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.

Economic crisis, immigrant women and changing availability of intimate partner violence services: a qualitative study of professionals' perceptions in Spain

Introduction: Since 2008, Spain has been in the throes of an economic crisis. This recession particularly affects the living conditions of vulnerable populations, and has also led to a reversal in social policies and a reduction in resources. In this context, the aim of this study was to explore intimate partner violence (IPV) service providers’ perceptions of the impact of the current economic crisis on these resources in Spain and on their capacity to respond to immigrant women’s needs experiencing IPV. Methods: A qualitative study was performed based on 43 semi-structured in-depth interviews to social workers, psychologists, intercultural mediators, judges, lawyers, police officers and health professionals from different services dealing with IPV (both, public and NGO’s) and cities in Spain (Barcelona, Madrid, Valencia and Alicante) in 2011. Transcripts were imported into qualitative analysis software (Atlas.ti), and analysed using qualitative content analysis. Results: We identified four categories related to the perceived impact of the current economic crisis: a) “Immigrant women have it harder now”, b) “IPV and immigration resources are the first in line for cuts”, c) “ Fewer staff means a less effective service” and d) “Equality and IPV policies are no longer a government priority”. A cross-cutting theme emerged from these categories: immigrant women are triply affected; by IPV, by the crisis, and by structural violence. Conclusion: The professionals interviewed felt that present resources in Spain are insufficient to meet the needs of immigrant women, and that the situation might worsen in the future.

Technical efficiency in the retail food industry: the influence of inventory investment, wage levels, and age of the firm

The objective of this paper is to estimate technical efficiency in retailing; and the influence of inventory investment, wage levels, and firm age on this efficiency. We use the output supermarket chains’ sales volume, calculated isolating the retailer price effect on its sales revenue. This output allows us to estimate a strictly technical concept of efficiency. The methodology is based on the estimation of a stochastic parametric function. The empirical analyses applied to panel data on a sample of 42 supermarket chains between 2000 and 2002 show that inventory investment and wage level have an impact on technical efficiency. In comparison, the effect of these factors on efficiency calculated through a monetary output (sales revenue) shows some differences that could be due to aspects related to product prices.

Open-access operating algorithms for commercial videokeratographer and improvement of corneal sampling

We present an algorithm to process images of reflected Placido rings captured by a commercial videokeratoscope. Raw data are obtained with no Cartesian-to-polar-coordinate conversion, thus avoiding interpolation and associated numerical artifacts. The method provides a characteristic equation for the device and is able to process around 6 times more corneal data than the commercial software. Our proposal allows complete control over the whole process from the capture of corneal images until the computation of curvature radii.

Carvacrol and thymol for fresh food packaging

Active packaging is becoming an emerging food technology to improve quality and safety of food products. One of the most common approaches is based on the release of antioxidant/antimicrobial compounds from the packaging material. In this work an antifungal active packaging system based on the release of carvacrol and thymol was optimized to increase the post-harvest shelf life of fresh strawberries and bread during storage. Thermal properties of the developed packaging material were determined by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). Volatile compounds in food samples contained in active packaging systems were monitored by using headspace solid phase microextraction followed by gas chromatography analysis (HS-SPMEGC-MS) at controlled conditions. The obtained results provided evidences that exposure to carvacrol and thymol is an effective way to enlarge the quality of strawberries and bread samples during distribution and sale.