'Come with me, my little cousin'. Marriage between first cousins among the gypsies of Andalusia

Este artículo pretende: 1. Establecer la frecuencia del matrimonio entre primos hermanos y su evolución durante el siglo XX en una amplia población gitana estudiada mediante una combinación de métodos demográficos y antropológicos. 2. Analizar un elemento central de este tipo de matrimonio: la diferenciación lineal o lateral entre los primos hermanos concebidos como cónyuges. 3. Establecer cómo se articulan los datos obtenidos en la reconstrucción demográfica y genealógica con las concepciones dominantes sobre el parentesco y los parientes en esta población gitana. 4. Evaluar, finalmente, si los resultados encontrados son compatibles con la visión patrilineal de la sociedad gitana o con la importancia de alianzas entre patrigrupos o patrilinajes como elemento central de sus estrategias matrimoniales, explicaciones ambas dominantes en la mayor parte de las principales monografías sobre gitanos españoles.This study undertakes the following: 1) to establish the frequency of marriage between first cousins and its evolution during the 20th century within a broad gypsy population studied by a combination of demographic and anthropological methods; 2) to analyse a central element of this type of matrimony, the linear or lateral differentiation among first cousins conceived as spouses; 3) to establish how the data are put together in the demographic and genealogical reconstruction with the dominant concepts concerning relations and relatives in this gypsy population; 4) to evaluate, finally, whether the results found are compatible with the patrilinear view of the gypsy society and with the importance of alliances among patrigroups or patrilineages as a core element of their marriages, both explanations being dominant in most of the main monographs on Spanish gypsies.Grupo de Investigación Antropología y Filosofía (SEJ-126). Universidad de Granad

Oculocutaneous Albinism and Consanguineous Marriage among Spanish Gitanos or Calé – A Study of 83 Cases

This paper studies 83 cases of oculocutaneous albinism (OCA) in family networks of Gitanos in southeastern Spain, and analyzes their sustained inbreeding patterns and complex genealogical relationships. It is based in the family and genealogy reconstitution of the Gitano population of 22 contiguous localities using ethnographic and historical demography methods. The study found a prevalence of OCA among Gitanos in the area of about 1: 1,200. Most of the cases belong to three extended kin networks in which consanguineous marriages have been common for generations. In these networks there are other cases of visual and auditive congenital anomalies, and other birth defects such as brachydactily, polydactily, neurological defects, Potter Sequence, etc. In 61 OCA cases it was possible to trace inbreeding links with a depth of three to nine generations. For these cases the estimated alpha (average of the inbreeding coefficient, F) is 0.0222. Relationships between the parents of people affected are of three types: close, as between first or second cousins; distant, as between third or fourth cousins, and non-existent, as in mixed marriages. In most cases, however, persons with albinism are linked by multiple consanguineous links. Albinism seems to be a visible example of a high prevalence of birth defects in this minority, associated with founder effects, sustained inbreeding and high fertility rates. These conditions derive from Gitano’s marriage preferences and pronatalist strategies. In turn, these strategies have to be related to the exclusion, persecution and segregation that Spanish Gypsies have suffered for centuries

Salud de los trabajadores

Actividad física y su relación con los factores de riesgo cardiovascular de carteros chilenosAnálisis de resultados: riesgos psicosociales en el trabajo Suceso-Istas 21 en Cesfam QuellónAusentismo laboral por enfermedades oftalmológicas, Chile 2009Brote de diarreas por norovirus, posterremoto-tsunami, Constitución, Región del MauleCalidad de vida en profesionales de la salud pública chilenaCaracterización del reposo laboral en personal del SSMN durante el primer semestre de 2010Concentración de nicotina en pelo en trabajadores no fumadores expuestos a humo de tabaco ambientalCondiciones de trabajo y bienestar/malestar docente en profesores de enseñanza media de SantiagoDisfunción auditiva inducida por exposición a xilenoErgonomía aplicada al estudio del síndrome de dolor lumbar en el trabajoEstimación de la frecuencia de factores de riesgo cardiovascular en trabajadores de una empresa mineraExposición a plaguicidas inhibidores de la acetilcolinesterasa en Colombia, 2006-2009Factores de riesgo y daños de salud en conductores de una empresa peruana de transporte terrestre, 2009Las consecuencias de la cultura en salud y seguridad ocupacional en una empresa mineraPercepción de cambios en la práctica médica y estrategias de afrontamientoPercepción de la calidad de vida en la Universidad del BiobíoPesos máximos aceptables para tareas de levantamiento manual de carga en población laboral femeninaRiesgo coronario en trabajadores mineros según la función de Framingham adaptada para la población chilenaTrastornos emocionales y riesgo cardiovascular en trabajadores de la salu

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

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The decline of infant and child mortality among Spanish Gitanos or Calé (1871−2005): A microdemographic study in Andalusia

Background: Most Romani groups in Europe have experienced a decline in childhood mortality during recent decades. These crucial transformations are rarely addressed in research or public policy. Objective: This paper analyzes the timing and structure of the decline of childhood mortality among the Gitano people of Spain. Methods: The paper is based on the family and genealogy reconstitution of the Gitano population of 22 contiguous localities in Southern Spain. Registry data from over 19,100 people and 3,501 reconstituted families was included in a dense genealogical grid ranging over 150 years. From this database we produced annual time series of infant and child mortality and of the registered causes of death from 1871 to 2005. Results: The analyzed data shows a rapid decline in infant and child mortality from about 1949 to 1970. The onset of the definitive decline occurred in the late 1940s and early 1950s. Child mortality was higher in the pre-transitional period and started to decline earlier, although it took longer to converge with majority rates. The mortality transition in the Gitano minority paralleled that of the dominant majority, but with important delays and higher mortality rates. The causes of death show the deprivation suffered by Gitano people. Conclusions: The childhood mortality decline facilitated the most important changes experienced recently by the Gitano minority, including its fertility transition and the transformation of Gitanos' gender and family systems. Contribution: This is one of the first historical reconstructions of the mortality transition of a Romani population

New methodological approaches in the anthropological demography of Romani groups : An example from the study of the evolution of the infant and child mortality of the Gitanos or Calé of Spain (1871-2007)

Probably the most important change that affected the Gitano people of Spain in its recent history has been the rapid decline in their infant and child mortality patterns. There is however an almost complete absence of studies on this process. Data is difficult to obtain, as ethnic affiliation is usually not recorded in parish or civil records, and the base population is generally unknown. In this paper we will describe the methods we followed to overcome those problems in the genealogical and family reconstitution of the Gitano population of 22 contiguous localities of Andalusia, which includes data on over 19,000 people. From this database we produced annual time series that show a differentiated model of mortality decline occurring between 1950 and 1975