Incidencia e influencia de las políticas en el cambio social: responsabilidad de las trabajadoras sociales e implicaciones para su educación teórica y práctica

La incidencia en las políticas sociales es una importante función profesional de las trabajadoras sociales que precisa ser integrada en la educación teórica y práctica en Trabajo Social. Este artículo indaga sobre los fundamentos de esta función de incidencia en los cambios sociales promoviendo políticas sociales que reconozcan los derechos humanos. Partiendo de los referentes internacionales del trabajo social, se analiza el caso de España teniendo en cuenta los códigos deontológicos, los planes de estudio en Trabajo Social, la práctica profesional y los nuevos Grados en Trabajo Social. Se concluye planteando interrogantes sobre el grado de responsabilidad y de implicación de las universidades y Colegios profesionales en coherencia con los principios y valores del Trabajo Social.

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules

Background: Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. Methods: This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. Results: A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. Conclusion: The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare.

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

El liberalismo social del Presidente Clinton. La cooperación como política pública

Bill Clinton recuperó la tradición de liberalismo social que, desde una perspectiva de transversalidad, conformaba su diseño de una Presidencia donde confluían la acción y la respuesta, en forma de política pública, de las demandas sociales. La Administración Clinton hizo de la democracia como un activo social de necesaria incorporación a la idea compartida de Buen Gobierno y servicio público. En este artículo se estudian diversos ámbitos de aplicación del liberalismo social implementado por el Presidente Clinton. Las políticas públicas constituyeron el centro de su acción de Gobierno, mediante la implementación de una elasticidad que abarcaba la atención al ciudadano y la defensa de su dignidad como miembro activo del demos. El despliegue de lo social como parte del patrimonio moral de la democracia.

Sexual health and socioeconomic-related factors in Spain

Purpose: The aim of the present study was to describe sexual health in Spain according to three important indicators of the World Health Organization definition and explore the influence of socioeconomic factors. Methods: We performed a population-based cross-sectional study of sexually active people aged 16-44 years residing in Spain in 2009 (2365 women and 2532 men). Three main aspects of sexual health were explored: sexual satisfaction, safe sex, and sexual abuse. The independent variables explored were age, age at first intercourse, reason for first intercourse, type of partner, level of education, country of origin, religiousness, parity, and social class. Bivariate and multivariate logistic regression models were fitted. Results: Both men and women were quite satisfied with their sexual life, their first sexual intercourse, and their sexual relationships during the previous year. Most participants had practiced safe sex both at first intercourse and during the previous year. Levels of sexual abuse were similar to those in other developed countries. People of disadvantaged socioeconomic position have less satisfying, more unsafe, and more abusive sexual relationships. Women experienced more sexual abuse and had less satisfaction at their first intercourse. Conclusions: The state of sexual health in Spain is relatively good. However, we observed inequalities according to gender and socioeconomic position.

Social determinants of sexual satisfaction in Spain considered from the gender perspective

Aims: To describe gender- and social class-related inequalities in sexual satisfaction and analyze their relationship with self-perceived health status. Methods: This population-based, cross-sectional study included 7384 sexually active people aged 16 years and over residing in Spain in 2009 (3951 men and 3433 women). The explanatory variables were gender, age, social class, share in performing domestic tasks, spend time looking after oneself, collaborate economically in supporting the family, caring for children, self-perceived health status, and the desire to increase or decrease frequency of having sexual relations. Bivariate and multivariate logistic regression models were fitted. Results: Among women, sexual satisfaction declines progressively after age 45. Sexual satisfaction is 1.7 times higher among women who look after themselves and who feel good compared with those who do not. The odds of wanting to increase sex is 3.3 times higher for women who are satisfied compared with women who desire a lower frequency of sexual intercourses; and good perceived health was associated with sexual satisfaction. In satisfied men, the corresponding odds is 1.9 times that of men desiring to reduce their frequency of sex. Conclusions: Gender and social class inequalities are found in sexual satisfaction. This is associated with perceived health status, adding evidence in support of the World Health Organization definition of sexual health.

The relevance of harmonising the technical level of social housing with the urban level of the neighbourhood through the example of the 500 dwellings in Albacete

The Architecture and Household Trade Union built nearly 2,000 subsidized dwellings in Albacete from 1941 to 1971. It was the responsible entity from the end of the Civil War until the beginning of Democracy of the social policy programs in Spain. Later on, and together with the National Housing Institute, were responsible for the construction activity. Its limited budget, scarcity of technical and human resources and an urgent need for new housing developments, constituted the basis for producing a vast housing market of low construction qualities. However, thanks to the true architectonic expertise of some of the professionals, some of the developments were designed with a clear urban strategy and in direct relation with the city, which characterizes them to be studied and conserved. This is the case for the selected development for the analysis, the urban complex of the 500 dwellings in Albacete, the Hermanos Falcó Neighborhood. Designed and built between 1963, Alfonso Crespo and Adolfo Gil architects, and 1977 second reformed project by the architect Fernando Rodríguez. It is characterized by its layout on the territory, its controlled relation with the city and its different types of open blocks. Above all, its spatial and human scale strengths, directly related to the European post-war proposals, have to be emphasized; although its technical deficiencies affect the interior quality of the houses. This paper examines its virtues and failures and proposes, using current tools, its renovation. This proposal main aims are to extend its lifetime and develop the particular and urban sustainability levels.