587 research outputs found

    Single-parent families, educational gradient, and child deprivation: The cases of Italy and Spain

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    Producción CientíficaThis work examines whether the increase of single parenthood in Italy and Spain, specifically amongst women in an unfavourable socioeconomic position, has repercussions for child well-being, understood here as material deprivation. In particular, our main objective is to analyse the possible differential impact of single parenthood on children’s material deprivation in relation to mothers’ level of education. Using the 2014 EU-SILC Module on material deprivation, we identify five areas of child deprivation based on the EU-MODA approach: nutrition, clothing, education, leisure, and social life. In the case of Italy, our main results indicate that, compared to children from two-parent households, children of single mothers with a low level of education have a higher risk of nutrition and clothing deprivation. In Spain, living in a single-parent household is associated with a higher risk of deprivation in terms of social life for those children whose mothers do not have a high level of education. Therefore, the findings suggest that in both countries the growth of single parenthood amongst women with a lower educational level may have an impact on child well-being inequality. This article contributes empirical data to the growing literature on the rise of child poverty in Southern European countries.Ministerio de Ciencia, Innovación y Universidades (RTI2018-099666-B-I00)Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

    Influence of Input/output Operations on Processor Performance

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    Nowadays, computers are frequently equipped with peripherals that transfer great amounts of data between them and the system memory using direct memory access techniques (i.e., digital cameras, high speed networks, . . . ). Those peripherals prevent the processor from accessing system memory for significant periods of time (i.e., while they are communicating with system memory in order to send or receive data blocks). In this paper we study the negative effects that I/O operations from computer peripherals have on processor performance. With the help of a set of routines (SMPL) used to make discrete event simulators, we have developed a configurable software that simulates a computer processor and main memory as well as the I/O scenarios where the periph-erals operate. This software has been used to analyze the performance of four different processors in four I/O scenarios: video capture, video capture and playback, high speed network, and serial transmission

    Estructura familiar, deterioro del mercado laboral y desigualdad en España para el período 2008-2017

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    En este artículo se estudia cómo el deterioro del mercado de trabajo español, a raíz de la crisis económica del año 2008, ha repercutido en la desigualdad laboral y económica de los hogares según la estructura familiar. Para ello, a partir de los datos de la Encuesta de Condiciones de Vida, comparamos la situación de los hogares monoparentales y biparentales en términos de intensidad laboral y bajos ingresos por trabajo. Los principales resultados muestran que, en relación con la intensidad laboral, tanto en el periodo de crisis económica como en el posterior de recuperación ha disminuido la ventaja que las familias monoparentales presentaban con respecto a la biparentales. Por otro lado, aunque los hogares monoparentales registran una mayor probabilidad de experimentar pobreza de ingresos laborales, la diferencia con los hogares biparentales no ha variado a lo largo del periodo de estudio

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

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    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

    Consumo temprano de alcohol y síntomas psicopatológicos en estudiantes universitarios

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    Background: Adolescent brain may be particularly vulnerable to alcohol. Plus, psychopathological disorders tend to emerge in this period. Consequently, early alcohol use may increase the risk of psychopathological disorders, with time and sex-dependent effects. However, few studies have analyzed the relationship between alcohol consumption and adolescent psychopathology in the general population. The objective was to determine the association between age of onset of alcohol use and psychopathological symptoms in university students, separately for both sexes. Method: A cross-sectional study involving fi rst-year university students (n = 3,696) was conducted. Symptoms were measured by the Symptom Checklist-R (SCL-90-R). The independent variable was age of fi rst alcohol use. Dependent variables were the SCL-90-R dimensions, dichotomized. Alcohol consumption was considered a mediator variable. Data were analyzed separately for males and females. Results: The fi ndings showed that a younger age of onset is a risk factor for the following global indexes: Global Severity Index, Positive Symptom Total for females, and Positive Symptom Distress Index, for males. Alcohol consumption showed a higher mediator effect for females than for males. Conclusion: Early age of alcohol use is associated with increased psychopathological symptomatology in both sexes during the college freshman year. The pattern of symptomatology is different in each sexAntecedentes: durante la adolescencia el cerebro es especialmente vulnerable a los efectos del alcohol. El consumo temprano de alcohol puede aumentar el riesgo de sintomatología psicopatológica. Pocos estudios han analizado la relación entre consumo de alcohol y sintomatología psicopatológica en adolescentes en la población general. El objetivo de este estudio es determinar la asociación entre edad de inicio del consumo de alcohol y síntomas psicopatológicos en estudiantes universitarios, separadamente para ambos sexos. Método: estudio transversal en estudiantes universitarios (n = 3.696). Los síntomas se midieron con el SCL-90-R. La variable independiente fue la edad de inicio del consumo de alcohol. Las variables dependientes fueron las dimensiones del SCL-90-R dicotomizadas. El consumo de alcohol fue una variable mediadora. Resultados: una temprana edad de inicio es un factor de riesgo para los siguientes índices globales: Índice de Severidad Global, Total de Síntomas Positivos, solo en mujeres, e Índice de Malestar, solo para hombres. El consumo de alcohol muestra un mayor efecto mediador en las mujeres. Conclusión: una temprana edad de inicio en el consumo de alcohol se asocia con un aumento de sintomatología psicopatológica en ambos sexos durante el primer año de Universidad. El patrón de sintomatología difi ere en hombres y mujeresS

    A Student Assessment Tool for Standardized Patient Simulations (SAT-SPS): Psychometric analysis

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    Background: The evaluation of the level of clinical competence acquired by the student is a complex process that must meet various requirements to ensure its quality. The psychometric analysis of the data collected by the assessment tools used is a fundamental aspect to guarantee the student's competence level. Aim: To conduct a psychometric analysis of an instrument which assesses clinical competence in nursing students at simulation stations with standardized patients in OSCE-format tests. Method: The construct of clinical competence was operationalized as a set of observable and measurable behaviors, measured by the newly-created Student Assessment Tool for Standardized Patient Simulations (SATSPS), which was comprised of 27 items. The categories assigned to the items were ‘incorrect or not performed’ (0), ‘acceptable’ (1), and ‘correct’ (2). Participants: 499 nursing students. Data were collected by two independent observers during the assessment of the students' performance at a four-station OSCE with standardized patients. Descriptive statistics were used to summarize the variables. The difficulty levels and floor and ceiling effects were determined for each item. Reliability was analyzed using internal consistency and inter-observer reliability. The validity analysis was performed considering face validity, content and construct validity (through exploratory factor analysis), and criterion validity. Results: Internal reliability and inter-observer reliability were higher than 0.80. The construct validity analysis suggested a three-factor model accounting for 37.1% of the variance. These three factors were named ‘Nursing process’, ‘Communication skills’, and ‘Safe practice’. A significant correlation was found between the scores obtained and the students' grades in general, as well as with the grades obtained in subjects with clinical content. Conclusions: The assessment tool has proven to be sufficiently reliable and valid for the assessment of the clinical competence of nursing students using standardized patients. This tool has three main components: the nursing process, communication skills, and safety management

    Diseño de una prueba de evaluación clínica objetiva estructurada de cuidados de enfermería del primer curso de prácticas clínicas

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    Objective: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. Method: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. Results: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. Conclusion: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program

    Manual de Casos Clínicos Simulados

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    El documento de trabajo titulado “Manual de Casos Clínicos Simulados” es producto de una actuación avalada presentada a la convocatoria de innovación docente 11-12 de la UCA. Este manual está enfocado a la mejora del aprendizaje a través de la simulación de situaciones clínicas reales de la práctica profesional enfermera.Este manual está enfocado a la mejora del aprendizaje a través de la simulación de situaciones clínicas reales de la práctica profesional enfermera. Esta metodología permite el refuerzo y la integración de los conocimientos previos. Permite una formación estandarizada, repetible, sin riesgo, que posibilita la capacitación de acuerdo al progreso individual, así como la formación para el trabajo en equipo y el desarrollo de estrategias de resolución de problemas con diferente y progresivo nivel de complejidad. El Manual de Casos Clínicos Simulados constituye una guía de usuario de esta metodología. Describe cómo se elabora un escenario de simulación, el diseño de los casos, la selección de situaciones reales de la práctica profesional enfermera que se pretenden simular y la evaluación de los mismos, así como los recursos necesarios.Archivo en formato pdf, 55 páginas.El Manual está estructurado en tres partes: En la primera parte se expone información básica sobre la simulación como metodología de aprendizaje, sus aplicaciones, ventajas e inconvenientes, el uso de la simulación clínica en Enfermería, las fases de la simulación y unas recomendaciones de buenas prácticas. Esta parte del Manual pretende servir de marco teórico para el uso de la simulación como metodología de aprendizaje. En la segunda parte se exponen las plantillas o formularios base de los diferentes prototipos o modelos de casos clínicos simulados. Para cada uno de ellos, se presentan las instrucciones del formulario, la plantilla y un ejemplo del prototipo de caso. Hasta ahora hemos desarrollado la plantilla para la construcción de simulaciones de pacientes de alta fidelidad. La tercera parte, consta una recopilación del material disponible y las personas de referencia para la implementación de los casos. El Manual también cuenta con un apartado de Bibliografía de consulta y recursos digitales internacionales y nacionales sobre simulación. Para usar el manual recomendamos: La lectura de la primera parte. Una vez que se decida utilizar la simulación, se recomienda seguir las fases de la simulación descritas en el texto y las normas de buenas prácticas recomendadas por la Asociación Internacional para el aprendizaje por simulación en Enfermería. A continuación procedería el diseño de los casos utilizando de base la plantilla, según el prototipo o modelo de caso planificado, con la ayuda de las instrucciones de la misma y tomando el ejemplo como punto de partida

    INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy

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    Background Hypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information. Objective The objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP. Method A comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index < 10(th) centile or a ponderal index < 10(th) centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden's index and probability ratios. Results The study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p < 0.01). Using body mass index (< 10(th) centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86-12.77) vs. 3.75 (95% CI: 1.49-9.43)) (DOR: 5.56 (95% CI: 1.82-16.98) vs. 4.84 (95% CI: 1.51-15.54)) Even when using Ponderal index (< 10(th) centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11-5.05) vs. 1.68 (95% CI: 0.70-4.03))(DOR 2.62 (95% CI: 1.00-6.87) vs. 1.90 (95% CI: 0.61-5.92)). Conclusion In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st
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