El proceso de valoración de los centros educativos por parte de las familias de clase media : el papel del orden expresivo en la búsqueda de la «distinción»

El presente artículo analiza la valoración que realizan las familias de clase media sobre el orden expresivo de distintos centros educativos. La composición social del alumnado, el proyecto educativo, la titularidad y el ambiente general son aspectos valorados por los padres durante el proceso de escolarización de sus hijos. Buscarán centros con «prestigio social», sean éstos públicos o privados, donde acudan otras familias con similares características socioculturales, con las que compartan valores y ambiciones. Concluimos que el proceso de elección de centro forma parte de aquellas dinámicas de cierre social destinadas a posicionar a los hijos en una situación privilegiada y ventajosa frente a otros.This article analyses the evaluation made by middle-class families regarding the expressive order of different schools. The social composition of the pupils, the educational project, their public or private character and the general atmosphere are highly valued aspects by those parents during the schooling process of their children. They look for schools with «social prestige», either public or private, where other families with similar socio-cultural characteristics, values and ambitions are also sending their children. We conclude that the school choice process is part of wider social closure dynamics destined to situate their children in a more privileged and advantageous position

The evaluation process of schools by middle-class families. The role of the expressive order in the search for distinction

El presente artículo analiza la valoración que realizan las familias de clase media sobre el orden expresivo de distintos centros educativos. La composición social del alumnado, el proyecto educativo, la titularidad y el ambiente general son aspectos valorados por los padres durante el proceso de escolarización de sus hijos. Buscarán centros con «prestigio social», sean éstos públicos o privados, donde acudan otras familias con similares características socioculturales, con las que compartan valores y ambiciones. Concluimos que el proceso de elección de centro forma parte de aquellas dinámicas de cierre social destinadas a posicionar a los hijos en una situación privilegiada y ventajosa frente a otros.This article analyses the evaluation made by middle-class families regarding the expressive order of different schools. The social composition of the pupils, the educational project, their public or private character and the general atmosphere are highly valued aspects by those parents during the schooling process of their children. They look for schools with «social prestige», either public or private, where other families with similar socio-cultural characteristics, values and ambitions are also sending their children. We conclude that the school choice process is part of wider social closure dynamics destined to situate their children in a more privileged and advantageous position

Atlas de otoscopia para estudiantes de medicina

Memoria ID-024. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022

Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study

Background: Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. Methods: We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. Results: Of 1701 participants treated for tuberculosis, 136 (8.0 %) died during tuberculosis treatment. HIV-positive patients constituted 11.0 % of the cohort and contributed to 34.6 % of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9 %, P < 0.001) and less likely to be cured (28.3 vs. 39.4 %, P = 0.003). On multivariate analysis, positive HIV status (hazard ratio [HR] = 6.06; 95 % confidence interval [CI], 3.96–9.27), unemployment (HR = 2.24; 95 % CI, 1.55–3.25), and sputum acid-fast bacilli smear positivity (HR = 1.91; 95 % CI, 1.10–3.31) were significantly associated with a higher hazard of death. Conclusions: We demonstrate that positive HIV status was a strong predictor of mortality among patients treated for tuberculosis in the early years after Peru started providing free antiretroviral therapy. As HIV diagnosis and antiretroviral therapy provision are more widely implemented for tuberculosis patients in Peru, future operational research should document the changing profile of HIV-associated tuberculosis mortality

Asociación entre Artritis Reumatoidea y otras enfermedades autoinmunes

Objetivos: determinar la frecuencia de enfermedades autoinmunes (EAI) en pacientes con Artritis Reumatoidea (AR) y comparar la frecuencia de EAI entre pacientes con AR y sin AR ni otra EAI reumatológica. Material y Métodos: estudio multicéntrico, observacional, analítico, retrospectivo. Se incluyeron pacientes consecutivos con AR (ACR/EULAR 2010) y como grupo control pacientes con diagnóstico inicial de Osteoartritis primaria (OA).

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

El proceso de valoración de los centros educativos por parte de las familias de clase media : el papel del orden expresivo en la búsqueda de la «distinción»

El presente artículo analiza la valoración que realizan las familias de clase media sobre el orden expresivo de distintos centros educativos. La composición social del alumnado, el proyecto educativo, la titularidad y el ambiente general son aspectos valorados por los padres durante el proceso de escolarización de sus hijos. Buscarán centros con «prestigio social», sean éstos públicos o privados, donde acudan otras familias con similares características socioculturales, con las que compartan valores y ambiciones. Concluimos que el proceso de elección de centro forma parte de aquellas dinámicas de cierre social destinadas a posicionar a los hijos en una situación privilegiada y ventajosa frente a otros.This article analyses the evaluation made by middle-class families regarding the expressive order of different schools. The social composition of the pupils, the educational project, their public or private character and the general atmosphere are highly valued aspects by those parents during the schooling process of their children. They look for schools with «social prestige», either public or private, where other families with similar socio-cultural characteristics, values and ambitions are also sending their children. We conclude that the school choice process is part of wider social closure dynamics destined to situate their children in a more privileged and advantageous position