A Rapid Scoping Review of Gender Inequities in the Medical Profession

Introduction: There continue to be large inequities in the representation of women at progressive levels of training and seniority in both academic and community practice settings. Gender inequity in medicine is not only problematic in its own right but has the potential to deliver inequitable outcomes, including the neglect of important research and care that continues to disadvantage women patients. As significant evidence is emerging on gender inequities in the medical profession, it is an opportune time to review the current evidence on the persisting gaps, potential causes, and possible solutions. Methods: A rapid scoping review was conducted for articles on the topic of gender inequity and the medical profession in PubMed and Google Scholar. The search was limited to articles published from 1990 to the search date (June 1, 2017), and included only papers published in English. Results: An initial 1055 articles were screened according to established inclusion and exclusion criteria. After initial and full-text review, supplemented by a hand search through the article references, 45 articles were included in the review. Articles were classified as a) evidence for gender inequities, b) causes of inequities, and c) solutions for inequities. Only 13% of articles found (6 studies) addressed possible interventions to reduce inequities. Significant gaps exist in the literature, particularly around part-time work options, parental and family leave options, and ad-dressing implicit biases to reduce sexism in professional settings. Discussion: The evidence highlights substantial inequities in the representation of women in the medical profession, in both the academic and community settings, in medical literature, and in leadership positions. This review also highlighted substantial gaps in the literature on understanding what can be done to reduce these gaps. More research is needed in the area of gender inequities in medicine to improve the representation of women in medicine

What Factors Determine the Levels of Physical Activity after Cardiac Rehabilitation Program?

introdução: Os Programas de Reabilitação Cardíaca ganharam enorme relevância na prevenção de doenças cardiovasculares constituindo um desafio assegurar a prática de exercício físico regular durante e após o fim do programa supervisionado. O objetivo deste trabalho foi determinar os fatores que influenciam os hábitos de atividade física 12 meses após um Programa de Reabilitação Cardíaca.Material e Métodos: Estudo prospetivo abrangendo 580 doentes com cardiopatia isquémica consecutivamente orientados para Programas de Reabilitação Cardíaca na Unidade de Reabilitação Cardiovascular do Centro Hospitalar do Porto, entre Janeiro de 2008 e Junho de 2011. Avaliaram-se os níveis de atividade física através do International Physical Activity Questionnaire realizado no início do programa, aos 3 e 12 meses depois. Foram testados como potenciais determinantes dos hábitos de atividade física a longo prazo: idade; sexo; fatores de risco modificáveis; capacidade funcional (alcançada em prova de esforço); análises laboratoriais (HbA1c, perfil lipídico, Proteína C Reativa e Peptideo Natriurético Cerebral). Realizou-se análise de regressão linear para identificar os preditores significativos e encontrar o melhor ajuste do modelo.Resultados: A idade avançada, género feminino, a capacidade funcional, níveis de atividade física baixos previamente ao Programa de Reabilitação Cardíaca e uma fraca evolução do International Physical Activity Questionnaire durante o programa foram os melhores preditores univariáveis de uma evolução menos favorável do International Physical Activity Questionnaire nos 12 meses de follow-up. A análise de regressão linear multivariável concluiu que o melhor modelo explicativo incluía: idade, género, evolução do IPAQ no programa (R2 ajust = 0,318; f = 60,62; p < 0,001).Conclusão: A identificação de subgrupos de doentes com menor tendência à prática de atividade física permite desenvolver estratégias individualizadas, maximizando o potencial terapêutico e preventivo dos Programas de Reabilitação Cardíaca

A distributed man-machine dispatching architecture for emergency operations based on 3GPP mission critical services

With the number of non-human devices expected to significantly overtake human users of LTE networks, it is no surprise that First Responders in Mission Critical operations will need to interact with an increasing number of unmanned devices, “bots” or drones. In the paper we propose the Mission Critical “bot” concept as an entity capable of gathering environmental/situational information and triggering certain automated actions without the need of human intervention. We prove that in certain circumstances these bots can help quickly resolve emergency situations and complement traditional centralized coordination from Dispatch Control Rooms. We explain how such “bots” relate and expand the 3GPP Mission Critical Communications architecture framework, considering different architectural approaches and complexity levels. Importantly, because First Responders must remain focused, hands-free and context-aware most of the time, we cover specifically the case where man-machine interaction is based on voice communication without having to use hands or look at a screen. It is hence of particular interest to convert “bot” interactions into audio information exchanged over push-to-talk communication services, be it through the cellular network or leveraging the 3GPP device-to-device capability. The paper is complemented with theoretical use cases as well as description and multimedia material of a prototype implementation of a concept emulator.Peer ReviewedPostprint (published version

Efeitos a longo prazo de um programa de reabilitação cardíaca no controlo dos fatores de risco cardiovasculares

Os programas de reabilitação cardíaca visam melhorar a capacidade funcional do doente com patologia cardíaca, assim como educar e acompanhar no controlo dos seus fatores de risco cardiovasculares. Objetivo Avaliar os efeitos de um programa de reabilitação cardíaca em doentes com doença cardíaca isquémica ao longo de 12 meses de follow-up no que se refere ao controlo dos fatores de risco cardiovascular. Métodos Estudo prospetivo que inclui doentes com diagnóstico de doença cardíaca isquémica que completaram programa de reabilitação cardíaca baseado no exercício entre janeiro de 2008 a dezembro de 2009, sem perda de dados no follow-up. Foram avaliados num momento inicial (primeira consulta da fase ii) aos 3, 6 e 12 meses depois, com registo dos seguintes parâmetros: índice de massa corporal, circometria abdominal, perfil lipídico, HbA1c nos doentes diabéticos, tensão arterial, tabagismo e nível de atividade física (através do International Physical Activity Questionnaire). Resultados Amostra de 256 doentes (76,2%; idade média: 67 anos); a dislipidemia revelou-se o fator de risco mais prevalente (74,2%) seguido de excesso ponderal (71,5%). No final da fase ii ocorreu uma melhoria estatisticamente significativa (p < 0,05) em todos os fatores de risco estudados, que se manteve aos 6 e 12 meses de follow-up, com a exceção do IMC (perda do significado estatístico na avaliação dos 6 meses; p=0,92). Conclusão Este estudo salienta a necessidade de programas de reabilitação cardíaca no contexto da prevenção secundária da doença cardiovascular e a importância de implementar estratégias que potenciem a manutenção dos benefícios a longo prazo.Introduction Cardiac rehabilitation programs are designed to improve patients’ functional capacity, as well as to educate them and to monitor their cardiovascular risk factors. Aim The study aims to evaluate the effects of cardiac rehabilitation programs in patients with coronary disease over a 12-month follow-up period with regard to control of cardiovascular risk factors. Methods This was a prospective study of patients diagnosed with coronary disease who completed an exercise-based cardiac rehabilitation program between January 2008 and December 2009 and who were not lost to follow-up. Patients were evaluated at an early stage (first medical consultation in phase II of the program) and 3, 6 and 12 months later, the following parameters being assessed: weight and body mass index, waist circumference, lipid profile, HbA1c in diabetic patients, blood pressure, smoking status and physical activity (using the International Physical Activity Questionnaire). Results In the sample of 256 patients (76.2% male, mean age 67 years), dyslipidemia proved to be the most prevalent risk factor (74.2%), followed by overweight (71.5%). There was a statistically significant improvement (p<0.05) in all risk factors studied at the end of phase II of the program, which was maintained at 6 and 12 months of follow-up, with the exception of body mass index (loss of statistical significance at 6-month assessment, p=0.92). Conclusion This study highlights the need for cardiac rehabilitation programs in the context of secondary prevention of cardiovascular disease and the importance of implementing strategies that promote long-term maintenance of their benefits

Web browsing optimization over 2.5G and 3G: end-to-end mechanisms vs. usage of performance enhancing proxies

Published version on Wiley's platform: https://onlinelibrary.wiley.com/doi/abs/10.1002/wcm.4562.5 Generation (2.5G) and Third Generation (3G) cellular wireless networks allow mobile Internet access withbearers specifically designed for data communications. However, Internet protocols under-utilize wireless widearea network (WWAN) link resources, mainly due to large round trip times (RTTs) and request–reply protocolpatterns. Web browsing is a popular service that suffers significant performance degradation over 2.5G and 3G. Inthis paper, we review and compare the two main approaches for improving web browsing performance over wirelesslinks: (i) using adequate end-to-end parameters and mechanisms and (ii) interposing a performance enhancingproxy (PEP) between the wireless and wired parts. We conclude that PEPs are currently the only feasible way forsignificantly optimizing web browsing behavior over 2.5G and 3G. In addition, we evaluate the two main currentcommercial PEPs over live general packet radio service (GPRS) and universal mobile telecommunications system(UMTS) networks. The results show that PEPs can lead to near-ideal web browsing performance in certain scenarios.Postprint (published version

Eficiencia en el sector de las energías renovables: la energía hidroeléctrica y eólica

El presente trabajo comienza con un análisis del contexto mundial y nacional del sector de las energías renovables, centrándose especialmente en las energías hidroeléctricas y eólicas. Para llevar a cabo el análisis se presentan los principales datos económicos de la industria, su estructura y la localización geográfica de la producción. A continuación, se han extraído los datos de las empresas hidroeléctricas y eólicas a través de la base SABI y se han calculado sus índices de eficiencia a través de la estimación del modelo no paramétrico DEA. Además, una vez obtenidos estos índices, se ha realizado un estudio econométrico para obtener conclusiones acerca de la influencia de las variables “tamaño de la empresa” y “localización geográfica” en la eficiencia de las empresas. En base a los resultados obtenidos se llega a la conclusión de que las empresas hidroeléctricas de mayor tamaño y que pertenecen a Aragón son más eficientes, mientras que las empresas eólicas más eficientes son de tamaño medio y el hecho de pertenecer a Aragón no influye sobre sus índices de eficiencia.<br /

Risk factors for chronic kidney disease of non-traditional causes: a systematic review

Objectives. To evaluate the potential associations between chronic kidney disease of uncertain or nontraditional etiology (CKDnT) and agrochemicals, heat stress, heavy metals, and other factors identified in the literature in any region of the world and at any time. Methods. This was a systematic review of the most frequent exposures suspected to be possible causes of CKDnT. A search was conducted of PubMed, LILACS, World Wide Science electronic databases, among other sources. Only medium- and high-quality studies were included. The synthesis of evidence included a narrative synthesis, meta-analysis, and meta-regression. Results. Four systematic reviews and 61 primary studies were included. Results of the meta-analysis suggest that exposure to agrochemicals and working in agriculture increase the risk of CKDnT, but this only reached significance for working in agriculture. When cross-sectional studies were excluded, agrochemical exposure became significant. However, there is substantial heterogeneity in the effect sizes. Conclusions. Based on the existing evidence and the precautionary principle, it is important to implement preventive measures to mitigate the damage caused by CKDnT to both agricultural workers and their communities (i.e., improvement of working conditions, cautious management of agrochemicals, etc.). More high-quality research is needed to measure impact and to build the evidence base.Facultad de Ciencias Médica

Evaluation of the application of not traumatic linking and learning techniques in two races of horses

Existe un conjunto de prácticas que permiten la familiarización del potrillo con el entorno, además de facilitar la detección y el diagnóstico de enfermedades, malformaciones y/o lesiones posparto (Gónzalez del Pino et al, 2009). Se conocen como Técnicas de Vinculación y Aprendizaje no Traumáticas (TVANT) y son realizadas mediante un contacto diario, tanto con el potrillo como con su madre, implicando una revisión habitual a cada individuo desde el día 7 al 14 desde el nacimiento. Nuestra experiencia en raza Criolla ha mostrado que las TVANT producen resultados satisfactorios (Abbiati et al, 2016). El objetivo de este trabajo fue comparar la duración del proceso para las razas Criolla y Silla Argentino en las maniobras de las TVANT.Facultad de Ciencias Veterinaria