Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain

Objective: To explore service providers’ perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. Methods: A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. Findings: Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). Conclusion: Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services.

Erosion of universal health coverage in Spain

Whereas the recent UN resolution urges governments to accelerate progress towards universal access to affordable and quality health-care services, the Spanish Government, bypassing the parliamentary procedure, enacted a Royal Decree to limit access to free services at the point of delivery for all-undermining the principle of universal coverage. Spanish health and social service budgets have been subjected to large cuts (13,7% in 2012 and 16,2% in 2013) with some regions imposing additional budget cuts.

Shear wave velocity estimation in the metropolitan area of Málaga (S Spain)

We carry out a seismic noise study based on array measurements at three sites in the Málaga basin, South Spain, for the further estimation of shear wave velocity profiles. For this purpose, we use both the H/V method and the f–k technique in order to characterize the different materials present in the zone, i.e., Quaternary sediments and Pliocene sedimentary rocks above the bedrock. The H/V analysis shows frequency peaks going from 1 Hz, in areas close to the border of the basin, to 0.3 Hz in places located toward the center of the formation. The f–k analysis allows obtaining the dispersion curves associated with each site and subsequently, estimating the Vs profiles by inversion of the respective group velocities. In this way, the basin basement can be characterized by S-wave velocities greater than 2000 m/s. Regarding the basin fill, it is divided into three layers defined by different wave velocity intervals. The shallowest one is featured by velocities ranging from 150 to 400 m/s and comprises the Quaternary sediments, while velocities going from 550–700 to1200–1600 m/s characterize the two underlying layers composed by Pliocene sediments. Finally, the information provided by the three Vs profiles is integrated in a 2D cross-section of the basin to have a spatial view of its sedimentary structure. The results obtained here, in addition to providing useful information about the infill of the basin near the metropolitan area of Málaga, will be very helpful for future seismic zonation studies in the region.

Energy consumption in an urban wastewater treatment plant: the case of Murcia Region (Spain)

Of all the costs associated with the operation and maintenance of wastewater treatment plants (WWTPs), those associated with energy use tend to be the most significant. From this point of view, it is hence logical that energy efficiency and saving strategies should be one of the current focuses of debate amongst those involved with the management of WWTPs. The present study's objective is to determine the correlation between size and energy consumption for a WWTP. To this end, 90 WWTPs currently in service were analysed and their energetic impact quantified in terms of kWh/m3 of water treated. The results obtained demonstrate that energy consumption ratio increases as the size of WWTPs decreases, either in terms of treatment volume or population equivalent served.

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.

Factors Associated with the Cessation of Intimate Partner Violence in Women Attending Primary Care in Spain

This study aimed to identify factors associated with the likelihood of IPV cessation among women attending Spanish primary healthcare. Of the 2465 women who reported lifetime IPV, 36.1 % stated that violence had ceased. Those women not currently abused had higher levels of education and social support, were workers or students, and had no dependent children. When IPV duration was less than 5 years, the likelihood of cessation was two times higher than when IPV continued beyond 5 years. For women who have experienced physical IPV, the probability of ending the violent relationship was 10 times higher than for those suffering from psychological IPV. The implications of the findings regarding clinical significance and future research are discussed.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences

Background: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. Method: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. Results: Three categories related to the crisis emerged – previous labour experiences, employment consequences and individual consequences – that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. Conclusion: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

Health inequality between immigrants and natives in Spain: the loss of the healthy immigrant effect in times of economic crisis

Background: The immigrant population living in Spain grew exponentially in the early 2000s but has been particularly affected by the economic crisis. This study aims to analyse health inequalities between immigrants born in middle- or low-income countries and natives in Spain, in 2006 and 2012, taking into account gender, year of arrival and socioeconomic exposures. Methods: Study of trends using two cross-sections, the 2006 and 2012 editions of the Spanish National Health Survey, including residents in Spain aged 15–64 years (20 810 natives and 2950 immigrants in 2006, 14 291 natives and 2448 immigrants in 2012). Fair/poor self-rated health, poor mental health (GHQ-12 > 2), chronic activity limitation and use of psychotropic drugs were compared between natives and immigrants who arrived in Spain before 2006, adjusting robust Poisson regression models for age and socioeconomic variables to obtain prevalence ratios (PR) and 95% confidence interval (CI). Results: Inequalities in poor self-rated health between immigrants and natives tend to increase among women (age-adjusted PR2006 = 1.39; 95% CI: 1.24–1.56, PR2012 = 1.56; 95% CI: 1.33–1.82). Among men, there is a new onset of inequalities in poor mental health (PR2006 = 1.10; 95% CI: 0.86–1.40, PR2012 = 1.34; 95% CI: 1.06–1.69) and an equalization of the previously lower use of psychotropic drugs (PR2006 = 0.22; 95% CI: 0.11–0.43, PR2012 = 1.20; 95% CI: 0.73–2.01). Conclusions: Between 2006 and 2012, immigrants who arrived in Spain before 2006 appeared to worsen their health status when compared with natives. The loss of the healthy immigrant effect in the context of a worse impact of the economic crisis on immigrants appears as potential explanation. Employment, social protection and re-universalization of healthcare would prevent further deterioration of immigrants’ health status.

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality

Background: Intimate partner violence (IPV) against women is a complex worldwide public health problem. There is scarce research on the independent effect on IPV exerted by structural factors such as labour and economic policies, economic inequalities and gender inequality. Objective: To analyse the association, in Spain, between contextual variables of regional unemployment and income inequality and individual women’s likelihood of IPV, independently of the women’s characteristics. Method: We conducted multilevel logistic regression to analyse cross-sectional data from the 2011 Spanish Macrosurvey of Gender-based Violence which included 7898 adult women. The first level of analyses was the individual women’ characteristics and the second level was the region of residence. Results: Of the survey participants, 12.2% reported lifetime IPV. The region of residence accounted for 3.5% of the total variability in IPV prevalence. We determined a direct association between regional male long-term unemployment and IPV likelihood (P = 0.007) and between the Gini Index for the regional income inequality and IPV likelihood (P < 0.001). Women residing in a region with higher gender-based income discrimination are at a lower likelihood of IPV than those residing in a region with low gender-based income discrimination (odds ratio = 0.64, 95% confidence intervals: 0.55–0.75). Conclusions: Growing regional unemployment rates and income inequalities increase women’s likelihood of IPV. In times of economic downturn, like the current one in Spain, this association may translate into an increase in women’s vulnerability to IPV.

No effect of unemployment on intimate partner-related femicide during the financial crisis: a longitudinal ecological study in Spain

Background: Spain’s financial crisis has been characterized by an increase in unemployment. This increase could have produced an increase in deaths of women due to intimate partner-related femicides (IPF). This study aims to determine whether the increase in unemployment among both sexes in different regions in Spain is related to an increase in the rates of IPF during the current financial crisis period. Methods: An ecological longitudinal study was carried out in Spain’s 17 regions. Two study periods were defined: pre-crisis period (2005–2007) and crisis period (2008–2013). IPF rates adjusted by age and unemployment rates for men and women were calculated. We fitted multilevel linear regression models in which observations at level 1 were nested within regions according to a repeated measurements design. Results: Rates of unemployment have progressively increased in Spain, rising above 20 % from 2008 to 2013 in some regions. IPF rates decreased in some regions during crisis period with respect to pre-crisis period. The multilevel analysis does not support the existence of a significant relationship between the increase in unemployment in men and women and the decrease in IPF since 2008. Discussion: The increase in unemployment in men and women in Spain does not appear to have an effect on IPF. The results of the multilevel analysis discard the hypothesis that the increase in the rates of unemployment in women and men are related to an increase in IPF rates. Conclusions: The decline in IPF since 2008 might be interpreted as the result of exposure to other factors such as the lower frequency of divorces in recent years or the medium term effects of the integral protection measures of the law on gender violence that began in 2005.

Validation of a Spanish version of the Distance Education Learning Environments Survey (DELES) in Spain

The aim of this study was to examine the validity of the Spanish version of the Distance Education Learning Environments Survey (Sp-DELES). This instrument assesses students’ perceptions of virtual learning environments using six scales: Instructor Support, Student Interaction and Collaboration, Personal Relevance, Authentic Learning, Active Learning, and Autonomy. Further, the Sp-DELES includes an additional scale that assesses students’ Satisfaction with their classes. The original DELES has been used in at least 27 independent studies with strong reliability and validity. For this study, we sampled 265 students from the University of Alicante enrolled in various hybrid and distance education courses taught by the Department of Health Psychology. We analysed the Sp-DELES for validity using principal component factor analysis with varimax rotation, and for reliability using Cronbach’s alpha. The Sp-DELES exhibited good reliability (Cronbach’s alpha for the scales ranging from 0.86 to 0.97) and the original six-factor structure was replicated and accounted for 72.9 % of the total variance. Overall the results are consistent with those of the original English-language version of the instrument. The Sp-DELES has proven to be a reliable and valid instrument for assessing psychosocial learning environments in tertiary-level hybrid and distance-education settings.

The regulation of professional advertising practices in Spain, 1988–2013

From the perspective of the sociology of professions, every professional activity should have its own clearly circumscribed and regulated sphere of action. Such an articulation facilitates the regulation of the production of a given profession as well as the way in which it is practiced. The purpose of the research reported here was to provide a comprehensive review and evaluation of the regulatory framework governing the advertising sector in Spain. To this end, the authors analysed external regulatory legislation and self-regulatory codes extracted from the data base of the Asociación para la Autoregulación de la Comunicación Comercial (Autocontrol) that had been enacted or adopted between 1988, the year that Law 11/1998 on General Telecommunications entered into force, and 2003 as well as other relevant documents retrieved from the Boletin Oficial del Estado (BOE) pertaining to the same period. Findings indicate that although there has been a groundswell of legislation governing advertising practices in Spain since 1988, especially at the regional level, lawmakers have focused on the content of advertising messages and shown very little interest in regulating the professions of advertising and public relations. Furthermore, Spanish legislation enacted in 2003 and EU policies appear to have encouraged the adoption of voluntary codes of ethics. Sectors traditionally subject to mandatory advertising regulation, either due to the vulnerability of their target audiences or the potential impact of their commercial messages on public health or the environment, are more likely to develop self-regulatory codes of conduct than others

Factors Associated With Women’s Reporting of Intimate Partner Violence in Spain

In Spain, in 2013, the 20% of women who were murdered by their partner had reported him previously. We analyze the 2011 Spanish-Macrosurvey on Gender Violence to identify and analyze the prevalence of and the principal factors associated with reporting a situation of intimate partner violence (IPV) and the main reasons women cite for not filing such reports, or for subsequently deciding to withdraw their complaint. Overall, 72.8% of women exposed to IPV did not report their aggressor. The most frequent reasons for not reporting were not giving importance to the situation (33.9%), and fear and lack of trust in the reporting process (21.3%). The main reasons for withdrawing the complaint were cessation of the violence (20.0%), and fear and threats (18.2%). The probability of reporting increased among women with young children who were abused, prevalence ratio (95% confidence interval [CI]): 2.14 [1.54, 2.98], and those whose mother was abused, prevalence ratio (95% CI): 2.25 [1.42, 3.57]. Always focusing on the need to protect women who report abuse, it is necessary to promote the availability of and access to legal resources especially among women who use them less: women who do not have children and women who do not have previous family exposure to violence.

The SAAS-R: A New Instrument to Assess the School Attitudes of Students with High and Low Academic Achievement in Spain

We examined the psychometric properties of the School Attitude Assessment Survey–Revised in a Spanish population (n = 1,398). Confirmatory factor analysis procedures supported the instrument’s five-factor structure. The results of discriminant analysis demonstrated the predictive power of the School Attitude Assessment Survey–Revised scales as regards academic performance. Implications for education and assessment are discussed.

Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain

Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.