Gambling in Spain: update on experience, research and policy

AIMS: To describe the current situation of gambling in Spain, sketching its history and discussing the regulations and legislation currently in force within the framework of the European Union (EU), and to review the epidemiology of gambling in Spain, the self-help groups and professional treatments available, and their potential effectiveness. METHODS: A systematic computerized search was performed in three databases (EMBASE, PubMed and PsychINFO, including articles and chapters) and the reference lists from previous reviews to obtain some of the most relevant studies published up to now on the topic of pathologic gambling in Spain. RESULTS: Similar to other EU countries, Spain has a high prevalence of pathologic gambling, focused on specific culturally bounded types of gambling. Expenditure in online gaming has risen significantly in the last few years, prompting the Spanish government to draft new legislation to regulate gaming. CONCLUSIONS: The gaming industry is expected to be one of the fastest growing sectors in Spain in the coming years owing to the rise of new technologies and the development of online gaming

Factors affecting foster care breakdown in Spain

La ruptura del acogimiento familiar se ha definido como aquella situación en la que alguna de las partes implicadas causa una terminación de la intervención antes de haber alcanzado los objetivos establecidos en el plan de caso. Este trabajo presenta un estudio llevado a cabo en una muestra española de 318 casos cerrados de niños que fueron acogidos en familia ajena y extensa. Los datos se obtuvieron a través de la revisión exhaustiva de los expedientes de protección y acogimiento, complementada conentrevistas a los técnicos encargados de cada caso. La tasa de ruptura del conjunto de la muestra fue de 26,1%, si bien fuesignificativamente diferente en familia extensa (19,7%) que en familia ajena (31,2%). Los resultados de este estudio indican que las variables relacionadas con la ruptura dependen de la modalidad del acogimiento, en familia ajena o extensa. En el primer caso destacamos las variables relacionadas con las características del niño, especialmente los problemas de conducta y escolares, con especial relevancia en el grupo de 9-12 años, y el haber estado en acogimiento residencial previamente. En cambio, en extensaresulta más importante la problemática en los padres (prisión, salud mental) y el tener una medida de tutela. También el hecho de que se realice el acogimiento tras pasar por hogares de acogida resulta trascendental. Finalmente, la disponibilidad de recursos económicos e incluso los estudios de los acogedores parecen ser variables relacionadas con la ruptura de la acogida

Jóvenes que estuvieron en el sistema de protección social a la infancia : reflexiones a partir de una investigación realizada en Girona, España = Young people who were in the child protection system : reflections from a study done in Girona, Spain

Research on residential care is still scarce despite its high implementation in Spain. This article presents the results of a research using qualitative methods. The study analyses the situation experienced by young people who lived in foster care in the province of Girona (1994-2002) based on their opinions and perceptions expressed in a semi-structured interview. The results, clustered into subcategories, show lack of knowledge about the reasons why they needed foster care, if it was better being there than staying with their parents, and the lack of support for transition to adulthood. The study shows implications for children and youth policies, professional practice and research

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

INTRODUCTION: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. METHODS: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. DISCUSSION: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.

Streptococcus suis infection and malignancy in man, Spain

Streptococcus suis is an emerging zoonotic agent. Human infection is associated with occupational exposure to swine. Affected persons are usually, but not always, healthy (1,2). Immunosuppressive conditions can predispose persons to S. suis infection, and cancer has classically been associated as a risk factor for S. suis infection (1,2). Nevertheless, the actual number of reported cases is low (27). We describe a severe case of S. suis infection in a man who had not been exposed to swine but for whom disseminated cancer was diagnosed 5 months after the infection.

Streptococcus suis infection and malignancy in man, Spain

Streptococcus suis is an emerging zoonotic agent. Human infection is associated with occupational exposure to swine. Affected persons are usually, but not always, healthy (1,2). Immunosuppressive conditions can predispose persons to S. suis infection, and cancer has classically been associated as a risk factor for S. suis infection (1,2). Nevertheless, the actual number of reported cases is low (27). We describe a severe case of S. suis infection in a man who had not been exposed to swine but for whom disseminated cancer was diagnosed 5 months after the infection.

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.

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.

Tourism, poverty alleviation and nature conservation : the state of contemporary research

Artikkeli perustuu kirjallisuuskatsaukseen, joka on tehty 17 lehden 112 vertaisarvioidusta artikkelista vuosilta 2003-2007.

Microbusiness: A new social business model to alleviate poverty in developing countries?

Poverty alleviation views have shifted from seeing the poor as victims or as potential consumers, to seeing them as gainers. Social businesses include microfinancing and microfranchising, which engage people at the bottom of the pyramid using business instead of charity. There are, however, social business firms that do not fit to the existing social business model theory. These firms provide markets to poor producers and mix traditional, local craftsmanship with western design. Social business models evolve faster than the academic literature can study them. This study contributes to filling this gap. The purpose of this Master’s thesis is to develop the concept of social business as poverty alleviation method in developing countries. It also aims; 1) to describe the means for poverty alleviation in developing countries; 2) to introduce microbusiness as a social business model; and 3) to examine the challenges of microbusinesses. Qualitative case study is used as a research strategy and theme interviews as a data collecting method. The empirical data is gathered from four interviews of Finnish or Finnish-owned firms that employ microbusiness – Mifuko, Tensira, Mangomaa and Tikau – and this is supported with secondary data including articles on case companies. The results show that microbusiness is a valid new social business model that aims at poverty alleviation by engaging the poor at the bottom of the pyramid. It is possible to map the value proposition, value constellation, and economic and social profit equations of the case firms. Two major types of firms emerge from the results; the first consists of design-oriented firms that emphasize the quality and design of the products, and the second consists of bazaar-like firms whose product portfolio is less sophisticated and who promote more the stories of the products – not the design. All microbusiness firms provide markets, promote traditional handicrafts, form close relationships to their producers, and aim at enhancing lives through their businesses. The attitudes towards social businesses are sometimes negative, but this is changing for the better. In conclusion, microbusiness answers to two different needs at the same time – consumers’ needs for ethical products and the social needs of the producers – but the social need is the ultimate reason why the entrepreneurs started business. Microbusiness continues as a poverty alleviation tool that sees the poor as gainers; by providing them steady employment, microbusiness increases the poor’s self-esteem and enables them for a better living. Academic literature has not been able to offer enough alternative business models to cover all social businesses; the current study contributes to this by concluding that microbusiness is another social business model.

Advocating recognition and redistribution in poverty alleviation programs in Ghana : an examination of state and NGO programs and policies

Abstract This thesis argues that poverty alleviation strategies and programs carried out by the government and Non Governmental Organizations in Ghana provide affirmative solutions to poverty. This is because, these intervention strategies have been influenced by conventional discourses on poverty that fail to adequately address non-economic issues of poverty such as powerlessness, marginalization and tmder-representation. The study is carried out in a two-pronged manner; first, it analyses state policies and strategies, particularly the Ghana Poverty Reduction Strategy (GPRS), on poverty alleviation and compares these to NGO programs, implemented with funds and support from external donor organizations. Specifically, I focus on how NGOs and the governnlent of Ghana negotiate autonomy and financial dependency with their funding donor-partners and how these affect their policies and programs. Findings from this study reveal that while external influences dominate poverty alleviation policies and strategies, NGOs and the government of Ghana exercise varying degrees of agency in navigating these issues. In particular, NGOs have been able to adapt their programs to the changing needs of donor markets, and are also actively engaged in re-orienting poverty back to the political domain through advocacy campaigns. Overall, rural communities in Ghana depend on charitable NGOs for the provision of essential social services, while the Ghanaian government depends on international donor assistance for its development projects.

The Clemente Course in the Humanities and critical pedagogy : a comparative analysis of Earl Shorris and bell hooks on poverty, racism, imperialism and patriarchy

The Clemente Course in the Humanities is an anti-poverty intervention for adults who self-identity as "poor" and humanities instructors. The course was created in 1995 by journalist Earl Shorris, who based the curriculum on a Socratic method of pedagogy and the "great books" canon of Robert Hutchins. It began as a community-based initiative in urban US settings, but since 1997 Mayan, Yup'ik and Cherokee iterations have been created, as well as on-campus bridge courses for non-traditional students to explore college-level education in Canada and the USA. The course potentially conflicts with critical pedagogy because the critical theories of Paulo Freire and contemporary cultural studies reject traditional notions of both the canon and teaching. However, a comparison between Shorris' and bell hooks' theories of oppression reveals significant similarities between his "surround of force" and her "capitalist imperialist white supremacist patriarchy," with implications for liberal studies and critical pedagogy.