Women’s representation in politics : voter bias, party bias, and electoral systems

Estudiamos cómo afecta el sistema electoral a la presencia de mujeres en política usando un modelo en el que tanto los votantes como los partidos pueden tener un sesgo de género. Aplicamos el modelo a las elecciones municipales españolas, en las que, según la ley, los municipios utilizan dos sistemas electorales distintos: uno de listas cerradas, en el que los votantes votan por un partido, o uno de listas abiertas, en el que votan por candidatos individuales. Usando un análisis de regresión discontinua, encontramos que el sistema de listas cerradas aumenta 2,5 puntos porcentuales la proporción de mujeres entre los candidatos y los concejales, y 4,3 puntos porcentuales entre los alcaldes. Según el modelo, estos resultados se explican por un sesgo de los votantes. Proporcionamos evidencia que apoya el mecanismo del modelo. En particular, mostramos que, con carácter general, cuando dos concejales casi empatan en votos, es considerablemente más probable que el que obtuvo «un voto más» sea nombrado alcalde, pero este resultado no se observa con generalidad cuando el más votado fue una mujer y el segundo un hombre, lo que sugiere la presencia de un cierto sesgo de género. También mostramos que, en una submuestra de municipios con poco sesgo —aquellos que han tenido una alcaldesa en el pasado—, la diferencia entre los dos sistemas electorales desapareceWe study how electoral systems affect the presence of women in politics using a model in which both voters and parties might have a gender bias. We apply the model to Spanish municipal elections, in which national law mandates that municipalities follow one of two different electoral systems: a closed-list system in which voters pick one party-list, or an open-list system, in which voters pick individual candidates. Using a regression discontinuity design, we find that the closed-list system increases the share of women among candidates and councilors by 2.5 percentage points, and the share of women among mayors by 4.3 percentage points. Our model explains these results as mostly driven by voter bias against women. We provide evidence that supports the mechanism of the model. In particular, we show that, when two councilors almost tied in general-election votes, the one with “one more vote” is substantially more likely to be appointed mayor, but this does not happen when the most voted was female and the second was male, suggesting the presence of some voter bias. We also show that, in a subsample of municipalities with low bias — proxied by having had a female mayor in the past — the difference between the two electoral systems disappear

Plan de emerxencias. Fundación Pública Urxencias Sanitarias de Galicia-061

A Fundación Pública Urxencias Sanitarias de Galicia-061 é a encargada de proporcionar, desde o momento que ocorre a emerxencia, un control da situación, unha primeira avaliación e unha asistencia sanitaria que logre salvar o maior número de vidas e volver á normalidade o antes posible. Para isto, a actuación sanitaria debe seguir unha metodoloxía perfectamente establecida, xa que as actuacións organizadas son as mellores ferramentas de traballo. Así pois, é necesario posibilitar normas de actuación o máis protocolizadas posible, para poder traballar nas mellores condicións de seguridade e manter unhas directrices xerais, onde cada persoa coñeza tanto a súa función como a do resto dos componentes do equipo, procedendo, ademais, á súa identificación funcional mediante signos externos (uniformidade, carteis, identificación, etc.); para facilitar o entendemento e a coordinación de todos os implicados en resolver a situación acaecida. Con este fin, preséntase o Plan de emerxencias que a continuación se expón, nun afán de dar sempre a mellor e máis axeitada resposta; obxectivo primordial desde que a FPUS de Galicia–061 se instaura como responsable da medicina prehospitalaria na nosa comunidade autónoma.La Fundación Pública Urxencias Sanitarias de Galicia-061 es la encargada de proporcionar, desde el momento en que ocurre la emergencia, un control de la situación, una primera evaluación y una asistencia sanitaria que logre salvar el mayor número de vidas y volver a la normalidad lo antes posible. Para esto, la actuación sanitaria debe seguir una metodología perfectamente establecida, ya que las actuaciones organizadas son las mejores herramientas de trabajo. Así pues, es necesario posibilitar normas de actuación lo más protocolizadas posible, para poder trabajar en las mejores condiciones de seguridad y mantener unas directrices generales, donde cada persona conozca tanto su función como la del resto de los componentes del equipo, procediendo, además, a su identificación funcional mediante signos externos (uniformidad, carteles, identificación, etc.); para facilitar el entendimiento y la coordinación de todos los implicados en resolver la situación acaecidad. Con este fin, se presenta el Plan de emergencias que a continuación se expone, en un afán de dar siempre la respuesta mejor y más idónea; objetivo primordial desde que la FPUS de Galicia-061 se instaura como responsable de la medicina prehospitalaria en nuestra comunidad autónoma

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

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

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

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

Privatization for the Public Good?: Welfare Effects of Private Intervention in Latin America

This book provides a detailed microeconomic analysis of the impact of various privatizations in different countries in the region. Its central message is that in many cases, contrary to popular belief, society as a whole and in particular the poor have benefited from privatization. The book presents a careful analysis of the various mechanisms through which privatization has an impact on welfare, an analysis that by and large has been missing from the debate. Case studies of water sector privatization in Argentina and Colombia, and also the telecom industry in Peru are included

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care