Més enllà dels divuit. Seguir les petjades.

Aquest article pretén recollir i analitzar les opinions i les vivències de joves que han viscut en centres del sistema de protecció infanto juvenil i en recursos destinats a la seva emancipació. S’han recollit les seves veus mitjançant una taula rodona, un grup de discussió, una entrevista amb profunditat, una conversa telefònica, una trobada per skype, un qüestionari per correu, i les paraules extretes d’algun estudi ja publicat. Volem generar una reflexió sobre la tasca educativa que es duu a terme en el dia a dia dels recursos de protecció a la infància i, com en altres recerques recents que hem consultat, hem procurat conèixer de prop l’experiència dels testimonis protagonistes de la reflexió. També pretenem afavorir el coneixement dels factors d’èxit, que contribueixen a la consecució d’històries de vida resilients, tot preguntant-nos quins aprenentatges hem de fer com a educadors i educadores després d’escoltar les seves veus

Manual lesional de suport per al dictamen de carns fresques: espècie bovina

Espècie bovina; Carn fresca; Patologies; LesionsEspecie bovina; Carne fresca; Patologías; LesionesBovine species; Fresh meat; Pathologies; InjuriesAquest document integra un conjunt de fitxes que contenen informació sobre les lesions i patologies que l’equip de veterinaris oficials d’escorxador es troba habitualment en la carn fresca de boví a Catalunya. L’objectiu del document és posar en comú l’experiència i coneixement d’aquest equip per compartir-los amb la resta de professionals i ajudar-los així a elaborar els dictàmens sobre l’aptitud o no de la carn destinada al consum humà. En les fitxes no es pretén descriure les lesions i patologies d’una manera teòrica, sinó fer-ho de manera senzilla i molt pràctica per donar eines que ajudin a explicar com s’arriba al dictamen, quina n’ha estat la motivació i si s’ha de fer una declaració obligatòria de la malaltia. La força del document rau en un recull de fotos realitzades en el moment de la inspecció post mortem adjuntes al dictamen que es va fer de la carn fresca.Este documento integra un conjunto de fichas que contienen información sobre las lesiones y patologías que el equipo de veterinarios oficiales de matadero se encuentra habitualmente en las carnes frescas de vacuno en Cataluña. El objetivo del documento es poner en común la experiencia y conocimiento de este equipo para compartirlos con el resto de profesionales y ayudarlos así a elaborar los dictámenes sobre la aptitud o no de las carnes destinadas al consumo humano. En las fichas no se pretende describir las lesiones y patologías de una manera teórica, sino hacerlo de un modo sencillo y muy práctico para ofrecer herramientas que ayuden a explicar cómo se llega al dictamen, cuál ha sido su motivación y si debe realizarse una declaración obligatoria de la enfermedad. La fuerza del documento radica en una recopilación de fotos realizadas en el momento de la inspección post mortem adjuntas al dictamen de las carnes frescas.This document integrates a set of sheets that contain information about the injuries and pathologies that are usually found by official slaughterhouse veterinarians’ team in fresh beef in Catalonia. The objective of the document is to share the experience and knowledge of this team to share with the rest of the professionals and help them to elaborate opinions on the suitability of meat for human consumption. The files are not intended to describe injuries and pathologies on a theoretical level, but rather in a simple and very practical basis to offer tools that help explain how the opinion is reached, what its motivation is and whether a mandatory notification of the disease should be made. The strength of the document lies in a collection of photos taken during the post mortem inspection attached to the opinion on fresh meat

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Altres ajuts: Departament de Salut. Generalitat de Catalunya ("Pla estratègic de recerca i innovació en salut (PERIS) 2019-2021"); Ministerio de Asuntos Económicos y Transformación Digital; Red Española de Investigación en Patología Infecciosa (REIPI).Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000patientdays. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000patientdays and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate:0.20episodes/1,000patientdays). Patients' median age was 64.1years; 36.6% (3,403/9,290) were female. In total, 73.7% (n=6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n=5,822) were related to central venous catheter (CVC), 24.1% (n=2,236) to peripheral venous catheters (PVC) and 13.3% (n=1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR:0.94;95%CI:0.93-0.96), especially in the ICU (IRR:0.88;95%CI:0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR:0.88;95%CI:0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC:1.08;95%CI:1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards

The CARBA-MAP study: national mapping of carbapenemases in Spain (2014–2018)

Introduction:Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018.Methods: A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0.Results: A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017–2018 compared to 2014–2016.Discussion: Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms

Identification of candidate Parkinson disease genes by integrating genome-wide association study, expression, and epigenetic data sets

Importance Substantial genome-wide association study (GWAS) work in Parkinson disease (PD) has led to the discovery of an increasing number of loci shown reliably to be associated with increased risk of disease. Improved understanding of the underlying genes and mechanisms at these loci will be key to understanding the pathogenesis of PD. Objective To investigate what genes and genomic processes underlie the risk of sporadic PD. Design and Setting This genetic association study used the bioinformatic tools Coloc and transcriptome-wide association study (TWAS) to integrate PD case-control GWAS data published in 2017 with expression data (from Braineac, the Genotype-Tissue Expression [GTEx], and CommonMind) and methylation data (derived from UK Parkinson brain samples) to uncover putative gene expression and splicing mechanisms associated with PD GWAS signals. Candidate genes were further characterized using cell-type specificity, weighted gene coexpression networks, and weighted protein-protein interaction networks. Main Outcomes and Measures It was hypothesized a priori that some genes underlying PD loci would alter PD risk through changes to expression, splicing, or methylation. Candidate genes are presented whose change in expression, splicing, or methylation are associated with risk of PD as well as the functional pathways and cell types in which these genes have an important role. Results Gene-level analysis of expression revealed 5 genes (WDR6 [OMIM 606031], CD38 [OMIM 107270], GPNMB [OMIM 604368], RAB29 [OMIM 603949], and TMEM163 [OMIM 618978]) that replicated using both Coloc and TWAS analyses in both the GTEx and Braineac expression data sets. A further 6 genes (ZRANB3 [OMIM 615655], PCGF3 [OMIM 617543], NEK1 [OMIM 604588], NUPL2 [NCBI 11097], GALC [OMIM 606890], and CTSB [OMIM 116810]) showed evidence of disease-associated splicing effects. Cell-type specificity analysis revealed that gene expression was overall more prevalent in glial cell types compared with neurons. The weighted gene coexpression performed on the GTEx data set showed that NUPL2 is a key gene in 3 modules implicated in catabolic processes associated with protein ubiquitination and in the ubiquitin-dependent protein catabolic process in the nucleus accumbens, caudate, and putamen. TMEM163 and ZRANB3 were both important in modules in the frontal cortex and caudate, respectively, indicating regulation of signaling and cell communication. Protein interactor analysis and simulations using random networks demonstrated that the candidate genes interact significantly more with known mendelian PD and parkinsonism proteins than would be expected by chance. Conclusions and Relevance Together, these results suggest that several candidate genes and pathways are associated with the findings observed in PD GWAS studies

The structures of youth participation in Catalonia since the democratic transition

Youth participation is and has been a concept with many considerations, meanings and forms of application, both nationally and internationally. In order to ascertain the evolution of the main structures of youth participation, this article starts with the frames that have motivated this participation in Europe, and then it analyses the evolution of some of the participative youth structures in Catalonia in recent decades: local and municipal youth councils. The article also examines some of the longstanding challenges of youth participation, which aim to overcome the structuring of traditional channels of participation and generate other ways of taking part in everyday community life.Key words: young people participation, youth participation, democracy, youth policies, CataloniaOriginal source: Educació i Història: Revista d'Història de l'Educació, 25: 211-237 (2015

The structures of youth participation in Catalonia since the democratic transition (DOI: 10.2436/20.3000.02.28)

Youth participation is and has been a concept with many considerations, meanings and forms of application, both nationally and internationally. In order to ascertain the evolution of the main structures of youth participation, this article starts with the frames that have motivated this participation in Europe, and then it analyses the evolution of some of the participative youth structures in Catalonia in recent decades: local and municipal youth councils. The article also examines some of the longstanding challenges of youth participation, which aim to overcome the structuring of traditional channels of participation and generate other ways of taking part in everyday community life.Key words: young people participation, youth participation, democracy, youth policies, CataloniaOriginal source: Educació i Història: Revista d'Història de l'Educació, 25: 211-237 (2015

Evaluación participativa del empoderamiento juvenil con grupos de jóvenes. Análisis de casos

Interpretations made by young people about their own realities are key to understand their actions and behaviours. Also for adapting to new social dynamics socio-educational programmes and projects. This article focuses on the analysis of those interpretations. What do youth understand by youth empowerment? Which specific indicators do they consider to identify it? In which spaces, moments and processes do they think that it could happen? In order to respond to these questions, 4 evaluation participatory processes with 42 young people from 14 to 25 years old in 4 Spanish cities were developed. The sample that sets the participatory evaluation groups for every case is intentional. This paper contextualizes cases, presenting the followed methodology in the participatory evaluation’s development and provides the main findings of each case. The results show that youth from the analyzed cases consider the empowerment to be related with a personal or group enrichment or improvement that is normally associated with a personal process, although its social influence is recognized. The most relevant indicators for youth empowerment are autonomy and self-esteem. Young people relate youth empowerment to spaces linked to family, school and friends. The extracurricular space, the street and the associative world appear to be significant to some of them. Youth empowerment processes have to do with overcoming experiences that made young people to have a perception of success, to overcome, being important to someone or eventually, to feel well being. Participatory evaluation has proved to be a very adequate socio-educational intervention strategy to help participants building different perspectives on their own lives.As interpretações que os jovens realizam sobre as suas próprias realidades são fundamentais para compreender as suas ações e comportamentos. Também para adaptar os projetos e programas socioeducativos às novas dinâmicas sociais. Este artigo centra-se na análise dessas interpretações. O que entendem os jovens por capacitação juvenil? Que indicadores específicos consideram que permitem identificá-lo? Em que espaços, momentos e processos pensam que se produz? Para dar resposta a estas questões, realizaram-se quatro processos de avaliação participativa com 42 jovens, entre os 14 e os 25 anos, em quatro cidades espanholas. A amostra de jovens que configura os grupos de avaliação participativa em cada um dos casos é intencional. O artigo contextualiza os casos, apresenta a metodologia seguida no desenvolvimento da avaliação participativa e indica os resultados principais de cada caso. Os resultados demonstram que os jovens dos casos analisados relacionam a capacitação com algum tipo de enriquecimento ou melhoria de tipo pessoal ou de grupo normalmente associado a um processo pessoal, apesar de se reconhecer a influência social. Os indicadores considerados mais relevantes para a capacitação juvenil são a autonomia e a autoestima. Os jovens relacionam a capacitação juvenil com espaços vinculados ao âmbito familiar e escolar e com as amizades. De acordo com as características dos grupos, aparecem também como significativos o espaço extracurricular, a rua e o mundo associativo. Os processos de capacitação juvenil têm a ver com vivências de superação que fizeram com que os jovens tivessem perceção do sucesso, de superação, de serem importantes para alguém e, por último, de sentirem bem-estar. A avaliação participativa revelou-se uma estratégia de intervenção socioeducativa muito adequada para ajudar as pessoas jovens participantes a criar perspetivas diferentes sobre as suas próprias vidas.Las interpretaciones que realizan los jóvenes sobre sus propias realidades son clave para comprender sus acciones y comportamientos. También para adaptar los proyectos y programas socioeducativos a las nuevas dinámicas sociales. Este artículo se centra en el análisis de dichas interpretaciones. ¿Qué entienden los jóvenes por empoderamiento juvenil? ¿Qué indicadores específicos consideran que permiten identificarlo? ¿En qué espacios, momentos y procesos piensan que se produce? Para dar respuesta a estos interrogantes se realizaron 4 procesos de Evaluación Participativa con 42 jóvenes, de entre 14 y 25 años, en 4 ciudades españolas. La muestra de jóvenes que configura los grupos de evaluación participativa en cada uno de los casos es intencional. El artículo contextualiza los casos, presenta la metodología seguida en el desarrollo de la evaluación participativa y aporta los resultados principales de cada caso. Los resultados muestran que los jóvenes de los casos analizados relacionan el empoderamiento con algún tipo de enriquecimiento o mejora de tipo personal o grupal normalmente asociado a un proceso personal, aunque se reconoce la influencia social. Los indicadores considerados más relevantes para el empoderamiento juvenil son la autonomía y la autoestima. Los jóvenes relacionan el empoderamiento juvenil con espacios vinculados al ámbito familiar, escolar y con las amistades. Según las características de los grupos aparecen también como significativos; el espacio extracurricular, la calle y el mundo asociativo. Los procesos de empoderamiento juvenil tienen que ver con vivencias de superación que hicieron que los jóvenes tuvieran percepción de éxito, de superación, de ser importantes para alguien o, por último, de sentir bienestar. La evaluación participativa ha resultado ser una estrategia de intervención socioeducativa muy adecuada para ayudar a las personas jóvenes participantes a construir perspectivas diferentes sobre sus propias vidas

Economic impact of a care bundle to prevent surgical site infection after craniotomy: a cost-analysis study

Background: Surgical site infections after craniotomy (SSI-CRAN) significantly impact patient outcomes and healthcare costs by increasing length of stay and readmission and reoperation rates. However, to our knowledge, no study has yet analysed the economic impact of a surgical care bundle for preventing SSI-CRAN. The aim is to analyse the hospital cost saving after implementation of a care bundle for the prevention of SSI-CRAN. Methods: A retrospective cost-analysis was performed, considering two periods: pre-care bundle (2013-2015) and care bundle (2016-2017). A bottom-up approach was used to calculate the costs associated with infection in patients who developed a SSI-CRAN in comparison to those who did not, in both periods and on a patient-by-patient basis. The derived cost of SSI-CRAN was calculated considering: (1) cost of the antibiotic treatment, (2) cost of length of stay in the neurosurgery ward within the 1-year follow up period, (3) cost of the re-intervention, and (4) cost of the implant for cranial reconstruction, when necessary. Results: A total of 595 patients were included in the pre-care bundle period and 422 in the care bundle period. Mean cost of a craniotomy procedure was approximately €8000, rising to €24,000 in the case of SSI-CRAN. Mean yearly hospital costs fell by €502,857 in the care bundle period (€714,886 vs. €212,029). Extra costs between periods were mainly due to increased length of hospital stay (€573,555.3 vs. €183,958.9; difference: €389,596.4), followed by the cost of implant for cranial reconstruction (€69,803.4 vs. €9,936; difference: €59,867.4). Overall, implementation of the care bundle saved the hospital €500,844.3/year. Conclusion: The implementation of a care bundle for SSI-CRAN had a significant economic impact. Hospitals should consider the deployment of this multimodal preventive strategy to reduce their SSI-CRAN rates, and also their costs