Sistema Nacional de Salud español. Características y análisis

La Ley General de Sanidad 14/1986 de 25 de Abril posibilitó el tránsito del antiguo modelo de Seguridad Social al actual modelo de Sistema Nacional de Salud (SNS), financiado con impuestos y de cobertura prácticamente universal. Desde entonces se han producido profundos cambios en el sistema que culminaron en el año 2002 con la descentralización total de competencias en materia de salud en las Comunidades Autónomas. La regulación nacional de competencias en materia de salud se realiza desde el Consejo Interterritorial del Sistema Nacional de Salud, organismo que agrupa a los máximos responsables autonómicos en materia de salud de cada Comunidad Autónoma y que tiene entre otras, la responsabilidad de evitar las desigualdades en servicios sanitarios dentro del territorio nacional. La creación y competencias del Consejo Interterritorial quedan recogidas en la Ley 16/2003 de 28 de mayo de Cohesión de la calidad del Sistema Nacional de Salud. La cartera de servicios comunes del SNS se establece en el Real Decreto 1030/2006 de 15 de Septiembre, actualizando el Real Decreto 63/1995 de 20 de enero sobre Ordenación de las prestaciones sanitarias, resultando del actual marco legislativo con la descentralización de competencias y gestión de los presupuestos un horizonte de posible variabilidad en los modelos de gestión de cada CCAA, que, si bien deben garantizar la universalidad de las prestaciones, también ofrece una diversidad de modalidades de gestionar los recursos en materia de salud. En cuanto al estado de salud de los españoles, destacar que la esperanza de vida al nacer se sitúa en 79,9 años, superior a la media europea, 78,3 años, y la esperanza de vida ajustada por incapacidad fue en 2002 de 72,6 años en España respecto a los 70,8 de la UE. Según cifras del propio Ministerio de Sanidad, la percepción de la salud de los ciudadanos fue positiva para un 73% de los hombres y un 63,2 de las mujeres. Alrededor del 60% de la población tiene un peso normal y la morbilidad sitúa en los primeros lugares las enfermedades del aparato circulatorio, el cáncer y las enfermedades del aparato respiratorio (CIE-9). El gasto sanitario en España, es un capítulo presupuestario importante, al situarse en torno al 7,5 del P.I.B, y los recursos e inversiones presentan aparentes desigualdades autonómicas. Los modelos de gestión y dependencia patrimonial de los recursos, variables entre Autonomías, plantean la necesidad de monitorizar un seguimiento que permita evaluar en los próximos diez años el impacto de la descentralización de competencias del Sistema. La estructura del Sistema tiene dos niveles asistenciales mayoritarios, atención primaria y especializada, absorbiendo la atención especializada la mayor parte del presupuesto. El incremento del gasto sanitario y la universalidad de las prestaciones han condicionado en gran medida la implantación de modelos de gestión diferentes a los tradicionales. Esta situación no es exclusiva del Estado Español. En los Estados del entorno de la Unión Europea, el Consejo de Ministros de Sanidad de la UE en su sesión celebrada los días 1 y 2 de Junio de 200625 concluyeron un documento que recoge los valores y principios comunes de los sistemas sanitarios de los países de la Unión Europea, resaltando los principios y valores de los sistemas sanitarios como soporte estructural de dichos estados. Como conclusión, en este momento (2007) el Sistema Nacional de Salud Español, está inmerso en un proceso de trasformación orientado a garantizar la eficiencia de las prestaciones de manera responsable, es decir, ofertar al ciudadano la mejor calidad de servicios al mínimo coste.

Relationship between taxocenoses of decapod crustaceans and characteristics of coastal detritic bottoms in the east and southeast of the Spanish coast

Se ha estudiado la composición de las poblaciones de crustáceos decápodos en los fondos detríticos circalitorales del Este y Sureste ibérico, con relación a sus diferentes facies, efectuándose diferentes análisis estadísticos sobre la composición y diversidad. La taxocenosis de crustáceos decápodos muestra elevados valores de abundancia, riqueza y diversidad en las localidades identificadas como fondos detríticos costeros de aspecto típico. Por último, algunos grupos de especies podrían ser utilizados para caracterizar las biocenosis típica de fondos detríticos costeros, tales como: Paguristes eremita, Ebalia edwardsi, E. deshayesi, Eurynome aspera, Galathea intermedia, Parthenope massena, y Anapagurus hyndmani; la biocenosis del detrítico costero enfangada: Ebalia tuberosa, Atelecyclus rotundatus, Ethusa mascarone, y Liocarcinus zariquieyi; y la biocenosis de arenas fangosas: Upogebia deltaura, Goneplax rhomboides.

The location of the Spanish technological centers

Paper submitted to the 42nd Congress of ERSA, Dortmund, August 27th–31st 2002.

Psychometric behaviour of the strengths and difficulties questionnaire (SDQ) in the Spanish national health survey 2006

Background: The Strengths and Difficulties Questionnaire (SDQ) is a tool to measure the risk for mental disorders in children. The aim of this study is to describe the diagnostic efficiency and internal structure of the SDQ in the sample of children studied in the Spanish National Health Survey 2006. Methods: A representative sample of 6,773 children aged 4 to 15 years was studied. The data were obtained using the Minors Questionnaire in the Spanish National Health Survey 2006. The ROC curve was constructed and calculations made of the area under the curve, sensitivity, specificity and the Youden J indices. The factorial structure was studied using models of exploratory factorial analysis (EFA) and confirmatory factorial analysis (CFA). Results: The prevalence of behavioural disorders varied between 0.47% and 1.18% according to the requisites of the diagnostic definition. The area under the ROC curve varied from 0.84 to 0.91 according to the diagnosis. Factor models were cross-validated by means of two different random subsamples for EFA and CFA. An EFA suggested a three correlated factor model. CFA confirmed this model. A five-factor model according to EFA and the theoretical five-factor model described in the bibliography were also confirmed. The reliabilities of the factors of the different models were acceptable (>0.70, except for one factor with reliability 0.62). Conclusions: The diagnostic behaviour of the SDQ in the Spanish population is within the working limits described in other countries. According to the results obtained in this study, the diagnostic efficiency of the questionnaire is adequate to identify probable cases of psychiatric disorders in low prevalence populations. Regarding the factorial structure we found that both the five and the three factor models fit the data with acceptable goodness of fit indexes, the latter including an externalization and internalization dimension and perhaps a meaningful positive social dimension. Accordingly, we recommend studying whether these differences depend on sociocultural factors or are, in fact, due to methodological questions.

Injury incidence in judokas at the Spanish National University Championship

Background and Study Aim: Understanding injury incidence rates will be a great help with regards to preventing potential future damages. It is for this reason that this study suggests studying a large number of variables. The purpose of research is the relationship of events (empirical variables) that are usually taken into account in developing injury prevention programs during the battles and training in judo tournament. Material and methods: In this research project, 57 male judokas taking part in the Spanish National University Championship in 2009 were asked to complete a retrospective questionnaire. We analysed the following events: the most commonly injured body regions, the medical diagnosis, how and when the injury happened, the type of injury, the side of the body and the type of medical attention received. For the statistical analysis, we used the SPSS statistics programme to apply the Chi-square test in order to determine the significance levels for non-parametric tests from p<.05. Results: Significant differences were found in the most commonly injured body region, the shoulder/clavicle (p<.05), and in the most common diagnosis, the sprain (p<.05). Impact injuries (p<.05) are the most common and training (p<.05) is the most dangerous time. About the type of injury, 78.38% are new injuries (p<.05) and 69.05% affect the right hand side of the body (p<.05). Doctors are the most consulted specialists, but the physiotherapists obtained the best marks. Have been out due to injury for over 21 days 36.36% of the participants, but not for the entire season. Conclusions: The most common diagnosis in university student judokas coincides with those of elite judokas, with the sprain being the most common. University student judokas have a higher rate of shoulder/clavicle injuries, while professional judokas are prone to a higher rate of knee injuries. Training is the most common moment in which injuries occur, both in university student judokas and professional judokas. New injuries are the most common types of injuries in university student judokas and, while doctors are the most consulted specialists, the physiotherapists obtained the best marks.

When Spanish owns English words

The English language and the Internet, both separately and taken together, are nowadays well-acknowledged as powerful forces which influence and affect the lexico-grammatical characteristics of other languages world-wide. In fact, many authors like Crystal (2004) have pointed out the emergence of the so-called Netspeak, that is, the language used in the Net or World Wide Web; as Crystal himself (2004: 19) puts it, ‘a type of language displaying features that are unique to the Internet […] arising out of its character as a medium which is electronic, global and interactive’. This ‘language’, however, may be differently understood: either as an adaptation of the English language proper to internet requirements and purposes, or as a new and rapidly-changing and developing language as a result of a rapid evolution or adaptation to Internet requirements of almost all world languages, for whom English is a trendsetter. If the second and probably most plausible interpretation is adopted, there are three salient features of ‘Netspeak’: (a) the rapid expansion of all its new linguistic developments thanks to the Internet itself, which may lead to the generalization and widespread acceptance of new words, coinages, or meanings, hundreds of times faster than was the case with the printed media. As said above, (b) the visible influence of English, the most prevalent language on the Internet. Consequently, (c) this new language tends to reduce the ‘distance’ between English and other languages as well as the ignorance of the former by speakers of other languages, since the ‘Netspeak’ version of the latter adopts grammatical, syntactic and lexical features of English. Thus, linguistic differences may even disappear when code-switching and/or borrowing occurs, as whole fragments of English appear in other language contexts. As a consequence of the new situation, an ideal context appears for interlanguage or multilingual word formation to thrive: puns, blends, compounds and word creativity in general find in the web the ideal place to gain rapid acceptance world-wide, as a result of fashion, coincidence, or sheer merit of the new linguistic proposals.

Spatiotemporal characteristics of the Huangtupo landslide in the Three Gorges region (China) constrained by radar interferometry

The Huangtupo landslide is one of the largest in the Three Gorges region, China. The county-seat town of Badong, located on the south shore between the Xiling and Wu gorges of the Yangtze River, was moved to this unstable slope prior to the construction of the Three Gorges Project, since the new Three Gorges reservoir completely submerged the location of the old city. The instability of the slope is affecting the new town by causing residential safety problems. The Huangtupo landslide provides scientists an opportunity to understand landslide response to fluctuating river water level and heavy rainfall episodes, which is essential to decide upon appropriate remediation measures. Interferometric Synthetic Aperture Radar (InSAR) techniques provide a very useful tool for the study of superficial and spatially variable displacement phenomena. In this paper, three sets of radar data have been processed to investigate the Huangtupo landslide. Results show that maximum displacements are affecting the northwest zone of the slope corresponding to Riverside slumping mass I#. The other main landslide bodies (i.e. Riverside slumping mass II#, Substation landslide and Garden Spot landslide) exhibit a stable behaviour in agreement with in situ data, although some active areas have been recognized in the foot of the Substation landslide and Garden Spot landslide. InSAR has allowed us to study the kinematic behaviour of the landslide and to identify its active boundaries. Furthermore, the analysis of the InSAR displacement time-series has helped recognize the different displacement patterns on the slope and their relationships with various triggering factors. For those persistent scatterers, which exhibit long-term displacements, they can be decomposed into a creep model (controlled by geological conditions) and a superimposed recoverable term (dependent on external factors), which appears closely correlated with reservoir water level changes close to the river's edge. These results, combined with in situ data, provide a comprehensive analysis of the Huangtupo landslide, which is essential for its management.

Influence of tree hollow characteristics on the diversity of saproxylic insect guilds in Iberian Mediterranean woodlands

Saproxylic diversity assessment is a major goal for conservation strategies in woodlands and it should consider woodland composition and configuration at site and tree level as key modelling factors. However, in Mediterranean woodlands little is known about the relation with the environmental factors that structure their assemblages, especially those linked to tree hollow microhabitats. We assessed the diversity of Syrphidae (Diptera) and Coleoptera saproxylic guilds that co-occurred in tree hollows located in three different Iberian Mediterranean woodlands in the Cabañeros National Park (Spain). Furthermore, we evaluated how differences in tree hollow microenvironmental variables (understood as the physical and biotic characteristics of a hollow and tree individual) influenced saproxylic guild diversity both within and among woodland sites. We found that woodland sites that provided greater heterogeneity of trees and hollow microhabitats determined higher saproxylic guild diversity. Nevertheless, certain species or even complete guilds can be favoured in woodlands where some hollow microhabitats predominate as a consequence of historical tree management. In general, hollow volume was the main determining factor for saproxylic guild richness and abundance in woodland sites, and large hollow volume was usually related to higher diversity, which highlighted the importance of multi-habitat hollow trees. Moreover, saproxylic guilds also responded to other different microenvironmental variables, which indicated different ecological preferences among guilds. The conservation of saproxylic insects in Iberian Mediterranean areas must be addressed to protect woodland sites that provide high diversity and large numbers of tree hollow microhabitats, and practices to enhance microhabitat heterogeneity should even be encouraged.

Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background: Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Methods: Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. Results: By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Conclusions: Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.

Mortalidad perinatal en los partos únicos asistidos a término en España entre 1995 y 2009 según ocurrieran en domicilio particular o en centro sanitario

Objetivo principal: Evidenciar posibles diferencias en la mortalidad perinatal de los partos únicos asistidos a término en España entre 1995 y 2009, según ocurrieran en domicilio particular o en centro sanitario. Metodología: Estudio de cohorte retrospectivo a partir del registro de partos del Instituto Nacional de Estadística de España (INE). Resultados principales: Entre 1995 y 2009 ocurrieron 23 muertes del feto o del recién nacido (hasta las primeras 24 horas de vida) sobre un total de 14.614 partos únicos asistidos a término en domicilio particular (1,57 muertes cada mil partos). El número de muertes en partos de las mismas características ocurridos en centros sanitarios fue de 7.548 sobre un total de 4.716.956 partos (1,60 muertes cada mil partos). OR=0,98 IC(95%)=0,65-1,48. Conclusión principal: Entre 1995 y 2009 no se han dado diferencias estadísticamente significativas en relación con la mortalidad del feto o el recién nacido registrada en el Boletín Estadístico del Parto, entre los partos únicos asistidos a término en domicilio particular y los partos de las mismas características atendidos en centro sanitario.

Investigating the influence of surfactants on the stabilization of aqueous reduced graphene oxide dispersions and the characteristics of their composite films

The stabilization of reduced graphene oxide (RGO) sheets in aqueous dispersion using a wide range of surfactants of anionic, non-ionic and zwitterionic type has been investigated and compared under different conditions of pH, surfactant and RGO concentration, or sheet size. The observed differences in the performance of the surfactants were rationalized on the basis of their chemical structure (e.g., alkylic vs. aromatic hydrophobic tail or sulfonic vs. carboxylic polar head), thus providing a reference framework in the selection of appropriate surfactants for the processing of RGO suspensions towards particular purposes. RGO-surfactant composite paper-like films were also prepared through vacuum filtration of the corresponding mixed dispersions and their main characteristics were investigated. The composite paper-like films were also electrochemically characterized. Those prepared with two specific surfactants exhibited a high capacitance in relation to their surfactant-free counterpart.

The new economy in Spain: a regional analysis

Paper submitted to the 44th European Congress of the European Regional Science Association, Porto, 25-29 August 2004.

Evidence-based editing: factors influencing the number of citations in a national journal

Purpose: Citations received by papers published within a journal serve to increase its bibliometric impact. The objective of this paper was to assess the influence of publication language, article type, number of authors, and year of publication on the citations received by papers published in Gaceta Sanitaria, a Spanish-language journal of public health. Methods: The information sources were the journal website and the Web of Knowledge, of the Institute of Scientific Information. The period analyzed was from 2007 to 2010. We included original articles, brief original articles, and reviews published within that period. We extracted manually information regarding the variables analyzed and we also differentiated among total citations and self-citations. We constructed logistic regression models to analyze the probability of a Gaceta Sanitaria paper to be cited or not, taking into account the aforementioned independent variables. We also analyzed the probability of receiving citations from non-Spanish authors. Results: Two hundred forty papers fulfilled the inclusion criteria. The included papers received a total of 287 citations, which became 202 when excluding self-citations. The only variable influencing the probability of being cited was the publication year. After excluding never cited papers, time since publication and review papers had the highest probabilities of being cited. Papers in English and review articles had a higher probability of citation from non-Spanish authors. Conclusions: Publication language has no influence on the citations received by a national, non-English journal. Reviews in English have the highest probability of citation from abroad. Editors should decide how to manage this information when deciding policies to raise the bibliometric impact factor of their journals.

A reassessment of traditional lexicographical tools in the light of new corpora: sports Anglicisms in Spanish

There is no question nowadays as to the international and powerful status of English at a global scale and, consequently, as to its presence in non-English speaking countries at different levels. Linguistically speaking, English is one of the languages which have mostly influenced Spanish throughout its history and especially from the late 1960s. In this study, the impact of English on Spanish is considered in the language of sports; particularly, sports Anglicisms and false Anglicisms are analysed. Due attention is paid to the different forms that an Anglicism may adopt and to which of those forms are more widely accepted or rejected by prescriptivists and speakers at large, in the light of a contrastive analysis of their appearance in the Nuevo diccionario de anglicismos, the Diccionario de la Real Academia Española and the Corpus de Referencia del Español Actual.

False anglicisms in the Spanish language of fashion and beauty

Many works have already dealt with anglicisms in Spanish, especially in science and information technologies. However, despite the high and growing number of English terms incorporated daily by the language of fashion, it has received comparative less attention in lexicographic and terminological studies than that of other areas, such as science or business. For several reasons, which include prestige or peer pressure, Spanish has not only adopted English words with new meanings and usage, but also contains other forms based on English patterns which users seem to consider more accurate or expressive. This paper concentrates on false anglicisms as indicators of some of the special relationships and influences between languages arising from the pervasive presence of English. We shall look at the Spanish language of fashion, which, in addition to genuine anglicisms, has for some time been using English words with different meanings, or even created items of its own (or imported them from other languages) with the appearance of English words. These false anglicisms, which have proven extremely popular in receiving languages (not only in Spanish) have frequently been disseminated by youth magazines and the new digital media, both in general spheres and in fashion-specific contexts.