Background: Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. Methods: A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. Results: The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence. Conclusions: Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

Spanish universities must guarantee optimum accessibility to facilitate the teaching-learning process of students with disabilities. The objective of this study was to investigate how Spanish students with disabilities perceive access to Higher Education and the day-to-day of their academic life. A qualitative design was performed, using sequential discourse analysis adapted to the area of studies with people with disabilities. Two focus groups and sixteen interviews with university students with disabilities were analyzed. The discursive strategies of the students presented an asymmetry between the normative and the factual, although within a framework of inclusion and integration into university life. Six types of barriers were identified: computer, bureaucratic, and architectural -more intense in the traditional universities-, and learning, personal, and social barriers -stronger in online universities. To ensure the inclusion of students with disabilities, there is a need to increase information and training and to establish common procedures across Higher Education institutions.

Objetivo: Calcular y analizar las contribuciones de los cambios de la mortalidad por grupos de edad y causas de muerte seleccionadas a la diferencia por sexo en la esperanza de vida al nacimiento en España, de 1980 a 2012. Métodos: Estudio transversal con tres momentos temporales (1980, 1995 y 2012). Datos de Human Cause-of-Death Database y de Human Mortality Database. Se utiliza la técnica de descomposición de las diferencias en la esperanza de vida a partir de los cambios en la mortalidad por edad quinquenal y las causas de muerte entre mujeres y hombres. Resultados: De 1980 a 1995, el incremento se sustentó en las contribuciones generadas por la menor mortalidad de las mujeres desde los 25 años de edad y en la diferencia en mortalidad por virus de la inmunodeficiencia humana (VIH)/sida, cáncer de pulmón y enfermedades pulmonares obstructivas crónicas. De 1995 a 2012, el recorte se generó por la mayor mejora en la mortalidad de los hombres hasta los 74 años de edad, y por la mejora en la mortalidad masculina por VIH/sida, infarto agudo de miocardio y accidentes de tráfico. Conclusiones: La diferencia en la esperanza de vida entre hombres y mujeres ha disminuido desde 1995, debido a la mejora en la mortalidad por causas de muerte asociadas a conductas y hábitos de riesgo de la población masculina en edad activa. Objective: To calculate and analyse the contributions of changes in mortality by age groups and selected causes of death to sex differences in life expectancy at birth in Spain from 1980 to 2012. Methods: Cross-sectional study with three time points (1980, 1995, and 2012). We used data from Human Cause-of-Death Database and Human Mortality Database. We use a decomposition method of the differences in life expectancy and gender differences in life expectancy from changes in mortality by 5-year age groups and causes of death between women and men. Results: From 1980 to 1995, the lower mortality of women from 25 years old, and the differences in mortality by HIV/AIDS, lung cancer, and chronic obstructive pulmonary diseases contributed to the gap increase. From 1995 to 2012, greatest improvement in mortality of males under 74 years of age, and in improving male mortality from HIV/AIDS, acute myocardial infarction and traffic accidents contributed to the narrowing. Conclusions: The difference in life expectancy at birth between men and women has decreased since 1995 due to a greater improvement in mortality from causes of death associated with risky behaviours and habits of the working age male population.