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Local government officials are accountable to citizens, who increasingly demand more transparency given the amount of taxes they pay. This paper analyses the relationship between municipal tax revenues and transparency in Spain. Based on a sample of 141 Spanish municipalities with more than 15,000 inhabitants and applying least squares regression and instrumental variable analysis based on two-stage least squares regression, we find that the most transparent municipalities collected more global taxes. Furthermore, more municipal financing through transfers from other levels of government leads to lower taxes on construction and capital gains generated by real estate transfers. [ABSTRACT FROM AUTHOR]

The football rivalry between Real Madrid CF and FC Barcelona is one of the most popular at club level globally. In Spain, where it is known as El Clásico (the Classic), it has an unrivalled status in the sports media industry. Its significance relies in part to the historical tension between Catalonia, the region of which Barcelona is the main centre, and Madrid, the capital of Spain. The exaltation of confrontation and partisanship is the central feature of highly popular radio programmes devoted to El Clásico. This study aimed to observe how the media discourse articulated by these programmes was affected by the fact that, during the Covid-19 pandemic, matches were played in empty venues. Through the comparisons of broadcasts of two games, one from 2017 and from 2020, the paper shows that the sensationalistic style is toned down, and a less polarised and partisan sports journalism is possible. [ABSTRACT FROM AUTHOR]

Platform capitalism is a growing reality with a widening social and economic impact. The rapid expansion of Short-Term Rental (STR) platforms has led to new challenges for policy regulation. The main objective of this paper is to shed some light on current conflicts surrounding the regulation of STR. The body of literature on this topic mainly focuses on the increasing substitution of sharing economy by commercial hosts. By contrast, we explain that the ideological notion of host hinders the understanding of the supply-side structure. A critical approach (as critique of ideology and ideological categories) should entail a class perspective based on rent theory and engage with critical works on platform capitalism. In this article, we propose an innovative analytical approach to STR supply-side supported by rent theory, which focuses on the relationship of agents with land and technology ownership and specialised management services, as these are forms of rent appropriation. From this point of view, these supply-side agents are not hosts, but class factions with common and competing economic interests in rent appropriation. Therefore, they can employ a variety of strategies to influence the political regulation of STRs. Based on in-depth interviews with landlords, individual managers, and corporate agencies in Andalusia (Southern Spain), we show the conflicting internal structure behind the ideological notion of host and even professionalisation. [ABSTRACT FROM AUTHOR]

Background: Next-generation sequencing liquid biopsy (NGS-LB) for colorectal cancer (CRC) detection and surveillance remains an expensive technology as economies of scale have not yet been realized. Nevertheless, the cost of sequencing has decreased while sensitivity has increased, raising the question of whether cost-effectiveness (CE) has already been achieved from the perspective of European healthcare systems. Objectives: This health economic (HE) modeling study explores the CE of NGS-LB for CRC based on direct treatment costs compared to standard care without liquid biopsy in Spain, France, and Germany. Methods: A structured literature search was used to collect evidence from 2009 to 2020 on the stage-dependent quality of life (quality-adjusted life-years, QALY), efficacy, and total direct treatment costs (TDC) of NGS-LB. A decision-analytic Markov model was developed. Over the remaining lifetime, cumulative life expectancy (LE), TDC, and QALYs were calculated for 60-year-old men and women in CRC stage III with different assumed effects of NGS-LB of 1% or 3% on improved survival and reduced stage progression, respectively. Results: The use of NGS-LB increases LE by 0.19 years in Spanish men (France: 0.19 years, Germany: 0.13 years) and by 0.21 years in Spanish women (France: 0.21 years, Germany: 0.14 years), respectively. The 3% discounted cost per QALY gained was 35,571.95 € for Spanish men (France: 31,705.15 €, Germany: 37,537.68 €) and 35,435.71 € for Spanish women (France: 31,295.57 €, Germany: 38,137.08 €) in the scenario with 3% improved survival and reduced disease progression. Compared to the other two countries, Germany has by far the highest TDC, which can amount to >80k euros in the last treatment year. Conclusion: In this explorative HE modeling study, NGS-LB achieves generally accepted CE levels in CRC treatment from the health system perspective in three major European economies under assumptions of small improvements in cancer recurrence and survival. Confirmation of these findings through clinical trials is encouraged. Plain language summary: Is it worthwhile to use next generation liquid biopsy for cancer recurrence detection on patients with colorectal cancer? Colon cancer is common. Worldwide, almost one million people die from it every year. Next Generation Sequencing Liquid Biopsy is a very sensitive technology for detecting cancer cells and their genetic information in the blood. Therefore, it is a good way to detect cancer and to detect early recurrence of a previously treated tumor. This test procedure is not yet used very often. Therefore, it is still expensive. Furthermore, there are still no studies that have demonstrated that and how liquid biopsy can aid doctors and patients after initial treatment. The research team of this study has developed an analytical model to investigate what performance liquid biopsy should have to demonstrate an affordable patient benefit in terms of quality of life, survival and cost per additional quality-adjusted life year gained. To do this, they studied the existing medical literature and many cost studies on colorectal cancer for the countries of Spain, France and Germany to feed their model. Then, they made different assumptions about the performance of liquid biopsy and did calculations. In the process, they also particularly examined the significance of specific influencing factors such as costs or disease progression in so-called sensitivity analyses. As a result, the authors found that there are large differences in treatment costs for colorectal cancer between the three countries Spain, France and Germany. Furthermore, even small improvements in the progression of cancer and the survival of cancer patients lead to the economic efficiency of liquid biopsy for the health care system. However, these are still thought experiments, so the research team of this study says that there should be further clinical trials to assess the impact of liquid biopsy on cancer progression and patient survival by using this technology. By this, one could confirm or contradict the authors' educated assumptions and possibly pave a new way towards medical progress for people with colorectal cancer. [ABSTRACT FROM AUTHOR]

Summary: In response to the so-called "refugee crisis," the Catalan regional government set up experimental services for children migrating without guardians, with the explicit aim of safeguarding their rights. With their continued arrival, however, overcrowding in the facilities and the youths' educational and life prospects have become topics of fierce debate. This article investigates whether young migrants can live in the educational centers that host them. Basing ourselves on the distinction between occupying and living in a place, we call into question the conditions of non-life that, from the educational perspective, the reception system offers migrant youth. A qualitative study was undertaken to gather and triangulate the views of the young migrants (n = 42), and that of their social educators (n = 15), and of the management of the reception centers (n = 2). Findings: Despite efforts to put in place policies affording quality attention, a series of contradictions cause the system to favor the homogenization of outcomes rather than adequately acknowledging and addressing the youths' individual needs. This added to the lack of resources mobilized, has yielded the result that the system that supposedly provides protection for minors, rather than being a lived-in place, has become a classical example of a non-occupied space. Applications: Providing a habitable place depends on the pedagogical commitment of social educators and managers to offering these children the chance to build emotional ties with the center, so that it may become a proper place in the world despite the bureaucratic and structural hurdles. [ABSTRACT FROM AUTHOR]

Objective: To evaluate therapeutic footwear expectations and usability of individuals with diabetes and foot complications. Design: A prospective multicenter study was conducted on participants with a high risk of developing a diabetic foot ulcer. Setting: Participants were enrolled in 11 different specialized diabetic foot units in Spain between March 2022 and June 2023. Subjects: Patients with diabetes at moderate to high risk of foot ulceration receiving first therapeutic footwear prescription. Interventions: All the patients included in the research were prescribed with their first pair of therapeutic footwear. Main measures: Primary outcome measures were MOS-pre and MOS-post questionnaires evaluating use and usability of prescribed therapeutic footwear. Secondary outcome measures aimed to evaluate footwear clinical efficacy as ulceration rate and self-reported perceived walking distance per day. Results: The use of therapeutic footwear exceeded the patient's pre-provision prediction of their anticipated use in 94% of people (n = 126). Based on the visual analogic satisfaction scale, the median satisfaction of daily wearing their therapeutic footwear was 7 points, Interquartile Range (IQR) [5–8.25]. During the follow-up period, 39 participants (29.1%) experienced diabetic foot ulcer. Perceived walking distance participants reported an improvement in their perceived walking ability during various daily life activities. Conclusions: Diabetes patients at moderate to high risk of diabetic foot ulcer improved their perception of walking ability after therapeutic footwear prescription. Adherence to the therapeutic footwear prescription resulted in less ulcerations. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents are particularly vulnerable to suicide attempts, which is a major risk factor for completed suicide in this age group. However, most research on suicide prevention interventions comes from high-income countries with predominantly white participants and English protocols. This study examines interventions that have been tested in Latin America and Spain. Methods: A systematic review was conducted to include interventions aimed at reducing suicide ideation, attempts, and increasing knowledge about it in these regions. Results: Sixteen articles were selected, and Dialectical Behaviour Therapy, Problem Solving Therapy, and Trauma-Focused Cognitive Behavioural Therapy were found to be more effective than standard treatments or wait-list conditions in reducing the outcomes. Discussion: This review highlights the need for more research on preventive interventions in Latin America and Spain. While all interventions evaluated were effective, further research and replication studies are necessary to strengthen the evidence base for these interventions. [ABSTRACT FROM AUTHOR]

The objective of universal health care systems is to achieve equality in the use of health services at the same level of care need. This study evaluates the relationship of socioeconomic position with the frequency of doctor visits in subjects with and without chronic diseases in Germany and Spain. The dependent variables included number of consultations and if a medical consultation occurred. The socioeconomic factors were income and education. The magnitude of the relationship between socioeconomic position and medical consultation frequency was estimated by calculating the percentage ratio using binomial regression and by calculating the difference in consultations by analysis of the covariance, in the case of number of visits. Statistically significant findings according to education were not observed. The percentage ratio in the medical consultations among those with lower and higher income was 1.03 (95% confidence interval [CI] 1.01-2.88) in Germany and 1.11 (95% CI 1.03-1.20) in Spain among subjects with any of the studied chronic conditions. Also, in Germany the difference in the average number of consultations comparing lower income subjects with higher was 3.98 (95% CI 2.40-5.57) in those with chronic conditions. In both countries, there were no differences in the frequency of doctor visits according to education. However, a pro-inequality trend exists in favor of subjects with lower income. [ABSTRACT FROM AUTHOR]

Summary : This article examines the role of social workers involved in a pilot home care project undertaken to attend to the social needs of people at the end of their lives and their carers. Mixed methods approach and evidence-based, constructivist, and comprehensive evaluation were chosen to achieve this aim. Analyses are based on 235 responses from a survey addressed to professionals working in the project, 22 in-depth interviews with a selected group of these professionals, and 114 semi-structured interviews with the sick people and their caregivers. The analysis of the data has considered the theoretical development and professional experience systematized in the Spanish and international literature on social work in end-of-life care. Findings : The results highlight the relevance that professionals, patients, and carers attribute to social care at the end of life and to the role, skills, and qualities of social workers. Their contribution has been valued in terms of the management of services and supports (speed, availability, kindness, sensitivity), the establishment of teamwork (coordination, facilitation), and the recognition of the basic principles of the care process (individualization, respect for privacy, confidentiality). Applications : Findings demonstrate that social work is a profession well placed to help in the recognition of people's dignity at the end of life, in the exercise of their self-determination, and in the humanization of the care process. Some challenges facing consolidation of this professional practice are also indicated within a framework constrained by a predominantly biomedical culture. [ABSTRACT FROM AUTHOR]

This study evaluates the changes in the expenditure–price elasticities of foreign tourists in the summer periods of 2019, 2020, and 2021. We first develop a theoretical characterization that combines microeconomic, loss aversion, price inequality and precautionary savings theories. Next, exploiting microdata for more than 34,000 foreign tourists visiting Spain, we estimate OLS and quantile regressions to empirically examine the expenditure elasticities with respect to the prices of transport services, leisure activities and bars and restaurants at the destination (17 regions). We find that (i) the expenditure–price elasticity of transportation (leisure activities) increases (decreases) during the pandemic, whereas that of bars and restaurants remains unchanged, (ii) foreign tourists are comparatively less expenditure–price elastic at high expenditure levels in transportation and bars and restaurants, and (iii) expenditure–price elasticities are highly heterogeneous depending on the origin country. Managerial and theoretical implications of the findings for firms' pricing strategies are discussed. [ABSTRACT FROM AUTHOR]

The situation of oppression and discrimination of Roma people is a fact that can be observed in many research studies. This is in conjunction with segregation and unequal educational conditions for Roma students, which do not seem to improve despite economic investment and specific intervention programmes. We understand that these situations are ever-present and structural in our society and that they segregate and exclude and become cultural, social and educational barriers for Roma students to successfully continue their academic careers until they reach university. The aim of this study was to understand the views of Roma students at a university in the south of Spain regarding the factors that had enabled them to overcome the initial difficulties they had faced during primary and secondary education, and which had acted as protective factors against educational exclusion. We have included quantitative data through the use of questionnaires, and qualitative data through the use of interviews. The results suggest that these factors are diverse, intersecting and are not mutually exclusive. Family and teacher support and the presence of a non-segregated environment, as well as personal motivation and self-awareness, are key factors. A relevant finding has been the flexibility of cultural reference models that have allowed them to navigate the exclusionary structures of the school. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity, the coexistence of multiple chronic conditions in an individual, is a complex phenomenon that is highly prevalent in primary care settings, particularly in older individuals. This systematic review summarises the current evidence on multimorbidity patterns identified in primary care electronic health record (EHR) data. Methods: Three databases were searched from inception to April 2022 to identify studies that derived original multimorbidity patterns from primary care EHR data. The quality of the included studies was assessed using a modified version of the Newcastle-Ottawa Quality Assessment Scale. Results: Sixteen studies were included in this systematic review, none of which was of low quality. Most studies were conducted in Spain, and only one study was conducted outside of Europe. The prevalence of multimorbidity (i.e. two or more conditions) ranged from 14.0% to 93.9%. The most common stratification variable in disease clustering models was sex, followed by age and calendar year. Despite significant heterogeneity in clustering methods and disease classification tools, consistent patterns of multimorbidity emerged. Mental health and cardiovascular patterns were identified in all studies, often in combination with diseases of other organ systems (e.g. neurological, endocrine). Discussion: These findings emphasise the frequent coexistence of physical and mental health conditions in primary care, and provide useful information for the development of targeted preventive and management strategies. Future research should explore mechanisms underlying multimorbidity patterns, prioritise methodological harmonisation to facilitate the comparability of findings, and promote the use of EHR data globally to enhance our understanding of multimorbidity in more diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: This article focuses on the evaluation of youth empowerment projects from the perspective of the educators themselves. Method: HEBE Rubric (collects quantitative and qualitative data) was applied to 20 youth projects. The selection of projects was based on intentional sampling. Results: The results show that the projects focus on some youth empowerment dimensions to the detriment of others. The most important dimensions are responsibility and self-sufficiency. There is also evidence of more work from the individual perspective of empowerment than from the community perspective, and from a perspective that is more internal to the project than in relation to the context. Discussion: Important educational work is carried out in the projects analyzed, according to the educators themselves. It would be interesting to reinforce the educational work carried out by these projects with activities and strategies that facilitate contact, openness, and educational work with the community. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is currently the most prevalent malignancy among women. Psychological resilience is an important factor that diminishes the stress-related emotional and psychosocial disturbances triggered when receiving the diagnosis. Furthermore, resilience appears to be associated with cortisol, the hormonal end-product of the hypothalamic-pituitary-adrenal axis; however, further studies are needed due to the mixed results reported. Thus, we aim to examine the predictive role of social support and cortisol in resilience among breast cancer patients. Methods: A total of 132 women with primary breast cancer completed the Medical Outcomes Study-Social Support Survey (MOS-SSS) and the Resilience Scale (RS-14) and provided four salivary samples for the estimation of participants' total daily cortisol production, for which the formula of the area under the curve with respect to the ground (AUCg) was applied. Moderation analyses were performed to study the influence of social support and AUCg on psychological resilience levels. Results: The regression analyses showed a direct significant effect for the emotional support subscale of MOS-SSS on resilience and the interaction between emotional support and AUCg was also found to be statistically significant. Specifically, the conditional effect of emotional support on resilience was found to be significant at middle (M = 3.08; p <.05) and low levels (M =.59; p <.001) of AUCg. Conclusions: Our results suggest that newly diagnosed breast cancer women with middle and low diurnal cortisol profiles may benefit more from emotional support based-interventions while women with high diurnal cortisol may need more individualized therapies. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality is prevalent in older people and impairs their quality of life. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines. The cytokine IL-1β has been shown to display both somnogenic and insomnia-promoting effects in experimental animals. Objectives: to evaluate the relationship between insomnia and salivary IL-1β concentration and the role of associated factors such as the symptoms of depression, use of hypnotics, intake of caffeinated beverages, smoking, and alcohol use in older individuals. An analytical, cross-sectional, observational research was carried out with a population of community-dwelling individuals over 60 years of age in Valencia (Spain). Sleep quality was measured with the Athens insomnia scale (AIS) and depressive symptoms with Geriatric Depression Scale (GDS). Results: 287 individuals participated in the study (mean age 74.08 years (76.7% women). 41.5% of the participants had insomnia, 36.9% took drugs for sleep problems, and 32.4% had relevant depressive symptoms. There was a significant inverse correlation between the IL-1β and total AIS score (rho = −0.302, p < 0.001), the sleep difficulty subdomain (rho = −0.259, p < 0.001), and the daytime sleepiness subdomain (rho = −0.322, p < 0.001). No significant correlation was observed between GDS and salivary IL-1β concentration. The IL-1β concentration was significantly lower in individuals taking drugs for sleeping compared with those not taking those drugs (1.11 ± 0.09 and 1.48 ± 0.08, respectively; p = 0.001). Regarding the AIS score, there was no significant difference in marital status, smoking, or the number of cups of tea or cola drinks, but there was a significant association with alcohol intake (p = 0.019) and in the number of daily intakes of coffee (p = 0.030). The receiver operating characteristic (ROC) curve analysis of IL-1β for diagnosis of moderate-severe insomnia showed an area under the curve (AUC) value of 0.78 (95% confidence interval 0.71–0.85). At the cut-off of 0.83 pg/µL of Il-1β, it had a sensitivity of 70.3% and a specificity of 69.8%. [ABSTRACT FROM AUTHOR]

Political actors play an increasingly important role in the dissemination of political information on social media. However, relatively little is known about the mechanisms why specific news items are shared with the support base instead of others. For a timespan between December 2017 and the end of 2018, we combine the analysis of Facebook content from 1,022 politicians associated with 20 political parties from Germany, Spain, and the UK, with an automated content analysis of media coverage from 22 major online news outlets, and survey data in a multilevel binomial regression approach. By comparing news items that have been shared by one or several political parties with news items that have not been shared by any of them, we overcome the selection biases of previous studies in the field of news dissemination. Findings show that a news item's likelihood to be shared by a politician increases (1) if that politician's party is mentioned in the news item, (2) the more salient their party's owned issues are in the news item, and (3) the more party supporters tend to read the news outlet in which the news item is published. We contextualize these findings in light of political actors' multi-faceted motivations for news sharing on social media and discuss how this process potentially reinforces an information bias that may contribute to the polarization and fragmentation of audiences. [ABSTRACT FROM AUTHOR]

The plea bargain is now the most frequent mode of conviction in many countries, yet several problems have been highlighted, such as loss of rights, enhanced sentencing disparities or increased false confessions. A central element to many of the issues is the sentence discount obtained by pleading or the penalty associated with going to trial. However, outside the United States and the United Kingdom, there have been few attempts to analyse plea-trial disparities, and in Spain research is almost non-existent. To help fill this gap, the present article provides the first quantitative examination of plea discounts and trial penalties in Spain. Regression models, covariate balancing propensity score and counterfactuals are estimated to show that, in comparison to going to trial, agreeing to a plea in the initial stage of the process is associated with shorter sentences and, more importantly, the results demonstrate that the probability of entering prison is significantly greater for those convicted at trial compared to both plea types analysed. In addition, evidence of concerning inequalities is found between Spanish nationals and foreigners. The findings indicate courtroom actors may be working conjointly to expedite the criminal process and we discuss the implications of this in relation to the fundamental principles of criminal justice systems, such as proportionality, equality and the presumption of innocence. [ABSTRACT FROM AUTHOR]

In the present study, we investigate the convergence of research and development (R&D) expenditure, a relevant factor in competitiveness, across Spanish regions through a club convergence analysis for the period 2000 to 2017. The results show large regional disparities in R&D expenditure in Spain. We have identified four clusters, plus a divergent region: the Basque Country. The results are similar for the two perspectives considered: percentage of GDP and per capita. We discuss these results taking into account the effects of the Great Recession and compare the outcomes with those for a club convergence of regional GDP per capita. Finally, we carry out an ordered logit model to analyse the factors behind the clusters, with human capital and economic openness being significant. [ABSTRACT FROM AUTHOR]

Do violence during a civil war and its aftermath leave a mark on political behaviour? In this article I study how violence perpetrated by the left and repression by the right during and after the Spanish Civil War shaped vote choice and turnout in 1977, in the first legislative election after a 40 year dictatorship. I argue that the effect of repression travels over time when actions are perpetrated by clearly identifiable antagonistic actors. By using a dataset that captures the intensity and the type of violence, results indicate that repression perpetrated by the Francoist dictatorship during and after the conflict had a positive and significant effect on left-wing support in 1977. Results are consistent across different indicators, such as religious violence, distance to mass graves or sanctions to teachers, confirming that violence triggered greater support for the political left. In contrast, results show no relationship between repression and turnout. [ABSTRACT FROM AUTHOR]