Economic evaluation of the levonorgestrel-releasing intrauterine system for the treatment of dysfunctional uterine bleeding in Spain

To compare the cost and effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus combined oral contraception (COC) and progestogens (PROG) in first-line treatment of dysfunctional uterine bleeding (DUB) in Spain. STUDY DESIGN: A cost-effectiveness and cost-utility analysis of LNG-IUS, COC and PROG was carried out using a Markov model based on clinical data from the literature and expert opinion. The population studied were women with a previous diagnosis of idiopathic heavy menstrual bleeding. The analysis was performed from the National Health System perspective, discounting both costs and future effects at 3%. In addition, a sensitivity analysis (univariate and probabilistic) was conducted. RESULTS: The results show that the greater efficacy of LNG-IUS translates into a gain of 1.92 and 3.89 symptom-free months (SFM) after six months of treatment versus COC and PROG, respectively (which represents an increase of 33% and 60% of symptom-free time). Regarding costs, LNG-IUS produces savings of 174.2-309.95 and 230.54-577.61 versus COC and PROG, respectively, after 6 months-5 years. Apart from cost savings and gains in SFM, quality-adjusted life months (QALM) are also favourable to LNG-IUS in all scenarios, with a range of gains between 1 and 2 QALM compared to COC and PROG. CONCLUSIONS: The results indicate that first-line use of the LNG-IUS is the dominant therapeutic option (less costly and more effective) in comparison with first-line use of COC or PROG for the treatment of DUB in Spain. LNG-IUS as first line is also the option that provides greatest health-related quality of life to patients.

Current status of pediatric home enteral nutrition in Spain: The importance of the NEPAD register

Home enteral nutrition (HEN) is a type of enteral nutrition (EN) which is becoming progressively more widespread in pediatrics due to the benefits it affords to patients, their families and to reducing hospital costs. However, the true extent of its use is unknown in Spain as the data-base set up for this purpose is still underused (Registro de Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria -NEPAD-). More thorough registration of patients in the NEPAD online register will provide information about the characteristics of HEN in Spain: prevalence, diagnosis, the population sector being administered HEN, complications and developments. Likewise, forecast and planning of the necessary resources could be made while those in use could be analysed.

Service Architecture in Mobile IP Telephony Network

Uudet palvelut ovat tarkeinta, mita asiakkaat odottavat uudelta teknologialta.Se on paaasiallinen syy siihen, etta asiakkaat ovat valmiita maksamaan uudesta teknologiasta ja kayttamaan sita. Sen vuoksi uuden verkon tuoma uusi palveluarkkitehtuuri on tarkea koko projektin onnistumiselle. Tama dokumentti keskittyy kolmannen sukupolven matkapuhelinverkkojen palveluarkkitehtuuriin, jonka viitemallista annetaan kuvaus. Verkon palvelut esitellaan ja kuvaillaan. Toteutukseen liittyvia asioita selostetaan. USA:n markkinoilla tarvittava WIN konsepti kuvataan ja sen toteutuksesta annetaan myos kuvaus. Lopussa kuvataan Pre-Paid tilaajien laskutustietojen kasittelya WIN konseptissa elvytystilanteessa.

Assessing trends in insured losses from floods in Spain 1971-2008

Economic impacts from floods have been increasing over recent decades, a fact often attributed to a changing climate. On the other hand, there is now a significant body of scientific scholarship all pointing towards increasing concentrations and values of assets as the principle cause of the increasing cost of natural disasters. This holds true for a variety of perils and across different jurisdictions. With this in mind, this paper examines the time history of insured losses from floods in Spain between 1971 and 2008. It as- sesses whether any discernible residual signal remains after adjusting the data for the increase in the number and value of insured assets over this period of time. Data on insured losses from floods were sourced from Consorcio de Com- pensacíon de Seguros (CCS). Although a public institution, CCS compensates homeowners for the damage produced by floods, and thus plays a role similar to that of a private insurance company. Insured losses were adjusted using two proxy measures: first, changes in the total amount of annual surcharges (premiums) paid by customers to CCS, and secondly, changes in the total value of dwellings per year. The adjusted data reveals no significant trend over the period 1971-2008 and serves again to confirm that at this juncture, societal in- fluences remain the prime factors driving insured and economic losses from natural disasters.

Plasma homocysteine and vitamin B12 serum levels, red blood cell folate concentrations, C677T methylenetetrahydrofolate reductase gene mutation and risk of recurrent miscarriage: a case-control study in Spain.

Background: Hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) gene mutation have been postulated as a possible cause of recurrent miscarriage (RM). There is a wide variation in the prevalence of MTHFR polymorphisms and homocysteine (Hcy) plasma levels among populations around the world. The present study was undertaken to investigate the possible association between hyperhomocysteinemia and its causative genetic or acquired factors and RM in Catalonia, a Mediterranean region in Spain. Methods: Sixty consecutive patients with ≥ 3 unexplained RM and 30 healthy control women having at least one child but no previous miscarriage were included. Plasma Hcy levels, MTHFR gene mutation, red blood cell (RBC) folate and vitamin B12 serum levels were measured in all subjects. Results: No significant differences were observed neither in plasma Hcy levels, RBC folate and vitamin B12 serum levels nor in the prevalence of homozygous and heterozygous MTHFR gene mutation between the two groups studied. Conclusions: In the present study RM is not associated with hyperhomocysteinemia, and/or the MTHFR gene mutation.

Responses to a crisis: FASA-Renault in Spain during the 1970s

[cat] Aquest treball analitza la trajectòria de l’empresa FASA-Renault durant la dècada dels setanta del segle XX. Aquest període compren els primers anys de la crisis experimentada per l’economia i la industria espanyola entre 1974 y 1985. A nivell extern, l’economia espanyola es va veure afectada per dos xocs en el preu del petroli. A nivell intern, la industria de l’automòbil es va veure afectat per un decret governamental: es tractava de l’anomenat decret “Ford”, aprovat l’any 1972, el qual facilitava l’establiment de Ford a Espanya. Aquest decret va tenir greus conseqüències per a SEAT, el principal productor espanyol. Entre 1972 y 1980 la producció de SEAT es va reduir en una tercera part i la seva situació financera va esdevenir insostenible. Per contra, en aquest període FASA-Renault va esdevenir el principal productor ubicat a Espanya (la seva producció es va multiplicar per 3,5 durant els anys setanta) i en líder de ventes en el mercat espanyol (la seva penetració es va incrementar del 23 al 36%). El principal objectiu del treball es analitzar els factor que expliquen l’èxit de FASARenault durant els anys setanta.

The determinants of social spending in Spain, 1950-1980, Are dictatorships less redistributive?

[spa] La mayoría de estudios sobre el Estado del Bienestar, hasta el momento, se han centrado en países democráticos y ricos. Sin embargo, los países pobres y no democráticos han recibido mucha menos atención. Este artículo aporta nueva evidencia empírica sobre la evolución del gasto social en España y Portugal entre 1950 y 1980. A partir de ésta se ha podido analizar la relación entre dictaduras y redistribución, ya que ambos países sufrieron gobiernos no democráticos durante la mayor parte del periodo. Además del gasto social público y su clasificación por funciones, en este artículo se analiza también la forma de financiación de dicho gasto social.

Qualitative social differentiation in tertiary education in Spain

[cat] En aquest treball, s'estudia si la hipòtesi de la desigualtat efectivament mantinguda “effectively maintained inequality” es cumpleix a Espanya. Es postula que en les transicions terciàries a Espanya, les influències dels pares no es manifesten tant a través de la probabilitat de fer la transició, sinó més aviat a través de les diferències qualitatives associades a aquesta transició en termes de les qualitats dels programes educatius. Analitzem dues característiques qualitatives dels estudis universitaris: la durada del programa i el seu prestigi acadèmic. Identifiquem per a quins individus la influència parental és més important en cada cas.

Responses to a crisis: FASA-Renault in Spain during the 1970s

[cat] Aquest treball analitza la trajectòria de l’empresa FASA-Renault durant la dècada dels setanta del segle XX. Aquest període compren els primers anys de la crisis experimentada per l’economia i la industria espanyola entre 1974 y 1985. A nivell extern, l’economia espanyola es va veure afectada per dos xocs en el preu del petroli. A nivell intern, la industria de l’automòbil es va veure afectat per un decret governamental: es tractava de l’anomenat decret “Ford”, aprovat l’any 1972, el qual facilitava l’establiment de Ford a Espanya. Aquest decret va tenir greus conseqüències per a SEAT, el principal productor espanyol. Entre 1972 y 1980 la producció de SEAT es va reduir en una tercera part i la seva situació financera va esdevenir insostenible. Per contra, en aquest període FASA-Renault va esdevenir el principal productor ubicat a Espanya (la seva producció es va multiplicar per 3,5 durant els anys setanta) i en líder de ventes en el mercat espanyol (la seva penetració es va incrementar del 23 al 36%). El principal objectiu del treball es analitzar els factor que expliquen l’èxit de FASARenault durant els anys setanta.

The determinants of social spending in Spain, 1950-1980, Are dictatorships less redistributive?

[spa] La mayoría de estudios sobre el Estado del Bienestar, hasta el momento, se han centrado en países democráticos y ricos. Sin embargo, los países pobres y no democráticos han recibido mucha menos atención. Este artículo aporta nueva evidencia empírica sobre la evolución del gasto social en España y Portugal entre 1950 y 1980. A partir de ésta se ha podido analizar la relación entre dictaduras y redistribución, ya que ambos países sufrieron gobiernos no democráticos durante la mayor parte del periodo. Además del gasto social público y su clasificación por funciones, en este artículo se analiza también la forma de financiación de dicho gasto social.

Qualitative social differentiation in tertiary education in Spain

[cat] En aquest treball, s'estudia si la hipòtesi de la desigualtat efectivament mantinguda “effectively maintained inequality” es cumpleix a Espanya. Es postula que en les transicions terciàries a Espanya, les influències dels pares no es manifesten tant a través de la probabilitat de fer la transició, sinó més aviat a través de les diferències qualitatives associades a aquesta transició en termes de les qualitats dels programes educatius. Analitzem dues característiques qualitatives dels estudis universitaris: la durada del programa i el seu prestigi acadèmic. Identifiquem per a quins individus la influència parental és més important en cada cas.

Economic ideas and economists in the Parliament in the liberal age: The attempt to implement a tax on incomes in Spain in 1868-1869

[spa] El estudio de la presencia de ideas económicas en los debates parlamentarios se ha convertido recientemente en un objeto importante dentro de la investigación sobre el proceso de institucionalización de la economía política en Europa Occidental en la llamada era liberal. En este marco general, este artículo se centra en el análisis de un caso de particular interés: La relevancia del pensamiento económico y el papel jugado por los economistas en los debates parlamentarios que siguieron a la creación de un nuevo impuesto que trataba de captar la renta personal, que fue lanzado por el ministro de Hacienda Laureano Figuerola en 1868. El artículo intenta demostrar, en primer lugar, que las ideas económicas jugaron efectivamente un papel relevante en las discusiones sobre el impuesto sobre la renta y que la presencia e influencia de los economistas en el Legislativo en este tiempo fue notable. En segundo lugar, que este fue un intento serio de modernizar la estructura fiscal española llevado a cabo por el Gobierno Provisional, el cual trató de diseñar un sistema impositivo capaz de fomentar el crecimiento económico del país.

Economic ideas and economists in the Parliament in the liberal age: The attempt to implement a tax on incomes in Spain in 1868-1869

[spa] El estudio de la presencia de ideas económicas en los debates parlamentarios se ha convertido recientemente en un objeto importante dentro de la investigación sobre el proceso de institucionalización de la economía política en Europa Occidental en la llamada era liberal. En este marco general, este artículo se centra en el análisis de un caso de particular interés: La relevancia del pensamiento económico y el papel jugado por los economistas en los debates parlamentarios que siguieron a la creación de un nuevo impuesto que trataba de captar la renta personal, que fue lanzado por el ministro de Hacienda Laureano Figuerola en 1868. El artículo intenta demostrar, en primer lugar, que las ideas económicas jugaron efectivamente un papel relevante en las discusiones sobre el impuesto sobre la renta y que la presencia e influencia de los economistas en el Legislativo en este tiempo fue notable. En segundo lugar, que este fue un intento serio de modernizar la estructura fiscal española llevado a cabo por el Gobierno Provisional, el cual trató de diseñar un sistema impositivo capaz de fomentar el crecimiento económico del país.

Wage differentials between native and immigrant women in Spain: accounting for differences in support

Purpose: The objective of the study is to quantify the wage gap between native and immigrant women in Spain, taking into account differences in their characteristics and the need to control for common support. If immigrant women are segregated in occupations with few native women, it is important to take this into account to analyse wage differentials between both collectives. Methodology: We use microdata from the Continuous Sample of Working Histories (Muestra Continua de Vidas Laborales) on wages and other personal characteristics such as gender, country of origin, and age to apply the matching procedure and the decomposition of the wage gap along the lines of Ñopo (2008) for the analysis of wage differentials between native and immigrant women. The advantage of this procedure is that we can simultaneously estimate the common support and the mean counterfactual wage for the women on the common support (i.e., comparing native and immigrant women with similar observable characteristics). In addition, we can describe differences not only at the mean but also along the entire wage distribution. Findings: The results obtained indicate that, on average, immigrant women earn less than native women in the Spanish labour market. This wage gap is bigger when we consider immigrant women from developing countries, but our main finding is that an important part of this wage gap is related to differences in common support (i.e., immigrant women are segregated in certain jobs with low wages different from those occupied by native women). If the need to control for common support is neglected, estimates of the wage gap will be biased. Originality: Studying the case of Spain is particularly interesting because it is a country with abundant and recent immigration. Immigrant women account for more than half of the total immigrants in Spain, and unlike other host countries, they come from a highly varied range of countries, with origins as diverse as Latin America, the Maghreb and Eastern Europe. To our knowledge, no other study has explicitly focused on the analysis of the wage differential of immigrant women in the Spanish labour market by taking into account the need to control for common support. Moreover, published papers illustrating the potentiality of Ñopo"s (2008) methodology are also very scarce.

Population Variation and Genetic Control of Modular Chromatin Architecture in Humans.

Chromatin state variation at gene regulatory elements is abundant across individuals, yet we understand little about the genetic basis of this variability. Here, we profiled several histone modifications, the transcription factor (TF) PU.1, RNA polymerase II, and gene expression in lymphoblastoid cell lines from 47 whole-genome sequenced individuals. We observed that distinct cis-regulatory elements exhibit coordinated chromatin variation across individuals in the form of variable chromatin modules (VCMs) at sub-Mb scale. VCMs were associated with thousands of genes and preferentially cluster within chromosomal contact domains. We mapped strong proximal and weak, yet more ubiquitous, distal-acting chromatin quantitative trait loci (cQTL) that frequently explain this variation. cQTLs were associated with molecular activity at clusters of cis-regulatory elements and mapped preferentially within TF-bound regions. We propose that local, sequence-independent chromatin variation emerges as a result of genetic perturbations in cooperative interactions between cis-regulatory elements that are located within the same genomic domain.