Obras completas

En portada: Real Academia EspañolaCopia digital. Valladolid : Junta de Castilla y León. Consejería de Cultura y Turismo, 2009-201

Lessons from COVID-19 for future disasters: an opinion paper.

A “Pandemic/Disaster Law” is needed to condense and organize the current dispersed and multiple legislation. The State must exercise a single power and command appropriate to each situation, with national validity. The production of plans for the use of land and real estate as potential centers for health care, shelter or refuge is recommended. There should be specific disaster plans at least for Primary Health Care, Hospitals and Socio-sanitary Centers. The guarantee of the maintenance of communication and supply routes is essential, as well as the guarantee of the autochthonous production of basic goods. The pandemic has highlighted the need to redefine the training plans for physicians who, in their different specialties, have to undertake reforms that allow a more versatile and transversal training. National research must have plans to be able to respond quickly to questions posed by the various crises, using all the nation’s resources and in particular, all the data and capabilities of the health sector. Contingency plans must consider ethical aspects, and meet the needs of patients and families with a humanized approach. In circumstances of catastrophe, conflicts increase and require a bioethical response that allows the best decisions to be made, with the utmost respect for people’s values. Rapid, efficient and truthful communication systems must be contained in a special project for this sector in critic circumstances. Finally, we believe that the creation of National Coordination Centers for major disasters and Public Health can contribute to better face the crises of the future.post-print176 K

Saynete nuevo El tio Peregil, ó el Traga balas

Fernández Gómez, Juan F. Catálogo de entremeses y sainetes del siglo XVIII, 1825Aguilar Piñal, Francisco. Bibliografía de autores españoles del Siglo XVIII, IV-2066Precede al tít.: "167"Datos de imp. obtenidos del colofónTexto a 2 col.Sign.: A

HispaVeg: a new online vegetation plot database for Spain

We describe a new online database, named HispaVeg, which currently holds data from 2663 vegetation plots of Spanish woodlands, scrublands and grasslands. Unlike other similar databases, a detailed description of the structure is stored with the floristic data of each plot (i.e., number and physiognomy of the vertical layers, cover values for each layer).Most of the vegetation plots are large rectangles (400 to 2000 square meters) with an average of 34 species per plot. The survey dates range from 1956 to present, with most of the records between 1964 and 1994. The elevation of the plots ranges from 0 to 2880, with most of the plots between 300 and 1500 m. HispaVeg is freely available to the scientific community. Users can query the online database, view printable reports for each plot and download spreadsheet-like raw data for subsets of vegetation plots

Concursos de acreedores en España: evolución, perspectivas y comparación con otros países

Análisis de la situación y evolución de los procedimientos concursales en España en los últimos años bajo diferentes criterios, según características de las empresas concursadas y en comparación con otros países. Causas del escaso éxito esperado con la implantación de la Ley Concursal

A parent motivational interviewing program for dental care in children of a rural population

Objectives: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. Study Design: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. Results: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p <0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p <0.0001). Bacterial plaque determined by the O'Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p = 0.002) respectively. Conclusions: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque

"INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes"

Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21s

Linear and non-linear patterns of internationalisation and funding in academic spin-offs

Academic spin-offs (ASOs) are typically technologically driven, and their expansion into foreign markets has become a priority for the generation of revenue, thereby recuperating the initial R&D and patent costs over a shorter time frame. However, the literature of how these firms internationalise and what sources they can rely on to obtain the financial resources remains very limited. Two main objectives are proposed in this paper: first, the analysis of whether those relationships that ASOs maintain with various agents to provide financial resources for internationalisation differ between ASOs that have internationalised and those that have not; and second, the study into whether those ASOs that internationalise by following different internationalisation patterns present differences in their agents that provide them with financial resources. From a sample of 173 Spanish ASOs, results of cluster analysis and post-hoc tests indicate that internationalised ASOs rely on financial agents different to those of domestic ASOs. We firstly conclude, that the most representative internationalisation pattern in ASOs is Born Global (BG), through the True Born Global (TBG) and Sporadic Born Global (SBG) sub-patterns. Second, the internationalisation patterns are supported by different financial agents, although governmental institutions and Venture Capital (VC) firms constitute the most relevant agents

Current situation of sepsis care in Spanish emergency departments

Objective. To describe the approach to the patients with suspected sepsis in the Spanish emergency department hospitals (ED) and analyze whether there are differences according to the size of the hospital and the number of visits to the emergency room. Method. Structured survey of those responsible for the 282 public EDs that serve adults 24 hours a day, 365 days a year. It was asked about assistance and management in the emergency room in the care of patients with suspected sepsis. The results are compared according to hospital size (large = 500 beds vs medium-small <500) and influx to the emergency room (discharge = 200 visits / day vs medium-low <200). Results. A total of 250 Spanish EDs responded (89%). Sepsis protocols are available in 163 (65%) EDs median weekly sepsis treated ranged from 0-5 per week in 39 (71%) ED, 6-10 per week in 10 (18%), 11-15 per week in 4 (7%), and more than 15 activations per week in 3 centers (3.6%). The criteria used for sepsis diagnosis were the qSOFA/SOFA in 105 (63.6%) of the hospitals, SIRS in 6 (3.6%), while in 49 (29.7%) they used both criteria simultaneously. In 79 centers, the sepsis diagnosis was computerized, and in 56 there were tools to help decision-making. 48% (79 of 163) of the EDs had data on bundles compliance. In 61% (99 of 163) of EDs there was training in sepsis and in 56% (55 of 99) it was periodic. Considering the size of the hospital, large hospitals participated more frequently as recipients of patients with sepsis and had an infectious, sepsis and short-stay unit, a microbiologist and infectious disease specialist on duty. Conclusion. Most EDs have sepsis protocols, but there is room for improvement. The computerization and development of alerts for diagnosis and treatment still have a long way to go in EDs