Horizontal Inequity in Access to Healthcare Services and Educational Level in Spain

The aim of this study is to measure horizontal equity in the use of healthcare services in Spain, proposing two methodological innovations. First by defending it as equality of access for equal need, irrespective of educational level, unlike the prevailing methodological approach to horizontal equity which relates it to income. Second, by estimating it by means of the slope index of the inequality of characteristics, analagous to the inequity index proposed by Kakwani, Wagstaff and van Doorslaer (1997; HIWV) but presenting some methodological advantages, the greater robustness of the data available on educational level than of those on income, and the possibility of isolating the net effect of the educational level on the use of healthcare by controlling for other variables. The methodology is designed in three parts: (1) estimation of the relationship between the educational level and the use of healthcare services by means of a model of the likelihood of demand for healthcare services, commonly used in the literature; (2) estimation of the relationship between educational level and health by approximating a production function of individuals' health according to their personal characteristics and other factors conditioning health; and (3) estimation of the slope index of inequality as a measure of horizontal inequity, using educational level instead of income as the criterion for ranking individuals. The data base used was a sample of 55,598 observations from the Survey of disabilities, handicaps and state of health of 1999, carried out in Spain. No significant statistical association was found between educational level and use of healthcare services. On the other hand, the relationship between educational level and health, with the three proxy variables used (perception of health, days of limitation and number of chronic illnesses) shows a positive correlation, i.e. an increase in educational level is associated with a greater probability of enjoying better health. Horizontal inequity, measured by the proposed slope index of inequality, gives a range of statistically significant values between 13.91% and 9.40%, depending on cases, i.e. the significant inverse relationship between state of health and educational level is not reflected proportionally in healthcare use, implying that, with greater need, the access of individuals with a lower educational level to public healthcare services is the same as for the rest. These results suggest that the educational level may be a variable to consider when characterizing the healthcare needs of a population in a defined geographical area, at least from the normative characterization of horizontal equity proposedEducation and health; Healthcare needs; Horizontal Inequity; Logistic regression ; Ordinal regression; Regional funding

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System

Gravitational waves from a Weyl-Integrable manifold: a new formalism

We study the variational principle over an Hilbert-Einstein like action for an extended geometry taking into account torsion and non-metricity. By extending the semi-Riemannian geometry, we obtain an effective energy-momentum tensor which can be interpreted as physical sources. As an application we develop a new manner to obtain the gravitational wave equations on a Weyl-integrable manifold taking into account the non-metricity and non-trivial boundary conditions on the minimization of the action, which can be identified as possible sources for the cosmological constant and provides two different equations for gravitational waves. We examine gravitational waves in a pre-inflationary cosmological model.Comment: Accepted in Physics of the Dark Univers

Use of discrete choice to obtain urban freight evaluation data

The ex-ante evaluation of urban freight solutions is a complex task, due to the interference of different stakeholder groups with different views and objectives. The multi-actor multi-criteria methods have developed as a response to this scenario, but the determination of the weights required by them remains an unclear and controversial task. We propose the use of discrete choice methods as a powerful tool to confront these multi-faced evaluation problems, since the resulting surveys are flexible and easy to respond, and do not give away the final quantitative results. We have applied this methodology to the selection of urban freight solutions in the city of Seville, in Spain, followed by the determination of the relative weights associated to different objectives, both analyses carried out from the side of the carriers stakeholder group.Ministerio de Economía y Competitividad TEC2013-47286-C3-3-

Applying Renewable Energy Technologies in an Integrated Optimization Method for Residential Building’s Design

Designing a Zero Energy Building (ZEB) requires an optimal choice of the materials of a building envelope. Different material properties and window areas could be selected to generate a set of possibilities of the design of a building, being the demand defined by its thermal characteristics. The energy demand of a building could be produced with renewable systems such as photovoltaic. Moreover, the HVAC (Heating, Ventilation, and Air Conditioning) systems could be selected considering the system cost. The present methodology focuses on finding a balance between investment and low energy consumption for a building, based on an integrated optimization method. Such methodology applies a Tabu search algorithm and a simplified model to select the passive design. Afterwards, active elements of the design, as photovoltaic systems, are selected. Therefore, the methodology faces the problem of estimating the annual energy demand and the life cycle cost. The goal is the design of a building with a large amount of energy generated by renewable energy, to have a ZEB, and in the worst case, a nearly Zero Energy Building (nZEB). This methodology reduces investment, reduces the energy demand and selects the best construction materials, renewable energy, and air conditioning system. The present paper analyzes a set of case studies considering different climatic zones in Spain. The results conclude that the methodology could help builders in the design stage, to find a new design that allows a ZEB with the optimal life cycle cost.Ministerio de Economía y Competitividad BIA2016-77431-C2-1-

A field study on adaptive thermal comfort in Spanish primary classrooms during summer season

The assessment of indoor thermal comfort in schools has become an essential object of study; however, applying existing thermal comfort criteria would assume children and adults have a similar range of thermal comfort, without considering discrepancies regarding their level of activity or their behavioural adaptation. Therefore, the objective of the present study was to investigate the thermal comfort in a school building based on an adaptive thermal comfort field study in Seville, in the southwest of Spain, during a summer season. In this study, 2 free-running and 1 air-conditioned classroom were analysed; 67 students aged 10–11 years participated and 2010 thermal questionnaires were collected. A discrepancy was observed between the predicted mean vote and the thermal sensation vote, showing the former is not a good predictor of thermal perception. Thermoneutrality was not always the desired sensation for children; a preference for coolness was detected. A neutral temperature was observed at an average indoor temperature of 24–27 °C and a widening in the thermal comfort range was detected compared with international standards. Regarding adaptive strategies, they showed a preference towards opening windows and doors over using fans or changing clothes. The results suggest that the application of the current models for adults would not be suitable for estimating the thermal comfort of children, and these data could be used to promote natural strategies for assessing thermal comfort over conditioning systems in schools, with the aim of both space ventilation and energy efficiency

Vertical transportation in buildings

Nowadays, the building industry and its associated technologies are experiencing a period of rapid growth, which requires an equivalent growth regarding technologies in the field of vertical transportation. Therefore, the installation of synchronised elevator groups in modern buildings is a common practice in order to govern the dispatching, allocation and movement of the cars shaping the group. So, elevator control and management has become a major field of application for Artificial Intelligence approaches. Methodologies such as fuzzy logic, artificial neural networks, genetic algorithms, ant colonies, or multiagent systems are being successfully proposed in the scientific literature, and are being adopted by the leading elevator companies as elements that differentiate them from their competitors. In this sense, the most relevant companies are adopting strategies based on the protection of their discoveries and inventions as registered patents in different countries throughout the world. This paper presents a comprehensive state of the art of the most relevant recent patents on computer science applied to vertical transportationConsejería de Innovación, Ciencia y Empresa, Junta de Andalucía P07-TEP-02832, Spain

La educación patrimonial en los museos: análisis del papel didáctico de las exposiciones, los materiales y los gestores patrimoniales.

SIAM. Series Iberoamericanas de Museología. Año 3, Vol.