The political economy of international private insurance and fiscal policy.

We consider a two-country model in which international risk-sharing is beneficial. Even though complete contingent markets exist to trade private wealth, the fact that fiscal policy voting decisions have an impact on contingent wealth prices implies that government spending will be inflated in good states and deflated in bad ones, with the following general implications: (i) Prices of contingent wealth are distorted; (ii) Volatility of public spending increases; (iii) Incomplete insurance arises. An example shows that apart from the increase in the volatility of public spending, it is also possible that average spending increases in both countries. These distortions are shown to be stronger the more similar the two countries are in ex ante terms . We compare the decentralized system with a fiscal union contrasting eqUilibrium properties in terms of government spending and allocation of risk.Private international insurance; Market; Fiscal Union; Decentralized fiscal policy; Risksharing;

Inflation in open economies with complete markets

This paper uses an overlapping generations model to analyze monetary policy in a two-country model with asymetric shocks. Agents insure against risk through the exchange of a complete set of real securities. Each central bank is able to commit to the contingent monetary policy rule that maximizes domestic welfare. In an attempt to improve their country's terms of trade of securities, central banks may choose to commit to costly inflation in favorable states of nature. In equilibrium the effects on the terms of trade wash out, leaving both countries worse off. Countries facing asymmetric shocks may therefore gain from monetary cooperation

Utilidad del bio-sentry® como tapón pleural en las biopsias pulmonares guiadas por tomografía computarizada

Treball de Final de Grau en Medicina. Codi: MD1158. Curs acadèmic 2016-2017Objetivo: Comprobar la reducción de complicaciones (neumotórax) tras la realización de una biopsia pulmonar guiada por TC en pacientes a los que se aplica un tapón de hidrogel (Bio-Sentry®), así como comparar la incidencia de complicaciones entre pacientes sometidos a biopsia con aguja gruesa (BAG) y pacientes sometidos a una punción-aspiración con aguja fina (PAAF), aplicando Bio-Sentry® en ambos casos. Material y métodos: Se realizan un total de 171 biopsias de pulmón, clasificadas en tres grupos: biopsias en las que no se usó Bio-Sentry® (Grupo 1, n=22), PAAFs (Grupo 2, n=89) y BAGs (Grupo 3, n=60). Tras la intervención se realizaba una TC de control para determinar la posible presencia de neumotórax, y a las 6 horas se realizaba otro control mediante radiografía simple. Se recogen más variables a partir de la información almacenada en la historia clínica de los pacientes y en nuestro sistema de imágenes (PACS). Resultados: Los porcentajes de neumotórax y necesidad de colocación de tubo pleural fueron respectivamente de 54.5% y 9% en el Grupo 1, de 29.2% y 11.2% en el Grupo 2, y, en el Grupo 3, de 25% y 0%. Conclusiones: Bio-Sentry® muestra una disminución de las tasas de las complicaciones de la biopsia pulmonar guiada por TC. Así mismo, el paso de realizar PAAF a BAG no parece conllevar un aumento de estas complicaciones.Purpose: To evaluate the decrease of complications (pneumothorax) in patients who underwent CT-guided lung biopsy and received afterwards a sealant plug of the biopsy tract (Bio-Sentry®), as well as to compare the complication rates of core-needle biopsies (CNB) versus fine-needle biopsies (FNB), applying Bio-Sentry® in both cases. Materials and Methods: An amount of 171 procedures were included and classified in three groups: procedures in which Bio-Sentry® was not used (Group 1, n=22), FNBs (Group 2, n=89), Grado en Medicina, UJI, 2017 4 CNBs (Group 3, n=60). After the procedure, a CT control was performed to exclude pneumothorax, and 6 hours later, another control was done with chest X-Ray. More variables were obtained from the medical histories and our image archive (PACS). Results: The rates of pneumothorax and chest tube insertion were respectively 54.5% and 9% in Group 1, 29.2% and 11.2% in Group 2 and 25% and 0% in Group 3. Conclusions: Bio-Sentry® shows a rate reduction of CT-guided biopsy complications. Moreover, the replacement of FNB for CNB doesn’t seem to suppose an increase of these complications

Perceptions and Misperceptions of Early Palliative Care Interventions for Patients With Hematologic Malignancies Undergoing Bone Marrow Transplantation

Hematopoietic stem cell or bone marrow transplantation (BMT) is one of the most promising and potentially curative therapeutic options available for eligible patients with hematologic malignancies (HMs) or leukemias. However, the nature and clinical course of HMs, specifically for patients undergoing BMT, are associated with significant morbidity, symptomatology, healthcare service utilization, psychosocial and end of life issues, and overall decreased quality of life. Early palliative care (PC) consultations and utilization for patients with HMs have been shown to improve patient outcomes, satisfaction, and autonomy as well as caregiver burden, shared-decision making, and holistic care management. Despite the complexity of care and complications for patients with HM undergoing BMT, early PC interventions are systematically underutilized and understudied in this population compared to patients with solid tumors or non-HMs. Herein, the authors reviewed the current literature and knowledge to assess and report the perceptions and barriers to early PC utilization in the care of patients with HMs undergoing BMT. Clinical and cultural aspects of PC perceptions as well as current PC care models and potential directions for PC implementation were reviewed to inform future research studies and clinical practice guidelines necessary for the improvement of care and quality of life for HM patients undergoing BMT

Revisiting Early Palliative Care for Patients With Hematologic Malignancies and Bone Marrow Transplant: Why the Delay?

Palliative care has been defined as specialized care for patients facing serious illnesses. Despite advancements in the field and studies documenting the effectiveness of early palliative care (PC) interventions in seriously ill patients, the fields of hematologic malignancies and bone marrow transplant still lag behind of a comprehensive framework for early and effective interventions. The aim of this literature review is to analyze and discuss the possible barriers to care and delayed referrals for hematologic malignancies and bone marrow transplant patients. Using the EBSCO and PubMed databases, articles regarding PC among patients with hematologic malignancies and bone marrow transplant were analyzed. There are three main domains with its respective barriers in PC: physicians, patients and caregivers, and the healthcare system. Issues that were identified included the lack of knowledge and misconceptions about PC among physicians, patients, and caregivers, delayed referral of patients with hematologic malignancies, unrealistic treatment expectations, lack of communication between specialties, difficulties with appointment availability, geographical distance between clinics, and lack of insurance coverage for PC services. We suggest possible alternatives including obligatory continuing medical education (CME) credits, loan forgiveness, rotations during residency and fellowship training, use of informational videos and pamphlets to educate patients and caregivers, obligatory early consults despite prognosis, an algorithm to evaluate patient\u27s needs, creating a platform within electronic medical records (EMR) systems shared by specialties, and having PC service in every cancer center. Findings suggest a need for further studies aimed towards implementing solutions to increase the early referral of patients with hematologic malignancies and bone marrow transplantation (BMT) to palliative care. Keywords: bone marrow transplant; hematologic malignancy; palliative care; quality of life

Floating against the tide : Spanish monetary policy, 1870-1931

The gold standard began to emerge as a universal monetary system in the late 1870s, and it had spread throughout the world economy by 1900. It was unusual for nations to be off the gold standard, and it meant that they were detached from the international financial community. Spain never joined the gold standard club in any of its varieties, either before or after 1914. Unlike the vast majority of the European currencies, the peseta’s exchange rate fluctuated, sometimes widely, against gold and gold currencies. Gold convertibility was suspended in 1883 and never resumed. Nevertheless, the monetary authorities were aware that the Spanish economy, off the gold standard, was an outlier in the international economy and made plans to put the peseta on gold both before and after 1914.Why Spain never adopted the gold standard is a complex issue, and our paper offers a possible answer by examining the behaviour of an issuing bank that refused to accept, or resisted, its role as a central bank. Our study also provides a basis for a comparison between the Bank of Spain, some of its features and policies, with other peripheral issuing institutions. Moreover, our paper encompasses both the pre-war and the post-war periods, which allows us to present both the similarities and the differences in the exchange and monetary policies of the Spanish authorities during the era of the classical gold standard and the years of the gold exchange standardGold standard, Monetary policy, Bank of Spain

Consideraciones en torno al establecimiento de un régimen tributario común para las entidades de la economía social

Las normas que regulan la tributación de las entidades pertenecientes a la Economía social se hallan dispersas en diferentes textos legales, aprobados en ocasiones en fechas muy alejadas y distantes. La fragmentación y dispersión de la regulación vigente hace que el tratamiento fiscal dispensado a cada uno de los diversos tipos de entidades de la economía social no responda a criterios comunes. Al contrario, esos regímenes fiscales singulares difieren ampliamente en buena parte de los casos, y, lo que es todavía más grave, se encuentran presididos por criterios que en ocasiones resultan ser abiertamente incompatibles y contradictorios entre sí. La Ley de Economía Social, a juicio del autor, concede nuevos y sólidos argumentos para corregir esas graves deficiencias de la regulación tributaria vigente y establecer un nuevo tratamiento fiscal, homogéneo y armónico, que alcance a toda clase de entidades integradas en el ámbito de la Economía Social

Different scenarios of dynamic coupling in glassy colloidal mixtures

Colloidal mixtures represent a versatile model system to study transport in complex environments. They allow for a systematic variation of the control parameters, namely size ratio, total volume fraction and composition. We study the effects of these parameters on the dynamics of dense suspensions using molecular dynamics simulations and differential dynamic microscopy experiments. We investigate the motion of the small particles through the matrix of large particles as well as the motion of the large particles. A particular focus is on the coupling of the collective dynamics of the small and large particles and on the different mechanisms leading to this coupling. For large size ratios, about 1:5, and an increasing fraction of small particles, the dynamics of the two species become increasingly coupled and reflect the structure of the large particles. This is attributed to the dominant effect of the large particles on the motion of the small particles which is mediated by the increasing crowding of the small particles. Furthermore, for moderate size ratios, about 1:3, and sufficiently high fractions of small particles, mixed cages are formed and hence the dynamics are also strongly coupled. Again, the coupling becomes weaker as the fraction of small particles is decreased. In this case, however, the collective intermediate scattering function of the small particles shows a logarithmic decay corresponding to a broad range of relaxation times