La participación laboral de las mujeres: un reto para el bienestar social.

Este trabajo ha sido posible gracias a la cobertura de los proyectos de investigación “Riesgos y oportunidades a lo largo del curso de la vida en las sociedades postindustriales” (CICYT. Sec2003-06799), dirigido por Esping-Andersen (Universitat Pompeu Fabra) y “Nuevos Riesgos Sociales y Trayectorias de las Políticas del Bienestar” (NURSOPOB) (MEC, Plan Nacional de I+D+I), dirigidos por Luis Moreno (Unidad de Políticas Comparadas, CSIC). Agradezco a ambos el apoyo que me han prestado para poderle llevar a cabo, y de forma muy particular, a Ana Arriba y Luis Moreno, por sus comentarios y colaboración en versiones anteriores del mismo

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Educational interventions to improve the effectiveness in clinical competence of general practitioners: problem-based versus critical reading-based learning

<p>Abstract</p> <p>Background</p> <p>Evidence suggests that continuing medical education improves the clinical competence of general practitioners and the quality of health care services. Thus, we evaluated the relative impact of two educational strategies, critical reading (CR) and problem based learning (PBL), on the clinical competence of general practitioners in a healthcare system characterized by excessive workload and fragmentation into small primary healthcare centers.</p> <p>Methods</p> <p>Clinical competence was evaluated in general practitioners assigned to three groups based on the educational interventions used: 1) critical reading intervention; 2) problem based learning intervention; and 3) no intervention (control group, which continued clinical practice as normal). The effect on the clinical competence of general practitioners was evaluated in three dimensions: the cognitive dimension, via a self-administered questionnaire; the habitual behavioral dimension, via information from patient’s medical records; and the affective dimension, through interviews with patients. A paired Student´s t-test was used to evaluate the changes in the mean clinical competence scores before and after the intervention, and a 3 x 2 ANOVA was used to analyze groups, times and their interaction.</p> <p>Results</p> <p>Nine general practitioners participated in the critical reading workshop, nine in the problem-based learning workshop, and ten were assigned to the control group. The participants exhibited no significant differences in clinical competence measures at baseline, or in socio-demographic or job characteristics (p > 0.05). Significant improvements in all three dimensions (cognitive, 45.67 vs 54.89; habitual behavioral, 53.78 vs 82.33; affective, 4.16 vs 4.76) were only observed in the problem-based learning group after the intervention (p > 0.017).</p> <p>Conclusions</p> <p>While no differences in post-intervention scores were observed between groups, we conclude that problem-based learning can be effective, particularly in a small-group context. Indeed, problem-based learning was the only strategy to induce a significant difference between pre– and post- intervention scores for all three CC dimensions.</p

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Chemical and physical methodologies for the replacement/reduction of sulfur dioxide use during winemaking: review of their potentialities and limitations

Sulfur dioxide (SO 2 ) is probably one of the most versatile and efficient additives used in winemaking due to its antiseptic and antioxidant properties. This compound is also important for minimizing phenolic polymerization rate and color loss during wine aging. However, allergies caused by SO 2 -derived compounds, namely the sulfites, are becoming more frequent, causing symptoms such as headaches, nausea, gastric irritation, and breathing difficulties in asthma patients. Consequently, the legislated maximum concentration of SO 2 allowed in wines has been gradually reduced. For this reason, it is crucial in a competitive global winemaking market strategy, to reduce or even eliminate the use of SO 2 as a preservative and to search for new healthier and safe strategies. This work gives an overview of the main methodologies that have been proposed so far and that have potential to be used in winemaking as an alternative to SO 2 . The addition of compounds such as dimethyl dicarbonate, bacteriocins, phenolic compounds, and lysozyme, and the use of physical methods, namely pulsed electric fields, ultrasound, ultraviolet radiation, and high pressure are discussed and critically evaluated

Tests of CMS Hadron Forward Calorimeter Upgrade Readout Box Prototype

A readout box prototype for CMS Hadron Forward calorimeter upgrade is built and tested in CERN H2 beamline. The prototype is designed to enable simultaneous tests of different readout options for the four anode upgrade PMTs, new front-end electronics design and new cabling. The response of the PMTs with different readout options is uniform and the background response is minimal. Multi-channel readout options further enhance the background elimination. Passing all the electronics, mechanical and physics tests, the readout box proves to be capable of providing the forward hadron calorimeter operations requirements in the upgrade era