Social investment in Spain: How do solidarity mutual funds decide the allocation of solidarity funding between social economy organizations?

Solidarity mutual funds (SMFs) are a financial product oriented toward funding social economy organizations (SEOs). The main characteristic of these mutual funds, known in other countries as social investment, is that part of their management fees is allocated to support SEOs. In Spain, the criteria used in the allocation process of these funds have not been studied. The aim of this paper is to analyze the decision model of SMFs. To this end, we developed a logit regression model. The obtained results show that the decision model of SMFs promotes the development of commercial activity and favors a specific ideology and values and an exclusive relationship with the main funders

Continuous and binary sets of responses differ in the field

This paper conducts a pre-registered study aimed to compare binary and continuous set of responses in survey questionnaires. Binary responses consist of two possible opposing response options (Yes/No). Continuous responses are numerical, where respondents can indicate an option on a 0–10 horizontal blind line. We study whether feasible sets of binary and continuous responses yield the same outcome (distribution) and have the same cost (duration in minutes). We collect data from 360 households in Honduras that were randomly assigned to Yes/No questions or given a slider (0–10 visual scale) to mark their responses, therefore, we provide causal evidence. We find that respondents are 13% more likely to respond “Yes” and spend 2.1 min less in the binary setting. Additionally, the results suggest that the type of question matters

Broadened Eligibility for Lung Cancer Screening: Challenges and Uncertainty for Implementation and Equity

In 2013, the US Preventive Services Task Force (USPSTF) recommended annual lung cancer screening with low-dose computed tomography (CT) in US adults aged 55 to 80 years who currently smoke or formerly smoked with a 30 pack-year history, and for those who formerly smoked, quitting within the past 15 years (grade “B” recommendation). In this issue of JAMA, the USPSTF updates this recommendation, proposing 2 significant changes, both related to the population recommended to undergo screening. The first change reduces the age at which to initiate annual screening from 55 to 50 years. The second change reduces the smoking intensity from 30 to 20 pack-year history. Thus, the USPSTF now “recommends annual screening for lung cancer with LDCT [low-dose CT] in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation)

Calidad de vida y función sexual en mujeres con disfunción del piso-pélvico del sur de Chile

Antecedentes/Objetivos: La disfunción del piso pélvico (DPP) es muy prevalente, afectando a un tercio de las mujeres adultas. Estas patologías no suponen un riesgo vital, pero sus síntomas pueden interferir con las actividades de la vida diaria incluyendo aspectos físicos, sociales y sexuales. En el sur de Chile, en el Hospital de alta complejidad (Regional-Concepción), se ha implementado la Unidad de Piso Pélvico (UPP). No hay evidencia sobre el efecto que supone en la calidad de vida y la función sexual de las mujeres que la padecen Describir la calidad de vida y función sexual de mujeres controladas en la Unidad de Piso Pélvico de un Hospital de alta complejidad en Chile. Métodos: Estudio transversal. Población: usuarias con DPP de la UPP del H. Regional-Concepción. Muestra 173. Variables: Caract. sociodemográficas, antecedentes obstétricos, tipo de DPP, Variables de Calidad de Vida (percepción del estado de salud, limitación emocional, limitación de actividades cotidianas, alteraciones de actividades sociales) (Short Form-12 Health Survey) y función sexual (PISQ-12). Análisis: medidas de dispersión, frecuencia absoluta- relativa. Resultados: Edad media 57 años, 88% con ingreso menor a 357€. 91% con IMC-sobrepeso y obesidad, 64% ≥ 3 hijos. Tipos DPP: 53% incontinencia de orina (IO), 35% prolapso vaginal (Pp), 12% IO+Pp. Calidad de vida (n = 173): Mala percepción de salud: 95%. Limitación emocional: 37%. Limitación de actividades cotidianas: 67%. Alteraciones de actividades sociales: 57% Función sexual (n = 95): Disfunción alta: 8,4%, moderada: 41,1%, baja 50,5%. El 15% nunca tuvo deseo-sexual los últimos 6 meses. El 14% admite no haber alcanzado el orgasmo en los últimos 6 meses, el mismo porcentaje admite no sentir excitación en el mismo período. El 19% admite no estar satisfechas con las actividades sexuales actuales, el 15% siente dolor durante las relaciones sexuales, el 40% admite sufrir de pérdidas de orina durante la actividad sexual, y el mismo número admite restringir su vida sexual debido al miedo de pérdida de orina durante el acto sexual. El 27% admite tener reacciones emocionales negativas durante las relaciones sexuales. El 10% y el 13% admite que sus parejas sufrían de disfunción eréctil y eyaculación, respectivamente. Por último, el 42% de las mujeres admite que sus orgasmos en los últimos 6 meses son más intensos. Conclusiones: Las mujeres con DPP presentan una alteración negativa de su calidad de vida y de su función sexual, aunque existe cierta incongruencia al valorar positivamente la calidad de los orgasmos cuando los demás aspectos de la vida sexual son negativos

Changes in Physician Knowledge, Attitudes, Beliefs, and Practices regarding Lung Cancer Screening

More patients die of lung cancer than breast, colorectal, and prostate cancers combined (1). After the National Lung Screening Trial finding of a 20% relative reduction in mortality of lung cancer with lung cancer screening (LCS) by low-dose computed tomography (LDCT) (2), the U.S. Preventive Services Task Force published recommendations for LCS in high-risk patients (current and former heavy smokers aged 55–80 yr) annually with LDCT (3)

Ordering in the dilute weakly-anisotropic antiferromagnet Mn(0.35)Zn(0.65)F2

The highly diluted antiferromagnet Mn(0.35)Zn(0.65)F2 has been investigated by neutron scattering in zero field. The Bragg peaks observed below the Neel temperature TN (approximately 10.9 K) indicate stable antiferromagnetic long-range ordering at low temperature. The critical behavior is governed by random-exchange Ising model critical exponents (nu approximately 0.69 and gamma approximately 1.31), as reported for Mn(x)Zn(1-x)F2 with higher x and for the isostructural compound Fe(x)Zn(1-x)F2. However, in addition to the Bragg peaks, unusual scattering behavior appears for |q|>0 below a glassy temperature Tg approximately 7.0 K. The glassy region T<Tg corresponds to that of noticeable frequency dependence in earlier zero-field ac susceptibility measurements on this sample. These results indicate that long-range order coexists with short-range nonequilibrium clusters in this highly diluted magnet.Comment: 7 pages, 5 figure

Mastectomía preservadora de piel con colgajo dermograso desepitelizado (técnica de Spira modificada) y reconstrucción mediante implante directo

Introducción La técnica de Spira es un tipo de mastectomía preservadora de piel que permite la reconstrucción inmediata (RMI), ideal en mamas ptósicas. Si bien, persiste controversia sobre resultados oncológicos en el cáncer de mama. El objetivo es analizar complicaciones, secuelas cosméticas, causas de reintervención y resultados oncológicos. Métodos Estudio observacional retrospectivo de pacientes intervenidas durante 2003-2018 en nuestro centro. La población de estudio la constituyen pacientes con carcinoma de mama o sometidas a mastectomía profiláctica por alto riesgo, en las que se realizó una mastectomía preservadora de piel con colgajo dermograso desepitelizado (técnica de Spira modificada) y reconstrucción mediante implante directo. Se analiza la presencia de complicaciones precoces y tardías, secuelas, recidiva tumoral y supervivencia. Resultados Se realizaron 247 mastectomías con reconstrucción en 139 pacientes, 216 bilaterales (87, 4%) y 31 unilaterales (12, 5%); 121 terapéuticas (49%) y 126 profilácticas (51%). La mediana de seguimiento fue de 81 meses. Se observaron complicaciones en un 16, 2%; necrosis cutánea en 5, 3% y cinco casos de necrosis del CAP (2%). La tasa de reintervención por secuelas cosméticas fue del 17, 4% (la más frecuente fue contractura capsular 11, 3%) y, de ellas, el 39, 3% recibieron RT. La tasa de recidiva fue del 14% (0, 8% cutánea, 3, 3% locorregional y 9, 9% a distancia). Ocho pacientes fallecieron (6, 6%). La SLE y SG fue del 92, 6% y 93, 3% a cinco años. Conclusión La técnica de Spira constituye una opción segura y ofrece buenos resultados cosméticos y oncológicos como tratamiento y profilaxis de cáncer de mama en mamas ptósicas de moderado a gran tamaño. Introduction: Spira technique is a type of nipple-sparing mastectomy that allows immediate reconstruction (IBR), ideal for ptosic breasts. Although, controversy persists regarding oncological results in breast cancer. The aim is to analyze complications, cosmetic outcomes, causes of reoperation and oncological results. Methods: Retrospective observational analysis of patients undergone surgery during 2003-2018 in our center. Study population is based on patients with breast carcinoma or undergoing prophylactic mastectomy due to high-risk, in which a skin-sparing mastectomy with a de-epithelialized derma-fat flap (modified Spira technique) and direct to implant reconstruction was performed. Short and long-term complications, sequelae, tumor recurrence and survival rates are analyzed. results: A total of 247 mastectomies with immediate reconstruction in 139 patients, 216 bilateral (87.4%) and 31 unilateral (12.5%) were performed. 121 therapeutic (49%) and 126 prophylactic (51%). Median follow-up 81 months. Complications were observed in 16.2%; skin necrosis 5.3% and 5 cases of NAC necrosis (2%). Reoperation rate due to cosmetic sequelae was 17.4% (capsular contracture was the most frequent, 11.3%) and a 39.3% of these patients have received RT. Recurrence of 14% (0.8% skin, 3.3% locoregional and 9.9% metastatic), 8 patients died (6.6%). Rates of FSD and OS were 92.6% and 93.3% respectively. Conclusion: Spira mastectomy is a safe option and provides good cosmetic and oncologic results as breast cancer treatment and prophylaxis in moderate-large ptosic breasts

Opinions and Practices of Lung Cancer Screening by Physician Specialty

BACKGROUND In response to the National Lung Screening Trial, numerous professional organizations published guidelines recommending annual lung cancer screening with low-dose computed tomography (LDCT) for high-risk patients. Prior studies found that physician attitudes and knowledge about lung cancer screening directly impacts the number of screening exams ordered.METHODS In 2015, we surveyed 34 pulmonologists and 186 primary care providers (PCPs) to evaluate opinions and practices of lung cancer screening in a large academic medical center. We compared PCP and pulmonologist responses using t-tests and χ2 tests.RESULTS The overall survey response rate was 40% (39% for PCPs and 50% for pulmonologists). Pulmonologists were more likely than PCPs to report lung cancer screening as beneficial for patients (88.2% versus 37.7%, P < .0001) and as being cost-effective (47.1% versus 14.3%, P = .02). More pulmonologists (76%) reported ordering a LDCT for screening in the past 12 months compared to PCPs (41%, P = .012). Pulmonologists and PCPs reported similar barriers to referring patients for lung cancer screening, including patient costs (82.4% versus 77.8%), potential for emotional harm (58.8% versus 58.3%), high false positive rate (47.1% versus 69.4%), and likelihood for medical complications (47.1% versus 59.7%).LIMITATIONS Our results are generalizable to academic medical centers and responses may be susceptible to recall bias, non-response bias, and social desirability bias.CONCLUSION We found significant differences in opinions and practices between PCPs and pulmonologists regarding lung cancer screening referrals and perceived benefits. As lung cancer screening continues to emerge in clinical practice, it is important to understand these differences across provider specialty to ensure screening is implemented and offered to patients appropriately

Opinions, practice patterns, and perceived barriers to lung cancer screening among attending and resident primary care physicians

Introduction: The US Preventive Services Task Force recommended annual lung cancer screening with low-dose computed tomography (LDCT) for high-risk patients in December 2013. We compared lung cancer screening-related opinions and practices among attending and resident primary care physicians (PCPs). Methods: In 2015, we conducted a 23-item survey among physicians at a large academic medical center. We surveyed 100 resident PCPs (30% response rate) and 86 attending PCPs (49% response rate) in Family Medicine and Internal Medicine. The questions focused on physicians’ opinions, knowledge of recommendations, self-reported practice patterns, and barriers to lung cancer screening. In 2015 and 2016, we compared responses among attending versus resident PCPs using chi-square/Fisher’s exact tests and 2-samples t-tests. Results: Compared with resident PCPs, attending PCPs were older (mean age =47 vs 30 years) and more likely to be male (54% vs 37%). Over half of both groups concurred that inconsistent recommendations make deciding whether or not to screen difficult. A substantial proportion in both groups indicated that they were undecided about the benefit of lung cancer screening for patients (43% attending PCPs and 55% resident PCPs). The majority of attending and resident PCPs agreed that barriers to screening included limited time during patient visits (62% and 78%, respectively), cost to patients (74% and 83%, respectively), potential for complications (53% and 70%, respectively), and a high false-positive rate (67% and 73%, respectively). Conclusion: There was no evidence to suggest that attending and resident PCPs had differing opinions about lung cancer screening. For population-based implementation of lung cancer screening, physicians and trainees will need resources and time to address the benefits and harms with their patients

Electromagnetic Transthoracic Nodule Localization for Minimally Invasive Pulmonary Resection

Background: Increased use of chest computed tomography and the institution of lung cancer screening have increased the detection of ground-glass and small pulmonary nodules. Intraoperative localization of these lesions via a minimally invasive thoracoscopic approach can be challenging. We present the feasibility of perioperative transthoracic percutaneous nodule localization using a novel electromagnetic navigation platform. Methods: This is a multicenter retrospective analysis of a prospectively collected database of patients who underwent perioperative electromagnetic transthoracic nodule localization before attempted minimally invasive resection between July 2016 and March 2018. Localization was performed using methylene blue or a mixture of methylene blue and the patient's blood (1:1 ratio). Patient, nodule, and procedure characteristics were collected and reported. Results: Thirty-one nodules were resected from 30 patients. Twenty-nine of 31 nodules (94%) were successfully localized. Minimally invasive resection was successful in 93% of patients (28/30); 7% (2/30) required conversion to thoracotomy. The median nodule size was 13 mm (interquartile range 25%-75%, 9.5-15.5), and the median depth from the surface of the visceral pleura to the nodule was 10 mm (interquartile range 25%-75%, 5.0-15.9). Seventy-one percent (22/31) of nodules were malignant. No complications associated with nodule localization were reported. Conclusions: The use of intraoperative electromagnetic transthoracic nodule localization before thoracoscopic resection of small and/or difficult to palpate lung nodules is safe and effective, potentially eliminating the need for direct nodule palpation. Use of this technique aids in minimally invasive localization and resection of small, deep, and/or ground-glass lung nodules