Rates In Spain Research Articles

Análisis de las causas endógenas y exógenas del abandono escolar temprano: una investigación cualitativa

Introducción: La situación laboral y educativa de los jóvenes es objeto de especial preocupación por parte de gobiernos y organismos internacionales, ya que afecta a cuestiones tan importantes como la cohesión social, la desigualdad, el modelo educativo, la productividad y la sostenibilidad de los sistemas de protección social. En este sentido, el abandono escolar representa, actualmente, una de las problemáticas socioeducativas de mayor relevancia y un indicador determinante en el éxito de las políticas educativas. La tasa de abandono escolar temprano en España se sitúa en 2016 en el 19%, dato muy superior al de la media de la UE-28 (10,7%), pese al descenso en los últimos años; y aún lejano al objetivo del 15% marcado en la Estrategia Europea 2020. Método: A partir de esta realidad, desde el Observatorio de la Exclusión Social de la Universidad de Murcia se desarrolló un estudio cualitativo con el propósito de analizar y comprender los procesos de abandono y retorno escolar de jóvenes de la Región de Murcia de edades comprendidas entre 18 y 34 años. En concreto, se realizó una amplia revisión de estudios recientes que abordan este fenómeno en España mediante fuentes primarias, al tiempo que se aplicaron, como fuentes propias, tres técnicas cualitativas: historias de vida (24), entrevistas a profesionales (16) y grupo de discusión (1). Resultados y Discusión: Se realizó un análisis de las principales causas del abandono escolar, teniendo en cuenta la vinculación directa, o no, con el estudiante, siendo clasificadas a su vez en los distintos ámbitos que las conforman: endógenas (personal y relacional) y exógenas (estructural e institucional). Los resultados muestran que el conocimiento sobre los determinantes del abandono escolar temprano está mediado por la técnica de investigación empleada (encuesta, entrevista, historia de vida) y por el tipo de informante seleccionado (estudiantes, educadores, profesionales, padres).

Does the environment affect suicide rates in Spain? A spatiotemporal analysis

IntroductionSuicide is an important public health problem, it represents one of the major causes of unnatural death, and there are many factors that affect the risk of suicidal behaviour. The present study analyzes the temporal and spatial variations of mortality by suicide in Spain and its relationship with gross domestic product (GDP) per capita. Material and methodsA retrospective study was performed, in which deaths by suicide, sex and age group in 50 Spanish provinces between 2000 and 2012 were analysed. The annual trend of suicide mortality was assessed using Kendall's tau-b correlation coefficient. Seasonality and monthly and weekly behaviour were evaluated by performing the ANOVA test and the Bonferroni adjustment. Finally, the relationship between GDP per capita and suicide was studied. ResultsBetween 2000 and 2012, 42,905 adult people died by suicide in Spain. The annual average incidence rate was 95 suicides per million population. The regions located in the south and in the northwest of the country registered the highest per capita mortality rates. There is a decreasing trend in mortality by suicide over the period studied (CC=–.744; P=.0004) in adults over the age of 64, and a seasonal behaviour was identified with summer maximum and autumn minimum values (f=.504; P<.0001). The regions with the highest GDP per capita showed the lowest mortality by suicide (r=–.645; P<.0001) and the relationship is stronger among older age groups. ConclusionsMortality by suicide does not follow a homogenous geographical distribution in Spain. Mortality in men was higher than in women. Over the period of study, there has been a decrease in mortality by suicide in Spain in adults over the age of 64. The seasonal cycle of suicides and the inverse relationship with GDP per capita found in this study, provide information which may be used as a tool for developing prevention and intervention strategies.

Reproductive Decision Making in Spain: Heterosexual Couples’ Narratives About How They Chose to Have Children

This article seeks to expand researchers’ understanding of choice in the reproductive decision-making narratives of heterosexual couples to help explain fertility rates in Spain. The data comprise 32 interviews and two focus groups with heterosexual mothers and fathers. Two broad categories have been identified: couples who chose “when” to have children and couples who chose “whether” to have children. The results show that couples choosing “when” considered having children to be a normal step in the life course and had a shared plan to become parents. Couples who chose “whether” considered having children to be a voluntary lifestyle choice and decisions were more individualized. Both groups reported having decided to have children. Parents’ sense of responsibility for this decision could help explain the postponement of motherhood and low fertility rates in Spain.

Economy and Divorces: Their Impact Over Time on the Self-Employment Rates in Spain

The paper used time-series data and examined the effect of economic and social variables on the male and female self-employment rates in Spain. We also employed cointegration analysis (with and without) structural breaks. We thus find strong evidence that long run relationships exist among the variables. More precisely, we find that the unemployment rates and the ratio of self-employment to employees’ earnings have a positive effect on self-employment, whereas, economic development and divorce rates have a negative effect. Importantly, we find that the economic variables have equal or stronger long run impact on females than males, with both groups reacting to changes in family circumstances. Finally, we show that the short run family circumstances are better predictors of self-employment choices rather than economic factors, with self-employment being a means of adjustment to new personal circumstances and economic needs.

Unemployment and labour force participation in Spain

ABSTRACTThis article examines the relationship between the unemployment rate and the labour force participation rate in Spain. Cointegration analysis is performed for aggregate, male and female time-series. Results suggest that there is no a long-run relationship between the two variables for the aggregate and male cases. However, the findings support a long-run relationship between the two variables for the female time-series. Thus, the unemployment invariance hypothesis is supported in the two former cases but not in the latter.

Los accidentes laborales y la prevención de riesgos en los editoriales de la prensa española (ABC, El País y El Mundo, 1994-2014)

El estudio de los editoriales de la prensa española –El País, El Mundo y ABC– en un estudio transversal a lo largo de dos décadas revela que estos dedican escasos esfuerzos a la siniestralidad laboral y su prevención. Tras la publicación en 1995 de la Ley de Prevención de Riesgos Laborales, la mayor cantidad de editoriales se deriva de graves accidentes en el periodo de máxima siniestralidad en España. Desde 2007, con la crisis económica, los editoriales prácticamente desaparecen, siendo utilizada la prevención como excusa para acusar a sindicatos de desvío de fondos. En el presente artículo, utilizando la metodología del Framing, se determina que, aunque los encuadres principales son coincidentes, el tratamiento es distinto. Mientras ABC y El Mundo acusan a los sindicatos, El País pide más voz para ellos, dando importancia a sectores productivos donde estos son más fuertes como la minería y la industria.

Factors associated with late fetal mortality.

Perinatal mortality has been decreasing in Europe thanks to a reduction in neonatal mortality. The causes of fetal mortality remain poorly studied. The objective was to determine the late fetal mortality rate in Spain in 2015 and the associated factors. A cross-sectional study was performed using data regarding births in 2015 in Spain extracted from the National Institute of Statistics. Single births at 28 or more weeks of pregnancy were included. The sample comprised 340,371 births. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with the fetal mortality from 28weeks of pregnancy as the dependent variable. The total number of late fetal deaths was 884 (2.6×1000). The MLR model showed that the following factors were associated with late fetal mortality: birth before 37weeks of pregnancy (OR 13.1); weight of the newborn<2500g (OR 3.22) and≥4000g (OR 3.36); low training level (OR 2.28); and others, such as African origin, maternal age≥35years, primiparity and mothers who were single. The rate of late fetal mortality in Spain has not decreased and has remained at the same level as in 2010. This result is related to prematurity, low birth weight, macrosomia and sociodemographic factors, such as low maternal preparation, mothers of African origin, age≥35years and mothers who are single. It is necessary to improve the quality and accessibility of prenatal care and the early detection of risk factors.

Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother-Child Cohort in Spain.

Objective The aim of the study was to identify factors associated with non-initiation and cessation of predominant breastfeeding (PBF) in a mother-child cohort from Spain. Materials and Methods The analysis included 2195 mother-infant from birth to 14 months post- delivery recruited between 2004 and 2008. Maternal characteristics were collected during the pregnancy. Lactation data were obtained at 6 and 14 months after delivery. PBF was defined as intake of breast milk plus liquids like juices or water. The PBF cessation was calculated using the date that women started PBF and the date that she reported to start giving infant formula and/or food. The relationship between maternal variables and PBF initiation and cessation was modeled using logistic and Cox proportional hazards regression analysis. Results The prevalence of PBF at hospital discharge was 85.3, 53.4% at 3 months, 46.1% at 4 months and 7.2% at 6 month. Only two women continued PBF at 12 months and none at 14 months. The initiating of PBF was associated with higher levels of maternal education, being a first-time mother and worked in a non-manual occupation. Higher level of physical activity, not smoking and having a healthy BMI, were also positively associated with PBF initiation. PBF cessation was higher in young, obese women, who had had complications during the pregnancy, and who had lower levels of education and smoked. The employment status of women, in week 32 of pregnancy and also in month 14 post-delivery, determined likelihood of PBF cessation. Conclusions Healthier habits and education positively influenced PBF initiation and duration. Decrease in PBF duration rates in Spain can be interpreted in part as a consequence of women returning to work.

Economic Recession in Spain: Exploring the Root Causes, Consequences and Recoveries for the Sustainable Economic Growth

Spain is currently facing its worst financial and economic crisis in the last fifty years. The Spanish economic recession began in 2008 during the world financial crisis of 2007-08. The main cause of Spain's crisis was the burst of the housing bubble. The recession has implied a strong increase of the unemployment rate in Spain that surpassed 25% in 2012, the highest rate in western economies in that year. Therefore, this research aims at exploring the root causes, consequences and recoveries of the economic recession for the sustainable economic growth in Spain. In this study we systematically examine previous research on these topics of economic recession. This study also provides a theoretical basis for further studies on economic recession existing in other developed countries.

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates

There are many factors that can influence surgical site infections (SSI) in cholecystectomies. Incidence of cholecystectomy SSI was studied and compared with the incidence in Madrid Region, Spain, and the United States. A prospective cohort study was conducted which included all patients who underwent gallbladder surgery for 5 consecutive years, at the Alcorcón Foundation University Teaching Hospital. SSI incidence rate was calculated. An association between risk factors and SSI incidence was assessed with the relative risk (RR). Infection rates were compared to those in the Madrid Region and to the overall Spanish and United States rates using the standardized infection ratio (SIR). The study included 1532 patients. Cumulative overall SSI was 1.96% (95% confidence interval [CI]: 1.3-2.7). The SIR was 0.89 with respect to the Madrid Region, 0.77 with respect to Spain's rate, and 1.77 with respect to the United States' rate. A laparoscopic route protected against infection (RR = 0.43; 95% CI: 0.2-0.9). Razor shaving in surgical preparation, duration of surgery, and neoplasm increased SSI incidence. SSI incidence rates among cholecystectomized patients at our hospital are higher than rates in the United States. A laparoscopic route protected against SSI.

Prognostic value of event-free survival at 12 and 24 months and long-term mortality for non-Hodgkin follicular lymphoma patients: A study report from the Spanish Lymphoma Oncology Group.

Relatively few studies have analyzed the mortality of follicular lymphoma (FL) patients in comparison with a sex- and age-matched general population. This study analyzed the overall survival (OS) of patients with FL and compared their survival with the expected survival of a general population. Patients diagnosed with FL were prospectively enrolled from 1980 to 2013. Standardized mortality ratios (SMRs) were obtained from yearly sex- and age-specific mortality rates in Spain, and OS was compared with age- and sex-matched general population data. A total of 1074 patients with newly diagnosed FL were enrolled. The median OS was 231 months (95% confidence interval [CI], 195-267 months). Event-free survival at 12 months (EFS12) and event-free survival at 24 months (EFS24) were associated with an increased probability of early death, with an SMR of 10.27 (95% CI, 8.26-12.77) for EFS12. The overall SMR, including all causes of death, was 2.55 (95% CI, 2.23-2.92), and it was higher for women (SMR, 3.02; 95% CI, 2.48-3.67) and young adults (SMR, 6.01; 95% CI, 3.13-11.55). More than 10 years after the diagnosis, mortality rates for FL patients were lower than those for the general population (SMR, 0.47; 95% CI, 0.28-0.78). When FL was excluded as a cause of death, the overall SMR was 1.35 (95% CI, 1.11-1.65) without a statistically significant mortality increase in the >60-year-old group in comparison with age- and sex-matched general population data. More than 15% of the patients included in the study (n = 158) had more than 10 years of follow-up. EFS12 and EFS24 predict an early increase in mortality. The long-term SMR, over the course of 10 years of follow-up, shows that patients with FL have a risk of dying similar to that of a sex- and age-matched general population. Cancer 2017;123:3709-3716. © 2017 American Cancer Society.

Sex and Age Specific Projections of Smoking Prevalence in Spain: A Bayesian Approach.

To project future smoking prevalence rates in Spain by sex and age groups using Bayesian methods and to estimate the probability of a 30% relative reduction between 2010 and 2025. We used the data from the Spanish National Health Surveys (2003, 2006, and 2011) to obtain information about current and former smoking. We reconstructed annual smoking rates from 1989 through 2011 by sex and 5-year age groups. The prevalence were projected for the period 2012-2025 using a Bayesian logistic binomial model and estimated the probability to achieve the 30% relative reduction endorsed by the WHO. We calculated the 95% credible interval (CrI) of the posterior distribution, which includes a 95% of the distribution of potential smoking prevalences. In men, the projections show a decline for crude (-2.64% annually, 95% CrI: -3.32; -1.97) and adjusted (-2.50%, 95% CrI:-3.14; -1.87) prevalence. In women, the projections show a decline for crude prevalence (-0.36%, 95% CrI: -1.02; -0.30)) and the age-adjusted prevalence (-1.02%, 95% CrI: -1.61, -0.47). By age groups, the decline is greater among women aged 15-39 years (-3.92%, 95% CrI: -4.92; -2.96)) while for women aged 40-64 years an increase (1.84%, 95% CrI: 1.06; 2.58) is expected. In men, the probability to achieve the WHO target is 0.728 and in women is less than 0.001. The age group 15-39 shows the highest probability to achieve the target. The results suggest smoking prevalence will decrease during 2012-2025 in all age groups for both sexes except for women aged 40-64. We found that the WHO target of a 30% reduction in prevalence is likely to be achieved overall and in the 15-39 years age groups for both sexes, but not achieved for older women and it is uncertain whether it will be achieved for older men. These results highlight the need to strengthen public health interventions that focus on reducing tobacco use in adult women aged 40-64 years old. We project a decrease in smoking prevalence in during 2012-2025 except for women aged 40-64. The WHO Target of a 30% relative reduction could be achieved in the population aged 15-39; but not in women and the results are inconclusive in men. These results highlight the need to strengthen public health interventions that focus on reducing tobacco use in adult women aged 40-64 years old.

A stochastic dynamic model to evaluate the influence of economy and well-being on unemployment control

This paper presents a stochastic dynamic mathematical model to study the evolution of the unemployment rate and other relevant related variables in a country. This model is composed by three basic interrelated subsystems: demographic, economic and well-being ones. A key aspect of this model is that it considers three UN well-being variables simultaneously: Human Development Index, Gender Empowerment Index and Gender Differentiation Index. These variables involve key concepts for human development, as Health, Education, Economy and Female Labor. With this model, the most outstanding variables found in the literature in relation with unemployment control can be used to design strategies and scenarios to reduce the unemployment rate in the future. The model has been fitted for the case of Spain in the 2002–2014 period, the largest one with information about all the variables involved in the model. Finally, several tentative scenarios and strategies have been tested to reduce the unemployment rate in Spain in the horizon of year 2025, and the corresponding forecast evolution of the Gender Differentiation Index, National income per capita, Public debt and the ratio between Public debt and Gross domestic product are shown.

Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access

ObjectivesThe main aims of our study were to estimate the current rates and pattern of electroconvulsive therapy (ECT) use in Spain, as well as exploring the causes that may be limiting its use in our country. MethodsA cross-sectional survey was conducted covering every psychiatric unit in Spain as of 31 December 2012. ResultsMore than half (54.9%) of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. There are wide variations with regard to ECT application rates between the different autonomous communities (0.00–1.39) and provinces (0.00–3.90). ECT was prescribed to a mean of 25.5 patients per hospital that used the technique and 4.5 in referral centre (P=.000), but wide differences were reported in the number of patients who were prescribed ECT from hospital to hospital. ConclusionsAlthough the percentage of psychiatric units applying ECT in our country is among the highest in the world, the ECT application rate in Spain is among the lowest within western countries. Large differences in ECT use have been reported across the various autonomous communities, provinces and hospitals. Thus, health planning strategies need to be implemented, as well as promoting training in ECT among health professionals, if these differences in ECT use are to be reduced.

Gender Differentials in Unemployment Ins and Outs during the Great Recession in Spain

The Great Recession had led to gender convergence in unemployment rates. In this paper we seek its sources to assess whether this convergence will remain once the Great Recession ends. We use Social Security records to study the determinants of unemployment ins and outs for men and women separately, over the course of a whole business cycle, i.e. 2000–2013. We focus on Spain—a country hit hard by unemployment increases in downturns. We find that unemployment outs are crucial in understanding changes in unemployment rates in Spain as well as to understand the gender convergence in unemployment rates. Among the determinants of the large drop in unemployment outs, lack of demand and negative state dependence emerge as key sources, which affect men more negatively than women. In a scenario of upcoming recovery, unemployment outs will increase for short-term unemployed, particularly for males. On the contrary, both male and female long-term unemployed workers will face enormous difficulties to access a job, as the job access rates for long-term unemployed is not sensitive to the economic cycle. Hence, we expect that the gender convergence in unemployment rates will persist only when considering the long-term unemployed.

Patterns of inpatient care for acute myocardial infarction and 30-day, 3-month and 1-year cardiac diseases readmission rates in Spain

BackgroundAcute myocardial infarction (AMI) is a common cause of hospital discharges and readmissions. Readmissions may indicate poor patient care and avoidable health expenditure, being key in quality improvement strategies. Our aim was to analyse cardiac diseases (CDs) readmissions in patients with AMI in Spain. MethodsA retrospective analysis of 33,538 hospital discharges with AMI being the “principal diagnosis” at hospitals of the Spanish National Health System in 2012 was performed using administrative data. We developed a logistic regression model and calculated 30-day, 3-month and 1-year CDs risk-standardized readmission rates (RSRRs) using a multivariate mixed model. ResultsVariables of the model (AMI location, age, previous angina pectoris/myocardial infarction or acute coronary syndrome, chronic kidney disease, rheumatic valvular disease, diabetes mellitus, vascular disease, female sex, chronic pulmonary disease, and anemia) were able to predict 30-day, 3-month and 1-year readmission rates and RSRRs after AMI (5.4%, 9.3% and 20.2%, respectively). For RSRRs the area under the ROC curve was 0.74 (p=0.0037), 0.77 (p=0.0041), and 0.73 (p=0.0025) for 1, 3months and 1-year readmission rate, respectively. Angioplasty, cardiology as the medical unit responsible for the discharge and a higher volume of activity (>204 AMI) were all significantly (p<0.001) associated with lower mortality, risk of development of heart failure and RSRRs. ConclusionsAngioplasty, cardiology as the medical unit responsible for the discharge and a higher volume of activity explain variability in CDs readmission rates after AMI, which can have implications for strategies to reduce readmissions rates.

PCV110 - Sacubitril/Valsartan Estimated Cost Savings Based on Paradigm-HF Results

To assess potential cost savings of sacubitril/valsartan use compared to ACE inhibitors in chronic heart failure patients with reduced ejection fraction (HFrEF) in Spain. Potential direct and indirect costs from the use of sacubitril/valsartan were analyzed with a social perspective in two scenarios: including the whole PARADIGM-HF population, and patients under 65 years. Hospitalization and caregivers costs were included as direct costs and productivity loss (temporary disability costs) due to hospitalization and death as indirect costs. Hospitalization and caregiver costs were calculated from PARADIGM-HF data and a heart failure burden study in Spain (Delgado, 2014) and a heart failure hospitalization cost study (Obradors, 2015). Productivity loss due to hospitalization were estimated from PARADIGM-HF data, average days of disability (Social Security Spanish Institute), and Spanish average salary (Statistics Spanish Institute). Productivity loss due to death was calculated by the estimation of Life Years Gained (Clagget, 2015) adjusted for one year. Indirect costs were adjusted for working age population and activity rate in Spain. Results were expressed as a differential costs of sacubitril/valsartan vs enalapril for both groups of patients. Use of sacubitril/valsartan could reduce direct and indirect costs by 2.083,1€ per patient/year (5,7€ per patient /day) in general population. Cost savings for patients under 65 years would be of 2.416,3 € per patient/year (6,6€ per patient/day). Sacubitril/valsartan potentially reduce direct and indirect costs in chronic heart failure patients with reduced ejection fraction (HFrEF) in Spain. As different sources of information have been used, future investigations in real-world evidence will be needed to confirm the results.

Bubble economics and structural change: the cases of Spain and France compared

This paper delves into the recent events that led to the formation of the housing bubble in Spain and the resulting structural change that is arguably needed to put the economy back into the right track. For this purpose, we calibrate a model with different equilibria descriptive of the labor markets in Spain and France, where the unemployment rates went from the same initial spot to very different levels. In addition to this, we run a counterfactual analysis that throws some more light on the performance of the Spanish labor market and the housing bubble. Our results suggest that the unemployment rate in Spain has jumped to much higher levels while switching between equilibria or, what is the same, because of structural change. Moreover, our counterfactuals indicate that, first, there has been an important misdirection of resources into the construction industry mainly fueled by excessively low real interest rates and, second, the Spanish labor reform has fallen short of its own goals.

Analysis of cerebrovascular mortality trends in Spain from 1980 to 2011

IntroductionIn recent decades, mortality rates for cerebrovascular diseases (CVD) have declined significantly in many countries. This study analyses changes in CVD mortality rates in Spain (1980-2011) to determine if previously observed trends remain. Patients and methodsData on CVD mortality rates and the population data needed for the analysis were provided by Spain's National Statistics Institute. We calculated age-specific mortality rate, age-standardised overall mortality, and age-truncated mortality (35-64 years) using the direct method and standard European population structure. Joinpoint analysis was used to estimate the percentage of annual change in rates and identify significant changes in trends. ResultsCVD mortality rate decreased considerably and continuously over the last 32 years in all age groups and in both sexes in Spain. For both sexes, joinpoint analysis identifies a final period with more marked decline: 2005-2011 in women (−6.3%) and 2007-2011 in men (−7.2%). ConclusionsCVD mortality rates displayed a marked and continuous decline in Spain between 1980 and 2011. Due to the ageing of the population, doctors expect an increase in CVD prevalence and therefore its magnitude in terms of disability and healthcare costs, which poses a challenge to our health system.

Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access.

The main aims of our study were to estimate the current rates and pattern of electroconvulsive therapy (ECT) use in Spain, as well as exploring the causes that may be limiting its use in our country. A cross-sectional survey was conducted covering every psychiatric unit in Spain as of 31 December 2012. More than half (54.9%) of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. There are wide variations with regard to ECT application rates between the different autonomous communities (0.00-1.39) and provinces (0.00-3.90). ECT was prescribed to a mean of 25.5 patients per hospital that used the technique and 4.5 in referral centre (P=.000), but wide differences were reported in the number of patients who were prescribed ECT from hospital to hospital. Although the percentage of psychiatric units applying ECT in our country is among the highest in the world, the ECT application rate in Spain is among the lowest within western countries. Large differences in ECT use have been reported across the various autonomous communities, provinces and hospitals. Thus, health planning strategies need to be implemented, as well as promoting training in ECT among health professionals, if these differences in ECT use are to be reduced.