Estimaciones del pleno empleo de las regiones españolas: métodos de alisamiento, equilibrio a largo plazo y el enfoque de los salarios

La Cumbre Europea de Lisboa (2000) señaló, entre otras cuestiones, los fuertes desequilibrios regionales existentes en Europa en materia de desempleo. Sin embargo, en la misma se decidió plantear los objetivos para el mercado de trabajo no en función del nivel de desempleo, sino en función del nivel de empleo: se pretende que el 70% de la población adulta (15-64 años) tenga empleo en el año 2010. Esta tasa de empleo implica aproximadamente una tasa de desempleo del 5%. Esta tasa parece ser la tasa consensuada de pleno empleo pero es necesaria una aproximación econométrica para estimar esta variable inobservable. La economía española no es precisamente ajena a los desequilibrios anteriores. Por ello, en este trabajo estimamos el pleno empleo de cada una de las regiones españolas. Para atender a dicha finalidad utilizamos distintas metodologías, lo que nos permite realizar comparaciones: a) Métodos de alisamiento (mínimo desempleo histórico, medias móviles y filtro de Hodrick-Prescott); b) Equilibrio a largo plazo (solución particular de un AR(1) para la tasa de desempleo); y c) El enfoque de los salarios (estimación de "time-varying" NAWRUs utilizando el método de Elmeskov)

Curvas de Phillips y NAWRUs regionales: Evidencia empírica para la economía española

En este trabajo proporcionamos estimaciones de las NAWRUs (Tasa de Desempleo no Aceleradora de los Salarios) regionales de la economía española para el periodo 1989-2000. Hemos utilizado el método de Elmeskov, ampliamente implementado en la última década -por ejemplo en el marco del FMI y la OCDE- con el objetivo de obtener una "time-varying" NAWRU. Estas estimaciones nos permiten introducir el desempleo cíclico como argumento de las curvas de Phillips para las distintas Comunidades Autónomas. Los resultados obtenidos no reflejan la esperada relación negativa entre inflación salarial y desempleo.NAWRU, hysteresis, Phillips curve, regional labour markets.

An example of adaptation: experience of virtual clinical skills circuits of internal medicine students at the Faculty of Medicine, University of Granada (Spain) during the COVID-19 pandemic

Background: The state of alarm declared in Spain in response to the Coronavirus pandemic (COVID-19) has had far-reaching consequences in all areas of life. At the University of Granada’s (UGR) Faculty of Medicine, online teaching was implemented immediately without any preexisting plan. Second-year undergraduates in medicine, particularly those enrolled in the subject ‘Bases of Internal Medicine,’ would normally undergo clinical skills circuits in faceto- face group settings. Objective: To facilitate undergraduates’ acquisition of specific transversal skills by means of an integrated online working system. Design: Before the pandemic, teaching/learning methods consisted of 1) face-to-face group work; 2) teletutoring; 3) written work uploaded to the PRADO online platform for marking by the teletutor; and 4) presentation of written work to the group. As a result of the lockdown, presentations in class were suspended and replaced by online presentations. The means adopted by students in online presentations were freely chosen using various communication techniques: linear projection systems (6); acting/simulation (4); dramatization (1); and roleplaying (1). Results: The number of online clinical skills circuits developed was 12, one for each of the clinical skills circuits established for imparting this subject. A total of 12 presentations were made by the 10 groups, each lasting 15 minutes followed by a 5-minute discussion to settle any questions raised. The presentations were marked jointly by the teaching staff, coordinator, and students. Conclusions: The transference of classroom learning to the online environment proved an essential resource for teaching/learning clinical/practical skills during the lockdown, which have never before been imparted at distance

Wearable System for Biosignal Acquisition and Monitoring Based on Reconfigurable Technologies

Wearable monitoring devices are now a usual commodity in the market, especially for the monitoring of sports and physical activity. However, specialized wearable devices remain an open field for high-risk professionals, such as military personnel, fire and rescue, law enforcement, etc. In this work, a prototype wearable instrument, based on reconfigurable technologies and capable of monitoring electrocardiogram, oxygen saturation, and motion, is presented. This reconfigurable device allows a wide range of applications in conjunction with mobile devices. As a proof-of-concept, the reconfigurable instrument was been integrated into ad hoc glasses, in order to illustrate the non-invasive monitoring of the user. The performance of the presented prototype was validated against a commercial pulse oximeter, while several alternatives for QRS-complex detection were tested. For this type of scenario, clustering-based classification was found to be a very robust option.This work was funded by Banco Santander and Centro Mixto UGR-MADOC through project SIMMA (code 2/16). The contribution of Víctor Toral was funded by the University of Granada through a grant from the “Iniciación a la investigación 2016” program. The contribution of Antonio García was partially funded by Spain’s Ministerio de Educación, Cultura y Deporte (Programa Estatal de Promoción del Talento y su Empleabilidad en I+D+i, Subprograma Estatal de Movilidad, within Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016) under a “Salvador de Madariaga” grant (PRX17/00287). The contribution of Francisco J. Romero was funded by Spain’s Ministerio de Educación, Cultura y Deporte under a FPU grant (FPU16/01451). The contribution of Francisco M. Gómez-Campos was funded by Spain’s Ministerio de Economía, Industria y Competitividad under Project ENE2016_80944_R

Design of a specific physical training program for first-time participants in basic life support

Objetivo: diseñar un programa de entrenamiento físico específico para profesionales del soporte vital básico que permita superar la fatiga que éstos padecen durante el desarrollo de la reanimación cardiopulmonar con el fin de proporcionar un masaje cardiaco de mayor calidad durante periodos de tiempo más largos. Método: el entrenamiento interválico de alta intensidad mejora la capacidad física y la salud al tiempo que reduce los niveles de grasa y aumenta el metabolismo basal mediante la alternancia entre ejercicios de alta y baja intensidad mejorando la capacidad anaeróbica y la disponibilidad aeróbica, lo que hace de este tipo de entrenamiento una herramienta idónea para trabajar con los profesionales de la reanimación cardiopulmonar. Resultado: programa de entrenamiento por estaciones que combinando actividades dinámicas de alta intensidad, ejercicios de fuerza en los que se implica directamente la musculatura interviniente en la reanimación cardiopulmonar y ejercicios en los que se utiliza el propio simulador de reanimación cardiopulmonar, permite adecuarnos al entrenamiento de alta intensidad aumentando la fuerza y la funcionalidad. Conclusiones: la relación existente entre el ejercicio físico y la calidad de las técnicas de reanimación cardiopulmonar impone la necesidad de desarrollar estudios específicos de las rutas metabólicas y los grupos musculares específicos que participan en estas técnicas con el objetivo de generar un programa de entrenamiento físico específico para los profesionales que participan en esta actividad para mejorar la calidad de dichas técnicas e influir de forma positiva en la supervivencia de los pacientes afectados por un episodio de parada cardiorrespiratoria.Objective: to design a specific physical training program for basic life support professionals to overcome the fatigue they suffer during the development of cardiopulmonary resuscitation in order to provide a higher quality cardiac massage for longer periods. Method: high intensity interval training improves physical fitness and health, reduce fat levels and increase basal metabolism by high and low intensity exercises alternation, improving anaerobic capacity and aerobic availability, which make this type of training an ideal tool for working with cardiopulmonary resuscitation professionals. Result: a circuit training program that allow us for adapting to a high intensity interval training combining high intensity activities, strength exercises that work the participant musculature in cardiopulmonary resuscitation and exercises in which the cardiopulmonary resuscitation simulator is used. Conclusions: the connection between physical exercise and cardiopulmonary resuscitation techniques quality impose the need to develop specific studies of metabolic pathways and participant muscle groups in cardiopulmonary resuscitation to generate a specific physical training program for professionals who participate in this activity in order to improve these techniques quality and cardiorespiratory arrest survival

Analysis of the development of the forgetfulness curve within a program of training in Basic Life Support for students of the Degree of Medicine from de University of granada. Pilot study.

Objetivo: El objetivo del estudio es analizar la curva del olvido en el aprendizaje del Soporte Vital Básico en estudiantes de medicina de la Universidad de Granada. Material y métodos: Se trata de un estudio observacional, descriptivo transversal, que establece como población diana a los estudiantes de Grado de Medicina de la Universidad de Granada que cursan cuarto y quinto curso. Periodo de estudio comprendido entre octubre de 2015 y enero de 2017.Se emplearon los datos obtenidos en una evaluación inicial que se realizó en la Facultad de Medicina, y los de una reevaluación que se les realizó a una muestra de cada uno de los cursos. Se incluyeron en el estudio de forma voluntaria todos los alumnos matriculados en la asignatura bases de la medicina interna II para cada uno de los cursos académicos. El análisis se realizó utilizando medidas de tendencia central, tablas de frecuencias y posteriormente se realizó un análisis estadístico mediante la Prueba T de Student. Resultados: Los alumnos de cuarto consiguieron una media en la primera evaluación de 13,91 sobre 15 puntos, mientras que en la segunda la media fue de 13,81. Por otro lado, los alumnos de quinto consiguieron una media de 13,80 en la primera evaluación y una de 13,18 en la reevaluación. Estos datos nos hablan de que, a pesar de que los cursos resultaron muy satisfactorios en ambos cursos, encontramos un mayor impacto de la curva del olvido en alumnos que llevan más tiempo sin realizar un reciclaje en Soporte Vital Básico. Conclusiones: A pesar de existir una disminución de los conocimientos y habilidades relacionados con la práctica del soporte vital al año de recibir la formación específica en ambos grupos, no existen diferencias estadísticamente significativas para los sujetos de nuestro grupo que obliguen a establecer programas de reciclaje entre seis y nueve meses como establecen las recomendaciones actuales. A la luz de nuestro estudio, recomendamos el desarrollo de programas específicos de reciclaje en períodos de tiempo superiores a los doce meses después de recibir la formación inicial.Aim: The aim of this study was to analyze the oblivion curve after the learning of Basic Life Support (BLS) in medicine students from the University of Granada. Method: This was an observational, transversal descriptive study, which established as target population students from the Faculty of Medicine (University of Granada) who attended fourth and fifth year. The Study period comprised between October 2015 and January 2017. The data which was used was obtained in an initial evaluation that was done at the Faculty of Medicine and in a re-evaluation which was applied to a selected sample of students from each year. All the students included voluntarily in the study were enrolled in the subject Internal Medicine II. The analysis was carried out using measures of central tendency, frequency tables and after that, a statistical analysis using the Student´s T-test. Results: Fourth year students obtained an average in the first evaluation of 13,91 over 15 points, while in the second evaluation it was 13,81. Meanwhile, fifth year students achieved an average of 13,80 in the first evaluation and of 13,18 in the re-evaluation. This data speak of very satisfactory results for students in both years, although the impact of the oblivion curve is higher in students who have spent more time without taking a recycling course of BLS. Conclusions:.Even though there is a decrease of knowledge and abilities related to the practice of basic life support a year after receiving the specific training in both groups, there are not differences statistically significant for the subjects of our group that would make us establish recycling programs after six or nine months, as advice the actual recommendations. 2.Based on the results we obtained, we would recommend the development of specific recycling programs in periods of time bigger than twelve months after receiving the initial training

Dosis diaria definida de antimicrobianos en la población neonatal

Consumo de antimicrobianos; Prescripción de antimicrobianos en neonatos; NeonatologíaAntimicrobial consumption; Neonatal antimicrobial prescription; NeonatologyConsum d'antimicrobians; Prescripció d'antimicrobians a nounats; NeonatologiaBackground Antimicrobial defined daily dose (DDD), a standardized metric to assess antimicrobial consumption in adult population, has limitations hampering its use in neonatal patients. This study proposes an alternative DDD design applicable for neonates. Methods Neonates (<1 month-old) from 6 Spanish hospitals during a 12-months period were included. Weight and weeks gestational age of each neonate were the variables collected. DDD (g) for each antimicrobial was calculated by multiplying the obtained weight times the recommended dose (mg/kg) of the antimicrobial for the most common infectious indication selected by the Delphi method. Results A total of 4820 neonates were included. Mean age was 36.72 weeks of gestational age and Mean weight was 2.687 kg. Standardized DDD (intravenous; oral route) for representative antimicrobials were: Amoxicillin (0.08; 0.08), amoxicillin-clavulanic acid (0.27; 0.08), ampicillin (0.27; x), cloxacillin (0.13; 0.13), penicillin G sodium (0.12), cefazolin (0.13), cefuroxime (0.27; x), cefotaxime (0.27), ceftazidime (0.27), ceftriaxone (0.13), cefepime (0.27) piperacillin-tazobactam (0.54), aztreonam (0.24), azithromycin (0.03; 0.03), clindamycin (0.04; 0.04), amikacin (0.04), gentamicin (0.01), metronidazole (0.04; 0.08), ciprofloxacin (0.04; 0.05), levofloxacin (x;x), fluconazole (0.02; 0.02), itraconazole (0.01; 0.01), fosfomycin (0.27). Restricted antimicrobials: meropenem (0.11), teicoplanin (0.02), vancomycin (0.08; 0.11), linezolid (0.08; 0.08), daptomycin (x), amphotericin B liposomal (0.01). Conclusions A useful method for antimicrobial DDD measurement in neonatology has been designed to monitor antimicrobial consumption in hospital settings. It should be validated in further studies and thereby included in the design for neonatal antimicrobial stewardship programs in the future.Antecedentes La dosis diaria definida de antimicrobianos (DDD), un método estandarizado para evaluar el consumo de antimicrobianos en la población adulta, tiene limitaciones que dificultan su uso en la población neonatal. Este estudio propone un diseño alternativo de la DDD aplicable a los recién nacidos. Métodos Se incluyeron neonatos (< 1 mes) de 6 hospitales españoles durante un período de 12 meses. El peso y las semanas de edad gestacional de cada recién nacido fueron las variables recogidas. Las DDD (g) de cada antimicrobiano se calcularon multiplicando el peso obtenido por la dosis recomendada (mg/kg) del antimicrobiano para la indicación infecciosa más común seleccionada por el método Delphi. Resultados Se incluyeron un total de 4.820 recién nacidos. La edad media fue de 36,72 semanas de edad gestacional y el peso medio fue de 2,687 kg. La DDD estandarizado (intravenoso; oral) para antimicrobianos seleccionados fueron: amoxicilina (0,08; 0,08), amoxicilina-ácido clavulánico (0,27; 0,08), ampicilina (0,27; x), cloxacilina (0,13; 0,13), penicilina G sódica (0,12), cefazolina (0,13), cefuroxima (0,27; x), cefotaxima (0,27), ceftazidima (0,27), ceftriaxona (0,13), cefepima (0,27) piperacilina-tazobactam (0,54), aztreonam (0,24), azitromicina (0,03; 0,03) clindamicina (0,04; 0,04), amikacina (0,04), gentamicina (0,01), metronidazol (0,04; 0,08), ciprofloxacina (0,04; 0,05), levofloxacina (x; x), fluconazol (0,02; 0,02), itraconazol (0,01; 0,01), fosfomicina (0,27). Antimicrobianos restringidos: meropenem (0,11), teicoplanina (0,02), vancomicina (0,08; 0,11), linezolid (0,08; 0,08), daptomicina (x), anfotericina B liposomal (0, 01). Conclusiones Se ha diseñado un método útil para la medición de las DDD de antimicrobianos en neonatología para controlar el consumo de antimicrobianos en entornos hospitalarios. Debería validarse en estudios posteriores para incluirse en el diseño de los programas de administración de antimicrobianos neonatales en el futuro

Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome

BACKGROUND: Mechanical ventilation with a tidal volume (V(T)) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (P(plat)) lower than 30 cmH(2)O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low V(T) combined with extracorporeal carbon dioxide removal (ECCO(2)R). METHODS: In fifteen patients with moderate ARDS, V(T) was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure – (P(plat)) between 23 and 25 cmH(2)O. Low-flow ECCO(2)R was initiated when respiratory acidosis developed (pH < 7.25, PaCO(2) > 60 mmHg). Ventilation parameters (V(T), respiratory rate, PEEP), respiratory compliance (C(RS)), driving pressure (DeltaP = V(T)/C(RS)), arterial blood gases, and ECCO(2)R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO(2)R when PaO(2)/FiO(2) was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO(2)R were also collected. RESULTS: During the 2 h run in phase, V(T) reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH < 7.25) in all fifteen patients. At steady state, ECCO(2)R with an average blood flow of 435 mL/min and sweep gas flow of 10 L/min was effective at correcting pH and PaCO(2) to within 10 % of baseline values. PEEP values tended to increase at V(T) of 4 mL/kg from 12.2 to 14.5 cmH(2)O, but this change was not statistically significant. Driving pressure was significantly reduced during the first two days compared to baseline (from 13.9 to 11.6 cmH(2)O; p < 0.05) and there were no significant differences in the values of respiratory system compliance. Rescue therapies for life threatening hypoxemia such as prone position and ECMO were necessary in four and two patients, respectively. Only two study-related adverse events were observed (intravascular hemolysis and femoral catheter kinking). CONCLUSIONS: The low-flow ECCO(2)R system safely facilitates a low volume, low pressure ultra-protective mechanical ventilation strategy in patients with moderate ARDS

Implementation of a Training Program in Advanced Life Support within map competence of future students of Medicine, University of Granada

Objetivo: Analizar la primera experiencia de formación en soporte vital avanzado (SVA) en estudiantes de medicina, incluyéndola como asignatura de libre configuración siguiendo las normas de la European Resuscitation Council. Metodología: Estudio observacional descriptivo transversal. Los datos se recogieron de los alumnos que participaron en el curso de SVA, como asignatura de libre configuración, realizado en la facultad de medicina de la Universidad de Granada. Se recogieron mediante encuesta variables sociodemográficas, variables de aspectos específicos de calidad del curso, así como la consideración de los alumnos ante la posibilidad de implantación del SVA en los estudios de Grado en la facultad de medicina. (Escala de puntuación= 1 mínimo- 5 máximo). Resultados: Se encuestaron a los 25 alumnos que asistieron al curso y su evaluación fue: Evaluación global del curso= 5,0, docentes participantes=4,8+ 0,3, material empleado=4,2+ 0,5 y las instalaciones= 3,7+ 0,6. Necesidad de la implantación de la formación en soporte vital avanzado en los estudios de Grado= 84% imprescindible y el 16% recomendable. Formación de los docentes que impartan esta asignatura= 4% Formación específica en urgencias y emergencias, 4% Formación específica en soporte vital y el 92% formación específica en soporte vital y metodología de la formación. Espacios docentes específicos para la formación en soporte vital = 56% imprescindible, 40% recomendable y el 4% opcional. Escogería la asignatura=100% de alumnos respondió que SI. Posible dotación de créditos=4% 8 créditos, 80% 6 créditos y el 16% se mostró indiferente. Elección del año académico a impartir la asignatura=52% en quinto y el 48% en sexto. Necesidad de reciclaje= el 100% de los alumnos respondieron SI. Conclusiones: El grado de satisfacción con la acción formativa es muy elevado, destacando la valoraciòn a los docentes. Los alumnos consideran imprescindible que los docentes sean expertos clínicos en la atención al paciente en situación de PCR, y además dispongan de formación específica en metodología de la formación aplicada a la enseñanza del soporte vital. Además consideran que el desarrollo de un mapa competencial específico en soporte vital debe estar incorporado al curriculum formativo de cualquier estudiante del Grado de Medicina.Objective: To analyze the first training experience in advanced life support (ALS) in medical students, including it as a free elective course following the rules of the European Resuscitation Council. Method: This is a cross-sectional observational study. Data were collected from the students who participated in the course of ALS, as free elective course, held at the Faculty of Medicine of the University of Granada. Dates were collected: sociodemographic, specific aspects of quality of the course, as well as consideration of the students at the possibility of implementation of SVA in graduate studies in the faculty of medicine. (Rating scale = 1, minimum 5 maximum).Results: The 25 students who attended the course and its evaluation was surveyed was: Overall Course Evaluation = 5.0, participating teachers = 4.8 + 0.3, material used = 4.2 + 0.5 = 3 facilities, 7 + 0.6. Need for the implementation of training in advanced life support in the Degree = 84 % essential and 16% recommended. Training of teachers to impart this course = 4 % Specific training in emergency , 4 % Specific training in life support and 92% specific training in life support and training methodologies . Specific teaching areas for training in life support = 56 % essential, 40 % and 4% recommended optional. Choose the course = 100 % of students answered YES. Possible allocation of credits = 4% 8 credits 6 credits 80 % and 16% were indifferent. Election of the academic year to teach the subject = 52% in the fifth and sixth 48 %. Need for recycling = 100% of the students answered YES. Conclusions: The degree of satisfaction with the training is very high, highlighting the valuation teachers. The students believe that teachers must be skilled in clinical patient care at-PCR, and also have specific training in training methodology applied to the teaching of life support. Also to consider developing a specific competence map in life support should be incorporated into the training curriculum for any student of Degree of Medicine

Polarimetric imaging for the detection of synthetic models of SARS-CoV-2: A proof of concept

Objective: To conduct a proof-of-concept study of the detection of two synthetic models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using polarimetric imaging. Approach: Two SARS-CoV-2 models were prepared as engineered lentiviruses pseudotyped with the G protein of the vesicular stomatitis virus, and with the characteristic Spike protein of SARS-CoV-2. Samples were prepared in two biofluids (saline solution and artificial saliva), in four concentrations, and deposited as 5-µL droplets on a supporting plate. The angles of maximal degree of linear polarization (DLP) of light diffusely scattered from dry residues were determined using Mueller polarimetry from87 samples at 405 nm and 514 nm. A polarimetric camera was used for imaging several samples under 380–420 nm illumination at angles similar to those of maximal DLP. Per-pixel image analysis included quantification and combination of polarization feature descriptors in 475 samples. Main results: The angles (from sample surface) of maximal DLP were 3° for 405 nm and 6° for 514 nm. Similar viral particles that differed only in the characteristic spike protein of the SARS-CoV-2, their corresponding negative controls, fluids, and the sample holder were discerned at 10-degree and 15-degree configurations. Significance: Polarimetric imaging in the visible spectrum may help improve fast, non-contact detection and identification of viral particles, and/or other microbes such as tuberculosis, in multiple dry fluid samples simultaneously, particularly when combined with other imaging modalities. Further analysis including realistic concentrations of real SARS-CoV-2 viral particles in relevant human fluids is required. Polarimetric imaging under visible light may contribute to a fast, cost-effective screening of SARS-CoV-2 and other pathogens when combined with other imaging modalities.12 página