La formación del capital social en los ejidos mexicanos. Decisiones sobre las tierras tras el artículo 27 de la reforma constitucional

The Mexican ejidos are complex land-based structures developed by the post-revolutionary state formation (1915-1992). The success of some ejidos was based on trust ties. With the economic liberalization of the country and the changes to the national legal system in the early 1990s (specifically Article 27 reform in 1992), the state structures that ran the ejidos were reorganized, and individual land tenure strategies reappeared. In La Antigua (Veracruz), a majority of the ejidatarios (71%) reacted to this situation by adopting the dominio pleno (full domain) land tenure regime. In analyzing these features and their connections with diachronic social capital, this paper discusses the role of the national structures and institutions across generations and the destruction of trust in the ejidos. Specific ejido histories help to compare pre-ejido land strategies with the post-Article 27 reform strategies in effect today. It will be concluded that inefficient coordination of the micro, meso and macro levels of the state creates distrust and encourages individual action.Los ejidos mexicanos son complejas estructuras de propiedad colectiva de la tierra, desarrolladas por el Estado post-revolucionario (1915-1992). El éxito de algunos de estos ejidos ha estado basado en los lazos de confianza entre los campesinos. A principios de los noventa, la liberalización económica y la reforma del Artículo 27 Constitucional en 1992, favorecieron una reorganización de las estructuras del Estado que dirigían el ejido y la reaparición de estrategias individuales de tenencia de la tierra. El ejido de La Antigua (Veracruz) presenta la particularidad de que un 71% de los ejidatarios reaccionaron antes este escenario adoptando el régimen de dominio pleno de tenencia de la tierra. Este trabajo tiene como objetivo analizar la conexión entre esta situación y i) el capital social diacrónico existente en este ejido y ii) el papel de las estructuras e instituciones nacionales en la generación o destrucción de la confianza en los ejidos. El análisis de historias particulares de este ejido ayuda a comparar las estrategias anteriores a la formación ejidal con las devenidas tras la reforma del Artículo 27. Se llega a la conclusión de que la ineficiente coordinación de los niveles micro, meso y macro del Estado, ha generado desconfianza y hecho que los ejidatarios actúen de manera individualista

Implementación de la telemedicina en la asistencia sanitaria pediátrica durante la pandemia COVID-19

Introducción: La pandemia COVID-19 ha supuesto un retosocial, económico, pero sobre todo sanitario. La consulta telefónica que se inició durante el confinamiento, inicialmente en atención primaria y después, con la relajación de las medidas, en la atención hospitalaria, se ha implementado como opción asistencial. Se ha elaborado un estudio para intentar conocer la satisfacción de las familias y de los profesionales, así como aspectos de seguridad de esta opción asistencial. Materialy métodos: Se llevóa cabo una encuesta anónima afamiliares depacientes pediátricos y a profesionales sanitarios que recibieron y prestaron asistencia de manera telefónica entre mayo y diciembre de 2020 en un hospital de segundo nivelasistencial. Las variables se recogieron y analizaron mediante Excel y SPSS. Resultados: Las familias valoraron positivamente la atención en el 89,6 %yal 73,5 % le gustaría seguir teniendo un modelo de atención mixta e integrarían otros elementos de telemedicina. El 91,9 % entendiócorrectamente las explicaciones.Respecto a los profesionales sanitarios, el 85,7% estuvo de acuerdo con el sistema de atención mixto. Al 76,1% la consulta le resulta más eficiente, pero solo el 33% incrementaría la proporción de este tipo de consultas. El 52% creen que esta atención no repercute en la seguridad del paciente, aunque el 61,9% cree que sí lo hace negativamente en la formación de los médicos internos residentes. Conclusiones: Existe un elevado grado de satisfacción de pacientes y profesionales, estando ambos predispuestos a continuar con este modelo asistencial. Parece que la pandemia por SARS-CoV2ha impulsado la instauración definitiva de la telemedicina en las consultas pediátricas hospitalarias.Introduction and objectives:The COVID-19 pandemic has been a social, economic but above all health challenge. The telephone consultation that began during confinement, initially in primary care and later, with the relaxation of the measures, in hospital care, has been implemented as a care option. This study has been carried out to analyze the satisfaction of families and professionals as well as safety aspects of this care option. Material and methods:An anonymous survey was carried out on patients and health professionals who received and provided assistance by telephone between May 2020 and December 2020 in a second level hospital. The variables were collected and analyzed using Exceland SPSS. Results:89.6% of the families valued the care positively. 91.9% of them correctly understood the explanations. In addition, 73.5% of the families would like to continue having a mixed care model and would integrate other elements of telemedicine. Regarding healthprofessionals, 85.7% of them agreed with the mixed care system. For 76.1% of them, this model is more efficient, but only the 33% of them would increase telehealth. The 52% of professionals believe that this new model does not affect patient safety, although 61.9% of them believe that it does negatively affect the training of internal medical residents. Conclusions: There is a high degree of satisfaction of patients and professionals, both being predisposed to continue with this care model. It seems that the COVID-19 pandemic has prompted the definitive establishment of telemedicine in hospital pediatric consultations

Guía del Trabajo Fin de Grado (TFG): Grado en Nutrición Humana y Dietética

La asignatura trabajo fin de grado (TFG) es una materia transversal que se desarrolla asociada a una de las áreas de conocimiento relacionadas con el plan de estudios. En la tutorización del TFG del Grado en Nutrición Humana y Dietética (NHyD) están implicados diversos departamentos de carácter multidisciplinar. Este hecho enriquece a la titulación y abre un amplio abanico de posibilidades para la realización del TFG, pero a su vez dificulta las tareas de evaluación de forma equitativa. Con la finalidad de minimizar este aspecto y unificar tanto los modelos de TFG como los criterios de evaluación, se ha elaborado un documento general de rúbrica donde se recogen los aspectos evaluables y su peso en la puntuación global. En su elaboración ha participado una red de profesorado y alumnado de la UA compuesto por ocho profesores y un alumno del cuarto curso del grado en NHyD. Está previsto que el documento elaborado sea único y válido tanto para el profesorado tutor como para el tribunal de evaluación. El documento provisional se divide en dos o tres bloques (para el tribunal o tutor, respectivamente) para conseguir un sistema de evaluación común y unificado para todos los departamentos participantes

Coordinación y promoción del grado en estudios franceses: taller de teatro en lengua francesa

Memoria ID-301. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Predictors of clinically significant quality of life impairment in Parkinson’s disease

COPPADIS Study Group.Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R 2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.Mir P. has received honoraria from AbbVie, Abbott, Allergan, Bial, Merz, UCB and Zambon and have received grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575] co-founded by ISCIII (Subdirección General de Evaluación y Fomento de la Investigación) and by Fondo Europeo de Desarrollo Regional (FEDER), the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0437-2012, PI-0471-2013], the Sociedad Andaluza de Neurología, the Jacques and Gloria Gossweiler Foundation, the Fundación Alicia Koplowitz, the Fundación Mutua Madrileña.Peer reviewe

Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

COPPADIS Study Group.[Background and objective] The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD).[Patients and Methods] PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%.[Results] In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2.[Conclusions] In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.Fundación Curemos el Parkinson (www.curemoselparkinson.org).Peer reviewe

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson’s Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up

COPPADIS Study Group.[Background and Objective] Non-motor symptoms (NMS) progress in different ways between Parkinson’s disease (PD) patients. The aim of the present study was to (1) analyze the change in global NMS burden in a PD cohort after a 2-year follow-up, (2) to compare the changes with a control group, and (3) to identify predictors of global NMS burden progression in the PD group.[Material and Methods] PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017, were followed-up with after 2 years. The Non-Motor Symptoms Scale (NMSS) was administered at baseline (V0) and at 24 months ± 1 month (V2). Linear regression models were used for determining predictive factors of global NMS burden progression (NMSS total score change from V0 to V2 as dependent variable).[Results] After the 2-year follow-up, the mean NMS burden (NMSS total score) significantly increased in PD patients by 18.8% (from 45.08 ± 37.62 to 53.55 ± 42.28; p < 0.0001; N = 501; 60.2% males, mean age 62.59 ± 8.91) compared to no change observed in controls (from 14.74 ± 18.72 to 14.65 ± 21.82; p = 0.428; N = 122; 49.5% males, mean age 60.99 ± 8.32) (p < 0.0001). NMSS total score at baseline (β = −0.52), change from V0 to V2 in PDSS (Parkinson’s Disease Sleep Scale) (β = −0.34), and change from V0 to V2 in NPI (Neuropsychiatric Inventory) (β = 0.25) provided the highest contributions to the model (adjusted R-squared 0.41; Durbin-Watson test = 1.865).[Conclusions] Global NMS burden demonstrates short-term progression in PD patients but not in controls and identifies worsening sleep problems and neuropsychiatric symptoms as significant independent predictors of this NMS progression.This research was funded by Fundación Española de Ayuda a la Investigación en Parkinson y otras Enfermedades Neuro-degenerativas (Curemos el Parkinson; www.curemoselparkinson.org).Peer reviewe