Food, nutrition and public health in contemporary Spain, 1900-1936

Within the context of the health reforms introduced in Spain in the early 20th century and the influence of international health organisations on their development, this article analyses the growing interest that surrounded nourishment and food-related problems at that time in relation to healthcare, the diagnosis provided by hygienists of such problems, and the public health measures applied to resolve them. The issue of hygienic diet and the collective aspect of nutritional problems became priorities in the field of healthcare. Two of the most prominent initiatives involved setting up a Department of Nutrition and Food Hygiene and Bromatological Technique during the early years of the Second Republic, as part of the National School of Health, as well as a Food Hygiene Service. Spanish hygienists underlined the importance of education and the dissemination of information about food hygiene, health and nutrition, in order to overcome the qualitative and quantitative deficiencies observed in the average diet of the Spanish population.

Excavated housing in Crevillente (Spain). Constructive and typologycal study

Underground architecture has sheltered man for many centuries, but the current need to emphasize the bioclimatic approach makes the study of excavated housing essential. This traditional construction is a part of the collective human living experience but also a reference in using the natural conditions of each region through simple proposals based on ground thermal inertia. The aim of this paper is to show the typological evolution of the excavated dwelling in Crevillente, in southeast Spain, compared to other worldwide architectural proposals or urban solutions. To show their adaptation to the regional geography and to comprehend both formal and material characteristics of these simple typologies, which do not need extra energy contribution for interior conditioning. This work is part of the doctoral thesis of the author.

La cobertura periodística de la obesidad en la prensa española (2000-2005)

Antecedentes: la obesidad es un problema de salud pública en España. Los medios de comunicación son una herramienta útil para la salud pública. Objetivo: explorar el tratamiento periodístico de la obesidad en la prensa escrita española durante 2000-2005, frecuencia de aparición, fuentes de información y enfoques, en relación con el contexto social. Materiales y métodos: análisis de contenido cuantitativo de 690 noticias publicadas en El País, El Mundo y ABC. Cálculo de frecuencias y odds ratio (OR) con intervalos de confianza (IC) del 95% y significación estadística. Resultados: incrementaron las noticias de 2000 (n=25) a 2005 (n=185). Se centraron en denuncias (36,4%) y magnitud del problema (15,7%), en detrimento de aquellas sobre iniciativas-estrategias políticas (3,8%). Destacan los hombres como fuentes informativas principales (75,5%) y las mujeres como primeras firmantes de las noticias (56,1%). Los hombres del ámbito médico-sanitario (OR=1,98;IC95%,1,11-3,57) y las mujeres del ámbito político (OR=2,54;IC95%1,46-4,42) tienen mayor probabilidad de ser la fuente informativa principal. Conclusiones: la cobertura periodística de la obesidad durante 2000-2005 aumentó, coincidiendo con el desarrollo de respuestas políticas en torno al tema. Principalmente, se denuncia el problema. Destaca la escasa cobertura periodística de iniciativas-estrategias políticas, sugiriendo incipiente interacción entre la agenda política y mediática.

Primeras políticas de vivienda en España y su influencia en la evolución de la tipología residencial: el caso de Benalúa (1883-1956)

El estudio del proceso de adaptación tipológica de las arquitecturas residenciales del barrio de Benalúa, una de las áreas consolidadas más singulares de la ciudad de Alicante (España), constituye un ejemplo clave para entender el alcance que tuvieron las primeras políticas de vivienda aplicadas en ese país, con anterioridad a la redacción de los Planes Generales que, en el transcurso del siglo XX, fueron ordenando las ciudades españolas y que en el caso de Alicante coincidió con la aprobación de la primera Ley del Suelo estatal (1956). De su análisis se obtienen las conclusiones que identifican los procedimientos que, por cambios sociales, políticos, de normativa o presión del mercado inmobiliario, condicionaron la evolución de la vivienda durante siete décadas, huellas que en la actualidad vienen desapareciendo a un ritmo vertiginoso, constatando el grado de intervención del Estado y de los municipios, así como su influencia y responsabilidad en la determinación de los tipos edificatorios.

The Spanish version of the Prenatal Breast-feeding Self-efficacy Scale: Reliability and validity assessment

Background: Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breast-feeding self-efficacy is a mother's confidence in her ability to breastfeed and is predictive of breastfeeding behaviors. The Prenatal Breast-feeding Self-efficacy Scale (PBSES) was developed among English-speaking mothers to measure breastfeeding self-efficacy before delivery. Objectives: To translate the PBSES into Spanish and assess its psychometric properties. Design: Reliability and validity assessment. Setting: A public hospital in Yecla, Spain. Participants: A convenience sample of 234 pregnant women in their third trimester of pregnancy. Methods: The PBSES was translated into Spanish using forward and back translation. A battery of self-administered questionnaires was completed by participants, including a questionnaire on sociodemographic variables, breastfeeding experience and intention, as well as the Spanish version of the PBSES. Also, data on exclusive breastfeeding at discharge were collected from hospital database. Dimensional structure, internal consistency and construct validity of the Spanish version of PBSES were assessed. Results: Confirmatory factor analysis suggested the presence of one construct, self-efficacy, with four dimensions or latent variables. Cronbach's alpha coefficient for internal consistency was 0.91. Response patterns based on decision to breastfeed during pregnancy provided evidence of construct validity. In addition, the scores of the Spanish version of the PBSES significantly predicted exclusive breastfeeding at discharge. Conclusions: The Spanish version of PBSES shows evidences of reliability, and contrasting group and predictive validity. Confirmatory factor analysis indicated marginal fit and further studies are needed to provide new evidence on the structure of the scale. The Spanish version of the PBSES can be considered a reliable measure and shows validity evidences.

Género y profesión en la evolución histórica de la Enfermería Comunitaria en España

El ámbito comunitario y de salud pública es probablemente el contexto donde las enfermeras han logrado mayores cotas de autonomía profesional y donde su contribución ha sido valorada en mayor medida. No obstante, todavía persisten grandes obstáculos para el pleno desarrollo, algunos de ellos vinculados a la variable género. Por ello, resulta relevante analizar, para el caso español, los antecedentes históricos de esta situación, en la medida que puede ayudar a entender muchos de los problemas y deficiencias que sigue mostrando la Enfermería Comunitaria en la actualidad. Las enfermeras comunitarias contribuyeron al desarrollo de la salud pública en la España contemporánea, proceso que se inició en los años 1920 y que culminó durante la Segunda República, pero el periodo franquista supuso un importante freno al proceso de profesionalización. A través del ejemplo del conflicto público entre enfermeras visitadoras y practicantes, que se gestó en la Segunda República, y se prolongó durante todo el periodo franquista, se analiza cómo el discurso de género estuvo presente, entre otros condicionantes, en la evolución de la Enfermería española y cómo ha venido contribuyendo, hasta nuestros días, en la estructuración de las competencias, y la distribución de responsabilidades y poder.

Professionals’ Perceptions of Support Resources for Battered Immigrant Women Chronicle of an Anticipated Failure

The aim of this study was to explore the experience of service providers in Spain regarding their daily professional encounters with battered immigrant women and their perception of this group’s help-seeking process and the eventual abandonment of the same. Twenty-nine in-depth interviews and four focus group discussions were conducted with a total of 43 professionals involved in providing support to battered immigrant women. We interviewed social workers, psychologists, intercultural mediators, judges, lawyers, and public health professionals from Spain. Through qualitative content analysis, four categories emerged: (a) frustration with the victim’s decision to abandon the help-seeking process, (b) ambivalent positions regarding differences between immigrant and Spanish women, (c) difficulties in the migratory process that may hinder the help-seeking process, and (d) criticisms regarding the inefficiency of existing resources. The four categories were cross-cut by an overarching theme: helping immigrant women not to abandon the help-seeking process as a chronicle of anticipated failure. The main reasons that emerged for abandoning the help-seeking process involved structural factors such as economic dependence, loss of social support after leaving their country of origin, and limited knowledge about available resources. The professionals perceived their encounters with battered immigrant women to be frustrating and unproductive because they felt that they had few resources to back them up. They felt that despite the existence of public policies targeting intimate partner violence (IPV) and immigration in Spain, the resources dedicated to tackling gender-based violence were insufficient to meet battered immigrant women’s needs. Professionals should be trained both in the problem of IPV and in providing support to the immigrant population.

Desigualdades de género en la investigación en salud pública y epidemiología en España (2007-2014)

Objetivo: Analizar las desigualdades de género en investigación en salud pública y epidemiología en España, en el periodo 2007-2014. Método: Estudio descriptivo según sexo de posiciones de liderazgo del Centro de Investigación Biomédica en Red (CIBER), especialmente en el área temática de epidemiología y salud pública (CIBERESP) en 2014; de sociedades científicas de salud pública (SESPAS) y epidemiología (SEE), 2009-2014; y de proyectos de investigación solicitados (13.320) y financiados (4699), e importes de convocatorias de Acción Estratégica en Salud (AES), 2007-2013. Resultados: Existe una clara infrarrepresentación de mujeres líderes y contratadas en investigación de excelencia en salud pública (CIBERESP), con predominio de los hombres en puestos de decisión. Aunque los proyectos de investigación de la Acción Estratégica en Salud (AES) liderados por mujeres han crecido ligeramente entre 2007 y 2013, entre los solicitados no alcanzan el 50%, con excepción de los de la Comisión de Salud Pública. La brecha de género es aún mayor en proyectos financiados. Los proyectos liderados por hombres tienen mayor probabilidad de obtener financiación, alcanzando el 29% en los de salud pública. Persiste una segregación horizontal de género en posiciones de reconocimiento científico en congresos de SESPAS y SEE. Conclusiones: La sobrerrepresentación de líderes masculinos en la investigación en salud pública en España debe entenderse como indicador y consecuencia del androcentrismo en las sociedades científicas y los grupos profesionales. Esta situación sexista pone en riesgo la existencia de productos y servicios innovadores desde la perspectiva de género que den respuestas a necesidades y demandas de toda la sociedad. Se necesitan más mujeres en investigación que tengan incorporada esta perspectiva.

Radon measurements in the cave houses of Crevillente (Spain)

This paper focuses on the cave houses of Crevillente (Spain) as a traditional housing experience which takes advantage of local environmental conditions through simple architectural proposals, paying particular attention to the presence of radon gas inside these underground constructions. Our aim is twofold: first, to analyse the architectural conditions of the different excavated typologies found in the municipality and second, to relate them to the existing radon gas levels after checking internal concentration by means of E-PERM® long-term devices placed inside the cave houses in 2011. The measurements corresponding to the main typologies in normal use conditions show that the highest values are 881.9 Bq/m3 in the cave typology, 484.1 Bq/m3 in the cave + attached constructions typology and 373.4 Bq/m3 in the cave + house typology, with geometric mean values of 572.1, 114.0 and 75.5 Bq/m3, respectively. It can be inferred from these results that cave house levels sometimes exceed those included in the 90/143/Euratom European Commission Recommendation on the protection of the public against indoor exposure to radon. The reason why cave houses are more susceptible to radon accumulation in their spaces lies in their direct and permanent contact with the ground where they are located.

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.

Inequality in analgesic prescription in Spain: a gender development issue

Objectives: It is well known that sex differences in analgesic prescription are not merely the logical result of greater prevalence of pain in women, since this therapeutic variability is related to factors such as educational level or social class. This study aims to analyse the relationship between analgesic prescription and gender development in different regions of Spain. Methods: Cross-sectional study of sex-differences in analgesic prescription according to the gender development of the regions studied. Analgesic prescription, pain and demographic variables were obtained from the Spanish Health Interview Survey in 2006. Gender development was measured with the Gender Development Index (GDI). A logistic regression analysis was conducted to compare analgesic prescription by sex in regions with a GDI above or below the Spanish average. Results: Once adjusted by pain, age and social class, women were more likely to be prescribed analgesics than men, odds ratio (OR) = 1.74 (1.59-1.91), as residents in regions with a lower GDI compared with those in region with a higher GDI: ORWomen = 1.26 (1.12-1.42), ORMen = 1.30 (1.13-1.50). Women experiencing pain in regions with a lower GDI were more likely than men to be treated by a general practitioner rather than by a specialist, OR = 1.32 (1.04-1.67), irrespective of age and social class. Conclusions: Gender bias may be one of the pathways by which inequalities in analgesic treatment adversely affect women's health. Moreover, research into the adequacy of analgesic treatment and the possible medicalisation of women should consider contextual factors, such as gender development.

Work-related health problems among resident immigrant workers in Italy and Spain

Background: in both Spain and Italy the number of immigrants has strongly increased in the last 20 years, currently representing more than the 10% of workforce in each country. The segregation of immigrants into unskilled or risky jobs brings negative consequences for their health. The objective of this study is to compare prevalence of work-related health problems between immigrants and native workers in Italy and Spain. Methods: data come from the Italian Labour Force Survey (n=65 779) and Spanish Working Conditions Survey (n=11 019), both conducted in 2007. We analyzed merged datasets to evaluate whether interviewees, both natives and migrants, judge their health being affected by their work conditions and, if so, which specific diseases. For migrants, we considered those coming from countries with a value of the Human Development Index lower than 0.85. Logistic regression models were used, including gender, age, and education as adjusting factors. Results: migrants reported skin diseases (Mantel-Haenszel pooled OR=1.49; 95%CI: 0.59-3.74) and musculoskeletal problems among those employed in agricultural sector (Mantel-Haenszel pooled OR=1.16; 95%CI: 0.69-1.96) more frequently than natives; country-specific analysis showed higher risks of musculoskeletal problems among migrants compared to the non-migrant population in Italy (OR=1.17; 95% CI: 0.48-1.59) and of respiratory problems in Spain (OR=2.02; 95%CI: 1.02-4.0). In both countries the risk of psychological stress was predominant among national workers. Conclusions: this collaborative study allows to strength the evidence concerning the health of migrant workers in Southern European countries.

Prevalence of exposure to occupational risks during preganancy in Spain

Objectives. We describe reported exposures to main categories of occupational agents and conditions in Spanish pregnant workers. Methods. Women were recruited at 12th week of pregnancy from main public gynaecological consults to be included in the INMA Spanish cohorts study (n = 2,058). Through personal interviews with structured questionnaires, information on working situation and working conditions during pregnancy was obtained. Results. Fifty percent of the women reported frequent exposure to physical load (standing, heavy lifting) and 45 % reported exposure to three or more indicators of job strain. Exposure to at least one physical agent (noise, vibrations, etc.) affected 25 % of the women. Exposure to chemicals was reported by 20 % of the women, mostly including solvents and cleaning products. Eight percent of the women worked at night shifts. Job strain was more prevalent in office workers and industrial operators. Industrial workers showed the highest prevalence of exposure to chemical and physical pollutants. Conclusions. Our data suggest that working conditions of pregnant women may need increased control in Spain.

A public key cryptosystem based on block upper triangular matrices

We propose a public key cryptosystem based on block upper triangular matrices. This system is a variant of the Discrete Logarithm Problem with elements in a finite group, capable of increasing the difficulty of the problem while maintaining the key size. We also propose a key exchange protocol that guarantees that both parties share a secret element of this group and a digital signature scheme that provides data authenticity and integrity.

Social determinants of self-perceived discrimination in Spain

Objectives: To analyse the association between self-perceived discrimination and social determinants (social class, gender, country of origin) in Spain, and further to describe contextual factors which contribute to self-perceived discrimination. Methods: Cross-sectional design using data from the Spanish National Health Survey (2006). The dependent variable was self-perceived discrimination, and independent and stratifying variables were sociodemographic characteristics (e.g. sex, social class, country of origin, educational level). Logistic regression was used. Results: The prevalence of self-perceived discrimination was 4.2% for men and 6.3% for women. The likelihood of self-perceived discrimination was higher in people who originated from low-income countries: men, odds ratio (OR) 5.59 [95% confidence interval (CI) 4.55–6.87]; women, OR 4.06 (95% CI 3.42–4.83). Women were more likely to report self-perceived discrimination by their partner at home than men [OR 8.35 (95% CI 4.70–14.84)]. The likelihood of self-perceived discrimination when seeking work was higher among people who originated from low-income countries than their Spanish counterparts: men, OR 13.65 (95% CI 9.62–19.35); women, OR 10.64 (95% CI 8.31–13.62). In comparison with Spaniards, male white-collar workers who originated from low-income countries [OR 11.93 (95% CI 8.26–17.23)] and female blue-collar workers who originated from low-income countries (OR 1.6 (95% CI 1.08–2.39)] reported higher levels of self-perceived discrimination. Conclusions: Self-perceived discrimination is distributed unevenly in Spain and interacts with social inequalities. This particularly affects women and immigrants.