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.

The Labour Market in Spain: Problems, Challenges and Future Trends. Policy Brief #2015/01

Spain’s economy was hit particularly hard by the financial crisis. After severe austerity measures have been implemented in recent years to contain a strong public debt increase, first signs of economic recovery are emerging. However, as SIM Europe results show, very few measures to soften the social consequences have been enacted. Spain scores second to last in the ‘Labour Market Access’ dimension of the Social Justice Index 2015, with the greatest deterioration among all EU countries compared to 2008. According to the Reform Barometer 2015, the quality of labour market reforms in Spain ranks last in the EU. With economic recovery gaining momentum, high priority should be given to ameliorating labour market access through higher education improvements, professional training, investments into R&D and promotion of high added-value industries.

Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence form a large-scale community-based clinical trial

Perinatal mortality is very high in Bangladesh. In this setting, few community-level studies have assessed the influence of underlying maternal health factors on perinatal outcomes. We used the data from a community-based clinical controlled trial conducted between 1994 and 1997 in the catchment areas of a large MCH/FP hospital located in Mirpur, a suburban area of Dhaka in Bangladesh, to investigate the levels of perinatal mortality and its associated maternal health factors during pregnancy. A total of 2007 women were followed after recruitment up to delivery, maternal death, or until they dropped out of the study. Of these, 1584 who gave birth formed our study subjects. The stillbirth rate was 39.1 per 1000 births [95% confidence interval (CI) 39.0, 39.3] and the perinatal mortality rate (up to 3 days) was 54.3 per 1000 births [95% CI 54.0, 54.6] among the study population. In the fully adjusted logistic regression model, the risk of perinatal mortality was as high as 2.7 times [95% CI 1.5, 4.9] more likely for women with hypertensive disorders, 5.0 times [95% CI 2.3, 10.8] as high for women who had antepartum haemorrhage and 2.6 times [95% CI 1.2, 5.8] as high for women who had higher haemoglobin levels in pregnancy when compared with their counterparts. The inclusion of potential confounding variables such as poor obstetric history, sociodemographic characteristics and preterm delivery influenced only marginally the net effect of important maternal health factors associated with perinatal mortality. Perinatal mortality in the study setting was significantly associated with poor maternal health conditions during pregnancy. The results of this study point towards the urgent need for monitoring complications in high-risk pregnancies, calling for the specific components of the safe motherhood programme interventions that are designed to manage these complications of pregnancy.

Myopia control with orthokeratology contact lenses in Spain (MCOS):refractive and biometric changes

PURPOSE. To compare axial length growth between white children with myopia wearing orthokeratology contact lenses (OK) and distance single-vision spectacles (SV) over a 2-year period. METHODS. Subjects 6 to 12 years of age with myopia -0.75 to -4.00 diopters of sphere (DS) and astigmatism ≤1.00 diopters of cylinder (DC) were prospectively allocated OK or SV correction. Measurements of axial length (Zeiss IOLMaster), corneal topography, and cycloplegic refraction were taken at 6-month intervals. RESULTS. Thirty-one children were fitted with OK and 30 with SV. Following 24 months, axial length increased significantly over time for both the OK group (0.47 mm) and SV group (0.69 mm; P < 0.001), with a significant interaction between time and group (P = 0.05) reflecting a greater increase in the SV group. Significant differences in refraction were found over time, between groups and for the interaction between time and group for spherical (all P < 0.001) but not cylindrical components of refraction (all P > 0.05). Significantly greater corneal flattening was evident in the OK group for the flatter and steeper corneal powers and for corneal shape factor (all P ≤0.05). CONCLUSIONS. Orthokeratology contact lens wear reduces axial elongation in comparison to distance single-vision spectacles in children. © 2012 The Association for Research in Vision and Ophthalmology, Inc.

Myopia control with orthokeratology contact lenses in Spain:a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles

Purpose: To compare vision-related quality-of-life measures between children wearing orthokeratology (OK) contact lenses and distance single-vision (SV) spectacles. Methods: Subjects 6 to 12 years of age and with myopia of -0.75 to -4.00 diopters and astigmatism less than or equal to 1.00 diopters were prospectively assigned OK contact lens or SV spectacle correction. A pediatric refractive error profile questionnaire was administered at 12- and 24-month intervals to evaluate children's perceptions in terms of overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, and peer perceptions. The mean score of all items was calculated as the overall score. Additionally, parents/guardians were asked to rate their child's mode of visual correction and their intention to continue treatment after study completion. Results: Thirty-one children were fitted with OK contact lenses and 30 with SV spectacles. Children wearing OK contact lenses rated overall vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, peer perceptions, and the overall score significantly better than children wearing SV spectacles (all P<0.05). Near vision and handling were, respectively, rated better (P<0.001) and similar (P=0.44) for SV spectacles in comparison to OK contact lenses. No significant differences were found between 12 and 24 months for any of the subjective ratings assessed (all P>0.05). Parents/guardians of children wearing OK contact lenses rated visual correction method and intention to continue treatment higher than parents of children wearing SV spectacles (P=0.01). Conclusion: The results indicate that the significant improvement in vision-related quality of life and acceptability with OK contact lenses is an incentive to engage in its use for the control of myopia in children.

Employment status and health in Spain before and after the Great Recession

This article analyzes the relationship between employment status (ES), on one hand, and self-rated health and psychological distress, on the other, in the context of the Great Recession beginning in 2008. For this purpose, it is necessary to move beyond the employment/unemployment dichotomy characteristics of previous theories and research concerning the relationship between the labor market, recession, and health. The authors use data from the Spanish National Health Surveys in 2006 (n = 15,128), before the crisis, and in 2012 (n = 11,124), when its consequences had taken effect. The results of the regression analysis indicate a structural change in the relationship between ES and health. Health inequality patterns changed during the crisis, with increased deterioration in the health of unemployed, especially the long-term unemployed, and self-employed workers. Health inequalities were reduced for temporary workers. The results support the idea that the structure of the association between ES and health varies according to the economic cycle. The association between recession, ES, and health would be directly related to the specific characteristics of the economic and employment contexts under study. In the Spanish case, labor market segmentation processes based on numerical flexibility—a key feature of the Mediterranean Variety of Capitalism—may explain the results obtained.

Green Economy and Employment: employment potential of the ecological transition in Spain

The Green Economy offers real possibilities for productive innovation, economic growth and employment creation in Spain. These three factors are critical to facilitate the necessary change in the productive model to overcome the crisis. However, the measures taken by the current Conservative government have moved in the opposite direction: significant cutting in incentives for renewable, increasing tax burden on renewable energy production to self-consumption and privatizing public spaces of social and environmental interest. This hinders the achievement of the environmental objectives of the Europe 2020 strategy. A strategy that is born already in itself highly limited, unambitious and subordinated to the interests of energy oligopolies and the imperatives of the Stability and Growth Pact (Maastricht) and the Austerity policies imposed from EU institutions to overcome the 2008 financial crisis. So the Ecological Transition goes further, claiming a substantially change in Economic Policy away form the increasing commodification proposed by the Green Economy. Despite these limitations, young and unemployed people have much to gain from a comprehensive development of environmental industries. Therefore, innovative-sustainable plans, investment and training in green sectors are necessary to make easier the transition from a services low-valued economy to an innovative and sustainable model to make our country an environmental reference in Europe.

What do school principals do? Leadership practices in Spain drawn from PISA and TALIS international studies

Principals play a key role in schools. Their actions affect the efficacy of schools and indirectly on the students’ academic performance. Numerous studies describe the different activities that principals perform in their daily practice, grouping them in dimensions, not existing unanimity neither around the practices carried out nor the dimensions. In Spain, the new educational law, LOMCE, emphasizes the importance of looking into what international research says regarding the field of education to support the need for change and justify the ones that are being made, and develops an extended list of competences of the principal. This study is a synthesis of a narrative research with the following analysis unit: the results of the PISA (Programme for International Student Assessment) and TALIS (Teaching and Learning International Study) international reports, and the data provided on school leadership and their practices, from which conclusions are inferred, comparing them with the competences stated in the LOMCE. The comparative analysis of the leadership practices presented depicts a still uneven and heterogeneous scenario, not existing agreement neither for the setting of boundaries for the leadership dimensions, nor for the number of practices that constitute them. Such a scenario points towards the need for further empirical research, in order to accurately obtain a homogeneous catalogue of the actions carried out by principal, that may open the door to the development of the role of principal, and to the improvement of effectiveness and performance of schools, as it is suggested internationally, and it is an objective of the new educational law.

The activity of the feminist online publications: challenges for the transmission of the feminist culture in Spain

Traditionally, big media corporations have contributed to hiding the women’s movement itself, as well as its main claims and topics of discussion (Marx, Myra y Hess, 1995; Rhode, 1995; Mendes, 2011). This has led the feminist movement to develop its own media generally print publications, usually, with a very specialized character and reduced audience. This is similar to what has occurred with quality main stream media, asthese publications have had to adapt themselves to a new communicatiion context, because of the financial crisis and  technological evolution. Feminist media has found in the Internet an excellent opportunity to access citizens and communicate their messages. , In view of this scene of change and renovation,  this article offers the results of a qualitative analysis focused on the experiences of four feminist online media sites edited in Spain: Pikaramagazine.com, Proyecto-kahlo.com, Mujeresenred.net and Laindependent.cat. Besides exploring the characteristics and content of these sites, the article pays attention to the virality of their contents spread through Facebook and Twitter. The onclusion estimates their social impact, insofar as they symbolize the specialization, diversification and dialogue promoted by the Web.

Low frequency of the TEL/AML1 fusion gene in acute lymphoblastic leukaemia in Spain.

We report on a series of Spanish patients with acute lymphoblastic leukaemia in whom the t(12;21) [TEL/AML1] translocation could not be identified with two sensitive techniques: reverse transcript-polymerase chain reaction (RT-PCR) and fluorescence in-situ hybridization (FISH). 101 cases were analysed: 38 children (29 B-cell precursor; nine T-cell precursor) and 63 adults (48 B-cell precursor; 15 T-cell precursor). Specific RT-PCR to amplify the TEL/AML1 fusion transcript was negative in all 101 cases. Moreover, all 38 paediatric samples were also negative by interphase FISH analysis for the presence of the TEL/AML1 fusion. These results suggest the existence of geographic/race variations in the genotype of acute lymphoblastic leukaemia (ALL).

Nutrition and health claims in products directed at children via television in Spain in 2012

Objective: To describe the use of nutrition and health claims in products directed at children via television in Spain and to analyse their nutrient profile. Methods: A cross-sectional study of television food advertisements over 7 days in five Spanish television channels popular among children. The products were classified as core, non-core or miscellaneous, and as either healthy or less healthy, according to the United Kingdom Nutrient Profile Model. We registered all claims contained on the product (packaging and labelling) and its advertisement. We calculated the frequency distributions of health and nutrition claims. Results: During the 420 hours of broadcasting, 169 food products were identified, 28.5% in the dairy group and 60.9% in the non-core category. A total of 53.3% of products contained nutrition claims and 26.6% contained health claims; 62.2% of the products with claims were less healthy. Low-fat dairy products were the food category containing the highest percentage of health and nutrition claims. Conclusion: Over half of all food products marketed to children via television in Spain made some type of nutrition or health claim. Most of these products were less healthy, which could mislead Spanish consumers.

Alcohol consumption and Mediterranean Diet adherence among health science students in Spain: the DiSA-UMH Study

Objective: To describe the association between consumption of different alcoholic beverages and adherence to the Mediterranean diet. Methods: A cross-sectional analysis was conducted of the baseline data of the DiSA-UMH study, an ongoing cohort study with Spanish health science students (n = 1098) aged 17-35 years. Dietary information was collected by a validated 84-item food frequency questionnaire. Participants were grouped into non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages. Mediterranean diet adherence was determined by using a modification of the relative Mediterranean Diet Score (rMED; score range: 0-16) according to consumption of 8 dietary components. We performed multiple linear and multinomial regression analyses. Results: The mean alcohol consumption was 4.3 g/day (SD: 6.1). A total of 19.5%, 18.9% and 61.6% of the participants were non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages, respectively. Participants who consumed beer and/or wine exclusively had higher rMED scores than non-drinkers (β: 0.76, 95%CI: 0.25-1.27). Drinkers of all types of alcoholic beverages had similar rMED scores to non-drinkers. Non-drinkers consumed less fish and more meat, whereas drinkers of all types of alcoholic beverages consumed fewer fruits, vegetables and more meat than exclusive beer and/or wine drinkers. Conclusions: The overall alcohol consumption among the students in our study was low-to-moderate. Exclusive beer and/or wine drinkers differed regarding the Mediterranean diet pattern from non-drinkers and drinkers of all types of alcohol. These results show the need to properly adjust for diet in studies of the effects of alcohol consumption.

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, cross-sectional 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 level of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.

Quality of implementation in evidence-based positive parenting programs in Spain: Introduction to the special issue

The main contribution of this special issue is to present evaluation studies involving large-scale experiences of implementation of positive parenting programs delivered through home, group-based, and on-line formats in Spain. Two research questions were addressed: (1) what factors affect implementation; and (2) for whom and under which implementation conditions the programs lead to positive outcomes. Target populations were mainly families from low and middle socioeconomic backgrounds, and parents at psychosocial risk attending family support services in need of improving their parenting skills. All the programs fall under the umbrella of the positive parenting initiative launched by the Council of Europe, are evidence-based, follow a collaborative schema with national, regional, or local authorities, have multi-site implementation, and are supported by highly experienced researchers from Spanish universities. Special attention is given to the program adaptations to different contexts, the profile of parents who benefited most from the programs, analyses of the implementation process, and the assessment of parenting programs in the community. The information provided will help to increase our knowledge of evidence-based parenting programs in Spain, their implementation processes and results, and the future challenges that need to be addressed to continue the current expansion of evidence-based parenting programs.

The evolution of the occupational status in Spain: An intergenerational approach

The relationship between the socio-economic status of parents and children is referred by the literature as intergenerational social mobility. The scope of this mobility encompasses different aspects such as educational attainment, income, wealth, prestige and occupational status. In particular, intergenerational occupational mobility is an interesting topic in the economic literature because it is positively associated with the economic achievement and the professional success. Low mobility implies that human capital, skills and talent can be misallocated. As a consequence, the workers’ efforts, their motivation and productivity could be negatively affected, which would have adverse effects on the economy growth and its competitiveness. This paper attempts to carry out the study of the evolution of intergenerational social mobility in Spain during the 21st century. The methodology applied involves to associate the National Classification of Occupations (CNO-94) with the New International Socio-economic Index of Occupational Status (ISEI-08), in order to establish a socio-economic hierarchy. Afterwards, once the occupational ranking is defined, we use statistic and econometric methods to assess the occupational transitions between fathers and children and to analyse the covariates’ effects on these transitions, including as explanatory variable the children’s educational attainment. Data used corresponds to the 2005 and 2011 Living Condition Survey (INE, 2005, 2011). The results of the study are displayed by distinguishing children according to their birth cohort.