Exploring the long term effects of educational policies on the income redistribution processes

Public finance of post-compulsory education modifies substantially the supply of educational qualifications. Such modification has crucial implications for the long-term income distribution processes: in a context of sustained increases of demand for educational qualifications (brought about by various factors, among which the incorporation of new technologies and international competition may be emphasized), growth in supply reduces the increasing trend of the educational wage premium, contributing, thus, to control the enlargement of primary income inequality. This long-term effect combines with the rest of redistributive effects generated by educational policies and, more specifically, by public finance. In this paper the mentioned long-term effects are tackled, both from a methodological perspective and from a comparative analysis applied to developed countries. The Luxembourg Income Study (LIS) databases, together with the European Community Household Panel (ECHP) database (for Spain) were used in the empirical work

Notes de lectura

Obra ressenyada: Ferdinand TÖNNIES, Comunitat i associació. Edicions 62 / Diputació de Barcelona, 1984

Rendimiento diagnóstico del estudio electrofisiológico en pacientes octogenarios con síncope y bloqueo de rama

Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2016-2017Introducción: El síncope es una entidad clínica frecuente cuya incidencia aumenta con la edad y la etiología arrítmica se asocia a un aumento de la morbimortalidad. El estudio electrofisiológico (EEF) se ha establecido como la principal técnica diagnóstica en pacientes con síncope no filiado tras la evaluación inicial y que presentan bloqueo de rama. Existe controversia y escasa información acerca de la utilidad del EEF en pacientes de edad avanzada. Objetivos: Determinar el rendimiento diagnóstico del EEF en pacientes octogenarios con síncope no filiado y bloqueo de rama, así como analizar la edad como variable predictiva de un EEF diagnóstico. Material y métodos: Estudio unicéntrico retrospectivo que incluyó pacientes con síncope no filiado y bloqueo de rama que fueron remitidos para valoración electrofisiológica. Se analizaron variables clínicas, electrocardiográficas, ecocardiográficas y electrofisiológicas. Resultados: Se incluyó un total de 169 pacientes con edad (media ± DE) de 74,4 ± 9,6 años; 34,3% con edad ≥ 80 años. El EEF fue diagnóstico en 94 pacientes (55,6%) siendo la principal etiología el bloqueo AV paroxístico (84%). En el análisis univariado, la edad ≥ 80 años se asoció a un EEF diagnóstico vs no diagnóstico (41,5% vs 25,3%, p=0,028). En el análisis multivariado, las variables predictoras del estudio electrofisiológico diagnóstico fueron el PR ≥ 200ms (OR=6,12; IC=2,9-12,9), la edad (OR=1,05; IC=1,0005-1,09) y el bloqueo de rama derecha + hemibloqueo anterior (BRDHH + HBA) (OR=2,16; IC=1,031-4,5). Conclusiones: La prolongación del intervalo PR, la edad y BRDHH + HBA se comportaron como predictores independientes de EEF diagnóstico.Introduction: Syncope is a frequent clinical situation which incidence rises with age and arrythmic aetiology is associated with an increaded morbimortality. The electrophysiological study (EPS) is stablished as the main diagnosis technique in patients with non-filiated syncope after initial evaluation and bundle branch block. There is controversy and lack of information about the usefulness of EPS in elderly patients. Purpose: To determine the diagnostic efficiency of EPS on octogenary patients with non-filiated syncope and bundle branch block, as well as to analize the age as a predictive variable of diagnostic EPS. Material and Methods: Retrospective unicentric study that included non-filiated syncope and bundle branch block patients referred for electrophysiological valoration. Clinical, electrocardiographic, ecocardiographic and electrophysiological variables were analyzed. Results: A total of 169 patients with 74,4 ± 9,6 years (mean± SD) were included in this study; 34,3% ≥ 80 years old. EPS was diagnostic in 94 patients (55,6%) with paroxistic AV block as the main cause (84%). On univariated analysis, age ≥ 80 years was associated with a diagnostic vs non-diagnostic EPS (41,5% vs 25,3%, p=0,028). The variables that predicted a diagnostic EPS on multivariable analysis were PR ≥ 200ms (OR=6,12; CI=2,9-12,9), age (OR=1,05; CI=1,0005-1,09) and right bundle branch block plus anterior hemiblock (RBBB + AHB) (OR=2,16; CI=1,031-4,5). Conclusions: PR interval prolongation, age and RBBB + AHB behaved as independent EPS diagnostic predictors