A systematic review of literature to compare the fertility desires among HIV positive women and cancer survivors

Background. Decision-making on reproductive issues is influenced by an interplay of individual, familial, medical, religious and socio-cultural factors. Women with chronic medical illnesses such an HIV infection and cancers are often fraught with decisional conflicts about child-bearing. With increase in the incidence of these illnesses as well as improvement in survival rates, there is a need to pay due attention to the issue of reproductive decision-making. Examining the prevalence and determinants of fertility desires in the two groups in a comparative manner would help bring to light perception of the medical community and the society in general on the two illnesses and the issue of motherhood. ^ Methods. Systematic literature search was undertaken using databases such as MEDLINE (PubMED), MEDLINE (Ovid), PsycInfo and Web of Science. Articles published in English and English language abstracts for foreign articles were included. Studies that explore ‘fertility desires’ as the outcome variable were included. Quantitative studies which have assessed the prevalence of fertility desires as well as qualitative studies which have provided a descriptive understanding of factors governing reproductive desires were included in the review. ^ Results. A total of 34 articles (29 studies examining HIV and 5 studies examining cancer in relation to fertility desires). Variables such as age, stage of illness, support of spouse and family, perception of the medical community and one’s own view of motherhood were key determinants among both groups. ^ Conclusion. There is a need for uniform, systematic research in this field. It is important that health care workers acknowledge these decisional conflicts, include them as part of the medical care of these patients and provide guidance with the right balance of information, practicality and compassion.^

A methodologic study of pain assessment in Anglo and Hispanic children with cancer

There is growing clinical evidence that even young children experience pain and accompanying anxiety. Few instruments have been validated to assess pain characteristics in children. The study of related demographic, illness, psychologic and parental factors in children has also been limited. This study examines the reliability and validity of pain assessment tools in an outpatient pediatric cancer population. A total of 78 children from three to fifteen years of age were observed and interviewed about the pain of invasive procedures. The effect of cultural factors and the stress of acculturation were examined by comparing data from two cultural groups, Anglo and Hispanic.^ Spielberger State-Trait Anxiety Scales were administered to children and parents prior to an invasive procedure. The Procedure Behavioral Checklist (PBCL) was used for observation of the child's response during the procedure. The Children's Procedural Interview (CPI) which contains items on the PBCL and visual analogues (scales of faces indicating varying degrees of pain and anxiety) was administered following the procedure.^ Reliability coefficients for Anglos were.78 on the PBCL,.79 on the CPI and.85 on the visual analogue scales. For Hispanics, the reliability for the PBCL was.54, while the CPI had a reliability of.72 and the visual analogue scales,.87. Construct validity was demonstrated by high correlations between the PBCL and CPI scores for both ethnic groups (.66 for Anglos and.64 for Hispanics) and by the significant correlation of State anxiety scores with both PBCL and CPI scores. Age was inversely correlated with PBCL and CPI scores for both ethnic groups. Hispanic parents' anxiety scores were higher than Anglo parents, but were not highly correlated with their child's PBCL, CPI or State-Trait anxiety scores. Caregivers' ratings were correlated with the PBCL scores for Anglos but not for Hispanics.^ The findings of this study indicate that pain responses may be reliably assessed using both observational and self-report methods in children, though differences in Anglo and Hispanic cultures exist. Differences in pain symptomatology and assessment in the two cultural groups warrant further study. ^

Hispanic incorporation and access to health care in Houston and Harris County, Texas: Adopting an Hispanic perspective to the Aday and Andersen model

This study examines Hispanic levels of incorporation and access to health care. Applying the Aday and Andersen framework for the study of access, the study examined the relationship between two levels of Hispanic incorporation into U.S. society, i.e., mainstream versus ethnic, and potential and realized measures of access to health care. Data for the study were drawn from a 1992 telephone survey of 600 randomly selected Hispanics in Houston and Harris County.^ The hypotheses tested were: (1) Hispanics who are incorporated into mainstream society are more likely to have better potential and realized access to health care than those who are incorporated into ethnic-group enclaves regardless of their socioeconomic status (SES), health status and health needs, and (2) there is no interaction between the levels of incorporation (mainstream or ethnic) and SES, health status, and health needs in predicting potential and realized access.^ The data analysis supported Hypothesis One for the two measures of potential access. The results of bivariate and multiple logistic regression analyses indicated that for Hispanics in Houston and Harris County, being in the "mainstream" incorporation category increased their potential access to care, having "health insurance" and a "regular place of care". For the selected measure of realized access, having a "regular check-up", the analysis did not demonstrate statistically significant differences in having a regular check-up among Hispanics incorporated in the ethnic or mainstream incorporation categories.^ Hypothesis Two, that there is no interaction between the levels of incorporation and socioeconomic characteristics, health status, and health needs in predicting potential and realized access among Hispanics was supported by the data. The results of the logistic regression analysis showed that, after adjusting for socioeconomic status, health status, and health needs, the association between "level of incorporation" and the two measures of potential access ("health insurance" and having a "usual place of care") was not modified by the control variables nor by their interaction with level of incorporation. That is, the effect of incorporation on Hispanics' health insurance coverage, and having a usual place of care, was homogenous across Hispanics with different SES and health status.^ The main research implication of this dissertation is the employment of a theoretical framework for the assessment of cultural factors essential to research on migrating heterogeneous subpopulations. It also provided strategies to solve practical and methodological difficulties in the secondary analyses of data on these populations. ^

Correlates of prenatal care initiation among low -income Hispanic women

Because Hispanic women are even less likely than women of other ethnic groups to receive early prenatal care, the purpose of this study was to identify factors that may influence these women to initiate care. After giving consent, 300 Hispanic women (100 who initiated first trimester care, 100 who initiated second trimester care, and 100 who initiated third trimester care or received no care) were interviewed in the post partum unit of a local public hospital. The interview included recollection of events leading to the first prenatal appointment, including first physical indicators of pregnancy, confirmation of pregnancy, feelings about the pregnancy, appointment making behavior, and system barriers encountered. The Health Belief Model was used as the theoretical framework for determining psychosocial variables. Using this model, perceived susceptibility to problems during pregnancy, perceived seriousness of possible problems, perceived benefits of prenatal care, perceived barriers to care, and cues to action were assessed. Time of entry into prenatal care was assessed by interview.^ In this sample of low-income Hispanic women, a higher perception of barriers to care was associated with later initiation of care and non-use of care, higher perceived benefits of care for the baby were associated with earlier care, especially in women without a card to access hospital district services, and having a card to access hospital district services was associated with earlier care. Several barriers to care were mentioned by women on open-ended questioning including long waiting times, embarrassment, and lack of transportation.^ Recommendations for practice included decreasing the number of visits for low-risk women while increasing the time spent with the provider, decreasing the number of vaginal exams for low-risk women, increasing the use of midwives, training lay workers to do risk assessment, giving specific messages about benefits of care to baby, and increasing general health motivation through community intervention methods. More research on the psychosocial and cultural factors associated with initiation of care is needed. In the meantime, the recommendations for practice can be implemented now to increase the use of prenatal care by low-income Hispanic women. ^

Careers guidance: an international perspective

The rationales for comparative studies of guidance systems are outlined. The key differences between guidance systems in different countries can be related to stage of economic development, to the political system, to social and cultural factors, to the education and training system, and to professional and organisational structures. The competing pressures towards convergence and divergence between guidance systems are explored.

Careers guidance: an international perspective

The rationales for comparative studies of guidance systems are outlined. The key differences between guidance systems in different countries can be related to stage of economic development, to the political system, to social and cultural factors, to the education and training system, and to professional and organisational structures. The competing pressures towards convergence and divergence between guidance systems are explored.

Careers guidance: an international perspective

The rationales for comparative studies of guidance systems are outlined. The key differences between guidance systems in different countries can be related to stage of economic development, to the political system, to social and cultural factors, to the education and training system, and to professional and organisational structures. The competing pressures towards convergence and divergence between guidance systems are explored.

Propuesta de algoritmos de predicción de glucosa en pacientes diabéticos

La diabetes mellitus es el conjunto de alteraciones provocadas por un defecto en la cantidad de insulina secretada o por un aprovechamiento deficiente de la misma. Es causa directa de complicaciones a corto, medio y largo plazo que disminuyen la calidad y las expectativas de vida de las personas con diabetes. La diabetes mellitus es en la actualidad uno de los problemas más importantes de salud. Ha triplicado su prevalencia en los últimos 20 anos y para el año 2025 se espera que existan casi 300 millones de personas con diabetes. Este aumento de la prevalencia junto con la morbi-mortalidad asociada a sus complicaciones micro y macro-vasculares convierten la diabetes en una carga para los sistemas sanitarios, sus recursos económicos y sus profesionales, haciendo de la enfermedad un problema individual y de salud pública de enormes proporciones. De momento no existe cura a esta enfermedad, de modo que el objetivo terapéutico del tratamiento de la diabetes se centra en la normalización de la glucemia intentando minimizar los eventos de hiper e hipoglucemia y evitando la aparición o al menos retrasando la evolución de las complicaciones vasculares, que constituyen la principal causa de morbi-mortalidad de las personas con diabetes. Un adecuado control diabetológico implica un tratamiento individualizado que considere multitud de factores para cada paciente (edad, actividad física, hábitos alimentarios, presencia de complicaciones asociadas o no a la diabetes, factores culturales, etc.). Sin embargo, a corto plazo, las dos variables más influyentes que el paciente ha de manejar para intervenir sobre su nivel glucémico son la insulina administrada y la dieta. Ambas presentan un retardo entre el momento de su aplicación y el comienzo de su acción, asociado a la absorción de los mismos. Por este motivo la capacidad de predecir la evolución del perfil glucémico en un futuro cercano, ayudara al paciente a tomar las decisiones adecuadas para mantener un buen control de su enfermedad y evitar situaciones de riesgo. Este es el objetivo de la predicción en diabetes: adelantar la evolución del perfil glucémico en un futuro cercano para ayudar al paciente a adaptar su estilo de vida y sus acciones correctoras, con el propósito de que sus niveles de glucemia se aproximen a los de una persona sana, evitando así los síntomas y complicaciones de un mal control. La aparición reciente de los sistemas de monitorización continua de glucosa ha proporcionado nuevas alternativas. La disponibilidad de un registro exhaustivo de las variaciones del perfil glucémico, con un periodo de muestreo de entre uno y cinco minutos, ha favorecido el planteamiento de nuevos modelos que tratan de predecir la glucemia utilizando tan solo las medidas anteriores de glucemia o al menos reduciendo significativamente la información de entrada a los algoritmos. El hecho de requerir menor intervención por parte del paciente, abre nuevas posibilidades de aplicación de los predictores de glucemia, haciéndose viable su uso en tiempo real, como sistemas de ayuda a la decisión, como detectores de situaciones de riesgo o integrados en algoritmos automáticos de control. En esta tesis doctoral se proponen diferentes algoritmos de predicción de glucemia para pacientes con diabetes, basados en la información registrada por un sistema de monitorización continua de glucosa así como incorporando la información de la insulina administrada y la ingesta de carbohidratos. Los algoritmos propuestos han sido evaluados en simulación y utilizando datos de pacientes registrados en diferentes estudios clínicos. Para ello se ha desarrollado una amplia metodología, que trata de caracterizar las prestaciones de los modelos de predicción desde todos los puntos de vista: precisión, retardo, ruido y capacidad de detección de situaciones de riesgo. Se han desarrollado las herramientas de simulación necesarias y se han analizado y preparado las bases de datos de pacientes. También se ha probado uno de los algoritmos propuestos para comprobar la validez de la predicción en tiempo real en un escenario clínico. Se han desarrollado las herramientas que han permitido llevar a cabo el protocolo experimental definido, en el que el paciente consulta la predicción bajo demanda y tiene el control sobre las variables metabólicas. Este experimento ha permitido valorar el impacto sobre el control glucémico del uso de la predicción de glucosa. ABSTRACT Diabetes mellitus is the set of alterations caused by a defect in the amount of secreted insulin or a suboptimal use of insulin. It causes complications in the short, medium and long term that affect the quality of life and reduce the life expectancy of people with diabetes. Diabetes mellitus is currently one of the most important health problems. Prevalence has tripled in the past 20 years and estimations point out that it will affect almost 300 million people by 2025. Due to this increased prevalence, as well as to morbidity and mortality associated with micro- and macrovascular complications, diabetes has become a burden on health systems, their financial resources and their professionals, thus making the disease a major individual and a public health problem. There is currently no cure for this disease, so that the therapeutic goal of diabetes treatment focuses on normalizing blood glucose events. The aim is to minimize hyper- and hypoglycemia and to avoid, or at least to delay, the appearance and development of vascular complications, which are the main cause of morbidity and mortality among people with diabetes. A suitable, individualized and controlled treatment for diabetes involves many factors that need to be considered for each patient: age, physical activity, eating habits, presence of complications related or unrelated to diabetes, cultural factors, etc. However, in the short term, the two most influential variables that the patient has available in order to manage his/her glycemic levels are administered insulin doses and diet. Both suffer from a delay between their time of application and the onset of the action associated with their absorption. Therefore, the ability to predict the evolution of the glycemic profile in the near future could help the patient to make appropriate decisions on how to maintain good control of his/her disease and to avoid risky situations. Hence, the main goal of glucose prediction in diabetes consists of advancing the evolution of glycemic profiles in the near future. This would assist the patient in adapting his/her lifestyle and in taking corrective actions in a way that blood glucose levels approach those of a healthy person, consequently avoiding the symptoms and complications of a poor glucose control. The recent emergence of continuous glucose monitoring systems has provided new alternatives in this field. The availability of continuous records of changes in glycemic profiles (with a sampling period of one or five minutes) has enabled the design of new models which seek to predict blood glucose by using automatically read glucose measurements only (or at least, reducing significantly the data input manually to the algorithms). By requiring less intervention by the patient, new possibilities are open for the application of glucose predictors, making its use feasible in real-time applications, such as: decision support systems, hypo- and hyperglycemia detectors, integration into automated control algorithms, etc. In this thesis, different glucose prediction algorithms are proposed for patients with diabetes. These are based on information recorded by a continuous glucose monitoring system and incorporate information of the administered insulin and carbohydrate intakes. The proposed algorithms have been evaluated in-silico and using patients’ data recorded in different clinical trials. A complete methodology has been developed to characterize the performance of predictive models from all points of view: accuracy, delay, noise and ability to detect hypo- and hyperglycemia. In addition, simulation tools and patient databases have been deployed. One of the proposed algorithms has additionally been evaluated in terms of real-time prediction performance in a clinical scenario in which the patient checked his/her glucose predictions on demand and he/she had control on his/her metabolic variables. This has allowed assessing the impact of using glucose prediction on glycemic control. The tools to carry out the defined experimental protocols were also developed in this thesis.

Contribuciones para el tratamiento de aguas residuales con sistemas alternativos de bajo coste. Aplicaciones para el desarrollo en poblaciones reducidas y cooperación

Este trabajo se ha centrado en la búsqueda y análisis de técnicas de saneamiento y depuración que proporcionen soluciones a poblaciones pequeñas, que por su situación económica o de desarrollo, carecen de estos servicios básicos. Es bien conocido los problemas que genera la falta de acceso al saneamiento básico en contextos de subdesarrollo, agravado en numerosos casos, por los incrementos en la dotación de agua sin introducir las infraestructuras para el tratamiento de las aguas residuales. Esta situación incide directamente sobre la salud de las personas y del medioambiente. Afortunadamente existen Organismos Internacionales y Agencias de Desarrollo y de Medioambiente, que intervienen directamente en estos temas. Los problemas no sólo se presentan en los llamados países en vías de desarrollo, sino que se ha comprobado que también afecta a poblaciones pequeñas con escasos recursos, del mundo más desarrollado. Muchas han sido las técnicas utilizadas con gran éxito en programas de cooperación, pero algunas han fracasado por pérdida de funcionalidad, por errores de diseño, por rápido deterioro de los materiales, o simplemente por falta de adaptabilidad al terreno o no previsión de controles y mantenimiento. La solución a estos eventos pasa por la innovación tanto tecnológica como de gestión, sin olvidar la componente socioeconómica y cultural. Tomar conciencia de un buen diseño adaptado a las características del terreno y de la población, evitaría fracasos por colapso, por falta de mantenimiento, de financiación etc. Por otra parte, se considera necesaria la implementación de programas educativos que incluyan mejoras en los hábitos higiénicos y el conocimiento de las infraestructuras que permitan a la población de destino, adquirir una formación sobre las propias instalaciones, su uso, su mantenimiento y conservación. El desarrollo y mejora de las técnicas de saneamiento y depuración requiere una continuidad en las investigaciones que facilite la adaptación de las instalaciones ya existentes a las diferentes coyunturas que puedan presentarse, garantizando su funcionamiento a largo plazo. Las técnicas denominadas “no convencionales” se caracterizan por ser soluciones económicas y sostenibles, que en algunos casos, requieren poco mantenimiento e incluso éste puede realizarse por personal no especializado, esto es, por los propios usuarios del servicio. Concretamente en el presente trabajo se ha llevado a cabo una revisión general de las tipologías conocidas, tanto convencionales como no convencionales y de su posible aplicación en función de la población de destino, con especial incidencia en las poblaciones más desfavorecidas. Una vez realizada, se han seleccionado las técnicas de saneamiento y depuración no convencionales por el interés personal en las poblaciones con mayores dificultades socioeconómicas. Se han estudiado distintas situaciones en diferentes países y contextos Nicaragua, Ecuador, India y España. Es en esta última, donde se han tenido más facilidades para la obtención de datos y análisis de los mismos, concretamente de la instalación del municipio de Fabara en la provincia de Zaragoza, situado en el Bajo Aragón. ABSTRACT The focus of this project lies on the research and analysis of sanitation and waste water treatment techniques able to provide solutions to small settlements which lack such basic services out of economic or underdevelopment reasons. The problems generated by the absence of access to basic sanitation services in underdevelopment contexts are well known, and many cases can be found where increase of water provision doesn’t involve installation of waste water treatment infrastructures. This situation has a direct impact on people’s health and also on the environment. Fortunately, there are International Organizations and Development Agencies which act directly on these matters. These problems don’t only occur in so called developing countries, as it has been confirmed that small settlements with scarce resources in the more developed world can also be affected. Many techniques have been successfully used in cooperation programs, but also some of them have failed due to loss of functionality, design mistakes, rapid material deterioration, or simply site inadequacy or lack of control and maintenance precautions. The solution to these incidents requires technological as well as management innovation, regarding for all cases the socioeconomic and cultural factors. The awareness of a good design, adapted to the site and population characteristics, would prevent from failures due to collapse, lack of maintenance, funding, etc. Furthermore, the implementation of education programs for improving hygienic habits and for transmitting the understanding of the infrastructures is considered necessary for allowing the aimed population to gain proper knowledge on their own infrastructure, its use, maintenance and preservation. The improvement of sanitation and waste water treatment techniques requires a continuous process of investigation, in order to adapt the existing infrastructure to the different situations that may come up, being able to ensure its long-term functioning. The so called non conventional techniques are characterized by being economic and sustainable solutions, requiring in some cases low maintenance, conducted even by non specialized personnel, that is, by the users themselves. In the present project a general overview of the already developed typologies has been carried out, taking into account the conventional as well as the non conven tional techniques and their possible application according to the aimed population, regarding especially the most underprivileged settlements. Thereupon, out of interest for the settlements with most socioeconomic difficulties, the non conventional sanitation and waste water techniques have been selected. A variety of situations in different countries and contexts has been examined, specifically in Nicaragua, Ecuador, India and Spain. The latest has proven easier for data collection and analysis, focusing finally on the existing infrastructure in the village of Fabara, province of Zaragoza, in the Bajo Aragón.

A taste of the technical cuisine: metals and other ingredients

According to cognitive linguistics, language has an experiential origin based on perception, sensory motor activities and our knowledge of the world. Our thought operates by establishing similarities, links and associations that enable us to talk about one thing in terms of another as shown in the example of love as a journey (Lakoff and Johnson, 1980). Metaphor and metonymy are conceptual and linguistic tools that make possible most of these cognitive operations. Since metaphor is an essential element of human communication, the discourse of specialised disciplines includes metaphorical mappings and numerous examples of metaphorical expressions, for example in economics, where business is mapped in terms of war (White, 2004; Herrera & White, 2000), electrotechnics with electrical components understood as couples (Roldán- Riejos in preparation) or in civil engineering where a bridge is conceptualized as a person (Roldán-Riejos, 2013). In this paper, the metaphors: WORKING WITH METALS IS COOKING/ TRABAJAR CON METALES ES COCINAR and METALS ARE CULINARY OBJECTS/ LOS METALES SON OBJETOS CULINARIOS are explored. The main aim is to show that the cooking metaphor is widely spread in the metallurgical domain in English and Spanish, although with different nuances in each language due to socio-cultural factors. The method adopted consists of analysing examples taken from the: Bilingual Dictionary of Scientific and Technical Metaphors and Metonymies Spanish- English/English-Spanish, a forthcoming and rigorously documented bilingual dictionary that sums up research on conceptual, linguistic and visual metaphor and metonymy in different areas of engineering (Roldán-Riejos and Molina, 2013). The present paper studies in detail English and Spanish cross-linguistic correspondences related to types of metals and processes. It is suggested that they reflect synesthetic metaphoric mappings. The exploitation of cognitive conceptual metaphor in the ESP classroom is lastly recommended.

Ethnohistory, genetics, and cancer mortality in Europeans

Geographic variation in cancer rates is thought to be the result of two major factors: environmental agents varying spatially and the attributes, genetic or cultural, of the populations inhabiting the areas studied. These attributes in turn result from the history of the populations in question. We had previously constructed an ethnohistorical database for Europe since 2200 B.C., permitting estimates of the ethnic composition of modern European populations. We were able to show that these estimates correlate with genetic distances. In this study, we wanted to see whether they also correlate with cancer rates. We employed two data sets of cancer mortalities from 42 types of cancer for the European Economic Community and for Central Europe. We subjected spatial differences in cancer mortalities, genetic, ethnohistorical, and geographic distances to matrix permutation tests to determine the magnitude and significance of their association. Our findings are that distances in cancer mortalities are correlated more with ethnohistorical distances than with genetic distances. Possibly the cancer rates may be affected by loci other than the genetic systems available to us, and/or by cultural factors mediated by the ethnohistorical differences. We find it remarkable that patterns of frequently ancient ethnic admixture are still reflected in modern cancer mortalities. Partial correlations with geography suggest that local environmental factors affect the mortalities as well.

Outreach to public health professionals: lessons learned from a collaborative Iowa public health project*

In 1995, the National Library of Medicine (NLM) and the Public Health Service (PHS) recommended that special attention be given to the information needs of unaffiliated public health professionals. In response, the National Network of Libraries of Medicine (NN/LM) Greater Midwest Region initiated a collaborative outreach program for public health professionals working in rural east and central Iowa. Five public health agencies were provided equipment, training, and support for accessing the Internet. Key factors in the success of this project were: (1) the role of collaborating agencies in the implementation and ongoing success of information access outreach projects; (2) knowledge of the socio-cultural factors that influence the information-seeking habits of project participants (public health professionals); and (3) management of changing or varying technological infrastructures. Working with their funding, personnel from federal, state, and local governments enhanced the information-seeking skills of public health professionals in rural eastern and central Iowa communities.

Interface between culturally based preferences and genetic preferences: female mate choice in Poecilia reticulata.

The relative contribution of genetic and socio-cultural factors in the shaping of behavior is of fundamental importance to biologists and social scientists, yet it has proven to be extremely difficult to study in a controlled, experimental fashion. Here I describe experiments that examined the strength of genetic and cultural (imitative) factors in determining female mate choice in the guppy, Poecilia reticulata. Female guppies from the Paria River in Trinidad have a genetic, heritable preference for the amount of orange body color possessed by males. Female guppies will, however, also copy (imitate) the mate choice of other females in that when two males are matched for orange color, an "observer" female will copy the mate choice of another ("model") female. Three treatments were undertaken in which males differed by an average of 12%, 24%, or 40% of the total orange body color. In all cases, observer females viewed a model female prefer the less colorful male. When males differed by 12% or 24%, observer females preferred the less colorful male and thus copied the mate choice of others, despite a strong heritable preference for orange body color in males. When males differed by 40% orange body color, however, observer females preferred the more colorful male and did not copy the mate choice of the other female. In this system, then, imitation can "override" genetic preferences when the difference between orange body color in males is small or moderate, but genetic factors block out imitation effects when the difference in orange body color in males is large. This experiment provides the first attempt to experimentally examine the relative strength of cultural and genetic preferences for a particular trait and suggests that these two factors moderate one another in shaping social behavior.

Cultura médica popular y evolución de la mortalidad: los cuidados de salud en la infancia durante la España contemporánea

Tomando como marco espacial y cronológico la España de finales del XIX y primeras décadas del siglo XX, el trabajo analiza los cuidados prodigados a la infancia en materia de salud, y aborda el estudio de las causas de «orden cultural» que explican el fenómeno del descenso de la mortalidad infantil y juvenil. A partir de la literatura de divulgación higiénico-sanitaria, se exponen algunas de las prácticas y los cuidados que se aplicaban en el ámbito familiar, de forma particular por parte de las madres, para resolver los problemas de salud de los más pequeños.

How Does Intimate Partner Violence Differ Depending on Level of Rurality of Residential Area in Spain?

Intimate partner violence (IPV) is recognized as a worldwide public health problem. Most theories ascribe IPV to individual, family, or cultural factors. Authors analyzed different residential areas in Spain in terms of IPV frequency as well as its impact on health and the use of services. A standardized self-administered cross-sectional survey was administered to ever-partnered adult women ages 18 to 70 years receiving care at primary health care centers (N = 10,322). Logistic regression analyzed the association between the level of rurality and health indicators, IPV, and use of services. The lowest frequency of IPV among women is reflected in higher rurality. Women of medium and low rurality presented a poorer self-perceived health and more physical health problems. Women from medium and low rurality areas declared seeking health services more frequently. These results show the importance of the environment in health and indicate the need for research on urban–rural differences in health problems to develop specific public health programs for each country.