Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Un estudio transversal sobre la percepción de la vitalidad etnolingüística en jóvenes y adultos de Catalunya = A cross-sectional study on ethnolinguistic vitality perception in young and adulthood people from Catalonia

El estudio utiliza un diseño transversal en el campo de la percepción de la vitalidad etnolingüística. Es el primero que compara la percepción de la vitalidad etnolingüística, así como los factores asociados, entre adultos jóvenes y adultos, en relación con los grupos castellanohablantes y catalanohablantes de la Comunidad Autónoma de Cataluña. Para ello, se aplicó el 'Cuestionario de vitalidad etnolingüística subjetiva' (CVS) a una muestra de 527 participantes, 268 jóvenes y 259 adultos, de los cuales se seleccionó una submuestra de individuos que tenían el catalán como lengua materna y se identificaban como catalanes (n=301). En ambas muestras se aduce una tendencia a descriminar favorablemente la vitalidad percibida por el grupo catalán, aspecto que se acentúa significativa en el grupo de jóvenes estudiados en relación al grupo de edad de los adultos. Se discuten los resultados según las repercusiones teóricas y pragmáticas de los estudios realizados en el ámbito de la comunicación intergrupal

El plan de lengua y cohesión social en Catañunya: primeros datos de una investigación = Language and Social Cohesion Plan in Catalonia: Initial research data

Los programas de inmersión lingüística han constituido y constituyen dentro del Sistema Educativo catalánla principal forma para que el alumnado de lengua familiar no-catalana aprenda una nueva lengua, el catalán,sin que, en su proceso de aprendizaje, vea mermado ni el desarrollo de su propia lengua ni su rendimientoacadémico. El éxito de la inmersión lingüística en las décadas anteriores ha sido frecuentemente utilizado comouno de los argumentos orientativos para justificar la política lingüística que se sigue en la escolarización de lainfancia extranjera. Sin embargo, los resultados obtenidos por investigaciones recientes parece que no avalanempíricamente dicho argumento. Este artículo analiza dichos resultados y expone, a partir del Plan para laLengua y Cohesión Social puesto en marcha por el Departamento de Educación de la Generalitat de Cataluña,cuáles son los retos que se presentan a su Sistema Educativo dentro del nuevo marco que supone el aumento de ladiversidad cultural y lingüística en la actual sociedad catalana

Implementing a Cancer Fast-track programme between primary and specialised care in Catalonia(Spain): amixed methods study

BACKGROUND: The Cancer Fast-track Programme's aim was to reduce the time that elapsed between well-founded suspicion of breast, colorectal and lung cancer and the start of initial treatment in Catalonia (Spain). We sought to analyse its implementation and overall effectiveness. METHODS: A quantitative analysis of the programme was performed using data generated by the hospitals on the basis of seven fast-track monitoring indicators for the period 2006-2009. In addition, we conducted a qualitative study, based on 83 semistructured interviews with primary and specialised health professionals and health administrators, to obtain their perception of the programme's implementation. RESULTS: About half of all new patients with breast, lung or colorectal cancer were diagnosed via the fast track, though the cancer detection rate declined across the period. Mean time from detection of suspected cancer in primary care to start of initial treatment was 32 days for breast, 30 for colorectal and 37 for lung cancer (2009). Professionals associated with the implementation of the programme showed that general practitioners faced with suspicion of cancer had changed their conduct with the aim of preventing lags. Furthermore, hospitals were found to have pursued three specific implementation strategies (top-down, consensus-based and participatory), which made for the cohesion and sustainability of the circuits. CONCLUSION: The programme has contributed to speeding up diagnostic assessment and treatment of patients with suspicion of cancer, and to clarifying the patient pathway between primary and specialised care.

Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain)

Background: Assessing of the costs of treating disease is necessary to demonstrate cost-effectiveness and to estimate the budget impact of new interventions and therapeutic innovations. However, there are few comprehensive studies on resource use and costs associated with lung cancer patients in clinical practice in Spain or internationally. The aim of this paper was to assess the hospital cost associated with lung cancer diagnosis and treatment by histology, type of cost and stage at diagnosis in the Spanish National Health Service. Methods: A retrospective, descriptive analysis on resource use and a direct medical cost analysis were performed. Resource utilisation data were collected by means of patient files from nine teaching hospitals. From a hospital budget impact perspective, the aggregate and mean costs per patient were calculated over the first three years following diagnosis or up to death. Both aggregate and mean costs per patient were analysed by histology, stage at diagnosis and cost type. Results: A total of 232 cases of lung cancer were analysed, of which 74.1% corresponded to non-small cell lung cancer (NSCLC) and 11.2% to small cell lung cancer (SCLC); 14.7% had no cytohistologic confirmation. The mean cost per patient in NSCLC ranged from 13,218 Euros in Stage III to 16,120 Euros in Stage II. The main cost components were chemotherapy (29.5%) and surgery (22.8%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs but an increase in chemotherapy costs. In SCLC patients, the mean cost per patient was 15,418 Euros for limited disease and 12,482 Euros for extensive disease. The main cost components were chemotherapy (36.1%) and other inpatient costs (28.7%). In both groups, the Kruskall-Wallis test did not show statistically significant differences in mean cost per patient between stages. Conclusions: This study provides the costs of lung cancer treatment based on patient file reviews, with chemotherapy and surgery accounting for the major components of costs. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain.

Yield in double cropping system as affected by N fertilization rate with pig slurry in a Catalonia dryland region

Intensive swine production is an important agricultural and economical activity in Europe. The high availability of pig slurry (PS) lead to attractive fertilization strategy to reduce costs, therefore is mainly applied as fertilizer in agricultural systems. The optimization N fertilization in these areas should be taken in into to avoid nitrates losses by lixiviation and to achieve maximum efficiency in crop nutrition. Many studies have shown that PS applications can achieve satisfactory yields in different crops by partially or completely replacing synthetic fertilizers. In addition, for the last years, in Northeast Spain (Catalonia) has been widely extended the double-cropping forage system.

Impacts of climate change on water resources in the Mediterranean basin : a case study in Catalonia, Spain

Most climate change projections show important decreases in water availability in the Mediterranean region by the end of this century. We assess those main climate change impacts on water resources in three medium-sized catchments with varying climatic conditions in north-eastern Spain. A combination of hydrological modelling and climate projections with B1 and A2 IPCC emission scenarios is performed to infer future stream flows. The largest reduction (22-48% for 2076-2100) of stream flows is expected in the headwaters of the two wettest catchments, while lower decreases (22-32% for 2076-2100) are expected in the drier one. In all three catchments, autumn and summer are the seasons with the most notable projected decreases in stream flow, 50% and 34%, respectively (2076-2100). Thus, ecological flows might be noticeably impacted by climate change in the catchments, especially in the headwaters of those wet catchments.

A note on Spatial Autocorrelation at a Local Level

In this paper we analyze the existence of spatial autocorrelation at a local level in Catalonia using variables such as urbanisation economies, population density, human capital and firm entries. From a static approach, our results show that spatial autocorrelation is weak and diminishes as the distance between municipalities increases. From a dynamic approach, however, spatial autocorrelation increased over the period we analysed. These results are important from a policy point of view, since it is essential to know how economic activities are spatially concentrated or disseminated. Key words: spatial autocorrelation, municipalities. JEL classification: R110, R120

Firm Size and Geographical Aggregation: An Empirical Appraisal in Industrial Location

This paper assesses empirically the importance of size discrimination and disaggregate data for deciding where to locate a start-up concern. We compare three econometric specifications using Catalan data: a multinomial logit with 4 and 41 alternatives (provinces and comarques, respectively) in which firm size is the main covariate; a conditional logit with 4 and 41 alternatives including attributes of the sites as well as size-site interactions; and a Poisson model on the comarques and the full spatial choice set (942 municipalities) with site-specific variables. Our results suggest that if these two issues are ignored, conclusions may be misleading. We provide evidence that large and small firms behave differently and conclude that Catalan firms tend to choose between comarques rather than between municipalities. Moreover, labour-intensive firms seem more likely to be located in the city of Barcelona. Keywords: Catalonia, industrial location, multinomial response model. JEL: C250, E30, R00, R12

RECERCAT. El Dipòsit de la Recerca de Catalunya

Seguint la tendència mundial de crear dipòsits institucionals d'accés lliure per recopilar i preservar els documents d'investigació generats en les institucions acadèmiques, el CESCA i el CBUC han posat en funcionament RECERCAT. RECERCAT és un dipòsit cooperatiu de documents digitals que inclou la literatura de recerca de les universitats i dels centres d'investigació de Catalunya, com ara articles encara no publicats (preprints), comunicacions a congressos, informes de recerca, working papers, projectes de final de carrera, memòries tècniques, etc. La comunicació pretén explicar els processos que s'han seguit per posar en marxa aquest projecte: des de la selecció i adaptació del programari amb el que funciona (DSpace), fins als treballs duts a terme per establir les polítiques d'accés, d’introducció de dades, de metadades Dublin Core necessàries per descriure els documents, el tipus de llicència de les Creative Commons sota la qual es troben subjectes els documents, etc.

Caracterización de la privación y de la pobreza en Catalunya

Este trabajo contribuye a la escasa literatura sobre la evaluación multidimensional del nivel de bienestar de los individuos más desfavorecidos de nuestra sociedad. Se distingue claramente entre pobreza monetaria y privación multidimensional, para proceder entonces a su cuantificación y caracterización empleando una base de datos nueva (PaD) para Cataluña y utilizando, por vez primera, una metodología que nos permite considerar de forma conjunta la pobreza y la privación. Nuestros resultados empíricos deberían informar a la política social. Aportamos evidencia nueva sobre viejas y nuevas relaciones entre situaciones de desventaja económica y características de los individuos, algunas de las cuales invitan a reconsiderar viejas concepciones. This paper contributes to the scarce literature on the multidimensional assessment of the well-being of the worse off individuals. We document and characterise monetary poverty and multidimensional deprivation using a new database (PaD) for Catalonia. The econometric methodology we employ allows for a join analysis of poverty and deprivation, which has not been seen before. Our empirical findings should be informative for social policy. We provide new evidence on old and new relations between situations of economic disadvantage and individual characteristics, some of which invite to reconsider old conceptions.

The Catalan countries project (1931-1939)

In the evolution of Catalan nationalism, as much politician as cultural, the period of II Spanish Republic (1931-1939) was essential. The obtaining of the Statute of Autonomy (1931-1932) supposed the beginning of a stage of expansion in multiple aspects. One of them were the contacts with the Catalanists nuclei of the rest of the cultural space of Catalan language in which, at that time, it would begin to call Catalan Countries (Balearic Islands, Valencian Country, Andorra, Rosselló, to l'Alguer). On Those Collaborations between cultural organizations, political and particular parties Catalonia always will be the model to follow. The Increasing connections will be visualized on press, as well as on cultural celebrations, policy of parties and Constituent Courts. This evolution will be cut by the Franco victory in the Civil War in 1939.

Use and users of electronic journals at Catalan universities: the results of a survey

Es presenten els resultats d’una enquesta sobre l’ús de revistes electròniques realitzada al professorat de les universitats que formen el Consorci de Biblioteques Universitàries de Catalunya (CBUC). Els resultats mostren un elevat grau de coneixement de la col·lecció de revistes electròniques entre el personal docent i investigador i una creixent preferència pel format electrònic en detriment de l’imprès. L’alt grau de coneixement i d’ús dels títols electrònics, i la preferència per aquest suport, comporten una elevada valoració de la col·lecció de revistes electròniques. Al mateix temps, la major part dels usuaris preveu un increment de l’ús dels títols electrònics durant els propers anys. Els resultats també confirmen la importància de la disciplina i de l’edat com a factors explicatius de l’ús de les revistes electròniques.

Nous perfils professionals de l'actual panorama informatiu audiovisual i multimèdia de Catalunya

Aquest treball forma part de una recerca –finançada pel Consell de l’Audiovisual de Catalunya- dedicada a l’anàlisi de les conseqüències dels processos de digitalització en els mitjans de comunicació de Catalunya (Espanya). El document presenta les transformacions que han afectat al periodista, especialment les noves tasques i funcions. Després d’una introducció dedicada al marc teòric i a la metodologia de la recerca, el document explica les tendències principals observades en les ràdios, emissores de televisió, agències de noticies i mitjans en línia de Catalunya. El document també presenta una sèrie de reflexions sobre la polivalència, la re-qualificació i altres processos que afecten als professionals de la informació. Finalment, es proposa una classificació de les formes que assumeix la polivalència en els mitjans.

Uso y usuarios de revistas electrónicas en las universidades catalanas: resultados de una encuesta

Se presentan los resultados de una encuesta sobre el uso de revistas electrónicas realizada al profesorado de las universidades que forman el Consorci de Biblioteques Universitàries de Catalunya (CBUC). Los resultados muestran un elevado grado de conocimiento de la colección de revistas electrónicas entre el personal docente e investigador y una creciente preferencia por el formato electrónico en detrimento del impreso. El alto grado de conocimiento y uso de los títulos electrónicos, y la preferencia por este soporte, comportan una elevada valoración de la colección de revistas electrónicas. Al mismo tiempo, la mayor parte de los usuarios prevén un incremento en el uso de los títulos electrónicos durante los próximos años. Los resultados también confirman la importancia de la disciplina y de la edad como factores explicativos del uso de las revistas electrónicas.