A longitudinal study of Type-B aortic dissection and endovascular repair scenarios: computational analyses

Conservative medical treatment is commonly first recommended for patients with uncomplicated Type-B aortic dissection (AD). However, if dissection-related complications occur, endovascular repair or open surgery is performed. Here we establish computational models of AD based on radiological three-dimensional images of a patient at initial presentation and after 4-years of best medical treatment (BMT). Computational fluid dynamics analyses are performed to quantitatively investigate the hemodynamic features of AD. Entry and re-entries (functioning as entries and outlets) are identified in the initial and follow-up models, and obvious variations of the inter-luminal flow exchange are revealed. Computational studies indicate that the reduction of blood pressure in BMT patients lowers pressure and wall shear stress in the thoracic aorta in general, and flattens the pressure distribution on the outer wall of the dissection, potentially reducing the progressive enlargement of the false lumen. Finally, scenario studies of endovascular aortic repair are conducted. The results indicate that, for patients with multiple tears, stent-grafts occluding all re-entries would be required to effectively reduce inter-luminal blood communication and thus induce thrombosis in the false lumen. This implicates that computational flow analyses may identify entries and relevant re-entries between true and false lumen and potentially assist in stent-graft planning.

Distribution and Efficiency of Bacteriolysis in the Gut of Arenicola Marina and Three Additional Deposit Feeders

A simple technique was developed to measure the bacteriolytic activities of the digestive fluids of the deposit-feeding polychaete Arenicola marina. Lysis of a cultured environmental isolate, incubated with extracts of gut luminal contents, was monitored spectrophotometrically. Concurrent direct counts were used to verify cell lysis. The ability of extracts from 8 longitudinal sections of the gut to lyse the bacterium was monitored. The digestive ceca, anterior stomach, and posterior stomach regions exhibited high lytic activities, whereas bacteriolytic activities in all other regions of the gut were negligible. Similarly, extracts of surface sediments and fecal castings showed negligible lytic capabilities. The sharply limited distribution of lytic activity implicates the ceca as the source of bacteriolytic agent and suggests a true plug-flow system, with little axial mixing. Questions regarding the fate of lytic agents, which disappear abruptly posterior to the stomach, remain unanswered. Localization of lysis in the gut coupled with estimates of gut residence time permit the calculation that ingested bacteria are exposed to strong lytic activity for approximately 20 min. Incubation of in situ sediment samples with gut fluids corroborates the distributional findings of the in vitro work although the efficiency of lysis is much reduced, possibly due to exopolymer capsules and slimes of natural sedimentary bacteria. Cross-phyletic comparisons of bacteriolytic activities reveal both qualitative and quantitative differences. Much less demarcation of lytic activity is observed in the guts of a holothuroid (Caudina arenata) and a hemichordate (Stereobalanus canadensis), with a pattern more similar to that of A. marina observed in another polychaete, Amphitrite johnstoni. Quantitatively, the polychaetes showed higher levels of activity with rates in A. marina exceeding those of the hemichordate and holothuroid by more than 10-fold.

Grain size distribution in surface sediments samples of the continental shelf and slope of southeast Greenland

During "Meteor" Cruise 6/1966 in the northwest Atlantic a systematic survey of the bottom topography of the southeast Greenland continental margin was undertaken. Eighty-seven profiles transverse to the shelf edge at distances of 3-4 nautical miles and two longitudinal profiles parallel to the coast were carried out with the ELAC Narrow Beam Echo-Sounder giving a reliable record of even steep slopes. On the basis of the echo soundings the topography and morphology of the continental shelf and slope are evaluated. A detailed bathymetric chart and a serial profile chart were designed as working material for the morphological research. These maps along with the original echograms are morphometrically evaluated. The analysis of the sea bottom features is the basis of a subsequent morphogenetical interpretation, verified and extended by means of interpretation of magnetic data and sediment analysis (grain size, roundness, lithology). The results of the research are expressed in a geomorphological map. The primary findings can be summarized as follows: 1) The southeast Greenland shelf by its bottom topography can be clearly designated as a glacially formed area. The glacial features of the shelf can be classified into two zones nearly parallel to the coast: glacial erosion forms on the inner shelf and glacial accumulation forms on the outer shelf. The inner shelf is characterized by the rugged and hummocky topography of ice scoured plains with clear west/east slope asymmetry. On the outer shelf three types of glacial accumulation forms can be recognized: ice margin deposits with clearly expressed terminal moraines, glacial till plains and glaciomarine outwash fans. Both zones of the shelf can be subdivided into two levels of relief. The ice scoured plains, with average depths of 240 meters (m), are dissected to a maximum depth of 1060 m (Gyldenloves Trough) by trough valleys, which are the prolongations of the Greenland fjords. The banks of the outer shelf, with an average depth of 180 m, surround glacial basins with a maximum depth of 670 meters. 2) The sediments of the continental shelf can be classified as glacial due to their grain size distribution and the degree of roundness of the gravel particles. The ice margin deposits on the outer shelf can be recognized by their high percentage of gravels. On the inner shelf a rock surface is suggested, intermittently covered by glacial deposits. In the shelf troughs fine-grained sediments occur mixed with gravels. 3) Topography and sediments show that the southeast Greenland shelf was covered by an ice sheet resting on the sea floor during the Pleistocene ice-age. The large end moraines along the shelf edge probably indicate the maximum extent of the Wurm shelf ice resting on the sea floor. The breakthroughs of the end moraines in front of the glacial basins suggest that the shelf ice has floated further seaward over the increasing depths. 4) Petrographically the shelf sediments consist of gneisses, granites and basalts. While gneisses and granites occire on the nearby coast, basalt is not known to exist here. Either this material has been drifted by icebergs from the basalt province to the north or exists on the southeast Greenland shelf itself. The last interpretation is supported bythe high portion of basalt contained in the sediment samples taken and the strong magnetic anomalies probably caused by basaltic intrusions. 5) A magnetic profile allows the recognition of two magnetically differing areas which approximately coincide with the glacial erosion and accumulation zones. The inner shelf shows a strong and variable magnetic field because the glacially eroded basement forms the sea floor. The outer shelf is characterized by a weak and homogenous magnetic field, as the magnetized basement lies at greater depthy, buried by a thick cover of glacial sediments. The strong magnetic anomalies of the inner shelf are probably caused by dike swarms, similar to those observed further to the north in the Kangerdlugssuaq Fjord region. This interpretation is supported by the high basalt content of the sediment samples and the rough topography of the ice scoured plains which correlates in general with the magnetic fluctuations. The dike structures of the basement have been differentially eroded by the shelf ice. 6) The continental slope, extending from the shelf break at 313 m to a depth of 1270 m with an average slope of 11°, is characterized by delta-shaped projections in front of the shelf basins, by marginal plateaus, ridges and hills, by canyons and slumping features. The projections could be identified as glaciomarine sediment fans. This conclusion is supported by the strong decrease of magnetic field intensity. The deep sea hills and ridges with their greater magnetic intensities have to be regarded as basement outcrops projecting through the glaciomarine sediment cover. The upper continental rise, sloping seaward at about 2°, is composed of wide sediment fans and slump material. A marginal depression on the continental rise running parallel to the shelf edge has been identified. In this depression bottom currents capable of erosion have been recorded. South of Cape Farvel the depression extends to the accumulation zone of the "Eirik" sedimentary ridge. 7) By means of a study of the recent marine processes, postglacial modification of the ice-formed relief can be postulated. The retention effect of the fjord troughs and the high velocity of the East Greenland stream prevents the glacial features from being buried by sediments. Bottom currents capable of active erosion have only been found in the marginal depression on the continental rise. In addition, at the time of the lowest glacio-eustatic sea level, the shelf bottom was not situated in the zone of wave erosion. Only on the continental slope and rise bottom currents, sediment slumps and turbidity currents have led to significant recent modifications. Considering these results, the geomorphological development of the southeast Greenland continental terrace can be suggested as follows: 1. initial formation of a "peneplain", 2. fluvial incision, 3. submergence, and finally 4. glacial modification.

Sedimentology, planktonic foraminifera distribution and stable isotope composition during marine isotope stage 3 of ODP Site 172-1060 in the West Atlantic

We have studied Ocean Drilling Program Site 1060 on the Blake Outer Ridge, which lies beneath the Gulf Stream. We focus on marine isotope stage 3, 60-25 thousand years before present (ka). Sea surface temperatures (SSTs) inferred both from foraminiferal fauna and alkenone ratios, as well as counts of iceberg melt-out debris and benthic stable isotope analyses, enable our record to be interpreted in terms of regional hydrographic changes as well as changing thermohaline circulation (THC). The observed SST record is consistent with the air temperature record from the Greenland ice cores. However, Site 1060 exhibits important differences in detail compared with the ice core record, and when compared to other sites within the North Atlantic, significant longitudinal differences emerge. At Site 1060 in the western Atlantic, all Greenland stadials (GS) whether associated with Heinrich events (HEs) or not, show a similar small amplitude of cooling; mean faunal-based SSTaug during GS is only 1.5°C colder than during Greenland interstadials (GIS). In addition, during GS the coldest SSTs are limited to apparently brief events. This is in contrast to several eastern Atlantic sites where HE stadials exhibit coolings that are enhanced by 2°C compared to other GS and where cold conditions are not restricted to cold pulses but cover 2 ka-long intervals. Furthermore, Site 1060 SSTs remained warm right through each interstadial, in contrast to the sustained and uniform cooling trend through interstadials that is consistently observed in Greenland, indicated by measurements of delta18O in ice.

Distribution of organic-walled dinoflagellate cysts in surface sediments of the Benguela upwelling system

To obtain insight in the relationship between the spatial distribution of organic-walled dinoflagellate cysts (dinocysts) and local environmental conditions, fifty-eight surface sediment samples from the coastal shelf off SW Africa were investigated on their dinocyst content with special focus on the two main river systems and the active upwelling that characterise this region. To avoid possible overprint by species-selective preservation, samples have been selected mainly from shelf sites where high sedimentation rates and/or low bottom water oxygen concentrations prevail. Multivariate ordination analyses have been carried out to investigate the relationship between the distribution patterns of individual species to environmental parameters of the upper water column and sediment transport processes. The main oceanographical variables at the surface (temperature, salinity, nutrients chlorophyll-a) in the region show onshore-offshore gradients. This pattern is reflected in the dinocyst associations with high relative abundances of heterotrophic dinocyst species in neritic regions characterised by high chlorophyll-aand low salinity conditions in surface waters. Phototrophic dinocyst species, notably Operculodinium centrocarpum, dominate in the more oceanic area. Differences in the distribution of phototrophic dinocyst species can be related to sea surface salinity and sea surface temperature gradients and to a lesser extent to chlorophyll-a concentrations. Apart from longitudinal gradients the dinocyst distribution clearly reflects regional environmental features. Six groups of species can be distinguished, characteristic for (1) coastal regions (cysts of Polykrikos kofoidii and Selenopemphix quanta), (2) the vicinity of active upwelling (Brigantedinium spp., Echinidinium aculeatum, Echinidinium spp. and Echinidinium transparantum), (3) river mouths (Lejeunecysta oliva, cysts of Protoperidinium americanum, Selenopemphix nephroides and Votadinium calvum), (4) slope and open ocean sediments (Dalella chathamense, Impagidinium patulum and Operculodinium centrocarpum, (5) the southern Benguela region (south of 24°S) (Spiniferites ramosus) and (6) the northern Benguela region (north of 24°S) (Nematosphaeropsis labyrinthus and Pyxidinopsis reticulata). No indication of overprint of the palaeo-ecological signal by lateral transport of allochthonous species could be observed.

Dimensions and determinants of upward mobility : a study based on longitudinal data from Delhi slums

This study based on two primary surveys of the same households in two different years (2007/08 and 2012) assesses the extent of inter-temporal change in income of the individual workers and makes an attempt to identify the factors which explain upward mobility in alternate econometric framework, envisaging endogeneity problem. It also encompasses a host of indicators of wellbeing and constructs the transition matrix to capture the extent of change over time at the household level. The findings are indicative of a rise in the income of workers across a sizeable percentage of households though many of them remained below the poverty line notwithstanding this increase. In fact, there is a wide spread deterioration in the wellbeing index constructed at the household level. Among several determinants of income rise two important policy prescriptions can be elicited. Inadequate education reduces the probability of upward mobility while education above a threshold level raises it. Savings are crucial for upward mobility impinging on the importance of asset creation. Views that entail neighbourhood spill-over effects also received validation. Besides, investment in housing and basic amenities turns out to be crucial for improvement in wellbeing levels.

Diseño de receptor de torre central para generación directa de vapor con perfil de potencia variable longitudinal y transversalmente

En este estudio se ha realizado el diseño de un receptor de una central de Torre Central de energía solar para generación directa de vapor, mediante el uso de métodos numéricos, con un perfil de potencia incidente variable longitudinal y transversalmente. Para ello se ha dividido la geometría del receptor según el método de diferencias finitas, y se ha procedido a resolver las ecuaciones del balance de energía. Una vez resuelto el sistema de ecuaciones se dispone de la distribución de temperaturas en el receptor y se puede proceder a analizar los resultados así como a calcular otros datos de interés. ABSTRACT In this study it has been made a Central Receiver Solar Thermal Power Plant’s Receiver design for direct steam production, by using numerical methods, with a variable longitudinally and transversely income solar power profile. With this propose, the receiver’s geometry has been divided using the finite difference method, and the energy balance equations have been solved. Once the equations system has been solved, the receiver´s temperature distribution is known, and you can analyze the results as well as calculate other interesting data.

Dificultades en el aprendizaje del diseño de software orientado a objetos: un estudio cualitativo longitudinal

Las compañías de desarrollo de software buscan reducir costes a través del desarrollo de diseños que permitan: a) facilidad en la distribución del trabajo de desarrollo, con la menor comunicación de las partes; b) modificabilidad, permitiendo realizar cambios sobre un módulo sin alterar las otras partes y; c) comprensibilidad, permitiendo estudiar un módulo del sistema a la vez. Estas características elementales en el diseño de software se logran a través del diseño de sistemas cuasi-descomponibles, cuyo modelo teórico fue introducido por Simon en su búsqueda de una teoría general de los sistemas. En el campo del diseño de software, Parnas propone un camino práctico para lograr sistemas cuasi-descomponibles llamado el Principio de Ocultación de Información. El Principio de Ocultación de Información es un criterio diferente de descomposición en módulos, cuya implementación logra las características deseables de un diseño eficiente a nivel del proceso de desarrollo y mantenimiento. El Principio y el enfoque orientado a objetos se relacionan debido a que el enfoque orientado a objetos facilita la implementación del Principio, es por esto que cuando los objetos empiezan a tomar fuerza, también aparecen paralelamente las dificultades en el aprendizaje de diseño de software orientado a objetos, las cuales se mantienen hasta la actualidad, tal como se reporta en la literatura. Las dificultades en el aprendizaje de diseño de software orientado a objetos tiene un gran impacto tanto en las aulas como en la profesión. La detección de estas dificultades permitirá a los docentes corregirlas o encaminarlas antes que éstas se trasladen a la industria. Por otro lado, la industria puede estar advertida de los potenciales problemas en el proceso de desarrollo de software. Esta tesis tiene como objetivo investigar sobre las dificultades en el diseño de software orientado a objetos, a través de un estudio empírico. El estudio fue realizado a través de un estudio de caso cualitativo, que estuvo conformado por tres partes. La primera, un estudio inicial que tuvo como objetivo conocer el entendimiento de los estudiantes alrededor del Principio de Ocultación de Información antes de que iniciasen la instrucción. La segunda parte, un estudio llevado a cabo a lo largo del período de instrucción con la finalidad de obtener las dificultades de diseño de software y su nivel de persistencia. Finalmente, una tercera parte, cuya finalidad fue el estudio de las dificultades esenciales de aprendizaje y sus posibles orígenes. Los participantes de este estudio pertenecieron a la materia de Software Design del European Master in Software Engineering de la Escuela Técnica Superior de Ingenieros Informáticos de la Universidad Politécnica de Madrid. Los datos cualitativos usados para el análisis procedieron de las observaciones en las horas de clase y exposiciones, entrevistas realizadas a los estudiantes y ejercicios enviados a lo largo del período de instrucción. Las dificultades presentadas en esta tesis en sus diferentes perspectivas, aportaron conocimiento concreto de un estudio de caso en particular, realizando contribuciones relevantes en el área de diseño de software, docencia, industria y a nivel metodológico. ABSTRACT The software development companies look to reduce costs through the development of designs that will: a) ease the distribution of development work with the least communication between the parties; b) changeability, allowing to change a module without disturbing the other parties and; c) understandability, allowing to study a system module at a time. These basic software design features are achieved through the design of quasidecomposable systems, whose theoretical model was introduced by Simon in his search for a general theory of systems. In the field of software design, Parnas offers a practical way to achieve quasi-decomposable systems, called The Information Hiding Principle. The Information Hiding Principle is different criterion for decomposition into modules, whose implementation achieves the desirable characteristics of an efficient design at the development and maintenance level. The Principle and the object-oriented approach are related because the object-oriented approach facilitates the implementation of The Principle, which is why when objects begin to take hold, also appear alongside the difficulties in learning an object-oriented software design, which remain to this day, as reported in the literature. Difficulties in learning object-oriented software design has a great impact both in the classroom and in the profession. The detection of these difficulties will allow teachers to correct or route them before they move to the industry. On the other hand, the industry can be warned of potential problems related to the software development process. This thesis aims to investigate the difficulties in learning the object-oriented design, through an empirical study. The study was conducted through a qualitative case study, which consisted of three parts. The first, an initial study was aimed to understand the knowledge of the students around The Information Hiding Principle before they start the instruction. The second part, a study was conducted during the entire period of instruction in order to obtain the difficulties of software design and their level of persistence. Finally, a third party, whose purpose was to study the essential difficulties of learning and their possible sources. Participants in this study belonged to the field of Software Design of the European Master in Software Engineering at the Escuela Técnica Superior de Ingenieros Informáticos of Universidad Politécnica de Madrid. The qualitative data used for the analysis came from the observations in class time and exhibitions, performed interviews with students and exercises sent over the period of instruction. The difficulties presented in this thesis, in their different perspectives, provided concrete knowledge of a particular case study, making significant contributions in the area of software design, teaching, industry and methodological level.

Determinants and impact of suboptimal asthma control in Europe : The INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study

Acknowledgements We are grateful to THERAmetrics for the study management, data collection and analysis. The authors would like to thank the following investigators for their contribution (>30 patients enrolled): F. Fohler, A.G. Haider, J. Hesse-Tonsa, J. Messner, W. Pohl (Austria); G. Joos, J.L. Halloy, R. Peche, H. Simonis, P. Van den Brande (Belgium); B. Bugnas, J.M. Chavaillon, P. Debove, S. Dury, L. Mathieu, O. Lagrange, A. Prudhomme, S. Verdier (France); A. Benedix, O. Kestermann, A. Deimling, G. Eckhardt, M. Gernhold, V. Grimm-Sachs, M. Hoefer, G. Hoheisel, C. Stolpe, C. Schilder, M. John, J. Uerscheln, K.H. Zeisler (Germany); A. Chaniotou, P. Demertzis, V. Filaditaki-Loverdou, A. Gaga, E. Georgatou-Papageorgiou, S. Michailidis, G. Pavkalou, M. Toumpis (Greece); K. Csicsari, K. Hajdu, M. Póczi, M. Kukuly, T. Kecskes, C. Hangonyi, J. Schlezak, E. Takács, M. Szabo,G. Szabó, C. Szabo (Hungary); G.W. Canonica, W. Castellani, A. Cirillo, M.P. Foschino Barbaro, M. Gjomarkaj, G. Guerra, G. Idotta, D. Legnani, M. Lo Schiavo, R. Maselli, F. Mazza, S. Nutini, P. Paggiaro, A. Pietra, O. Resta, S. Salis, N.A. Scichilone, M.C. Zappa, A. Zedda (Italy); M. Goosens, R. Heller, K. Mansour, C. Meek, J. van den Berg (The Netherlands); A. Antczak, M. Faber, D. Madra-Rogacka, G. Mincewicz, M. Michnar, D. Olejniczak, G. Pulka, Z. Sankowski, K. Kowal, I. Krupa-Borek, B. Kubicka Kozik, K. Kuczynska, P. Kuna, A. Kwasniewski, M. Wozniak (Poland); F. Casas Maldonado, C. Cisneros, J. de Miguel Díez, L.M. Entrenas Costa, B. Garcìa-Cosio, M.V. Gonzales, L. Lores, M. Luengo, C. Martinez, C. Melero, I. Mir, X. Munoz, A. Pacheco, V. Plaza, J. Serra, J. Serrano, J.G. Soto Campos (Spain); T. Bekci, R. Demir, N. Dursunoglu, D. Ediger, A. Ekici, O. Goksel, H. Gunen, I.K. Oguzulgen, Z.F. Ozseker, (Turkey); L. Barnes, T. Hall, S. Montgomerie, J. Purohit, J. Ryan (United Kingdom). The authors would also like to thank P. Galletti (THERAMetrics S.p.A., Sesto San Giovanni, Italy) and K. Stockmeyer (THERAMetrics GmbH, Essen, Germany) for providing editorial assistance in the preparation of this manuscript. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Consumo alimentar e estilo de vida: um estudo longitudinal com estudantes universitários

A universidade é um local de aprendizagem no qual conhecimento acadêmico, social e cultural permeia a relação entre os estudantes, onde estes terão a oportunidade de vivenciar diferentes situações durante o curso. A maior preocupação é como esta experiência influenciará o estado nutricional com a possível mudança dos hábitos cotidianos, como abuso de bebidas alcoólicas, uso irrestrito de suplementos vitamínicos e alimentares e a alimentação inadequada. O consumo alimentar de universitários foi o foco desta pesquisa que teve como objetivo geral identificar as principais mudanças do consumo de alimentos/ bebidas e estilos de vida por meio de estudo de coorte, envolvendo estudantes ingressantes nos cursos de graduação da Escola Superior de Agricultura \"Luiz de Queiroz\" - ESALQ/USP, e como objetivos específicos desenvolver, validar e aplicar um instrumento com a finalidade de identificar medidas comportamentais relacionadas aos hábitos de consumo alimentar, atividade física, situação socioeconômica e relacionar as informações obtidas ao estado nutricional do estudante; descrever o consumo dentro e fora do domicílio. Participaram da pesquisa estudantes com idade entre 18 e 30 anos. Um questionário foi aplicado juntamente com a avaliação antropométrica para mensuração do peso, altura e classificação do estado nutricional por meio do Índice de Massa Corporal (IMC). Este protocolo foi repetido após 8 meses de curso para que fosse identificada a situação do estado nutricional de cada indivíduo relacionada às mudanças do comportamento alimentar. Os dados coletados foram armazenados em base de dados no Microsoft Excel, sendo analisados por meio do Statistical Analysis System. Os dados quantitativos foram expressos em média e desvio-padrão (DP) com cálculos de intervalos de confiança de 95%. O teste do qui-quadrado foi utilizado para comparar a distribuição da prevalência de sobrepeso e obesidade quanto à variável sexo, associando-se ao IMC. Foi utilizado o coeficiente de correlação intraclasse de Pearson para verificação de concordância entre peso e altura aferidos e referidos. Foi realizada análise de regressão múltipla para identificação da mudança de consumo entre as fases, assim como para peso corporal. Utilizou-se o nível de significância de 5%. Observaram-se entre as duas fases quantidades preocupantes de nutrientes ingeridos aquém ou além dos limites preconizados para ambos os sexos; destaque para o elevado consumo de sódio, e insatisfatório de carotenóides. No caso dos carotenóides, houve crescimento significativo da contribuição da categoria 3 para as alunas. O consumo de cafeína na segunda fase foi maior, predominando o fornecimento pelos alimentos ultraprocessados. De forma geral houve aumento do consumo de alimentos processados e ultraprocessados. Observou-se aumento (significativo a 5%) no consumo de lipídios. Constatou-se diminuição na prática de exercícios físicos e aumento na ingestão de bebidas alcoólicas, e destas com energéticos e no tabagismo. Concluiu-se que o ingresso na universidade contribui para a mudança nos hábitos alimentares e estilos de vida de maneira negativa, sendo necessária intervenção adequada visando a promoção da saúde dos estudantes.

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.

Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background: Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Methods: Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. Results: By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Conclusions: Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.