Reseñas

Obra ressenyada: Raquel (Lucas) PLATERO, Por un chato de vino. Historias de travestismo y masculinidad femenina. Barcelona: Bellaterra, 2015

Coherencias e incoherencias de la política de cooperación en salud española en África: el ejemplo de Etiopía y Senegal

La comunicación aborda la inserción y coherencia de las políticas internacionales de desarrollo en salud españolas a través de los estudios de caso de Etiopía y Senegal. Ambos casos comprenden la salud como un aspecto clave del Desarrollo Humano y un espacio de gobierno donde interactúan diferentes actores y redes internacionales, estatales y locales. Esta multiplicidad de actores despliega distintos intereses y agendas en torno la salud, el desarrollo humano, la extensión de una agenda de buen gobierno, el control migratorio, la internacionalización de la economía española o la securitización de enfermedades como el VIH/SIDA. Al identificar el marco técnico-normativo así como la naturaleza de estos intereses en los casos diferenciales de Senegal y Etiopía, poniendo especial interés en el ámbito del VIH/SIDA, la ponencia muestra la importancia de abordar las políticas internacionales de salud pública en África como el resultado holístico de la combinación de intereses socio-políticos que combinan aspectos sanitarios y bio-estratégicos dentro de contextos socio-culturales específicos caracterizados por su pluralismo médico

Buenas prácticas, tensiones y desafíos ético-deontológicos en la evaluación psicológica forense del maltrato y abuso sexual infantil

La evaluación psicológica forense del maltrato y del abuso sexual ha sido abordada prioritariamente desde una perspectiva técnico-metodológica. La consideración de los aspectos ético-deontológicos implicados ha resultado más incipiente y comienzan gradualmente a integrarse como una dimensión relevante de la práctica profesional. El presente artículo explora las principales tensiones y desafíos para los psicólogos que realizan evaluaciones forenses en esta materia. Se revisan cómo los principios rectores de la bioética se adaptan a la realidad de las evaluaciones forenses que permiten orientar el desarrollo de buenas prácticas en el área

Mechanical Properties of Three Bamboo Species: Effect of External Climatic Conditions and Fungal Infestation in Laboratory Conditions

Bamboo is a material with good tensile and flexural resistance. As a construction material with structural capacity, using bamboo implies considerable environmental advantages in relation to other typical materials such as steel or concrete. For its correct implementation, it is necessary to define its mechanical properties and durability. Bamboo is susceptible to degradation due to the lack of natural toxins and thin walls, which means that shallow decomposition processes can imply appreciable reductions in its mechanical capacity. The main degrading agents considered in this study were beetles, termites, and xylophagous fungi. The aim of this study was to analyze the durability of three different species: DS, PA, and AA. Durability and mechanical tests results after 6 months of exposure to biotic and abiotic agents were compared with their original properties and chemical composition. In this study, durability was analyzed in two ways. Firstly, the loss of mass due to fungal infection was investigated. The results obtained were based on the standard EN 113 using the fungus CP. Secondly, bending and compressive strength was evaluated after a durability test according to the standard EN 335:2013 for the CU3.1 use class after a 6 month period in the city of Donostia/San Sebastian, Spain. The DS and AA varieties were rated as very durable CD1, while the PA variety is durable CD2, thus proving to be an attractive material for construction.Financial support from the Basque Country Government in the frame of Grupos Consolidados (IT-1690-22)

Occupational injuries in workers of a Spanish bank

BACKGROUND: In 2017, 69 108 work-related traffic injuries with medical leave were documented, constituting 12% of all occupational injuries (OI) in Spain. AIMS: The aim of this study was to describe OI within a Spanish bank company during 2017. METHODS: A cross-sectional analysis was conducted using the company's mandatory OI records, presenting data in both absolute (n) and relative (%) frequencies. The chi-square test was employed for comparisons. RESULTS: Among the company's 10 399 employees, 176 OI cases were recorded. Most were minor musculoskeletal incidents, with one severe myocardial infarction and one mild anxiety episode. Lower limb injuries were the most prevalent. Injuries of the trunk (P < 0.001), neck (P < 0.05), and upper limbs (P < 0.001) were linked to workplace factors. Approximately 62% of OI occurred outside the workplace and resulted in more extended medical leave (P < 0.01). Traffic-related injuries accounted for 39% of OI cases and caused 49% of days lost due to OI (P < 0.001).Female gender (P < 0.001) and age over 40 years (P < 0.05) were significantly associated with OI. CONCLUSIONS: In our study, musculoskeletal injuries were the most common, with a single cardiovascular event being the most severe. OI occurring outside the workplace was more frequent and led to longer medical leaves. Notably, traffic-related injuries were especially significant, exceeding official statistics 4-fold

Successful pandemic management through computer science: a case study of a financial corporation with workers on premises

Background: In November 2019, an infectious agent that caused a severe acute respiratory illness was first detected in China. Its rapid spread resulted in a global lockdown with negative economic impacts. In this regard, we expose the solutions proposed by a multinational financial institution that maintained their workers on premises, so this methodology can be applied to possible future health crisis. Objectives: To ensure a secure workplace for the personnel on premises employing biomedical prevention measures and computational tools. Methods: Professionals were subjected to recurrent COVID-19 diagnostic tests during the pandemic. The sanitary team implemented an individual following to all personnel and introduced the information in databases. The data collected were used for clustering algorithms, decision trees, and networking diagrams to predict outbreaks in the workplace. Individualized control panels assisted the decision-making process to increase, maintain, or relax restrictive measures. Results: 55,789 diagnostic tests were performed. A positive correlation was observed between the cumulative incidence reported by Madrid’s Ministry of Health and the headcount. No correlation was observed for occupational infections, representing 1.9% of the total positives. An overall 1.7% of the cases continued testing positive for COVID-19 after 14 days of quarantine. Conclusion: Based on a combined approach of medical and computational science tools, we propose a management model that can be extended to other industries that can be applied to possible future health crises. This work shows that this model resulted in a safe workplace with a low probability of infection among workers during the pandemic

Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors.

BACKGROUND: Absence of cardiovascular risk factors (CVRFs) is traditionally considered low risk for atherosclerosis; however, individuals without CVRFs, as currently defined, still have events. OBJECTIVES: This study sought to identify predictors of subclinical atherosclerosis in CVRF-free individuals. METHODS: Participants from the PESA (Progression of Early Subclinical Atherosclerosis) study (n = 4,184) without conventional CVRFs were evaluated (n = 1,779; 45.0 ± 4.1 years, 50.3% women). CVRF freedom was defined as no current smoking and untreated blood pressure <140/90 mm Hg, fasting glucose <126 mg/dl, total cholesterol <240 mg/dl, low-density lipoprotein cholesterol (LDL-C) <160 mg/dl, and high-density lipoprotein cholesterol ≥40 mg/dl. A subgroup with optimal CVRFs (n = 740) was also defined as having blood pressure <120/80 mm Hg, fasting glucose <100 mg/dl, glycosylated hemoglobin <5.7%, and total cholesterol <200 mg/dl. We evaluated ultrasound-detected carotid, iliofemoral, and abdominal aortic plaques; coronary artery calcification; serum biomarkers; and lifestyle. Adjusted odds ratios (with 95% confidence interval) and ordinal logistic regression models were used. RESULTS: Subclinical atherosclerosis (plaque or coronary artery calcification) was present in 49.7% of CVRF-free participants. Together with male sex and age, LDL-C was independently associated with atherosclerosis presence and extent, in both the CVRF-free and CVRF-optimal groups (odds ratio [×10 mg/dl]: 1.14 to 1.18; p < 0.01 for all). Atherosclerosis presence and extent was also associated in the CVRF-free group with glycosylated hemoglobin levels. CONCLUSIONS: Many CVRF-free middle-aged individuals have atherosclerosis. LDL-C, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major CVRFs. These findings support more effective LDL-C lowering for primordial prevention, even in individuals conventionally considered at optimal risk. (Progression of Early Subclinical Atherosclerosis [PESA] Study; NCT01410318)

Glycated Hemoglobin and Subclinical Atherosclerosis in People Without Diabetes.

The metabolic injury caused by protein glycation, monitored as the level of glycated hemoglobin (HbA1c), is not represented in most risk scores (i.e., Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease risk scale). The purpose of this study was to assess the association between HbA1c and the extent of subclinical atherosclerosis (SA) and to better identify individuals at higher risk of extensive SA using HbA1c on top of key cardiovascular risk factors (CVRFs). A cohort of 3,973 middle-aged individuals from the PESA (Progression of Early Subclinical Atherosclerosis) study, with no history of cardiovascular disease and with HbA1c in the nondiabetic range, were assessed for the presence and extent of SA by 2-dimensional vascular ultrasound and noncontrast cardiac computed tomography. After adjusting for established CVRFs, HbA1c showed an association with the multiterritorial extent of SA (odds ratio: 1.05, 1.27, 1.27, 1.36, 1.80, 1.87, and 2.47 for HbA1c 4.9% to 5.0%, 5.1% to 5.2%, 5.3% to 5.4%, 5.5% to 5.6%, 5.7% to 5.8%, 5.9% to 6.0%, and 6.1% to 6.4%, respectively; reference HbA1c ≤4.8%; p < 0.001). The association was significant in all pre-diabetes groups and even below the pre-diabetes cut-off (HbA1c 5.5% to 5.6% odds ratio: 1.36 [95% confidence interval: 1.03 to 1.80]; p = 0.033). High HbA1c was associated with an increased risk of SA in low-risk individuals (p < 0.001), but not in moderate-risk individuals (p = 0.335). Relative risk estimations using Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease predictors confirmed that inclusion of HbA1c modified the risk of multiterritorial SA in most risk categories. Routine use of HbA1c can identify asymptomatic individuals at higher risk of SA on top of traditional CVRFs. Lifestyle interventions and novel antidiabetic medications might be considered to reduce both HbA1c levels and SA in individuals without diabetes.The PESA study is funded by the Centro Nacional de Investigaciones Cardiovasculares (CNIC) and Banco Santander. The study also receives funding from the Instituto de Salud Carlos III (ISCIII, PI15/ 02019, PI17/00590, and PI20/00819) and the European Regional Development Fund (ERDF) “A way to make Europe.” The CNIC is supported by the ISCIII, the Ministerio de Ciencia e Innovación, and the Pro CNIC Foundation. Dr. Bueno has received grants from the Instituto de Salud Carlos III; has received consultancy fees from Bayer, Novartis, Ferrer, MEDSCAPE-the Heart-org, and Janssen; has received grants, consultancy fees, and nonfinancial support from AstraZeneca; and has received grants and consultancy fees from Bristol Myers Squibb-Pfizer, all unrelated to the present study. Dr. Ibanez is supported by the European Commission (ERC-CoG grant No 819775), the Spanish Ministry of Science and Innovation (MCN, ‘RETOS 2019’ grant No PID2019-107332RB-I00), and the Comunidad de Madrid (S2017/BMD-3867 RENIM-CM). The funders had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.S

Predicting Subclinical Atherosclerosis in Low-Risk Individuals: Ideal Cardiovascular Health Score and Fuster-BEWAT Score.

BACKGROUND: The ideal cardiovascular health score (ICHS) is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]) score (FBS), are also available. OBJECTIVES: The purpose of this study was to compare the effectiveness of ICHS and FBS in predicting the presence and extent of subclinical atherosclerosis. METHODS: A total of 3,983 participants 40 to 54 years of age were enrolled in the PESA (Progression of Early Subclinical Atherosclerosis) cohort. Subclinical atherosclerosis was measured in right and left carotids, abdominal aorta, right and left iliofemoral arteries, and coronary arteries. Subjects were classified as having poor, intermediate, or ideal cardiovascular health based on the number of favorable ICHS or FBS. RESULTS: With poor ICHS and FBS as references, individuals with ideal ICHS and FBS showed lower adjusted odds of having atherosclerotic plaques (ICHS odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.31 to 0.55 vs. FBS OR: 0.49; 95% CI: 0.36 to 0.66), coronary artery calcium (CACS) ≥1 (CACS OR: 0.41; 95% CI: 0.28 to 0.60 vs. CACS OR: 0.53; 95% CI: 0.38 to 0.74), higher number of affected territories (OR: 0.32; 95% CI: 0.26 to 0.41 vs. OR: 0.39; 95% CI: 0.31 to 0.50), and higher CACS level (OR: 0.40; 95% CI: 0.28 to 0.58 vs. OR: 0.52; 95% CI: 0.38 to 0.72). Similar levels of significantly discriminating accuracy were found for ICHS and FBS with respect to the presence of plaques (C-statistic: 0.694; 95% CI: 0.678 to 0.711 vs. 0.692; 95% CI: 0.676 to 0.709, respectively) and for CACS ≥1 (C-statistic: 0.782; 95% CI: 0.765 to 0.800 vs. 0.780; 95% CI: 0.762 to 0.798, respectively). CONCLUSIONS: Both scores predict the presence and extent of subclinical atherosclerosis with similar accuracy, highlighting the value of the FBS as a simpler and more affordable score for evaluating the risk of subclinical disease

Association of Sleep Duration and Quality With Subclinical Atherosclerosis.

BACKGROUND Sleep duration and quality have been associated with increased cardiovascular risk. However, large studies linking objectively measured sleep and subclinical atherosclerosis assessed in multiple vascular sites are lacking. OBJECTIVES The purpose of this study was to evaluate the association of actigraphy-measured sleep parameters with subclinical atherosclerosis in an asymptomatic middle-aged population, and investigate interactions among sleep, conventional risk factors, psychosocial factors, dietary habits, and inflammation. METHODS Seven-day actigraphic recording was performed in 3,974 participants (age 45.8 4.3 years; 62.6% men) from the PESA (Progression of Early Subclinical Atherosclerosis) study. Four groups were defined: very short sleep duration 8 h. Sleep fragmentation index was defined as the sum of the movement index and fragmentation index. Carotid and femoral 3-dimensional vascular ultrasound and cardiac computed tomography were performed to quantify noncoronary atherosclerosis and coronary calcification. RESULTS When adjusted for conventional risk factors, very short sleep duration was independently associated with a higher atherosclerotic burden with 3-dimensional vascular ultrasound compared to the reference group (odds ratio: 1.27; 95% confidence interval: 1.06 to 1.52; p ¼ 0.008). Participants within the highest quintile of sleep fragmentation presented a higher prevalence of multiple affected noncoronary territories (odds ratio: 1.34; 95% confidence interval: 1.09 to 1.64; p ¼ 0.006). No differences were observed regarding coronary artery calcification score in the different sleep groups. CONCLUSIONS Lower sleeping times and fragmented sleep are independently associated with an increased risk of subclinical multiterritory atherosclerosis. These results highlight the importance of healthy sleep habits for the prevention of cardiovascular disease. (J Am Coll Cardiol 2019;73:134–44) © 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation.post-print454 K