A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods: qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results: use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions: the results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat i

Estimates of patient costs related with population morbidity: Can indirect costs affect the results?

A number of health economics works require patient cost estimates as a basic information input. However the accuracy of cost estimates remains in general unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs in order to allow for improvements in the analysis of patient costs estimates. Instead of focusing on the costing method, this paper proposes to highlight changes in variance explained observed when a methodology is chosen. We compare three overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups (CRG), and we obtain different series of full-cost group estimates. As a result, there are significant gains in the proportion of the variance explained, depending upon the methodology used. Furthermore, we find that the global amount of variation explained by risk adjustment models depends mainly on direct costs and is independent of the level of aggregation used in the classification system.Patient costs, Clinical Risk Groups, Variation explained, Overhead allocation

Trends in legal and illegal trade of wild birds: a global assessment based on expert knowledge

Wildlife trade is a profitable economic activity. Birds are among the most heavily traded animals worldwide, with numerous species threatened by pet trade. Information on both legal and illegal aspects of trade and consumer demand is difficult to obtain across different countries, particularly given substantial socio-economic and cultural variation. Focusing on consumer demand in each country, we conducted a global survey among 105 international experts on bird conservation to identify expected trends, drivers and market characteristics of legal and illegal wild-caught pet bird trade. Our results suggest that future trends in legal bird trade will be mostly driven by socio-cultural motivations and intentional demand for wild-caught, rather than captive-bred birds. Bird popularity and rarity are the main factors expected to influence the choice of which bird species will be the most traded legally. Percentage of rural population was the main national-level socio-economic predictor for legal bird trade in the future. Demand for future illegal trade is expected to be driven by bird popularity and particular species identity. Experts consider illegal trade to be sustained mainly by consumers from higher socio-economic and educational backgrounds. Human population growth rate was the main national-level socio-economic predictor of illegal trade expected for the future. Legislation enforcement remains a critical issue in wildlife trade. Expanding trade networks and socio-economic changes continue to incorporate new regions into the wildlife trade. Investigating the multidimensional and synergistic determinants of wildlife trade will thus help address potential detrimental impacts bird trade might cause on biodiversity.This research was funded by FEDER Funds through the Operational Competitiveness Factors Program “COMPETE”, and by national funds through the Foundation for Science and Technology (FCT) within the framework of project “PTDC/AAG-GLO/0463/2014-POCI-01-0145-FEDER-016583”. A.N. acknowledges the support of the Darwin Initiative. J.R. acknowledges the support from FCT through Grant ICETA 2017-38 within project “PTDC/AAG-GLO/0463/2014-POCI-01-0145-FEDER-016583”. L.R. and C.C. acknowledge support from the FCT through Grants SFRH/BPD/93079/2013 and SFRH/BPD/84422/2012, respectively

Ciudadanos del este de Europa consumidores de drogas en Barcelona

Desde mayo de 1999 hasta mayo de 2001, hemos contactado en el SAPS (Servicio de Atención Social y Sanitaria) de Barcelona con usuarios de drogas de países del este de Europa. Acuden a centros terapéuticos gratuitos, aunque pagan por la organización del viaje unos 500 euros. Son jóvenes entre 18 y 30 años y mantienen el contacto con sus familiares. Conocen los riesgos de transmisión de enfermedades, pero suelen reutilizar las jeringas. Es alta la prevalencia de hepatitis C (92%) y B (62%) y menor la de infección por el VIH (19%). Si no abandonan las drogas, el retorno es un fracaso y tienen dificultades para proseguir los tratamientos con metadona o antirretrovirales. La respuesta asistencial ha de adecuarse a sus necesidades. Se debe procurar la mediación cultural y la información en los lugares de origen, supervisar los centros terapéuticos y diseñar alternativas a los abandonos. Hay que desarrollar la colaboración internacional, estimular programas de disminución de riesgos derivados del consumo y evitar que del tratamiento se haga un comercio

Estimates of patient costs related with population morbidity: Can indirect costs affect the results?

A number of health economics works require patient cost estimates as a basic information input. However the accuracy of cost estimates remains in general unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs in order to allow for improvements in the analysis of patient costs estimates. Instead of focusing on the costing method, this paper proposes to highlight changes in variance explained observed when a methodology is chosen. We compare three overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups (CRG), and we obtain different series of full-cost group estimates. As a result, there are significant gains in the proportion of the variance explained, depending upon the methodology used. Furthermore, we find that the global amount of variation explained by risk adjustment models depends mainly on direct costs and is independent of the level of aggregation used in the classification system

Estimates of patient costs related with population morbidity: Can indirect costs affect the results?

A number of health economics works require patient cost estimates as a basic information input. However the accuracy of cost estimates remains in general unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs in order to allow for improvements in the analysis of patient costs estimates. Instead of focusing on the costing method, this paper proposes to highlight changes in variance explained observed when a methodology is chosen. We compare three overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups (CRG), and we obtain different series of full-cost group estimates. As a result, there are significant gains in the proportion of the variance explained, depending upon the methodology used. Furthermore, we find that the global amount of variation explained by risk adjustment models depends mainly on direct costs and is independent of the level of aggregation used in the classification system

Prevalence and associated factors with sexual violence victimisation youth before, during and after the COVID-19 lockdown: a cross-sectional study in Spain

Objectives To analyse the prevalence of sexual violence (SV) and associated factors in Spanish young adults in the last year and before, during and after the COVID-19 lockdown. Design Cross-sectional study based on the online ‘SV in Young People Survey’ (2020). Setting Non-institutionalised population residing in Spain. Participants 2515 men and women aged 18–35 years old. The participants were obtained from a probability based, online closed panel of adults aged 16 or older that is representative of the non-institutionalised population. The sample designed includes quotas by sex, age, region and country of origin. Outcomes measures and analyses SV victimisation by sociodemographics, sexual attraction and couple-related characteristics during the past year and before, during and after the COVID-19 lockdown (March–June 2020). Prevalence ratios were calculated using robust Poisson regression models. Results In Spain, 8.5% of young people experienced SV during the past year. The greatest prevalence was observed in women with bisexual attraction (17.5%) and in men with homosexual attraction (14.2%). During the COVID-19 lockdown, the prevalence of SV victimisation was lower (1.9%), but unwanted intercourses increased, affecting 64.4% of those exposed to SV during the period. People with homosexual or bisexual attraction were more likely to experience SV in all of the studied periods (PRbefore: 2.01; p<0.001; PRduring: 2.63 p=0.002; PRafter: 2.67; p<0.001). Women were more likely than men to experience SV prior to the lockdown, while no cohabitation increased the likelihood to experience SV after this period. Conclusions SV victimisation in Spanish youth is high. During COVID-19, there were changes in the magnitude of factors associated with SV. It seems that SV events decreased in people who did not live with their partners, but unwanted intercourses increased. The development of prevention strategies to address SV in youth should take into account social inequalities by sex, sexual orientation and origin.This research was supported by the CIBER of Epidemiology and Public Health of Spain; Grant ESP20PI02

An experimental and theoretical core-level study of tautomerism in guanine

The core level photoemission and near edge X-ray photoabsorption spectra of guanine in the gas phase have been measured and the results interpreted with the aid of high level ab initio calculations. Tautomers are clearly identified spectroscopically, and their relative free energies and Boltzmann populations at the temperature of the experiment (600 K) have been calculated and compared with the experimental results and with previous calculations. We obtain good agreement between experiment and the Boltzmann weighted theoretical photoemission spectra, which allows a quantitative determination of the ratio of oxo to hydroxy tautomer populations. For the photoabsorption spectra, good agreement is found for the C 1s and O 1s spectra but only fair agreement for the N 1s edge