Changes in institutional and social–ecological system robustness due to the adoption of large-scale irrigation technology in Navarre (Spain)

Many regional and national organisations promote the modernisation of agriculture by supporting new technologies to increase their territory's competitiveness in a free-market context. Such technologies and their associated intensive land management practices are geared towards obtaining higher yields. However, their application also entails changes in water and land management institutions, which could alter interactions among multiple components of the agrarian social ecological system and potentially weaken the system. Here, we assess how these components and their relations change in a village situated in Navarre (Spain) after the uptake of large-scale irrigation infrastructure. Specifically, we analyse such changes by comparing how the design principles for robust social ecological systems manifest before and after the adoption of large-scale irrigation. Our findings indicate that an unequal distribution of water and land induces some farmers to abandon their agrarian activities. Our case study also shows how irrigation communities have partially lost their autonomy to self-organise and make agrarian management-related decisions. We suggest that the adoption of large-scale irrigation in this region contributes to a decrease in cooperation among resource users, and between users and infrastructure providers. This is due to a decline in the capacity to achieve collective-choice arrangements and higher external control and monitoring of water use. We argue that the current agrarian management changes may damage social ecological system robustness and affect the sustainable use of common-pool resources, leading farmers to maladaptation to climate and market variability. © 2020 John Wiley & Sons, Ltd and ERP EnvironmentThis work is the outcome of a research collaboration between the Basque Centre for Climate Change (BC3) and the Institut de Ciència i Tecnologia Ambientals (ICTA), at the Autonomous University of Barcelona (UAB). It has received funds from the European Union Seventh Framework Programme (FP7/2007‐2013) under Grant Agreement 264465 (EcoFINDERS), and BC3 has also cofunded different parts of the fieldwork. We also want to thank the grant for contracts of Postdoctoral Training of the Education Department of the Eusko Jaurlaritza. Thanks to Jean Francois Bissonnette for proofreading previous versions of this manuscript, as well as Professor Frances Cleaver and Dr. Robert Hardie for the final reviews in the last stage of publication. Finally, thanks to Julen Ugalde for transcribing the focus group discussions and his support during all the research. This work is the outcome of a research collaboration between the Basque Centre for Climate Change (BC3) and the Institut de Ciència i Tecnologia Ambientals (ICTA), at the Autonomous University of Barcelona (UAB). It has received funds from the European Union Seventh Framework Programme (FP7/2007-2013) under Grant Agreement 264465 (EcoFINDERS), and BC3 has also cofunded different parts of the fieldwork. We also want to thank the grant for contracts of Postdoctoral Training of the Education Department of the Eusko Jaurlaritza. Thanks to Jean Francois Bissonnette for proofreading previous versions of this manuscript, as well as Professor Frances Cleaver and Dr. Robert Hardie for the final reviews in the last stage of publication. Finally, thanks to Julen Ugalde for transcribing the focus group discussions and his support during all the research

Hyaluronic acid levels are increased in complicated parapneumonic pleural effusions

Background and Aim. Hyaluronic acid (HA) is a component of extracellular matrix and may play a role in the pleural inflammation which is implicated in parapneumonic effusions.The aim of the current study was to investigate HA levels in serum and pleura in patients with parapneumonic effusions. Methods. We prospectively studied pleural and serum levels of HA in 58 patients with pleural effusions due to infection (complicated and uncomplicated parapneumonic effusions), malignant effusions and transudative effusions due to congestive heart failure. In addition to HA, TNF-α and IL-1β levels were determined in pleural fluid and serum by ELISA. Results. The median±SD HA levels (pg/ml) in pleural fluid of patients with complicated effusions (39.058±11.208) were significantly increased (p<0.005), compared to those with uncomplicated parapneumonic effusions (11.230±1.969), malignant effusions (10.837±4.803) or congestive heart failure (5.392±3.133). There was no correlation between pleural fluid and serum HA values. Pleural fluid TNF-α levels (146±127 pg/mL) and IL-1β levels (133.4±156 pg/mL) were significantly higher in patients with complicated parapneumonic effusions compared to patients with other types of effusion (p<0.05). No significant association between HA and TNF-α or IL-1β was found. Conclusions. HA may play a significant role in the inflammatory process which characterises exudative infectious pleuritis. Further investigation might reveal whether HA is a useful marker in the management of parapneumonic effusions

Covid-19 and the role of smoking: The protocol of the multicentric prospective study COSMO-IT (covid19 and smoking in italy)

The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality

Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077]

<p>Abstract</p> <p>Background</p> <p>Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple <it>Candida </it>testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases.</p> <p>Methods/Design</p> <p>Using a prospective, randomised, open-label, blinded-endpoint (PROBE) study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care <20 weeks gestation with singleton pregnancies are eligible for inclusion. The intervention is a 6-day course of clotrimazole vaginal pessaries (100 mg) and the primary outcome is spontaneous preterm birth <37 weeks gestation.</p> <p>The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone) to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care). Outcomes will be obtained from population databases.</p> <p>A sample size of 3,208 women with <it>Candida </it>colonisation (1,604 per arm) is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8). Analyses will be by intention to treat.</p> <p>Discussion</p> <p>For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with <it>Candida </it>may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design.</p> <p>This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in pregnancy significantly reduces the rate of spontaneous preterm birth. If it can be demonstrated that treating asymptomatic candidiasis reduces preterm births this will change current practice and would directly impact the management of every pregnant woman.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry <a href="http://www.anzctr.org.au/ACTRN12610000607077.aspx">ACTRN12610000607077</a></p

A consensus statement for the management and rehabilitation of communication and swallowing function in the ICU : a global response to COVID-19

Objective To identify core practices for workforce management of communication and swallowing functions in COVID-19 positive patients within the ICU. Design A modified Delphi methodology was utilized, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. Setting Electronic modified Delphi process. Participants 35 speech-language pathologists (SLPs) from 6 continents representing 12 countries. Interventions Not applicable. Main Outcome Measures The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: “0” = strongly disagree, “10” strongly agree). Prioritization rank order of statements in a 4th round was also conducted. Results SLPs with a median of 15 years ICU experience, working primarily in clinical (54%), in academic (29%) or managerial (17%) positions, completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. Conclusions A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focus on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic

Cartografías literarias: anotaciones a propósito de la novela de migración mexicana

Abstract: This article examines the representation of the migration experience of Mexicans to the United States in the 20th and 21st century Mexican novel. The article first proposes a critical exploration of the formal, structural, and thematic aspects of the so-called migration literature, in order to later elaborate a map of Mexican novelistic production on migratory themes based not only on literary temporality, but also on the interrelation that the works maintain with the diverse historical moments of Mexican migration.Resumen: Este artículo examina la representación de la experiencia migratoria de mexicanos en los Estados Unidos en la novela mexicana del siglo XX y XXI. Como primera parte se plantea una exploración crítica de los aspectos formales, estructurales y temáticos de la llamada literatura de migración, para después elaborar un mapa de la producción novelística mexicana de temática migratoria basado no sólo en la temporalidad literaria, sino en la interrelación que las obras guardan con los diversos momentos históricos de la migración mexicana