Variation in perceived health across gender, working status, educational level, and regional health care expenditure in Spain (2014-2017).

A gender perspective was used to analyze whether and how education, unemployment, and per capita public health expenditure were associated with perceived health among the Spanish population between the years 2014 and 2017. Using multilevel methodologies (looking at year, individual, and region) and linear and logistic specifications, we analyzed longitudinal microdata files from the Survey on Living Conditions. The results suggest that women with lower educational levels tend to report worse health than their more educated counterparts. On the other hand, women's bad health was not associated with unemployment, unlike men's. Regional per capita public health expenditure was not associated with perceived health in either men or women.

Long term unemployment, income, poverty, and social public expenditure, and their relationship with self-perceived health in Spain (2007-2011).

BACKGROUND: There is scant research that simultaneously analyzes the joint effects of long-term unemployment, poverty and public expenditure policies on poorer self-perceived health during the financial crisis. The aim of the study is to analyze the joint relationship between long-term unemployment, social deprivation, and regional social public expenditure on one side, and self-perceived health in Spain (2007-2011) on the other. METHODS: Longitudinal data were extracted from the Survey on Living Conditions, 2007-2010 and 2008-2011 (9105 individuals and 36,420 observations), which were then used to estimate several random group effects in the constant multilevel logistic longitudinal models (level 1: year; level 2: individual; level 3: region). The dependent variable was self-perceived health. Individual independent interest variables were long and very long term unemployment, available income, severe material deprivation and regional variables were per capita expenditure on essential public services and per capita health care expenditure. RESULTS: All of the estimated models show a robust association between bad perceived health and the variables of interest. When compared to employed individuals, long term unemployment increases the odds of reporting bad health by 22% to 67%; very long-term unemployment (24 to 48 months) increases the odds by 54% to 132%. Family income reduces the odds of reporting bad health by 16% to 28% for each additional percentage point in income. Being a member of a household with severe material deprivation increases the odds of perceiving one's health as bad by between 70% and 140%. Regionally, per capita expenditure on essential public services increases the odds of reporting good health, although the effect of this association was limited. CONCLUSIONS: Long and very long term unemployment, available income and poverty were associated to self-perceived bad health in Spain during the financial crisis. Regional expenditure on fundamental public services is also associated to poor self-perceived health, although in a more limited fashion. Results suggest the positive role in health of active employment and redistributing income policies.

Reaching a Vapor Sensitivity of 0.01 Parts Per Quadrillion in the Screening of Large Volume Freight.

The feasibility of detecting explosives in the atmosphere at concentrations as low as 0.01 ppq hinges on the poorly known question of what interfering species exist at these or higher concentrations. To clarify the issue, hundreds of samples of ambient air, either clean or loaded with explosives (from lightly contaminated environments) have been collected in fiberglass/stainless steel filters coated with Tenax-GR, thermally desorbed at variable temperature, and ionized with Cl- via secondary electrospray (SESI). They are analyzed with a narrow-band mobility filter (SEADM's P5 DMA) and a triple quadrupole mass spectrometer (Sciex's 5500), configured in series to transmit precursor and fragment ions of the explosives Nitroglycerin, PETN, RDX, and TNT. Blanks were sampled outdoors at a rural site (Boecillo, Valladolid, Spain), and loads were sampled at diverse locations. For RDX and TNT, atmospheric background inhibits detection below 1 part/trillion (ppt) without mobility filtering. This interference was drastically reduced by the DMA, allowing detection up to 1 part/quadrillion (ppq). Further sensitivity increase was achieved by scanning over a mobility region several percent around that of the target explosive, to separate various isobaric compounds by Gaussian deconvolution. (i) All four MS/MS channels analyzed exhibit several background peaks within the narrow mobility intervals investigated. At least one of these interferents is much stronger than the instrument background at the explosive's mobility, making DMA separation most helpful. (ii) For Nitroglycerin and PETN the combined filtering techniques have not lowered ambient chemical noise down to 0.01 ppq. (iii) Interferents are greatly reduced for TNT and RDX, resulting in minimal chemical noise: 322 blank tests for RDX yielded mean signal of 0.0012 ppq and standard deviation σ = 0.0035 ppq (mean + 3σ detection limit of 0.01 ppq).

Eficiencia técnica de los hospitales públicos y de las empresas públicas hospitalarias de Andalucía / Technical efficiency of traditional hospitals and public enterprises in Andalusia (Spain)

Objetivo: Evaluar la eficiencia técnica de los hospitales públicos tradicionales sin personalidad jurídica específica y sujetos al derecho administrativo, y de las empresas públicas hospitalarias, sujetos de derecho y regidas parcialmente por el derecho privado del Sistema Sanitario Público de Andalucía, durante el periodo 2005-2008. Métodos: El estudio comprende los 32 hospitales públicos de Andalucía durante el periodo 2005-2008. La metodología consta de dos etapas. Primero se calcularon los índices de eficiencia técnica de los hospitales mediante análisis envolvente de datos, y la evolución de la eficiencia con el índice de Malmquist. Los resultados se compararon por calidad percibida, y se realizó un análisis de sensibilidad mediante un modelo auxiliar y bootstrapping. En la segunda etapa se realizó un análisis bivariado entre la eficiencia de los hospitales y su tipo de organización. Resultados:Las empresas públicas fueron más eficientes que los hospitales tradicionales en todos los años del estudio (más de un 10% de media). Sin embargo, se observa un proceso de convergencia entre ambos tipos de organizaciones, ya que mientras que los hospitales tradicionales aumentaron ligeramente su eficiencia en el periodo, un 0,50%, las empresas públicas sufrieron una disminución en su eficiencia de más de un 2%. Discusión: La principal causa de la superior eficiencia de las empresas públicas puede radicar en su mayor flexibilidad laboral y presupuestaria. El proceso de convergencia observado apunta, no obstante, a un proceso de aprendizaje mutuo no necesariamente eficiente (AU)

Objective: To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008. Methods: The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type. Results: Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%. Discussion: The possible reasons for the greater efficiency of public enterprises include their greater budgetary and employment flexibility. However, the convergence process observed points to a process of mutual learning that is not necessarily efficient (AU)

Multilevel analysis of income, income inequalities and health in Spain.

The aim of this study is to test the influence of personal income (absolute income hypothesis), income inequalities and welfare (relative income hypothesis) on health. A multilevel cross-sectional logit model is used with two alternative specifications of the dependent variable: self-perceived health and chronic illnesses, and six specifications of the income inequality: three positive and three normative. This study incorporates lagged values of the regional variables and interactions between the individual and the regional variables. The data is drawn from the Spanish Life Conditions Survey for 2007 and consists of 28,023 individuals over 16 from 17 autonomous communities. The results support the absolute income hypothesis that a higher level of personal income is correlated with a lower probability of negative health outcomes. The relative income hypothesis results are mixed with only some indicators showing a significant relationship with health. The results also indicate that being a man, being married, working and having a high level of education are related to improved health. This study emphasizes the importance both of the health variable and of the specification of income inequality, and contributes to augmenting the limited empirical evidence available in Spain on the influence of income and income inequalities on the health of the population.