State corporatism and democratic industrial relations in Spain 1926-1935: a reappraisal

In this paper, we explore the development of Spanish industrial relations institutions in the late 1920s and early 1930s. This period witnessed a change from a semifascist dictatorship toward a democratic regime as well as from economic growth to a deep economic recession. In spite of these transformations, we evidence remarkable continuity in the corporatist industrial relations institutions created in the last years of the Primo de Rivera dictatorship. The analysis of collective bargaining practices in two regions with different trade union traditions and industrial configurations shows how the experience of Comite´s Paritarios (joint committees) initiated in 1926 had lasting institutional effects. This contrasts with the views expressed by some authors, as well as accepted wisdom according to which state corporatism is necessarily rhetorical and accounts for little more than a mechanism to disarm the labor movement. Based on a historiographic analysis and a previously unexploited source, we provide further support to the view that Primo de Rivera contributed significantly to the modernization of labor relations in Spain. Collective bargaining expanded significantly during this period, and the joint committees system was an institutional innovation that persisted, with minor changes, during the Second Republic, until 1935

Discriminación étnica en el mercado laboral: influencias en el acceso y en la permanencia

Las personas gitanas encuentran importantes obstáculos en su trayectoria dentro del mercado laboral. Esta desigualdad se intenta justificar desde algunos sectores con argumentos relativistas que desvalorizan la cultura gitana y la de otras minorías étnicas. Sin embargo, el trabajo llevado a cabo en WORKALÓ demuestra que las barreras a la comunidad gitana en el mercado laboral tienen su origen en prácticas y actitudes discriminatorias y en el racismo que pretende justificarlas. Todo ello se manifiesta en el trato desigual que reciben las personas gitanas en la contratación, la permanencia, la promoción y el encasillamiento en determinadas profesiones. El racismo tiene, además, importantes efectos negativos sobre el autoconcepto de las personas gitanas. El sentimiento de inferioridad, el miedo por desvelar la propia identidad o el vivir en una tensión constante por romper los estereotipos sobre la propia cultura se convierte así en barreras para la inclusión laboral de las personas gitanas en condiciones de igualdad.Ijitoek eragozpen garrantzitsuak aurkitzen dituzte lan-merkatuaren barruko ibilbidean. Desberdintasun hori sektore batzuk arrazoi erlatibisten bidez justifikatzen ahalegintzen dira; arrazoiok, ijitoen nahiz beste gutxiengo etnikoen kulturaren balioa murrizten dute. Hala ere, WORKALÓn burututako lanaren ondorioz erakusten da ijitoen komunitateari lan-merkatuan ezarritako mugen jatorria diskriminazio-jarduera eta —jokaeretan dagoela, bai eta horiek justifikatzen dituen arrazakerian ere—. Guzti hori, ijitoak kontratatzeko unean, iraupenean eta sustapenean, eta, lanbide jakin batzuetan sailkatzean horiei begira dagoen tratu desberdinean azaltzen da. Arrazakeriak,¡ gainera, ijitoen autokontzeptuari buruzko ondore negatiboak ditu. Gutxiagotasun-sentimendua, euren nortasuna agertzeko beldurra edota tentsio iraunkorrean bizitzea kulturaren gaineko estereotipoak apurtzeagatik, ijitoak merkatuan berdintasun-baldintzetan sartzeko mugak bihurtuko dira.Gypsy people encounter many obstacles once into the labour market. Some sections justify such unequal treatment by means of relativist arguments that devalue not only the Gypsy culture, but also that of other ethnic minorities. Nevertheless, the work done in WORKALÓ, proves that the barriers set upon the Gypsy community in the labour market come from discriminatory practices and attitudes, as well as from a racist behaviour that aims at justifying them. As a result, Gypsies are often treated differently in certain jobs as far as hiring, permanence, promotion and classification are concerned. Moreover, racism has many negative effects upon the way Gypsy people see themselves —feeling inferior, being afraid of revealing their own identity, or not daring to break with the stereotypes set upon their culture—, become barriers for them to enter the labour market on an equal basis

High rates of de novo 15q11q13 inversions in human spermatozoa

Low-Copy Repeats predispose the 15q11-q13 region to non-allelic homologous recombination. We have already demonstrated that a significant percentage of Prader-Willi syndrome (PWS) fathers have an increased susceptibility to generate 15q11q13 deletions in spermatozoa, suggesting the participation of intrachromatid exchanges. This work has been focused on assessing the incidence of de novo 15q11q13 inversions in spermatozoa of control donors and PWS fathers in order to determine the basal rates of inversions and to confirm the intrachromatid mechanism as the main cause of 15q11q13 anomalies

Deletions and duplications of the 22q11.2 region in spermatozoa from DiGeorge/velocardiofacial fathers

Altres ajuts: Universitat Autònoma de Barcelona CF-180034 i PIF/2012Background: DiGeorge/velocardiofacial syndrome (DGS/VCFS) is the most common deletion syndrome in humans. Low copy repeats flanking the 22q11.2 region confer a substrate for non-allelic homologous recombination (NAHR) events leading to rearrangements. This study sought to identify DGS/VCFS fathers with increased susceptibility to deletions and duplications at the 22q11.2 region in spermatozoa and to assess the particular contribution of intra-chromatid and/or inter-chromatid NAHR. Semen samples from nine DGS/VCFS fathers were analyzed by triple-color FISH using a probe combination that discriminated between normal, deleted and duplicated genotypes. Microsatellite analysis were performed in the parents and the affected children to determine the parental origin of the deleted chromosome 22. - Results: A significant increase in 22q11.2 deletions was observed in the sperm of two out of nine DGS/VCFS fathers (odds ratio 2.03-fold, P < 0.01), and in both cases the deletion in the offspring was transmitted by the father. Patients with significant increases in sperm anomalies presented a disturbed deletion:duplication 1:1 ratio (P < 0.01). - Conclusions: Altogether, results support that intra-chromatid NAHR is the mechanism responsible for the higher rate of sperm deletions, which is directly related to the transmission of the deleted chromosome 22 to offspring. Accordingly, the screening of sperm anomalies in the 22q11.2 region should be taken into account in the genetic counseling of DGS/VCFS families

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients : Study protocol of the MindFit project randomized controlled trial

Post-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health. One hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans. The effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample. The MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients' cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes. , identifier NCT04759950

Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8

Background and importance: A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. Objective: We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization. Methods: We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls. Results: We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50‰; 95% confidence interval (CI), 1.23-1.80‰]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52‰; 95% CI, 1.45-1.69‰; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45). Conclusions: DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients: Study protocol of the MindFit project randomized controlled trial

Background: Post-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health. Materials and methods: One hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans. Results: The effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample. Discussion: The MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients' cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT04759950

State of emergency medicine in Spain

Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care centers (PCC), in an extrahospital setting by emergency medical services (EMS) and at hospital emergency departments (ED). We have more than 3,000 PCCs, which are run by family doctors (general practitioners) and pediatricians. On average, there is 1 PCC for every 15,000 to 20,000 inhabitants, and every family doctor is in charge of 1,500 to 2,000 citizens, although less populated zones tend to have lower ratios. Doctors spend part of their duty time in providing emergency care to their own patients. While not fully devoted to emergency medicine (EM) practice, they do manage minor emergencies. However, Spanish EMSs contribute hugely to guarantee population coverage in all situations. These EMS are run by EM technicians (EMT), nurses and doctors, who usually work exclusively in the emergency arena. EDs dealt with more than 25 million consultations in 2008, which implies, on average, that one out of two Spaniards visited an ED during this time. They are usually equipped with a wide range of diagnostic tools, most including ultrasonography and computerized tomography scans. The academic and training background of doctors working in the ED varies: nearly half lack any structured specialty residence training, but many have done specific master or postgraduate studies within the EM field. The demand for emergency care has grown at an annual rate of over 4% during the last decade. This percentage, which was greater than the 2% population increase during the same period, has outpaced the growth in ED capacity. Therefore, Spanish EDs become overcrowded when the system exerts minimal stress. Despite the high EM caseload and the potential severity of the conditions, training in EM is still unregulated in Spain. However, in April 2009 the Spanish Minister of Health announced the imminent approval of an EM specialty, allowing the first EM resident to officially start in 2011. Spanish emergency physicians look forward to the final approval, which will complete the modernization of emergency health care provision in Spain

Origen i recurrència de trastorns genòmics causats per delecions cromosòmiques

Els trastorns genòmics són un grup de malalties genètiques causades per reorganitzacions cromosòmiques de segments de DNA de més de 1Kb que resulten de la inestabilitat del genoma en regions que presenten una arquitectura genòmica particular, caracteritzada per la presència de duplicacions segmentals (low-copy repeats – LCR). Els LCR afavoreixen el malaparellament d’aquestes regions durant la meiosi fent-les susceptibles a la recombinació homòloga no al·lèlica (non-allelic homologous recombination – NAHR) que genera diferents tipus de reorganitzacions cromosòmiques en funció de la orientació dels LCR, del número i tipus de cromàtides implicades en la recombinació. Entre les reorganitzacions cromosòmiques generades per NAHR, les delecions i duplicacions són les causants de la majoria de trastorns genòmics. Mentre que el risc de recurrència de trastorns genòmics s’ha establert per consens en ser inferior al 0.5%, recentment s’han descrit haplotips específics que podrien predisposar a aquestes regions a la NAHR i per tant incrementar el risc de transmetre certs trastorns genòmics a la descendència. Aquests haplotips de predisposició a la NAHR poden ser inversions de les regions crítiques o bé variacions del número de còpies dels blocs d’homologia que formen els LCR. La tècnica d'hibridació in situ fluorescent (FISH) en nuclis descondensats d'espermatozoides proporciona una eina útil per estimar la freqüència de NAHR a través dels seus productes. Pel que fa a l’anàlisi d’haplotips de predisposició, la tècnica de FISH sobre fibres estirades cromatina (Fiber-FISH), que permet obtenir una resolució de fins a 1 Kb, presenta un gran potencial per l’anàlisi de l’arquitectura genòmica dels LCR complexes. Així doncs, en aquest treball es va analitzar la freqüència de delecions i duplicacions de les regions 7q11.23, 15q11-q13 i 22q11.2, així com la freqüència d’inversions de la regió 15q11-q13 mitjançant FISH en espermatozoides en una sèrie d’individus control i de tres poblacions problema que consistien en pares amb descendència afecta per tres trastorns genòmics causats per deleció: la síndrome de Prader-Willi (SPW), la síndrome de Williams-Beuren (SWB) i la síndrome de DiGeorge (SDG). A més, es va utilitzar la tècnica de fiber-FISH per mapar LCR complexes. Les dades obtingudes en la població control varen indicar unes freqüències similars de delecions i duplicacions de les regions analitzades i unes freqüències d’inversions de la regió 15q11-q13 que eren un grau de magnitud superiors a les anteriors. Es van observar increments significatius d’anomalies cromosòmiques en espermatozoides d’individus amb descendència afecta per trastorns genòmics: en la població de pares amb descendència afecta per la SPW, 4 dels 16 individus van mostrar increments de delecions i inversions, mentre que 6 dels individus presentaven increments de delecions. Els resultats van suggerir que els increments d’anomalies en espermatozoides són independents de l’origen genètic de la SPW en la descendència. Aquests increments són un reflex de la inestabilitat que presenta la regió 15q11-q13 que la predisposa a diferents tipus de reorganitzacions cromosòmiques. En la població de pares amb descendència afecta per la SWB, 3 dels 15 individus mostraven increments significatius de delecions, mentre que en la població de pares amb descendència afecta per la SDG es van observar increments en 2 dels 10 individus analitzats. Aquests individus s’han de considerar de risc, en el sentit que presenten un risc incrementat de transmetre una anomalia cromosòmica a la descendència. L’anàlisi de les freqüències de delecions i duplicacions de diferents regions en aquests individus van mostrar que els increments d’anomalies cromosòmiques observats en espermatozoides d’individus amb descendència afecta per trastorns genòmics poden tenir el seu origen en la presència d’haplotips de predisposició o en un increment generalitzat de la susceptibilitat a la NAHR. Els increments significatius de delecions i inversions en espermatozoides d’individus amb descendència afecta per trastorns genòmics indiquen un increment de la freqüència del fenomen de NAHR intracromàtide. Es va demostrar que la tècnica de Fiber-FISH permet mapar LCR complexes i avaluar la presència de diferents haplotips. Els estudis de FISH en espermatozoides, dirigits a determinar la incidència de delecions i duplicacions, aporten una informació valuosa en el consell genètic reproductiu en pares amb descendència afecta per trastorns genòmics. Un resultat de FISH en espermatozoides alterat, independentment del valor numèric, s’interpretarà com l’evidència d’anomalies en el procés de recombinació i és indicatiu d’un factor de risc.Genomic disorders are a group of human diseases caused by chromosomal reorganizations of DNA segments longer than 1 Kb resulting from the genomic instability of regions that show specific architectural features, characterized for the presence of low-copy repeats (LCR). LCR favor the mispairing of these regions during meiosis thus increasing their susceptibility to non-allelic homologous recombination (NAHR) that triggers different types of chromosomal rearrangements according with the LCR orientation, the number and type of chromatids involved in the event. Among the chromosomal rearrangements generated by NAHR, the most frequently involved in genomic disorders are deletions and duplications. NAHR events are thought to be sporadic, thus the risk of recurrence have been established in less than 0.5%. However, there have been recently described some haplotypes that could predispose these regions to NAHR thus increasing the risk of transmission of certain genomic disorders to the offspring. Those predisposing haplotypes are both inversions of the critical regions and copy-number variations of the blocks that build the flanking LCRs. The use of fluorescence in situ hybridization (FISH) on decondensed sperm nuclei provides a useful tool to estimate the frequency of NAHR events throughout its products. Besides, the methodology of FISH on stretched DNA fibers (Fiber-FISH) that allow a resolution up to 1 Kb, has a great potential for mapping complex LCRs. In this work we analyzed the frequency of deletions and duplications of the 7q11.23, 15q11-q13 and 22q11.2 regions, plus the frequency of 15q11q13 inversions using sperm-FISH in a series of control individuals and in three populations consisting on fathers with a deletion-caused genomic disorder affected offspring: Prader-Willi syndrome (PWS), Williams-Beuren syndrome (WBS) and DiGeorge syndrome (DGS). Furthermore, we used the Fiber-FISH methodology to study complex LCR. Data obtained in the control population showed equivalent frequencies of sperm deletions and duplications in the regions analyzed and frequencies of 15q11q13 inversions that were an order of magnitude higher than the previous anomalies. We observed significant increases of sperm anomalies in some individuals with genomic disorders affected offspring: in the populations of PWS fathers, 4 out of 16 subjects showed higher frequencies of deletions and inversions, while 6 subjects showed increases of deletions. Results suggested that the increases of sperm anomalies are independent of the genetic origin of the PWS in the offspring. The significant increases of sperm anomalies are a reflex of the genomic instability of the 15q11-q13 region that makes it prone to different types of chromosomal rearrangements. In the populations of WBS fathers, 3 out of 15 individuals showed significant increased frequencies of anomalies and in the population of DGS fathers we observed 2 out of 10 subjects that showed higher frequencies of anomalies. These subjects should be considered risky individuals, because they show an increased risk of transmission of genomic disorders to the offspring. From the analysis of deletions and duplications of different regions in each individual, our results pointed out that the increased frequencies of sperm anomalies had their origin in the presence of predisposing haplotypes and a generalized susceptibility to NAHR events. The significant increases of sperm deletions and inversions suggested that the fathers with genomic disorders affected offspring have an increased frequency of the intrachromatid NAHR mechanism. There have been demonstrated the potential of the Fiber-FISH methodology to map complex LCRs and for the assessment of variable haplotypes. The methodology of sperm-FISH for analyzing the incidence of deletions and duplications, offers valuable information for the reproductive genetic counseling in fathers with offspring affected by a genomic disorder. An altered sperm-FISH result, independently of the numerical value, will be interpreted as the evidence of anomalies in the process of recombination and, therefore, indicates a risk factor