Perspectives on healthcare, chronic noncommunicable disease and healthworlds in an urban and rural setting

Background: This study is located within a complex network of paradigmatical methodological, and institutional relationships, and draws concepts from a range of scholastic traditions. The hermeneutical tradition within Sociology, particularly as exemplified in the work of Jurgen Habermas, provides a starting point for exploring and interpreting the experiences of chronic illness and healthcare access. The concept of the lifeworld/ healthworld as a description of the complex of health beliefs and behaviours of individuals in relation to the ailing body is used to describe chronic illness and healthcare access, both as lived experience and as fields for public health intervention. Aim: To understand how women living with chronic illness experience their illness and access healthcare in an urban and rural context. Methods: This study is a mixed-methods comparative case study of the healthcare access experiences of women with chronic illness in an urban and rural area in South Africa. The core of the study methodology is a comparative qualitative case study, with quantitative methods serving to contextualise the findings. The urban component of the study was conducted in Birth to Twenty (Bt20), a birth cohort study located in Johannesburg-Soweto. The rural component of the study was conducted in Agincourt, a sub-district of the Bushbuckridge district in Mpumalanga Province. The quantitative context for the Soweto case study uses secondary data collected by Bt20 to construct a historical overview of the use of formal and informal healthcare services in Soweto. It also uses the findings of a large scale cross sectional survey of the primary caregivers of the Bt20 cohort, conducted between November 2008 and June 2010. The rural case study is contextualised by a detailed review of research conducted in the Agincourt sub-district. For the qualitative case studies I employed a qualitative methodology incorporating serial narrative interviews to present an experience-based overview of concepts of disease causation, self treatment and coping. Results: The cross-sectional survey describes a low resource population with a high prevalence of chronic noncommunicable disease (NCDs). Over one third (37.3%) of the population in Soweto could be categorised as having a low socio-economic status, defined as access to only one or less of 5 socio-economic items. Slightly over half the respondents in Soweto (50.7%) reported having at least one chronic illness. Only around a third (33.3%) of the survey participants with chronic illnesses reported accessing formal healthcare services in the last 6 months. Similar trends were found in the review of research carried out in Agincourt. The qualitative case study in Soweto is characterised by a preoccupation with how the medicine from the clinic interacts with the body. The search for alternative remedies took place not as an attempt to cure disease, but to reach a deeper understanding of the diseased state of the body. The Agincourt qualitative case study highlights the importance of church membership, particularly of African Christian Churches, as the strongest factor motivating against the open use of traditional medicine. In both study sites there is evidence that traditional healers were consulted for social purposes rather than health-related purposes. Discussion: Soweto and Agincourt share similar patterns of healthcare utilisation and healthcare belief. Both study sites were characterised by increasing trends in formalisation. At the same time, only a small portion of individuals in both study sites with chronic illness utilised formal healthcare services. A consideration of the findings suggests five broad themes for further research: (1) Processes of constructing body narratives; (2) Encounters with purposive-rational systems; (3) Encounters with traditional medicine; (4) Encounters with contemporary informal medicine; and (5) Religion and healthcare. These five themes constitute the beginning of a comprehensive map of the lifeworld/ healthworld schema. Such a schema has implications for healthcare policy and practice, particularly with regard to the development of integrative paradigms in South Africa as exemplified by Community Oriented Primary Care (COPC). Conclusion: The aims and objectives of the study were met through the development of an initial lifeworld/ healthworld schema, which suggests that the coexistence of diverse public healthcare concerns of high NCD prevalence and low formal healthcare utilisation is best addressed through the adoption of integrated healthcare approaches based on lifeworld/ healthworld rationalistion

How Do Journalists in Mexico Report on Organised Crime: Representing the facts, Interpretation and Self-Critique

Among the many outcomes of the so-called War on Drugs, Mexico has become one of the most dangerous countries in the world for journalism. Besides killings and kidnappings, journalists are also frequent victims of beatings, arbitrary detentions, and online harassment, as well as many other acts of aggression. Anti-press violence has an evident impact on Mexican journalists’ daily activities, particularly as related to the coverage of organised crime. The endemic risk that news workers constantly face determines how they represent and interpret the stories they report on when it comes to this issue. Thus, this inquiry aims to analyse the practices that reporters and editors implement during the news-making process when covering cartels’ activities. In doing so, this paper draws on a set of in-depth interviews with news workers from Mexico’s main national newspapers, and from all the states where journalists were killed in 2017. The main findings indicate that there is a lack of written norms for the coverage of organised crime, and that reporters refer to criminals with a sense of familiarity. In addition, this study contributes to the understanding of journalists’ decisions in the field when doing their job, especially in dangerous conditions

Prospeccion de la necesidad de formacion de tecnicos en servicios turisticos para la explotacion turistica del Radal Siete Tazas : Caso Liceo Polivalente de Molina

180 p.La presente investigación tiene como propósito prospectar la necesidad de formación de técnicos en turismo en el Liceo Polivalente de Molina, para la explotación turística del Radal Siete Tazas. Para dar cumplimiento a los objetivos planteados se realizó una investigación cualitativa y cuantitativa. La investigación cualitativa permitió determinar la fuente de financiamiento para la capacitación a los profesores, a través de entrevistas en profundidad con el director comunal de educación de Molina; competencias requeridas por los egresados de la carrera, información obtenida a través del Ministerio de Educación; costo del programa de capacitación de los profesores, objetivo que se pretendió lograr a través de entrevistas a docentes del área turismo; las actividades turísticas que se pueden realizar dentro del Radal Siete Tazas, otorgadas por la Ilustre Municipalidad de Molina y consultas realizadas a CONAF. Dentro de la investigación cuantitativa se diseñaron dos encuestas estadísticas, una dirigida a los alumnos del liceo, para determinar el conocimiento que poseen sobre el Radal Siete Tazas y grado de interés por la carrera de servicios turísticos. La segunda encuesta fue dirigida a los profesores del establecimiento, cuya finalidad es determinar el grado de interés para capacitarse en turismo. Previo a ejecutar el trabajo en terreno, se realizó un piloteo de cada encuesta. En el caso de los alumnos se debió extraer una muestra de la población en estudio y en el caso de los profesores se realizó un censo. Además, fue necesario consultar a las agencias y operadores de tour, como también a las instituciones educacionales que imparten cameras de turismo. Finalmente, se determinó un alto grado de interés de los alumnos por la carrera propuesta. El técnico-profesional debe poseer alto conocimiento cultural, histórico, geográfico y administrativo en el ámbito turístico, además debe mantener buenas relaciones sociales y un manejo de idiomas. Por otra parte los docentes se encuentran interesados en capacitarse para impartir dicha carrera. El Ministerio de Educación otorga el financiamiento respectivo para los programas de capacitación, junto con la Ilustre Municipalidad de Molina, la cual concursa para obtener mas financiamiento de otros fondos estatales. Además se logro determinar la alta demanda y una oferta limitada del lugar en estudio. Las palabras claves del estudio son: necesidad, turismo, capacitación y financiamient

Majorana Neutrino Masses from Anomalous U(1) Symmetries

We explore the possibility of interpreting the solar and atmospheric neutrino data within the context of the Minimal Supersymmetric Standard Model augmented by a single U(1) anomalous family symmetry spontaneously broken by non-zero vacuum expectation values of a pair of singlet fields. The symmetry retains a dimension-five operator which provides Majorana masses for left-handed neutrino states. Assuming symmetric lepton mass matrices, the model predicts inverse hierarchical neutrino mass spectrum, theta_{13}=0 and large mixing while at the same time it provides acceptable mass matrices for the charged fermions.Comment: 14 pages, no figure

Fast T2 gradient-spin-echo (T2-GraSE) mapping for myocardial edema quantification: first in vivo validation in a porcine model of ischemia/reperfusion

Background: Several T2-mapping sequences have been recently proposed to quantify myocardial edema by providing T2 relaxation time values. However, no T2-mapping sequence has ever been validated against actual myocardial water content for edema detection. In addition, these T2-mapping sequences are either time-consuming or require specialized software for data acquisition and/or post-processing, factors impeding their routine clinical use. Our objective was to obtain in vivo validation of a sequence for fast and accurate myocardial T2-mapping (T2 gradient-spin-echo [GraSE]) that can be easily integrated in routine protocols. Methods: The study population comprised 25 pigs. Closed-chest 40 min ischemia/reperfusion was performed in 20 pigs. Pigs were sacrificed at 120 min (n = 5), 24 h (n = 5), 4 days (n = 5) and 7 days (n = 5) after reperfusion, and heart tissue extracted for quantification of myocardial water content. For the evaluation of T2 relaxation time, cardiovascular magnetic resonance (CMR) scans, including T2 turbo-spin-echo (T2-TSE, reference standard) mapping and T2-GraSE mapping, were performed at baseline and at every follow-up until sacrifice. Five additional pigs were sacrificed after baseline CMR study and served as controls. Results: Acquisition of T2-GraSE mapping was significantly (3-fold) faster than conventional T2-TSE mapping. Myocardial T2 relaxation measurements performed by T2-TSE and T2-GraSE mapping demonstrated an almost perfect correlation (R-2 = 0.99) and agreement with no systematic error between techniques. The two T2-mapping sequences showed similarly good correlations with myocardial water content: R-2 = 0.75 and R-2 = 0.73 for T2-TSE and T2-GraSE mapping, respectively. Conclusions: We present the first in vivo validation of T2-mapping to assess myocardial edema. Given its shorter acquisition time and no requirement for specific software for data acquisition or post-processing, fast T2-GraSE mapping of the myocardium offers an attractive alternative to current CMR sequences for T2 quantification.This work was supported by a competitive grant from the Ministry of Economy and Competitiveness (MINECO) through the Carlos III Institute of Health -Fondo de Investigacion Sanitaria (PI13/01979)-, the Fondo Europeo de Desarrollo Regional (FEDER, RD: SAF2013-49663-EXP), and in part by the FP7-PEOPLE-2013-ITN Next generation training in cardiovascular research and innovation-Cardionext. Rodrigo Fernandez-Jimenez is recipient of a Rio Hortega fellowship from the Ministry of Economy and Competitiveness through the Instituto de Salud Carlos III, and a FICNIC fellowship from the Fundacio Jesus Serra, the Fundacion Interhospitalaria de Investigacion Cardiovascular (FIC) and the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC). Javier Sanchez-Gonzalez is an employee of Philips Healthcare. Jaume Aguero is a FP7-PEOPLE-2013-ITN-Cardionext fellow. Carlos Galan-Arriola is recipient of a ``Contrato Predoctoral de Formacion en Investigacion en Salud (PFIS), FI14/00356´´. This study forms part of a Master Research Agreement (MRA) between CNIC and Philips Healthcare. Borja Ibanez is supported by the Red de Investigacion Cardiovascular (RIC) of the Spanish Ministry of Health (RD 12/0042/0054). The CNIC is supported by the Spanish Ministry of Economy and Competitiveness and the Pro-CNIC Foundation.S

Entrenamiento de las señales corticales a través de un sistema BMI-EEG, evolución e intervención. A propósito de un caso = Training cortical signals by means of a BMI-EEG system, its evolution and intervention. A case report

INTRODUCTION: In the last years, new technologies such as the brain-machine interfaces (BMI) have been incorporated in the rehabilitation process of subjects with stroke. These systems are able to detect motion intention, analyzing the cortical signals using different techniques such as the electroencephalography (EEG). This information could guide different interfaces such as robotic devices, electrical stimulation or virtual reality. CASE REPORT: A 40 years-old man with stroke with two months from the injury participated in this study. We used a BMI based on EEG. The subject's motion intention was analyzed calculating the event-related desynchronization. The upper limb motor function was evaluated with the Fugl-Meyer Assessment and the participant's satisfaction was evaluated using the QUEST 2.0. The intervention using a physical therapist as an interface was carried out without difficulty. CONCLUSIONS: The BMI systems detect cortical changes in a subacute stroke subject. These changes are coherent with the evolution observed using the Fugl-Meyer Assessment

The Low Redshift survey at Calar Alto (LoRCA)

The Baryon Acoustic Oscillation (BAO) feature in the power spectrum of galaxies provides a standard ruler to measure the accelerated expansion of the Universe. To extract all available information about dark energy, it is necessary to measure a standard ruler in the local, z<0.2, universe where dark energy dominates most the energy density of the Universe. Though the volume available in the local universe is limited, it is just big enough to measure accurately the long 100 Mpc/h wave-mode of the BAO. Using cosmological N-body simulations and approximate methods based on Lagrangian perturbation theory, we construct a suite of a thousand light-cones to evaluate the precision at which one can measure the BAO standard ruler in the local universe. We find that using the most massive galaxies on the full sky (34,000 sq. deg.), i.e. a K(2MASS)<14 magnitude-limited sample, one can measure the BAO scale up to a precision of 4\% and 1.2\% using reconstruction). We also find that such a survey would help to detect the dynamics of dark energy.Therefore, we propose a 3-year long observational project, named the Low Redshift survey at Calar Alto (LoRCA), to observe spectroscopically about 200,000 galaxies in the northern sky to contribute to the construction of aforementioned galaxy sample. The suite of light-cones is made available to the public.Comment: 15 pages. Accepted in MNRAS. Please visit our website: http://lorca-survey.ft.uam.es

Symmetries and fermion masses

We discuss whether quark, charged lepton and neutrino masses and mixing angles may be related by an extended flavour and family symmetry group. We show that current measurements of all fermion masses and mixing angles are consistent with a combination of an underlying SU(3) family symmetry together with a GUT symmetry such as SO(10). In this the near bi-maximal mixing observed in the neutrino sector is directly related to the small mixing observed in the quark sector, the difference between quark and lepton mixing angles being due to the see-saw mechanism. Using this connection we make a detailed prediction for the lepton mixing angles determining neutrino oscillation phenomena.Comment: 24 pages, 1 figure. To be submitted to Nucl. Phys.

Single breath-hold saturation recovery 3D cardiac T1 mapping via compressed SENSE at 3T.

To propose and validate a novel imaging sequence that uses a single breath-hold whole-heart 3D T1 saturation recovery compressed SENSE rapid acquisition (SACORA) at 3T. The proposed sequence combines flexible saturation time sampling, compressed SENSE, and sharing of saturation pulses between two readouts acquired at different RR intervals. The sequence was compared with a 3D saturation recovery single-shot acquisition (SASHA) implementation with phantom and in vivo experiments (pre and post contrast; 7 pigs) and was validated against the reference inversion recovery spin echo (IR-SE) sequence in phantom experiments. Phantom experiments showed that the T1 maps acquired by 3D SACORA and 3D SASHA agree well with IR-SE. In vivo experiments showed that the pre-contrast and post-contrast T1 maps acquired by 3D SACORA are comparable to the corresponding 3D SASHA maps, despite the shorter acquisition time (15s vs. 188s, for a heart rate of 60 bpm). Mean septal pre-contrast T1 was 1453 ± 44 ms with 3D SACORA and 1460 ± 60 ms with 3D SASHA. Mean septal post-contrast T1 was 824 ± 66 ms and 824 ± 60 ms. 3D SACORA acquires 3D T1 maps in 15 heart beats (heart rate, 60 bpm) at 3T. In addition to its short acquisition time, the sequence achieves good T1 estimation precision and accuracy.TFdS has received funding from the European Union Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement N722427. CGA is a P-FIS fellow (Instituto deSalud Carlos III). This study was partially supported by the Comunidad de Madrid (S2017/BMD-3867 RENIM-CM) and cofunded with European structural and investment funds. The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia, Innovación y Universidades (MCNU) and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015-0505).S