From cocooning to Skyping: An ethnographic study of young children's everyday mobilities in an English town

‘From cocooning to Skyping: an ethnographic study of mobilities in young children’s everyday lives in an English town’ posits the question of how the movements of people, objects, ideas, information and images through physical, virtual, communicative and imaginative means are practiced, experienced and represented by and in relation to young children, in a small English town that I will call Wishwell. This question involves identifying the manifold forms of mobilities that shaped young children’s lives in this particular location: from babies bodily movements and everyday trips within town, to journeys to other countries, cards and parcels sent and received through the post, and videoconferencing on Skype. It also involves tracing the varied places, people and things to which children were connected through these mobilities, and the discourses and representation of childhood and mobility that gave meaning to young children’s mobile experiences and practices. The research question acknowledges children as positioned in relation to phenomena beyond their immediate space of perception, but at the same time it highlights the necessity to empirically explore how these connections are made and experienced, rather than taking them for granted. Therefore, the ‘from’ and ‘to’ on this title do not denote a progressive and linear movement through life cycle stages. Instead, it highlights the diverse range of overlapping and interdependent means and scales of movement that I encountered

Movilidades infantiles en pandemia: develando espacialidades invisibles de la niñez en Latinoamérica

Una diversidad de formas y escalas interdependientes de movilidad constituyen lo que entendemos por vida social. La actual pandemia ha revelado espacialidades y movilidades esenciales en la vida cotidiana de la niñez, usualmente invisibilizadas, así como diferentes formas en que estas movilidades están interconectadas. En este artículo reflexionamos sobre cómo las medidas adoptadas frente a la pandemia en Brasil, Chile y Colombia están reconfigurando las movilidades y espacialidades de la niñez en estos contextos caracterizados por agudas desigualdades socioeconómicas, revelando además aspectos del cotidiano de la niñez y sus movilidades ignoradas o poco presentes en estudios de infancia y movilidades, en general. Analizar la reconfiguración de la vida de niñez en pandemia desde una perspectiva de movilidades nos lleva a enfatizar la relevancia de sus micro-movilidades, por ejemplo, en el espacio doméstico, lo cual ilustramos con dos cartografías de bebés desarrolladas en Brasil y Colombia, antes y durante la pandemia.

Fluorosis dental en escolares y exploración de factores de riesgo. Municipio de Frontino, 2003

ABSTRACT: The purposes of this study were: 1. To determine the prevalence and distribution of dental fluorosis in schoolchildren ages 8-12 and 15 years of age in the town of Frontino-Colombia, 2. To explore the behavior of the risk factors associated with dental fluorosis (fluoride concentration in the water, salt and toothpastes). Dental fluorosis was evaluated in a representative sample of 810 schoolchildren distributed in 4 geographic strata according to the previous knowledge on cases of reported dental fluorosis. The Thylstrup and Fejerskov index (TFI) was used for the classification of clinical findings. The water samples collected (33) from the most recognized sources by urban and rural inhabitants as well as salt samples (38) were analyzed using the direct method, and the toothpaste samples by the microdiffusion method (HDMS). The prevalence of dental fluorosis was 67%, being 1-3 levels the most frequent ones. Fluoride concentrations in all the water samples were under 0.05mg/L. Among the salt samples collected from the town grocery stores and homes, 60.4%, did not comply with the norm on fluoride.RESUMEN: Los objetivos de la investigación fueron: 1) determinar la prevalencia y distribución de la fluorosis dental en escolares de 8-12 y 15 años de edad del municipio de Frontino, 2) explorar el comportamiento de los factores de riesgo asociados con fluorosis (concentración de flúor en agua, sal y cremas dentales). La fluorosis se evalúo en una muestra representativa de 810 escolares, distribuidos en 4 estratos geográficos de acuerdo con el conocimiento previo sobre casos de fluorosis reportados; para la clasificación de los hallazgos clínicos se utilizó el índice de Thylstrup y Fejerskov (TFI). Las muestras de agua recolectadas (33) de las fuentes más reconocidas por los pobladores rurales y urbanos, así como las muestras de sal (48), fueron analizadas mediante el método directo y las de crema dental (27) mediante el método de microdifusión (HMDS). La prevalencia de fluorosis dental fue del 67%, siendo los grados 1-3 los más frecuentes. Las concentraciones de flúor en todas las muestras de agua estuvieron por debajo de 0,05 mg/L. El 60,4% de las muestras de sal recolectadas en hogares y expendios del municipio, no cumplía con la norma sobre concentración de flúor establecida en Colombia. La concentración promedio de flúor en las muestras de crema dental fue de 1.504 + 387 ppm. Se concluye que el problema de fluorosis se explica por una ingesta múltiple de flúor proveniente de la sal de cocina y de las cremas dentales. Se requiere vigilancia permanente del programa de fluoruración de sal y educación a la comunidad y a los profesionales para la correcta utilización de los productos fluorurados

Impact of treatment and clinical characteristics on the survival of children with medulloblastoma in Mexico

IntroductionData on medulloblastoma outcomes and experiences in low- and middle-income countries, especially in Latin America, is limited. This study examines challenges in Mexico’s healthcare system, focusing on assessing outcomes for children with medulloblastoma in a tertiary care setting.MethodsA retrospective analysis was conducted, involving 284 patients treated at 21 pediatric oncology centers in Mexico.ResultsHigh-risk patients exhibited markedly lower event-free survival than standard-risk patients (43.5% vs. 78.3%, p<0.001). Influential factors on survival included anaplastic subtype (HR 2.4, p=0.003), metastatic disease (HR 1.9, p=0.001); residual tumor >1.5cm², and lower radiotherapy doses significantly impacted event-free survival (EFS) and overall survival (OS). Platinum-based chemotherapy showed better results compared to the ICE protocol in terms of OS and EFS, which was associated with higher toxicity. Patients under 3 years old displayed notably lower OS and EFS compared to older children (36.1% vs. 55.9%, p=0.01)

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

The CARMENES search for exoplanets around M dwarfs Guaranteed time observations Data Release 1 (2016-2020)

I. Ribas et al.[Context] The CARMENES instrument, installed at the 3.5 m telescope of the Calar Alto Observatory in Almería, Spain, was conceived to deliver high-accuracy radial velocity (RV) measurements with long-term stability to search for temperate rocky planets around a sample of nearby cool stars. Moreover, the broad wavelength coverage was designed to provide a range of stellar activity indicators to assess the nature of potential RV signals and to provide valuable spectral information to help characterise the stellar targets.[Aims] We describe the CARMENES guaranteed time observations (GTO), spanning from 2016 to 2020, during which 19 633 spectra for a sample of 362 targets were collected. We present the CARMENES Data Release 1 (DR1), which makes public all observations obtained during the GTO of the CARMENES survey.[Methods] The CARMENES survey target selection was aimed at minimising biases, and about 70% of all known M dwarfs within 10 pc and accessible from Calar Alto were included. The data were pipeline-processed, and high-level data products, including 18 642 precise RVs for 345 targets, were derived. Time series data of spectroscopic activity indicators were also obtained.[Results] We discuss the characteristics of the CARMENES data, the statistical properties of the stellar sample, and the spectroscopic measurements. We show examples of the use of CARMENES data and provide a contextual view of the exoplanet population revealed by the survey, including 33 new planets, 17 re-analysed planets, and 26 confirmed planets from transiting candidate follow-up. A subsample of 238 targets was used to derive updated planet occurrence rates, yielding an overall average of 1.44 ± 0.20 planets with 1 M⊕ < Mpl sin i < 1000 M⊕ and 1 day < Porb < 1000 days per star, and indicating that nearly every M dwarf hosts at least one planet. All the DR1 raw data, pipeline-processed data, and high-level data products are publicly available online.[Conclusions] CARMENES data have proven very useful for identifying and measuring planetary companions. They are also suitable for a variety of additional applications, such as the determination of stellar fundamental and atmospheric properties, the characterisation of stellar activity, and the study of exoplanet atmospheres.CARMENES is an instrument at the Centro Astronómico Hispano en Andalucía (CAHA) at Calar Alto (Almería, Spain), operated jointly by the Junta de Andalucía and the Instituto de Astrofísica de Andalucía (CSIC). CARMENES was funded by the Max-Planck-Gesellschaft (MPG), the Consejo Superior de Investigaciones Científicas (CSIC), the Ministerio de Economía y Competitividad (MINECO) and the European Regional Development Fund (ERDF) through projects FICTS-2011-02, ICTS-2017-07-CAHA-4, and CAHA16-CE-3978, and the members of the CARMENES Consortium (Max-Planck-Institut für Astronomie, Instituto de Astrofísica de Andalucía, Landessternwarte Königstuhl, Institut de Ciències de l’Espai, Institut für Astrophysik Göttingen, Universidad Complutense de Madrid, Thüringer Landessternwarte Tautenburg, Instituto de Astrofísica de Canarias, Hamburger Sternwarte, Centro de Astrobiología and Centro Astronómico Hispano-Alemán), with additional contributions by the MINECO, the Deutsche Forschungsgemeinschaft (DFG) through the Major Research Instrumentation Programme and Research Unit FOR2544 “Blue Planets around Red Stars”, the Klaus Tschira Stiftung, the states of Baden-Württemberg and Niedersachsen, and by the Junta de Andalucía. We acknowledge financial support from the Spanish Agencia Estatal de Investigación of the Ministerio de Ciencia e Innovación (AEI-MCIN) and the ERDF “A way of making Europe” through projects PID2020-117493GB-I00, PID2019-109522GB-C5[1:4], PID2019-110689RB-I00, PID2019-107061GB-C61, PID2019-107061GB-C64, PGC2018-098153-B-C33, PID2021-125627OB-C31/AEI/10.13039/501100011033, and the Centre of Excellence “Severo Ochoa” and “María de Maeztu” awards to the Institut de Ciències de l’Espai (CEX2020-001058-M), Instituto de Astrofísica de Canarias (CEX2019-000920-S), Instituto de Astrofísica de Andalucía (SEV-2017-0709), and Centro de Astrobiología (MDM-2017-0737). We also benefited from additional funding from: the Secretaria d’Universitats i Recerca del Departament d’Empresa i Coneixement de la Generalitat de Catalunya and the Agència de Gestió d’Ajuts Universitaris i de Recerca of the Generalitat de Catalunya, with additional funding from the European FEDER/ERDF funds, and from the Generalitat de Catalunya/CERCA programme; the DFG through the Major Research Instrumentation Programme and Research Unit FOR2544 “Blue Planets around Red Stars” (RE 2694/8-1); the University of La Laguna through the Margarita Salas Fellowship from the Spanish Ministerio de Universidades ref. UNI/551/2021-May-26, and under the EU Next Generation funds; the Gobierno de Canarias through projects ProID2021010128 and ProID2020010129; the Spanish MICINN under Ramón y Cajal programme RYC-2013-14875; the “Fondi di Ricerca Scientifica d’Ateneo 2021” of the University of Rome “Tor Vergata”; and the programme “Alien Earths” supported by the National Aeronautics and Space Administration (NASA) under agreement No. 80NSSC21K0593. TPeer reviewe

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Movilidades infantiles en pandemia: develando espacialidades invisibles de la niñez en Latinoamérica

A diversity of interdependent types and scales of mobility constitute what we know as social life. The current pandemic is revealing everyday mobilities and spatialities in children's lives that usually remain invisible, as well as the ways in which they are interconnected. In this paper we reflect upon how the measures taken for facing the pandemic in Brazil, Chile and Colombia are reconfiguring children¦s mobilities and spatialities in these highly unequal contexts, unveiling aspects of children's everyday lives and mobilities usually ignored or rarely present in childhoods and mobilities studies in general. Analyzing the reconfiguration of the infant's life in pandemic from a mobility perspective leads us to emphasize the relevance of their micro-mobilities, for example in the domestic space, which we illustrate with two cartographies of babies developed in Brazil and Colombia, before and during the pandemic.Diversas formas e escalas de mobilidade interdependentes constituem o que entendemos por vida social. A atual pandemia revelou espacialidades e mobilidades essenciais no cotidiano das crianas, geralmente invisÝveis, bem como diferentes formas de interligaNo destas mobilidades. Neste artigo refletimos sobre a forma como as medidas adotadas em resposta Ó pandemia no Brasil, Chile e Col?mbia reconfiguram as mobilidades e espacialidades das crianas nestes contextos caracterizados por graves desigualdades socioecon?micas, revelando aspectos do cotidiano das crianas e das suas mobilidades que foram ignorados ou pouco presentes nos estudos sobre a infÔncia e as mobilidades em geral. Analisar a reconfiguraNo da vida infantil na pandemia sob a ?tica da mobilidade nos leva a enfatizar a relevÔncia de suas micro-mobilidades, por exemplo no espao domÚstico, que ilustramos com duas cartografias de bebrs desenvolvidas no Brasil e na Col?mbia, antes e durante a pandemia.Una diversidad de formas y escalas interdependientes de movilidad constituyen lo que entendemos por vida social. La actual pandemia ha revelado espacialidades y movilidades esenciales en la vida cotidiana de la ni?ez, usualmente invisibilizadas, asÝ como diferentes formas en que estas movilidades estßn interconectadas. En este artÝculo reflexionamos sobre c?mo las medidas adoptadas frente a la pandemia en Brasil, Chile y Colombia estßn reconfigurando las movilidades y espacialidades de la ni?ez en estos contextos caracterizados por agudas desigualdades socioecon?micas, revelando ademßs aspectos del cotidiano de la ni?ez y sus movilidades ignoradas o poco presentes en estudios de infancia y movilidades, en general. Analizar la reconfiguraci?n de la vida de ni?ez en pandemia desde una perspectiva de movilidades nos lleva a enfatizar la relevancia de sus micro-movilidades, por ejemplo, en el espacio domÚstico, lo cual ilustramos con dos cartografÝas de bebÚs desarrolladas en Brasil y Colombia, antes y durante la pandemia