La trascendencia del poder en la negociación contractual y las desigualdades negociales

[Resumen] Se plantea la necesidad de analizar conforme a la moderna Teoría General del contrato, recurriéndose al análisis económico del Derecho y a los principios jurídicos el proceso de negociación contractual y las diferentes categorías contractuales (contratos discrecionales, contratos de adhesión y contratos de consumo), analizándose la proble- mática de las cláusulas y de la interpretación conforme a la Buena Fe.[Abstract] Arises the need to analyse according to modern General Theory of contract, use the economic analysis of the law and to the legal principles the process of contract nego- tiation and different contractual categories (contracts discretionary, membership con- tracts and contracts of consumption), analysed the problems of the clauses and the inter- pretation according to the Bona fides

Estudios en homenaje de Louise Fothergill-Payne: introducción

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COVID-19 and Unmet Healthcare Needs of Older People: Did Inequity Arise in Europe?

Background: The disruption in healthcare provision due to the COVID-19 pandemic forced many non-urgent medical treatments and appointments to be postponed or denied, which is expected to have huge impact on non-acute health conditions, especially in vulnerable populations such as older people. Attention should be paid to equity issues related to unmet needs during the pandemic. Methods: We calculated concentration indices to identify income-related inequalities and horizontal inequity in unmet needs due to postponed and denied healthcare in people over 50 during COVID-19, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Results: Very few countries show significant income-related inequalities in postponed, rescheduled or denied treatments and medical appointments, usually favouring the rich. Only Estonia, Italy and Romania show a significant horizontal inequity (HI) in postponed healthcare, which apparently favours the poor. Significant pro-rich inequity in denied healthcare is found in Italy, Poland and Greece. Conclusions: Although important income-related horizontal inequity in unmet needs of European older adults during the early waves of the COVID-19 pandemic is not evident for most countries, some of them have to carefully monitor barriers to healthcare access. Delays in diagnosis and treatments may ultimately translate into adverse health outcomes, reduced quality of life and, even, widen socio-economic health inequalities among older people

Social inequalities in health: measuring the contribution of housing deprivation and social interactions for Spain

Abstract Introduction Social factors have been proved to be main determinants of individuals’ health. Recent studies have also analyzed the contribution of some of those factors, such as education and job status, to socioeconomic inequalities in health. The aim of this paper is to provide new evidence about the factors driving socioeconomic inequalities in health for the Spanish population by including housing deprivation and social interactions as health determinants. Methods Cross-sectional study based on the Spanish sample of European Statistics on Income and Living Conditions (EU-SILC) for 2006. The concentration index measuring income-related inequality in health is decomposed into the contribution of each determinant. Several models are estimated to test the influence of different regressors for three proxies of ill-health. Results Health inequality favouring the better-off is observed in the distribution of self-assessed health, presence of chronic diseases and presence of limiting conditions. Inequality is mainly explained, besides age, by social factors such as labour status and financial deprivation. Housing deprivation contributes to pro-rich inequality in a percentage ranging from 7.17% to 13.85%, and social interactions from 6.16% to 10.19%. The contribution of some groups of determinants significantly differs depending on the ill-health variable used. Conclusions Health inequalities can be mostly reduced or shaped by policy, as they are mainly explained by social determinants such as labour status, education and other socioeconomic conditions. The major role played on health inequality by variables taking part in social exclusion points to the need to focus on the most vulnerable groups. JEL Codes H51, I14, I18</p

The male germ cell gene regulator CTCFL is functionally different from CTCF and binds CTCF-like consensus sites in a nucleosome composition-dependent manner

This is an Open Access article distributed under the terms of the Creative Commons Attribution License.-- et al.[Background]: CTCF is a highly conserved and essential zinc finger protein expressed in virtually all cell types. In conjunction with cohesin, it organizes chromatin into loops, thereby regulating gene expression and epigenetic events. The function of CTCFL or BORIS, the testis-specific paralog of CTCF, is less clear. [Results]: Using immunohistochemistry on testis sections and fluorescence-based microscopy on intact live seminiferous tubules, we show that CTCFL is only transiently present during spermatogenesis, prior to the onset of meiosis, when the protein co-localizes in nuclei with ubiquitously expressed CTCF. CTCFL distribution overlaps completely with that of Stra8, a retinoic acid-inducible protein essential for the propagation of meiosis. We find that absence of CTCFL in mice causes sub-fertility because of a partially penetrant testicular atrophy. CTCFL deficiency affects the expression of a number of testis-specific genes, including Gal3st1 and Prss50. Combined, these data indicate that CTCFL has a unique role in spermatogenesis. Genome-wide RNA expression studies in ES cells expressing a V5- and GFP-tagged form of CTCFL show that genes that are downregulated in CTCFL-deficient testis are upregulated in ES cells. These data indicate that CTCFL is a male germ cell gene regulator. Furthermore, genome-wide DNA-binding analysis shows that CTCFL binds a consensus sequence that is very similar to that of CTCF. However, only ~3,700 out of the ~5,700 CTCFL- and ~31,000 CTCF-binding sites overlap. CTCFL binds promoters with loosely assembled nucleosomes, whereas CTCF favors consensus sites surrounded by phased nucleosomes. Finally, an ES cell-based rescue assay shows that CTCFL is functionally different from CTCF. [Conclusions]: Our data suggest that nucleosome composition specifies the genome-wide binding of CTCFL and CTCF. We propose that the transient expression of CTCFL in spermatogonia and preleptotene spermatocytes serves to occupy a subset of promoters and maintain the expression of male germ cell genes.This work was supported by the Earth and Life Sciences (ALW) and Medical Sciences (ZonMw) divisions of the Netherlands Organization for Scientific Research (NWO), the Dutch Cancer Society (KWF), the Dutch Cancer Genomics Centre (CGC) and Centre for Biomedical Genetics (CBG), an EC Integrated Project (EuTRACC), and the Spanish Fondo Investigaciones Sanitarias.Peer Reviewe

Descentralización sanitaria y financiación autonómica: Incidencia en el período 1997 - 2000 y escenarios alternativos para el período 2002 - 2006

El presente documento de trabajo evalúa, partiendo de la distribución territorial completa de las competencias sanitarias bajo distintas hipótesis, los efectos financieros generados en la evolución de los recursos de las Comunidades Autónomas, mediante la comparación del actual sistema de financiación diferenciada de la sanidad con la situación de integración en el sistema de financiación general autonómica. El análisis contempla dos períodos, que coinciden con los quinquenios -actual y futuro- de financiación regional. Para el segundo período se consideran escenarios alternativos de financiación, que contemplan diversos cambios en la cesta de impuestos cedidos a las Comunidades Autónomas.

Desgaste profesional, estrés y abandono de la profesión en enfermería

Los sistemas sanitarios y sus profesionales se justifican en la medida que están al servicio de las personas y son capaces de dar respuesta a las necesidades de salud y a las expectativas de la comunidad. El reconocimiento a las enfermeras como un valor humano y profesional de primera magnitud dentro del sistema de salud de cualquier país, y en general a las profesiones sanitarias, se caracteriza por el compromiso, la vocación y el espíritu de servicio, y el mayor activo del sistema son los recursos humanos

Satisfacción en el trabajo y factores laborales en la profesión enfermera

La satisfacción se considera como un constructo de carácter multidimensional y asociada a la calidad de vida en términos de condiciones objetivas y componentes subjetivos, siendo inevitable la relación satisfacción laboral y conducta o acción. El análisis de la satisfacción en el trabajo (ST), como indicador del equilibrio entre trabajo y vida familiar, se entiende como el grado de bienestar percibido por el individuo, siendo un..