Social cooperation and resource management dynamics among late hunter-fisher-gatherer societies in Tierra del Fuego (South America)

This paper presents the theoretical basis and first results of an agent-based model (ABM) computer simulation that is being developed to explore cooperation in hunter–gatherer societies. Specifically, we focus here on Yamana, a hunter-fisher-gatherer society that inhabited the islands of the southernmost part of Tierra del Fuego (Argentina–Chile). Ethnographical and archaeological evidence suggests the existence of sporadic aggregation events, triggered by a public call through smoke signals of an extraordinary confluence of resources under unforeseeable circumstances in time and space (a beached whale or an exceptional accumulation of fish after a low tide, for example). During these aggregation events, the different social units involved used to develop and improve production, distribution and consumption processes in a collective way. This paper attempts to analyse the social dynamics that explain cooperative behaviour and resource-sharing during aggregation events using an agent-based model of indirect reciprocity. In brief, agents make their decisions based on the success of the public strategies of other agents. Fitness depends on the resource captured and the social capital exchanged in aggregation events, modified by the agent’s reputation. Our computational results identify the relative importance of resources with respect to social benefits and the ease in detecting—and hence punishing—a defector as key factors to promote and sustain cooperative behaviour among populationSpanish Ministerio de Ciencia e Innovación (projects CONSOLIDER-INGENIO 2010 SimulPast-CSD2010-00034 and HAR2009-06996) as well as from the Argentine Consejo Nacional de Investigaciones Científicas y Técnicas (project PIP-0706) and the Wenner-Gren Foundation for Anthropological Research (project GR7846)

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Implante permanente de marcapasos en nonagenarios

Introducción: Debido al envejecimiento poblacional es cada vez mayor el número de personas de edad muy avanzada que requieren implante de marcapasos permanente como tratamiento de las enfermedades degenerativas del sistema de conducción eléctrica del corazón.Objetivo: Describir las características demográficas, clínicas y relacionadas con el proceder quirúrgico y su evolución en pacientes nonagenarios a los cuales se les implantó marcapasos permanente.Método: Estudio descriptivo, observacional y de corte transversal en pacientes nonagenarios procedentes del Servicio de Cardiología del Hospital Universitario “General Calixto García” a los cuales se les implantó un marcapasos permanente. Se analizaron variables demográficas, clínicas y relacionadas con el proceder y la evolución. Se utilizó estadística descriptiva para el análisis de los resultados.Resultados: Predominó el sexo femenino y la Hipertensión arterial como enfermedad asociada. El síntoma más frecuente fue el decaimiento, el bloqueo aurículo-ventricular de 3er grado la principal causa del implante. Más del 80% de los pacientes recibió el modo de estimulación VVI/VVIR. Se implantaron solo tres marcapasos reusados. Se presentaron complicaciones en 2 pacientes. Al año del implante habían fallecido 25 pacientes (44,6 %) por causas diferentes a la enfermedad cardiaca.Conclusiones: Se concluye que el implante de marcapasos en adultos nonagenarios implica tener en cuenta las características propias de este grupo poblacional lo cual tributa al manejo diferenciado.

Cambio climático y sus impactos en el Gran Caribe

Este libro recoge las experiencias del Primer Seminario sobre Cambio Climático y sus impactos en el Gran Caribe de 2019, dictado en la Universidad de La Habana, Cuba, y organizado por el Grupo de Trabajo de CLACSO "Crisis, Respuestas y Alternativas en el Gran Caribe" de conjunto con la Cátedra de Estudios del Caribe "Norman Girvan". Los ejes transversales que atraviesan a los artículos seleccionados son el papel de las políticas públicas en el enfrentamiento al cambio climático en el Gran Caribe; la articulación con movimientos sociales y activismo en el enfrentamiento al cambio climático en el Gran Caribe; y la necesidad de la construcción de redes que impacten incluso en el discurso global y las relaciones internacionales. Considérese que, para los países caribeños, en la formulación de política exterior y participación en foros internacionales sobre clima y medio ambiente, resulta central el reconocimiento de la pequeñez y vulnerabilidad del Caribe. Tal argumento es estratégico para el desarrollo de las negociaciones. Las posiciones regionales necesitan identificar similitudes para concurrir desde una posición Caribe y convencer a donantes internacionales sobre la urgencia de destinar fondos y apoyos a proyectos para la adaptación y mitigación. El Seminario fue una experiencia positiva en el esfuerzo de articular ciencias naturales y sociales en torno a un tema singular: el cambio climático y sus impactos. En la región falta mucho por hacer en términos de avanzar hacia una comprensión integral sobre el cambio climático desde esferas de lo político, jurídico y económico. Lo ambiental no puede verseaislado de lo social, la conciencia ambiental no puede formarse sin una dimensión social

Implementing stakeholder engagement to explore alternative models of consent: An example from the PREP-IT trials

Introduction: Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent. Methods: The PREP-IT program consists of two multi-center cluster randomized crossover trials that engaged patient advisors to determine an optimal model of consent. Patient advisors and stakeholders met regularly and reached consensus on decisions related to the trial design including the model for consent. Patient advisors provided valuable insight on how key decisions on trial design and conduct would be received by participants and the impact these decisions will have. Results: Patient advisors, together with stakeholders, reviewed the pros and cons and the requirements for the traditional model of consent, deferred consent, and waiver of consent. Collectively, they agreed upon a deferred consent model, in which patients may be approached for consent after their fracture surgery and prior to data collection. The consent rate in PREP-IT is 80.7%, and 0.67% of participants have withdrawn consent for participation. Discussion: Involvement of patient advisors in the development of an optimal model of consent has been successful. Engagement of patient advisors is recommended for other large trials where the traditional model of consent may not be optimal

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care