase III trial (NCT00410761). However, little evidence is available on safety and efficacy of vandetanib in daily-practice patients. This is a retrospective multicenter analysis of the safety and activity of vandetanib in the community setting. Methods: Pts with advanced, unresectable MTC and documented radiological disease progression were included in a compassionate use program in Spain. Pts received vandetanib 300 mg qd as the initial dose, allowing dose reductions as per toxicity. Primary endpoint was response rate (RR) by RECIST and secondary endpoints were safety, progression-free survival (PFS) and correlation between RR and biomarkers. The program was validated by regulatory authorities and all patients signed an informed consent form. Results: 27 pts were enrolled (med age: 48 yo; male: 52%). Vandetanib was given as first-line MKI in 59%, second-line in 22% and third-line in 19% of pts. Dose reductions were needed in 44% of pts to manage toxicity. Most common grade 1-2 adverse events were rash (33%), fatigue (33%), diarrhea (33%), hand-foot syndrome (19%), AST/ALT elevation (19%), mucositis (15%), nausea and vomiting (15%), anorexia (15%) and hypertension (11%). The most frequent grade 3-4 side effects were rash (22%), hypertension (4%), mucositis (4%) and cardiac toxicity ( Conclusions: Vandetanib showed meaningful activity with an acceptable safety profile inadvanced and progressive MTC in a cohort of patients with a worse prognosis than previously reported. Activity is seen regardless of treatment line. Disclosure: All authors have declared no conflicts of interest.

RESISTANCE TO LEAF RUST IN A SET OF DURUM WHEAT CULTIVARS AND LANDRACES IN SPAIN

SUMMARY Durum wheat (Triticum turgidum var. durum) is an important crop in the Mediterranean basin, and in southern Spain. One of the most important biotic constraints to durum wheat production is leaf rust. Breeder deployed resistant cultivars, but mutations in the pathogen create new virulent pathotypes that erode resistance. In this work, two collections of genotypes have been characterized for their leaf rust resistance both in field trials (in Spain and Mexico) and in the greenhouse (with an array of Spanish pathotypes). The first collection included 14 cultivars and lines, mostly from CIMMYT origin, plus six genotypes with known resistance genes. The second collection comprised 29 cultivars commercially available in Spain, plus 11 landraces from the Spanish germplasm bank. Besides, six resistant cultivars of particular importance were crossed with two cultivars with known effective genes (Lr14a and Lr27 + Lr31), and a susceptible one to infer the genetic basis of their resistance. F2 populations were analyzed. At adult plant stage, 20 genotypes including four landraces were resistant in greenhouse to all Spanish pathotypes. In field trials, 24 genotypes were resistant in Spain, and 22 genotypes in Mexico. The presence of resistant genes Lr14a and the complementary genes Lr27+Lr31 has been deduced in some cultivars either by gene postulation or by genetic analysis. These results provide an opportunity for breeding programs in Spain and elsewhere to target their crossing and selection activities so they can yield lines with effective resistance in the Mediterranean region.

Low knowledge and anecdotal use of unauthorized online HIV self-test kits among attendees at a street-based HIV rapid testing programme in Spain

The objectives of this study were to estimate the percentage of potential users who know that unauthorized HIV self-tests can be purchased online and the percentage of those who have already used them, and to determine socio-demographic and behavioural correlates. A self-administered questionnaire was employed to collect data from attendees at a street-based HIV testing programme. Logistic regression for rare events was performed. Of the 3340 participants, 5.3% (95% confidence interval (CI) 4.5-6.0%) had knowledge of self-tests being sold online and 7.5% (95% CI 6.6-8.5%) thought they existed but had never seen them; only 0.6% (95% CI 0.3-0.9%) had ever used one. Knowing that self-tests are sold online (odds ratio (OR) 3.6, 95% CI 2.4-5.4) and using them (OR 7.3, 95% CI 2.2-23.8) were associated with having undergone more than two previous HIV tests. Use was also associated with being neither Spanish nor Latin American (OR 3.8, 95% CI 1.2-12.0) and with having a university degree (OR 0.2, 95% CI 0.1-0.7). At the time of the study, the impact on the population of issues related to the use of unauthorized tests was very low. However, media coverage following the approval of self-testing in the USA might have changed the situation.

Evaluation of the spatial and temporal distribution of and risk factors for Bluetongue serotype 1 epidemics in sheep Extremadura (Spain), 2007–2011

Extremadura has been one of the regions in Spain most severely affected by Bluetongue (BT) epidemics. The first incursion of BTV, which was successfully eradicated one year later, occurred in 2004, involving the BTV-serotype 4. However, a second incursion occurred in September 2007, this time involving serotype 1. Since then, the implementation of intensive vaccination programs have significantly reduced BTV-1 occurrence, but the disease has not been completely eradicated yet.This study aimed to provide, for the first time, a complete description of the spatial and temporal patterns of BTV-1 occurrence in sheep in Extremadura from 2007 to 2011 and to identify the risk factors that contributed to the seasonal occurrence of BTV-1 in this region. The results showed that risk factors contributing to BTV-1 occurrence in sheep changed between 2007 and 2011. Initially, when the population was still immunologically naïve, the main risk factors for BTV-1 occurrence were extensive management practices, large sheep farms and Culicoides abundance on farms. However, after the implementation of vaccination, other factors became more relevant for BTV-1 occurrence, mostly related to BTV reservoirs, such as the proximity of cattle farms or the introduction of cattle into farms. The Talaverana sheep breed also seemed to be associated with a significantly higher risk of BTV-1 occurrence, although it may be due to confounding factors, such as the geographical concentration of where this breed is kept and/or management practises used for this breed. The results of this study suggest that preventive and control strategies, including vaccination and active surveillance strategies, should be primarily focused on cattle farms kept in close vicinity to sheep flocks as well as in high-risk sheep farms (i.e. farms with a large farm size keeping both cattle and sheep and with a high number of animal introductions). Methods and results presented here may be used to guide decisions for the annual update of the control and eradication program in Spain.

Theoretical assumptions of Maffesoli's sensitivity and problem-based learning in nursing education.

Objectiveunderstand the everyday and the imaginary of Nursing students in their knowledge socialization process through the Problem-Based Learning (PBL) strategy.MethodAction Research, involving 86 students from the second year of an undergraduate Nursing program in Spain. A Critical Incident Questionnaire and Group interview were used. Thematic/categorical analysis, triangulation of researchers, subjects and techniques.Resultsthe students signal the need to have a view from within, reinforcing the criticism against the schematic dualism; PBL allows one to learn how to be with the other, with his mechanical and organic solidarity; the feeling together, with its emphasis on learning to work in group and wanting to be close to the person taking care.ConclusionsThe great contradictions the protagonists of the process, that is, the students experience seem to express that group learning is not a form of gaining knowledge, as it makes them lose time to study. The daily, the execution time and the imaginary of how learning should be do not seem to have an intersection point in the use of Problem-Based Learning. The importance of focusing on the daily and the imaginary should be reinforced when we consider nursing education.

Citizens’ perception of the efficacy of airport noise insulation programmes in Spain

Airport noise insulation programmes (NIPs) implement active measures for reducing the amount of noise to which people are exposed without impacting the operating capacity of an airport. This is the reason why they are one of the most extended actions adopted internationally by airport authorities to fight noise in airport surroundings.Beyond the assumption that a correct implementation of the NIP will significantly reduce sound exposure, this research aims to determine the efficacy of the NIP as a result of the beneficiaries’ subjective perception in terms of satisfaction, and the reduction of the reported annoyance.A telephone survey was carried out in more than 650 dwellings in the surroundings of several Spanish Airports (Alicante, Bilbao, Grand Canary, Malaga, Palma de Mallorca). The results have shown that: (a) the beneficiaries have a generally positive perception regarding the actions implemented, (b) they are quite satisfied regarding the insulation of the façades after NIP implementation, (c) they report a reduction of the annoyance, but (d) they still perceive aircraft noise as a source of disturbance.The statistical analysis of the results has also shown that there are some non-acoustic factors influencing citizens’ perception of NIPs. Factors such as the aesthetic of windows, or the reliability and professionalism of the workers and technicians involved in the NIP, have been shown to modify people’s reaction. But, the dissatisfaction with legal aspects of Spanish regulations concerning a lower protection of some practical spaces (like, bathrooms and kitchens that have been left out in many cases) has been found to be the factor most affecting people’s response.

Means of discourse manipulations in political party programs in Spain

Thanks to different mass media sources, members of any society are well aware of political developments and events and politicians. Every person has his or her own formed political beliefs and affirmations, interpreters other people's actions during political developments and evaluates events that take place. Political forces, in turn, see a person (a potential elector) as an object of external information influence. This lets them use political communication when competing for the power. In the modern democratic society this competition is carried out via parliamentarian debates, politicians' speeches, examining political parties' programs, political agitation and voting. General audience-oriented political discourse implements its function of political information influence. As the goal of any political party's program (as an independent form of text in the system of political discourse) is to win the elections and come to power, thus the audience influence function is one of the most fundamental and serve as the basis for the text. The text of a program itself is characterized by its persuasive orientation towards the audience, which reveal itself in such methods as convincing, argumentation, manipulation and evaluation. All the political programs pertain to parties which are at the power or which are in opposition. The main characteristic of oppositional programs is the criticism of the power, vice versa, the dominant party's programs confirm the correctness of their policy. All the political programs are multi-authored. The written form of any political program lets put into practice a detailed text analysis. This article presents the analysis of the texts of two leading Spanish political parties (the Spanish socialist worker's party and the people's party of Spain).

Road to Impunity: The Absence of Transitional Justice Programs in Spain

This article analyzes the ongoing process of recovering Spain’s historical memory and building a transitional justice agenda to end the impunity of crimes against humanity committed during the Francoist dictatorship. Over thirty years after the transition to democracy, based on an agreement to silence and forget, a social movement that challenges the narrative of successful democratization has interrupted Spain’s political landscape. Victim associations, relatives, and citizens who support the recovery of historical memory have generated a debate about how to deal with the dictatorial past. In 2007, the Spanish Parliament passed the Historical Memory Act to recognize and enhance victims’ rights. However, victims and victim associations criticized the Act severely due to the absence of mechanisms that guarantee the implementation of a transitional justice agenda, including a failure to investigate the past or create a truth commission. In the wake of a 2012 Spanish Supreme Court decision, which asserts that it is legally impossible to conduct a judicial investigation into the crimes committed during the Francoist dictatorship, it appears that Spain is now further than ever from achieving this goal.

Heterogeneity and emotions in the valuation of non-use damages caused by oil spills

Oil spills are capable of causing major environmental insults that raise the emotional loads of individuals across society. In this paper we consider the role of emotions in heterogeneous responses of individuals in the non-market valuation of an oil prevention program in Spain. Heterogeneity is modeled with a smoothly mixing regression (SMR) model that allows researchers to explain the probability that individuals belong to the latent segments of WTP. The results show that heterogeneity in WTP responses is explained by the specific emotional reactions of individuals (upset, sadness, indifference) rather than by their socioeconomic characteristics. Thus, the investigation of the emotional reactions of individuals can provide useful tools for the design of non-market valuation studies, providing more accurate predictions of the potential behavior of individuals in constructed markets for damage assessment.

Challenges to public service news programmes in Spain: Professionals and viewers’ discourses wavering between institutional reform and counter-reform

This article presents the results of a study analysing the perceptions held by both Spanish public service television (TVE) news professionals and viewers as regards the main challenges faced by Spanish public service broadcasting (PSB), some of which are also common to European PSB. The global changes of the last decade have created a new social, economic, political and technological context to which PBS channels must adapt. Achieving the pluralism demanded by public institutions, differentiating themselves from commercial channels and forging a closer relationship with their audiences are three of the chief hurdles that must be overcome. PSB channels in the Mediterranean region are faced with a further obstacle: maintaining their independence from government, an issue that has led TVE to implement a number of reforms and counter-reforms in the period from 2006–2012. Regarded as a symbol of the public service duty of state-owned broadcasters, news programmes are central to achieving these goals. Therefore, this work intends to contribute to a research agenda, linking audience research to production studies and analysing the broader media policy context (Livingstone, 1998: 2–5), by approaching the complex dynamics between communication policies and specific interpretations of media discourses in Europe. In the case of Spain, this analysis shows that in the period from 2006–2011, PSB news professionals highly valued their new-found independence. However, the seemingly modest increase in viewers’ support does not bode well for the healthy development of PSB in Spain in a scenario in which institutional support is weak.