Erosion of universal health coverage and trend in the frequency of physician consultations in Spain

Background: We studied the frequency of physician visits in the native and immigrant populations in Spain before and after implementation of a governmental measure to restrict the use of public healthcare services by undocumented immigrants beginning in 2012. Methods: Data were taken from the 2009 and 2014 European Health Surveys carried out in Spain. We investigated any physician consultation in the last 4 weeks before the interview, as well as visits to a family physician, public specialist physician and private specialist physician. We estimated the frequency of visits in 2009 and in 2014 in the native and immigrant populations and the difference in the frequency between the two populations, by calculating the percentage ratio estimated by binomial regression and adjusted for different confounders that are indicators of the need for assistance. Results: The percentage of persons who consulted any physician in 2009 and 2014 was 31.7 and 32.9% in the native population, and 25.6 and 30.1% in the immigrant population, respectively. In the immigrant population, the frequency of visits to the general practitioner and public specialist physician increased, whereas in the native population only public specialist physician visits increased. The frequency of private specialist visits remained stable in both populations. After adjusting for the indicators of need for healthcare, no significant differences between the immigrant and native populations were seen in the frequency of visits, except for private specialist consultations, which were less frequent among immigrants. Conclusion: The restriction of universal healthcare coverage in Spain did not reduce the frequency of physician visits between 2009 and 2014, as the frequency of these consultations was seen to increase in both the native and immigrant populations.This study was supported by a grant from the “Plan Estatal de I + D, Ministry of Science, Innovation and Universities of Spain (no. CSO2017–83180-P)

The Mythical Hero's Quest in Jeanette Winterson's The Passion

Un principio común entre los críticos postmodernistas es que el escritor postmodernista “ha heredado la actitud crítica del modernista, desprovista de sus elementos míticos y metafísicos” (Wesseling 98). The Passion es una metaficción historiográfica con marcados rasgos feministas. Narrada alternativamente por dos narradores autodiegéticos, Villanelle y Henri, esta novela combina elementos históricos tales como lugares, eventos y personajes relacionados con las campañas imperialistas de Napoleón con elementos metaficcionales tales como los estribillos “Te estoy contando cuentos, créeme” o “Eso no te lo creas” y con abundantes ecos intertextuales no solo de escritores canónicos como Eurípides o Eliot sino, también, del Tarot, un claro indicador de la estructura mítica de la novela. Todos estos elementos se analizan en este Trabajo Fin de Grado aunque el núcleo del análisis gira en torno a la figura de Henri, un joven soldado francés que trabaja como pinche para Napoleón. La hipótesis de partida es que Henri es un héroe psicológicamente fragmentado que se encuentra inmerso en un proceso de individuación tanto físico como espiritual. El análisis proporciona amplia evidencia textual de la estructura mítica del viaje realizado por Henri y demuestra que, aunque lleva a cabo las mismas etapas que el héroe mítico en el monomito de Joseph Campbell, Henri no consigue culminar el proceso de individuación. El hecho de que la vida de Henri sea una búsqueda fallida demuestra que The Passion adopta una posición paradójica de absorción y rechazo de este patrón mítico que responde plenamente a su carácter postmodernista