A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods: qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results: use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions: the results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat it

La salut reproductiva de la dona immigrant: una anàlisi des de la influència cultural

El progressiu increment del flux migratori en els darrers anys a Catalunya genera un major percentatge de dones en estat fèrtil que requereixen d’una atenció vinculada a la seva salut reproductiva. D’aquesta manera, els professionals sanitaris es veuen sotmesos a treballar sota una diversitat cultural que moltes vegades genera un “xoc intercultural” dificultant la relació assistencial entre professional i usuari. Per aquest motiu, el següent estudi pretén donar una aproximació de la influència cultural de la dona immigrant (marroquina i subsahariana) en quatre àmbits: embaràs, part, post-part i maternitat.Hipòtesis: S’identifiquen necessitats bàsiques assistencials no resoltes satisfactòriament en el grup de dones immigrants (marroquines i subsaharianes) en el període del part, puerperi immediat i intermedi, a més d’un impacte intercultural associat.Objectiu principal: Conèixer les vivències, percepcions i conductes de les dones marroquines i subsaharianes en l’embaràs, el part, el post-part, la maternitat dins el seu marc cultural i com influeixen en l’atenció sanitària del nostre país.Material i mètodes: S’ha realitzat un estudi de disseny mixt. Per una banda s’ha disposat d’una metodologia qualitativa descriptiva que utilitza la teoria fonamentada “Grounded Theory” com a instrument metodològic, i per l’altra, s’ha optat per una metodologia quantitativa per analitzar les dades clíniques i epidemiològiques de gestants immigrants que havien donat a llum al Servei d’Obstetrícia-Sala de Parts de l’Hospital Sta. Caterina (Girona), durant el període comprès entre el mes de novembre de 2012 i gener de 2013.La recollida de dades s’ha realitzat sota una entrevista semiestructurada i una observació participant com a instruments qualitatius, i el suport del “carnet de l’embaràs” i la “història obstètrica” de cada dona per elaborar l’estudi quantitatiu. Pel que fa a l’anàlisi de les dades en l’estudi qualitatiu s’ha seguit el procés analític plantejat per la Teoria fonamentada i en el cas de l’estudi quantitatiu, s’ha comptatamb el suport d’una tesi doctoral per comparar els resultats amb els de les dones autòctones, dels quals fa referència la tesi.Resultats: En l’estudi qualitatiu, s’han trobat especificitats culturals en relació a la percepció del part, desenvolupament del part ( a nivell conductual), implicació en el post-part, valoració de l’atenció sanitària rebuda i el concepte de maternitat. Pel que fa a l’estudi quantitatiu comparatiu, s’han indentificat diferències entre el col·lectiu de la mostra estudiada i les dones autòctones referent als antecedents obstètrics i paritat, al control gestacional i al desenvolupament del part ( a nivell fisiològic)

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.

Implementació amb Visual Basic d'un algorisme per a encriptar i desencriptar

Treball de recerca realitzat per un alumne d’ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l’any 2005. La criptografia és l’art d’escriure un llenguatge convingut, amb l’ús d’unes claus i de la seva operació inversa se’n diu criptoanalitzar. Els sistemes criptogràfics han estat emprats al llarg de la història. Actualment existeixen multituds de software i de hardware destinats a analitzar el tràfic de dades en xarxes de computadores. Encara que aquestes eines constitueixen un avenç en tècniques de seguretat i protecció, el seu ús indegut es al mateix temps un greu problema i una enorme font d’atacs a la intimitat dels seus usuaris i a la integritat dels seus propis sistemes. Des d’aquest punt de vista, s’explica com s’ha dissenyat dos aplicacions informàtiques per encriptar i desencriptar.

Aprender investigando. Una experiencia formativa en el ámbito de la enfermería = Research teaching processes used as a methodological strategy in the education of healthcare professionals

Este trabajo tiene como propósito presentar y valorar, desde la perspectiva del alumnado participante, un proyecto de investigación-formación puesto en marcha durante el curso 2003-2004 en la elaboración del trabajo de tesina, fin de carrera, en la Escuela de Enfermería de Vitoria, dentro del programa de Licenciatura Europea de Enfermería. Constituye el punto de partida de un proyecto a largo plazo, iniciado con la intención de desarrollar principios teóricos y procedimientos prácticos que nos permitan sistematizar procesos formativos que, centrados en la investigación, articulen la teoría y la práctica e integren una perspectiva comunicativa y cooperativa.

Modified differentials and basic cohomology for Riemannian foliations

We define a new version of the exterior derivative on the basic forms of a Riemannian foliation to obtain a new form of basic cohomology that satisfies Poincaré duality in the transversally orientable case. We use this twisted basic cohomology to show relationships between curvature, tautness, and vanishing of the basic Euler characteristic and basic signature.

Index theory for basic Dirac operators on Riemannian foliations

In this paper we prove a formula for the analytic index of a basic Dirac-type operator on a Riemannian foliation, solving a problem that has been open for many years. We also consider more general indices given by twisting the basic Dirac operator by a representation of the orthogonal group. The formula is a sum of integrals over blowups of the strata of the foliation and also involves eta invariants of associated elliptic operators. As a special case, a Gauss-Bonnet formula for the basic Euler characteristic is obtained using two independent proofs.

Price policies and Price dispersion in the private healthcare insurance industry: The Catalan case

We present an overlapping generations model that explains price dispersion among Catalonian healthcare insurance firms. The model shows that firms with different premium policies can coexist. Furthermore, if interest rates are low, firms that apply equal premium to all insureds can charge higher average prices than insurers that set premiums according to the risk of insured. Economic theory, health insurance, health economics.

WePreserve 2009: DPE/Planets/CASPAR/nestor Joint Training Event: The Preservation challenge: basic concepts and practical applications (Barcelona, 23-27 març 2009)

Reseña del congreso WePreserve 2009 que tuvo lugar los pasados 23 al 27 de marzo en Barcelona, organizadopor la Facultad de Biblioteconomía y Documentación de la Universitat de Barcelona, con la colaboración del Institut d'Estudis Catalans, la Biblioteca de Catalunya y el Consorci de Biblioteques de Barcelona. El seminario 2009 WePreserve se celebra anualmente desde el año 2007 y participan todas las figuras de referencia europeas en materia de investigación en sistemas y metodologías que garantizan la preservación digital de los documentos: Digital Preservation Europe (DPE), Preservation and Long-term Access Through Networked Services (Planets), Cultural Artistic and Scientific Knowledge for Preservation, Access and Retrieval (CASPAR), y Network of expertise in Digital long-term preservation (nestor).

CoDaPack. An Excel and Visual Basic based software of compositional data analysis. Current version and discussion form upcoming versions

In the eighties, John Aitchison (1986) developed a new methodological approach for the statistical analysis of compositional data. This new methodology was implemented in Basic routines grouped under the name CODA and later NEWCODA inMatlab (Aitchison, 1997). After that, several other authors have published extensions to this methodology: Marín-Fernández and others (2000), Barceló-Vidal and others (2001), Pawlowsky-Glahn and Egozcue (2001, 2002) and Egozcue and others (2003). (...)

A Sustainable Development Strategy for the Pyrenees-Mediterranean Euroregion: Basic Guidelines

L'estudi presenta té per objecte formular els requisits necessaris per posar en marxa una estratègia per al desenvolupament sostenible de l'Euroregió Pirineus-Mediterrània. Aquest és un projecte de cooperació transfronterera regional promogut per l'expresident de la Generalitat, Honorable Sr Pasqual Maragall, que, a més de Catalunya, inclou Aragó, Illes Balears, Llenguadoc-Rosselló i Migdia-Pirineus. A la Unió Europea hi ha més de 70 euroregions, que han estat en funcionant per diferents periodes de temps, després d'haver estat creat per regions o entitats locals, o ambdós

Financiación capitativa, articulación entre niveles asistenciales y descentralización de las organizaciones sanitarias

Public organisations are subjected to weak incentivesfor competition. Therefore, institutional Darwinismcannot apply. Regulation and performance monitoring isrequired to protect the public interest. This isparticularly the case of organisations in the healthcare arena, since strong incentives may risk the wholesupply of public health services. Regarding to the pathdependence of the Spanish public health institutionswith respect to the international experience and theobserved health technological changes, this paper triesto ground some theoretical bases for the organisationalchange in our health system. We do this by building ourargument from the very basic public goal: the improvementof the health status of the Spanish population. Thisrequires a better integration of health care services.To this regard, capitation in finance shows somecomparative advantages: it takes an integral view forthe care of the population, it allows for a betterdecentralisation ('deconcentration') of risks to healthproviders and favours managed care under a globalperspective, replacing partial payment to differentproviders. However, the paper shows some potentiallimitations for this purpose and the need of a gradualstrategy for its implementation.

Creació d'un programa de rentat industrial amb Visual Basic

Treball de recerca realitzat per alumnes d’ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l’any 2010. L’objectiu del treball ha consistit a desenvolupar un programa informàtic per controlar les fases d'un procés de rentat industrial.