Emergency hospital services utilization in Lleida (Spain): a cross-sectional study of immigrant and Spanish-born populations

Background: The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). Methods: Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population. Results: Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts. Conclusion: In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.

Differences in pharmaceutical consumption and expenses between immigrant and Spanish-born populations in Lleida, (Spain): a 6-months prospective observational study

Background: There are few studies comparing pharmaceutical costs and the use of medications between immigrants and the autochthonous population in Spain. The objective of this study is to evaluate whether there are differences in pharmaceutical consumption and expenses between immigrant and Spanish-born populations. Methods: Prospective observational study in 1,630 immigrants and 4,154 Spanish-born individuals visited by fifteen primary care physicians at five public Primary Care Clinics (PCC) during 2005 in the city of Lleida, Catalonia (Spain). Data on pharmaceutical consumption and expenses was obtained from a comprehensive computerized data-collection system. Multinomial regression models were used to estimate relative risks and confidence intervals of pharmaceutical expenditure, adjusting for age and sex. Results: The percentage of individuals that purchased medications during a six-month period was 53.7% in the immigrant group and 79.2% in the autochthonous group. Pharmaceutical expenses and consumption were lower in immigrants than in autochthonous patients in all age groups and both genders. The relative risks of being in the highest quartile of expenditure, for Spanish-born versus immigrants, were 6.9, 95% CI = (4.2, 11.5) in men and 5.3, 95% CI = (3.5, 8.0) in women, with the reference category being not having any pharmaceutical expenditure. Conclusion: Pharmaceutical expenses are much lower for immigrants with respect to autochthonous patients, both in the percentage of prescriptions filled at pharmacies and the number of containers of medication obtained, as well as the prices of the medications used. Future studies should explore which factors explain the observed differences in pharmaceutical expenses and if these disparities produce health inequalities.

Comparison of the consumption of antidepressants in the immigrant and native populations in a Spanish health region: an observational study

BACKGROUND: Health professionals and organizations in developed countries adapt slowly to the increase of ethnically diverse populations attending health care centres. Several studies report that attention to immigrant mental health comes up with barriers in access, diagnosis and therapeutics, threatening equity. This study analyzes differences in exposure to antidepressant drugs between the immigrant and the native population of a Spanish health region. METHODS: Cross-sectional study of the dispensation of antidepressant drugs to the population aged 15 years or older attending the public primary health centres of a health region, 232,717 autochthonous and 33,361 immigrants, during 2008. Data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies. Age, sex, country of origin, visits, date of entry in the regional health system, generic drugs and active ingredients were considered. Statistical analysis expressed the percentage of persons exposed to antidepressants stratified by age, gender, and country of origin and prevalence ratios of antidepressant exposition were calculated. RESULTS: Antidepressants were dispensed to 11% of native population and 2.6% of immigrants. Depending on age, native women were prescribed antidepressants between 1.9 and 2.7 times more than immigrant women, and native men 2.5 and 3.1 times more than their immigrant counterparts. Among immigrant females, the highest rate was found in the Latin Americans (6.6%) and the lowest in the sub-Saharans (1.4%). Among males, the highest use was also found in the Latin Americans (1.6%) and the lowest in the sub-Saharans (0.7%). The percentage of immigrants prescribed antidepressants increased significantly in relation to the number of years registered with the local health system. Significant differences were found for the new antidepressants, prescribed 8% more in the native population than in immigrants, both in men and in women. CONCLUSIONS: All the immigrants, regardless of the country of origin, had lower antidepressant consumption than the native population of the same age and sex. Latin American women presented the highest levels of consumption, and the sub-Saharan men the lowest. The prescription profiles also differed, since immigrants consumed more generics and fewer recently commercialized active ingredients.

Variation of grain nitrogen content in relation with grain yield in old and modern Spanish wheats grown under a wide range of agronomic conditions in a Mediterranean region

Wheat yield and grain nitrogen concentration (GNC; mg N/g grain) are frequently negatively correlated. In most growing conditions, this is mainly due to a feedback process between GNC and the number of grains/m2. In Mediterranean conditions, breeders may have produced cultivars with conservative grain set. The present study aimed at clarifying the main physiological determinants of grain nitrogen accumulation (GNA) in Mediterranean wheat and to analyse how breeding has affected them. Five field experiments were carried out in north-eastern Spain in the 2005/06 and 2006/ 07 growing seasons with three cultivars released at different times and an advanced line. Depending on the experiment, source-sink ratios during grain filling were altered by reducing grain number/m2 either through pre-anthesis shading (unshaded control or 0.75 shading only between jointing and anthesis) or by directly trimming the spikes after anthesis and before the onset of the effective grain filling period (un-trimmed control or spikes halved 7–10 days after anthesis). Grain nitrogen content (GN content ; mg N/grain) decreased with the year of release of the genotypes. As the number of grains/m2 was also increased by breeding there was a clear dilution effect on the amount of nitrogen allocated to each grain. However, the increase in GN content in old genotypes did not compensate for the loss in grain nitrogen yield (GNY) due to the lower number of grains/m2. GN content of all genotypes increased (increases ranged from 0.13 to 0.40 mg N/grain, depending on experiment and genotype) in response to the post-anthesis spike trimming or pre-anthesis shading. The degree of source-limitation for GNA increased with the year of release of the genotypes (and thus with increases in grain number/m2) from 0.22 (mean of the four manipulative experiments) in the oldest cultivar to 0.51 (mean of the four manipulative experiments) in the most modern line. It was found that final GN content depended strongly on the source-sink ratio established at anthesis between the number of grains set and the amount of nitrogen absorbed at this stage. Thus, Mediterranean wheat breeding that improved yield through increases in grain number/m2 reduced the GN content by diluting a rather limited source of nitrogen into more grains. This dilution effect produced by breeding was further confirmed by the reversal effect produced by grain number/m2 reductions due to either pre-anthesis shading or post-anthesis spike trimming.

Ecology of Armillaria species on silver fir (Abies alba) in the Spanish Pyrenees

We describe the distribution and the ecology of three Armillaria species observed in silver fir (Abies alba) forests of the Pyrenees. We surveyed the presence and abundance of Armillaria above and belowground in 29 stands. Isolates were identified by the PCR-RFLP pattern of the IGS-1 region of their ribosomal DNA. We measured several ecological and management parameters of each stand in order to describe Armillaria infected sites. Armillaria cepistipes was the most abundant of three species observed. Armillaria gallica was dominant in soils with a higher pH and at lower elevations. Armillaria ostoyae seemed to be more frequent in stands where A. alba recently increased its dominance relative to other forest tree species. Thinning activities correlated with an increased abundance of Armillaria belowground. In 83% of the stands the same Armillaria species was observed above and belowground. It seems that in a conifer forest, A. cepistipes can be more frequent than A. ostoyae, a virulent conifer pathogen. Since logging is related to a higher abundance of Armillaria in the soil, the particular Armillaria species present in a given stand could be considered an additional site factor when making management decisions.

Testing website usability in Spanish-Speaking Academia through heuristic evaluation and cognitive walkthroughs

Although usability evaluations have been focused on assessing different contexts of use, no proper specifications have been addressed towards the particular environment of academic websites in the Spanish-speaking context of use. Considering that this context involves hundreds of millions of potential users, the AIPO Association is running the UsabAIPO Project. The ultimate goal is to promote an adequate translation of international standards, methods and ideal values related to usability in order to adapt them to diverse Spanish-related contexts of use. This article presents the main statistical results coming from the Second and Third Stages of the UsabAIPO Project, where the UsabAIPO Heuristic method (based on Heuristic Evaluation techniques) and seven Cognitive Walkthroughs were performed over 69 university websites. The planning and execution of the UsabAIPO Heuristic method and the Cognitive Walkthroughs, the definition of two usability metrics, as well as the outline of the UsabAIPO Heuristic Management System prototype are also sketched.

MPRO-Spanish: development and experiments with a linguistic parser for Spanish texts

This paper describes the main features and present results of MPRO-Spanish, a parser for morphological and syntactic analysis of unrestricted Spanish text developed at the IAI1. This parser makes direct use of X-phrase structure rules to handle a variety of patterns from derivational morphology and syntactic structure. Both analyses, morphological and syntactic, are realised by two subsequent modules. One module analyses and disambiguates the source words at morphological level while the other consists of a series of programs and a deterministic, procedural and explicit grammar. The article explains the main features of MPRO and resumes some of the experiments on some of its applications, some of which still being implemented like the monolingual and bilingual term extraction while others need further work like indexing. The results and applications obtained so far with simple and relatively complex sentences give us grounds to believe in its reliability.

Competitive positioning of Spanish agricultural cooperatives

Cooperatives are the basis of the social economy in many agricultural sectors. The present research work investigates the management situation of the olive oil cooperatives in Catalonia. The study identifies a typology of cooperatives based on their attitudes towards to the sector. A positioning map of the different types of cooperatives is then established on the basis of their characteristics. The study concludes with important managerial aspects of olive oil cooperatives in Catalonia.

Meat characteristics of chickens from an F1 cross of two improved Spanish breeds depending on slaughter age

The present study analysed the meat characteristics of i) improved Castellana Negra chickens slaughtered at 18 weeks (CN-18) and ii) F1 crossbred chickens from improved Castellana Negra hens and improved Penedesenca Negra cocks (CNPN) slaughtered at 12 weeks and 18 weeks of age (young and adult animals, respectively). Purebred and crossbred specimens were compared at similar weights (CN-18 and CNPN-12) and ages (CN-18 and CNPN-18). The protein content of the meat was similar for the three types of animals; heavier animals (CNPN-18) had more fat than those slaughtered at lower weights (CNPN-12 and CN-18). Adults had a higher saturated fatty acid content and the young CNPN chickens had more monounsaturated fatty acids than CN chickens. In the CNPN adults, less water was lost during cooking, which is directly related to the juiciness of the meat. With regard to sensory analysis, a darker colour was observed in the meat as much as the internal fat of adult animals, in addition to greater colour uniformity. The meat of young CNPN birds was juicier, whereas that of the CN chickens was more fibrous. Therefore, we conclude that meat from CNPN chickens presents chemical, physical, and sensorial characteristics that make these animals a genetic base for alternative poultry production.

Progress in the Spanish National Barley Breeding Program

The Spanish Barley Breeding Program is carried out by four public research organizations, located at the most representative barley growing regions of Spain. The aim of this study is to evaluate the program retrospectively, attending to: i) the progress achieved in grain yield, and ii) the extent and impact of genotype-by-environment interaction of grain yield. Grain yields and flowering dates of 349 advanced lines in generations F8, F9 and F10, plus checks, tested at 163 trials over 11 years were analized. The locations are in the provinces of Albacete, Lleida, Valladolid and Zaragoza. The data are highly unbalanced because the lines stayed at the program for a maximum of three years. Progress was estimated using relative grain yield and mixed models (REML) to homogenize the results among years and locations. There was evident progress in the program over the period studied, with increasing relative yields in each generation, and with advanced lines surpassing the checks in the last two generations, although the rate of progress was uneven across locations. The genetic gain was greater from F8 to F9 than from F9 to F10. The largest non-purely environmental component of variance was genotype-by-location-by-year, meaning that the genotype-by-location pattern was highly unpredictable. The relationship between yield and flowering time overall was weak in the locations under study at this advanced stage of the program. The program can be continued with the same structure, although measures should be taken to explore the causes of slower progress at certain locations.

Spanish adaptation of the Expectancy Questionnaire (EQ) about alcohol effects in adolescents

Background: Alcohol-related expectancies are especially relevant in relation to alcohol consumption during adolescence. The main aim of this study was to adapt and translate into Spanish (Castilian) the Expectancy Questionnaire (EQ), and to study its psychometric properties in adolescents. Method: The sample was composed of 514 adolescents (57.20% female, mean age = 15.21; SD = .63) who completed the EQ and the alcohol consumption questionnaire AIS-UJI. Results: Confi rmatory factor analysis indicated that an eight-factor model, grouped into two general factors of positive and negative expectancies, had acceptable fi t indices. Cronbach’s alphas ranged from .75 to .96. Finally, the structural equation model showed that positive expectancies were positively related to alcohol use, whereas negative expectancies were negatively related to drinking. Conclusions: Results showed that the Spanish version of the EQ for adolescents is a valid and reliable questionnaire to measure expectancies about alcohol effects.

European employment strategy and spanish labour market policies

The paper aim is to analyse the influence of the European Employment Strategy (EES)in the implementation of the Spanish labour market policies. The first part of the paper describes the evolution and content of the EES. In the second one, the definition of activation is also explained. In addition to that, the ways how the EES develops and promotes active labour market policies are examined. The evolution of labour market policies in Spain and the current configuration of both active and passive policies are studied in the next three chapters. In these parts, the paper investigates to which extent the provisions of the EES have been implemented in Spain. The paper shows that: i) activation has been rising in the European countries since the implementation of the EES; ii) this fact has also happened in relative terms (comparing the evolution of active to passive policies); iii) Spain has been one of the countries which has led these processes; iv) the EES seems to have been influencing

A Spanish version of the athens insomnia scale

Objectives To develop and validate a Spanish version of the Athens Insomnia Scale (AIS). Methods The AIS is designed to assess sleep difficulty and comprises eight items: the first five refer to the sleep disturbance and the last three to the daytime consequences. Either the full eight-item scale (AIS-8) or the brief form (AIS-5) can be administered. The adaptation used a backtranslation design. The validation process was based on a sample of 323 participants (undergraduates, community sample and psychiatric outpatients), which completed the AIS and other questionnaires: anxiety (BAI), depression (BDI) and psychological well-being (GHQ-12) scales. Results The internal consistency coefficients for both versions were above 0.80. The study of dimensionality revealed a single factor with high loadings and a percentage of explained variance above 50% in both versions. Test-retest reliability was above 0.70 (AIS-5) and over 0.80 (AIS-8) at a one-month interval. The correlation between the AIS and the previously mentioned scales was for both the AIS-5 and the AIS-8 above 0.40 and 0.50, respectively.

Psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory - Adult Form

One of the goals of psychological assessment focuses on the adaptation of its instruments to different populations. The objective of this study is to establish the psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory- Adult Form (CRI-Adult, Moos, 1993). The following criteria were analyzed: a) descriptive statistics; b) internal consistency reliability (Cronbach"s alpha, and intercorrelations between scales); c) test-retest reliability (4-week interval); d) dimensionality of CRI-Adult (exploratory factor analysis); e) construct validity (confirmatory factor analysis); f) convergent criterion validity (correlations between CRI-Adult and Coping Strategies Indicator, CSI, Amirkhan, 1990), and g) predictive criterion validity (correlations between CRI-Adult, and SCL-90-R, Derogatis, 1983). The results, obtained with 800 adults from Barcelona and surrounding area (334 men and 466 women, aged between 18 to 76 years) indicate that the Spanish version of CRIAdult has satisfactory psychometric properties that allow using this test with guarantee.