Forensic intelligence-led prevention of drug-facilitated sexual assaults.

This work explores the potentially broader contribution of forensic science to preventive public health through the proactive view promoted by forensic intelligence. For that purpose, a new working framework is applied as a strategic tool that channelizes forensic intelligence in a more understandable and didactic way for decision-makers, guiding preventive crime processes. Concretely, the implementation of this operational framework focuses on preventing drug-facilitated sexual assaults in the nightlife context. Through a two-stage research scheme, the working framework is used as a study tool for understanding this violent phenomenon and as a strategic thinking and action platform for overcoming it. Forensic intelligence-guided actions significantly enhanced institutional and direct support facing this specific form of sexual violence. Awareness messages targeting potential assailants, witnesses, and victims reached more than half a thousand students from the university and pre-university education through a preventive intervention within the educational system. Moreover, the inter-professional dialogue between forensic science and other health, security, and education disciplines shows the broader proactive role of forensic science beyond the traditional retroactive view limited to courtrooms and intelligence-led policing. This study demonstrates as forensic intelligence becomes applicable for civilians, who participate as decision-makers in intelligence-led preventive processes, anticipating the need for intervention by police and judicial authorities.Ministerio de Sanidad (Delegación del Gobierno para el Plan Nacional sobre Drogas) e Instituto Universitario de Investigación en Ciencias Policiales (UAH, IUICP

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Alcalá : tres religiones, una cultura

Este material muestra la convivencia, el respeto y la tolerancia en que vivieron tres comunidades diferentes, cristiana, judía y musulmana en Alcalá de Henares durante los siglos XII, XIV, XV y principios del XVI. El objetivo es educar en la interculturalidad, fomentando en los alumnos actitudes de curiosidad, conocimiento y respeto hacia otras culturas, para así poder superar los prejuicios y defender los derechos de las personas. El documento se centra en varios aspectos de las relaciones entre las tres comunidades, como la religión, las actividades laborales, la cultura, los centros importantes y las leyes. Se incluye un pequeño vocabulario, actividades de profundización y varios planos de la ciudad de distintas épocas.MadridES

V Premio Nacional de Educación para el Desarrollo “Vicente Ferrer” 2014 : buenas prácticas

Ed. especial 25 aniversario de la AECIDTít. de la cubierta: V Premio Nacional de Educación Para el Desarrollo "Vicente Ferrer"La AECID junto con el Ministerio de Educación, Cultura y Deporte convoca anualmente los premios de educación para el desarrollo que están dirigidos a todos los centros docentes españoles sostenidos con fondos públicos que impartan educación infantil, educación primaria, educación secundaria obligatoria, bachillerato y formación profesional. Se recogen las buenas prácticas de los docentes premiados en esta sexta edición. Docentes que en el ejercicio de su función educadora han convertido el proceso educativo en un proceso dinámico e interactivo que permite al alumnado desarrollar un conocimiento crítico de nuestro mundo. Profesores y profesoras que han estimulado la participación del alumnado en la construcción de estructuras sociales más justas y solidarias, y han promovido actuaciones basadas en el principio de la corresponsabilidad de todos los actores implicados. El premio reconoce el esfuerzo realizado por centros educativos que establecen y creen en un modelo educativo que propone resaltar el papel de las personas y generar conciencias de carácter global que permitan al alumnado ser pieza clave de la ciudadanía del futuro, con un dinamismo que afronte las nuevas realidades desde una perspectiva más humana y responsable con el territorio en el que se ubican.ES

Effect of accompanying antiretroviral drugs on virological response to pegylated interferon and ribavirin in patients co-infected with HIV and hepatitis C virus

The effects of antiretroviral drugs on the response to pegylated interferon plus ribavirin remain uncertain. We evaluated whether antiretroviral drugs affected the response to pegylated interferon plus ribavirin in patients co-infected with HIV and hepatitis C virus (HCV). We conducted a retrospective analysis of two cohorts of HIV/HCV-co-infected patients treated with pegylated interferon plus ribavirin between 2001 and 2007 in Spain. The outcome measure was sustained virological response (SVR). Logistic regression models were used to test possible associations between non-response and pre-treatment characteristics, including accompanying antiretroviral drugs. The study sample comprised 1701 patients: 63% were infected with HCV genotype (G) 1 or 4 and 88% were taking highly active antiretroviral therapy (HAART). Factors independently associated with increased odds of SVR were G2 or 3, HVC RNA <500,000 IU/mL and CDC clinical category A or B. When we adjusted for these prognostic factors and dose of ribavirin/kg, the adjusted odds ratio (AOR) of SVR for patients without HAART was 1.31 [95% confidence interval (CI) 0.91-1.88; P = 0.144]. Taking the backbone of tenofovir and lamivudine/emtricitabine as a reference, we found that, with the exception of regimens including zidovudine, the effect of other nucleoside reverse transcriptase inhibitor backbones had little effect on SVR. The AOR of SVR for zidovudine and lamivudine was 0.65 (95% CI 0.46-0.93, P = 0.017). We carried out several sensitivity analyses, the results of which were consistent with the findings of the primary analysis. In conclusion, our results suggest that, with the exception of regimens including zidovudine, accompanying antiretroviral drugs have little effect on the virological response to pegylated interferon plus ribavirin in HIV/HCV-co-infected patients.5.068 JCR (2011) Q1, 7/70 Infectious diseases, 18/114 Microbiology, 20/261 Pharmacology & pharmac

Comparison of 1-year outcome in patients with severe aorta stenosis treated conservatively or by aortic valve replacement or by percutaneous transcatheter aortic valve implantation (data from a multicenter Spanish registry)

The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77.3 ± 10.6 years, and 377 were women (51.8%). The most common management was conservative therapy in 468 (64.5%) followed by AVR in 199 (27.4%) and TAVI in 59 (8.1%). The strongest association with aortic valve intervention was patient management in a tertiary hospital with cardiac surgery (odds ratio 2.7, 95% confidence interval 1.8 to 4.1, p <0.001). The 2 main reasons to choose conservative management were the absence of significant symptoms (136% to 29.1%) and the presence of co-morbidity (128% to 27.4%). During 1-year follow-up, 132 patients died (18.2%). The main causes of death were heart failure (60% to 45.5%) and noncardiac diseases (46% to 34.9%). One-year survival for patients treated conservatively, with TAVI, and with AVR was 76.3%, 94.9%, and 92.5%, respectively, p <0.001. One-year survival of patients treated conservatively in the absence of significant symptoms was 97.1%. In conclusion, most patients with severe AS are treated conservatively. The outcome in asymptomatic patients managed conservatively was acceptable. Management in tertiary hospitals is associated with valve intervention. One-year survival was similar with both interventional strategies