Vocational continuing training in Spain: contribution to the challenge of industry 4.0 and structural unemployment

Purpose: To diagnose the situation of vocational continuing training in Spain and propose improvements to its management to reduce the structural unemployment rate, taking into account the effects of Industry 4.0 and COVID-19. Design/methodology: Study of the background and current context of vocational continuing training and Industry 4.0 in Spain based on a review of previous academic literature, legislative developments in education and training, and various reports from public and private institutions on productivity and employment. Findings: Definition of eight challenges and lines of action related to completing the implementation of Industry 4.0 and adopting coordinated policies to develop VCT, improving the governance of the FCP by the public administration, promoting training in work and vocational training and guidance for the unemployed, meeting business recruitment needs, promoting business–university relationships, and reducing unemployment. Practical implications: Adapting vocational continuing training to economic sectors where there is more demand for employment and to regions where there is more structural unemployment can contribute to the overall reduction of structural unemployment in Spain. These decreases could have immediate consequences for those who become employed and allow a quicker recovery in future economic crises. Originality/value: This study, despite the scarce empirical evidence that exists about Spanish vocational continuing training, provides a vision of the four areas in which it is developed professional training, postgraduate training, on-the-job training, and training for the unemployed to provide thirty proposals that, through education and training, promote the competitiveness of the Spanish economy and permanent employmen

Continuous vocational training in response to the challenge of industry 4.0: Required skills and business results

Purpose: To identify the technical skills which, linked to digitalization processes, are required to achieve different types of business results. Design/methodology/approach: The Delphi method was applied, through the opinions of a group of Spanish experts, to identify the importance of certain skills for the advancement of digitalization and the implementation of Industry 4.0. Findings: The results show that: 1) skills in Robotics, the Internet of Things, Networks and Artificial Intelligence are necessary to achieve results in the management of company technical areas; 2) commercial management needs skills in Intelligent Systems, Big Data, Cybersecurity, Distributed Technology and Contents; and 3) for the business challenges of sustainable development, the environment and energy efficiency, the most needed skills are in Big Data, Intelligent Systems and Artificial Intelligence. Originality/value: The results are useful, firstly, in providing firms with a training and selection tool for the development of I4.0 and, secondly, in offering training centers criteria for drawing up their training programsPeer Reviewe

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Competencias para desarrollar la carrera profesional

La expresión "carrera profesional" define la sucesión de responsabilidades -puestos de trabajo- que un profesional va desempeñando a lo largo de su vida laboral. Normalmente, se aplica a personas con grado universitario

Carry-over effects of tourism on traditional activities

One of the justifications for promoting tourism development is the capacity that it has to generate spillover effects on traditional economic activities. However, the strength of these spillover effects depends, largely, on the complementary or competitive nature of the traditional sector with respect to the resources used by tourism. Using time series analysis techniques, this paper examines the relationship existing between tourism development and the local fisheries sector. The results suggest that fisheries have been benefiting from growth in tourism, not so much in terms of an increase in the volume of catches but rather due to an increase in their value.This work was supported by the MICT/SET and European Union NextGenerationEU (TUR-RETOS2022-049) and Universidad de Alcalá de Henares

Aquaculture in tourist destinations: the need to consider economic aspects in environmental impact studies

The search for sustainable alternative food sources has led to the expansion of aquaculture, with the proliferation of marine farms in more and more places, some of them very touristic. The installation of these farms in the waters of consolidated Sun and Beach tourist destinations represents a planning challenge, which requires consideration of the potential environmental and economic impacts of those activities on tourism attractions. This article critically analyzes the implementation of marine farms in the Costa Blanca (Alicante), one of the most consolidated Sun and Beach tourist destinations in the Mediterranean. The case study shows that the environmental impact studies and other documentation accompanying these projects do not include tourism aspects, which represents a deficiency that jeopardizes the economic and social sustainability of the projects.This work was supported by Excelencia para el profesorado universitario de la Universidad de Alcalá [grant number EPU-INV-UAH/2021/003]