The ‘Dys-Appearing’ Body in Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough?

If the old body is usually read as a synonym of fragility and upcoming illness, even though not the case for most elderly citizens, the reality is that the longer we live, the increased probability of being affected by different illnesses cannot be eluded or denied. In Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough? the reader is invited to participate in the day-to-day routines of two aged female protagonists, as well as to empathize with their inner feelings as they go through their last life stage. In fact, their ‘dys-appearing’ bodies, marked by their respective terminal illnesses, force these characters to grow closer to those around them and to accept the help of their families and friends, despite their desire to keep their free will and independence until the very end. The analysis of the two novels within the framework of ageing studies aims to show the contradictions existing between a growing ageing society and the negative cultural connotations of old age in Western society and the need to revise them.

The effects of unemployment benefits on migration in lagging regions

[spa] En este trabajo se analizan los efectos sobre la movilidad geográfica de una política pública (SIPTEA) que aumenta la protección por desempleo en Extremadura y Andalucía. Utilizando la discontinuidad geográfica en la política estudiada y datos de los Censos de Población de 1981 y 1991 a nivel municipal, se estima el efecto de SIPTEA en el crecimiento de la población y en las probabilidades de emigrar e inmigrar en áreas rurales que experimentan elevadas tasas de paro y de emigración. Los resultados del trabajo indican que la política mitigó estas pérdidas de población aunque los efectos son cuantitativamente moderados. También se exploran los efectos de dicha política en el ámbito laboral, encontrándose un incremento de la tasa del desempleo asociado a la implementación de la política de entre 10 y 13 puntos porcentuales.

The effects of unemployment benefits on migration in lagging regions

[spa] En este trabajo se analizan los efectos sobre la movilidad geográfica de una política pública (SIPTEA) que aumenta la protección por desempleo en Extremadura y Andalucía. Utilizando la discontinuidad geográfica en la política estudiada y datos de los Censos de Población de 1981 y 1991 a nivel municipal, se estima el efecto de SIPTEA en el crecimiento de la población y en las probabilidades de emigrar e inmigrar en áreas rurales que experimentan elevadas tasas de paro y de emigración. Los resultados del trabajo indican que la política mitigó estas pérdidas de población aunque los efectos son cuantitativamente moderados. También se exploran los efectos de dicha política en el ámbito laboral, encontrándose un incremento de la tasa del desempleo asociado a la implementación de la política de entre 10 y 13 puntos porcentuales.

Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR study)

Background: Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care. Methods: Patients were recruited by general practitioners and randomized to community pharmacist intervention (87) that received an educational intervention and usual care (92). Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs), use of healthcare services and productivity losses were measured at baseline, 3 and 6 months. Results: There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the community pharmacist intervention compared with usual care was 1,866 for extra adherent patient and 9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP) is 30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective). From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is 30,000. Conclusion: A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.

The regional distribution of unemployment. What do micro-data tell us?

Regional disparities in unemployment rates are large and persistent. The literature provides evidence of their magnitude and evolution, as well as evidence of the role of certain economic, demographic and environmental factors in explaining the gap between regions of low and high unemployment. Most of these studies, however, adopt an aggregate approach and so do not account for the individual characteristics of the unemployed and employed in each region. This paper, by drawing on micro-data from the Spanish wave of the Labour Force Survey, seeks to remedy this shortcoming by analysing regional differentials in unemployment rates. An appropriate decomposition of the regional gap in the average probability of being unemployed enables us to distinguish between the contribution of differences in the regional distribution of individual characteristics from that attributable to a different impact of these characteristics on the probability of unemployment. Our results suggest that the well-documented disparities in regional unemployment are not just the result of regional heterogeneity in the distribution of individual characteristics. Non-negligible differences in the probability of unemployment remain after controlling for this type of heterogeneity, as a result of differences across regions in the impact of the observed characteristics. Among the factors considered in our analysis, regional differences in the endowment and impact of an individual’s education are shown to play a major role.

Identifying Specific Cues and Contexts Related to Smoking Craving for the Development of Effective Virtual Environments

Craving is considered the main variable associated with relapse after smoking cessation. Cue Exposure Therapy (CET) consists of controlled and repeated exposure to drug-related cues with the aim of extinguishing craving responses. Some virtual reality (VR) environments, such as virtual bars or parties, have previously shown their efficacy as tools for eliciting smoking craving. However, in order to adapt this technology to smoking cessation interventions, there is a need for more diverse environments that enhance the probability of generalization of extinction in real life. The main objective of this study was to identify frequent situations that produce smoking craving, as well as detecting specific craving cues in those contexts. Participants were 154 smokers who responded to an ad hoc self-administered inventory for assessing craving level in 12 different situations. Results showed that having a drink in a bar/pub at night, after having lunch/dinner in a restaurant and having a coffee in a cafe or after lunch/dinner at home were reported as the most craving-inducing scenarios. Some differences were found with regard to participants' gender, age, and number of cigarettes smoked per day. Females, younger people, and heavier smokers reported higher levels of craving in most situations. In general, the most widely cited specific cues across the contexts were people smoking, having a coffee, being with friends, and having finished eating. These results are discussed with a view to their consideration in the design of valid and reliable VR environments that could be used in the treatment of nicotine addicts who wish to give up smoking.

Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis

BACKGROUND & AIMS: The prognostic value of the different causes of renal failure in cirrhosis is not well established. This study investigated the predictive value of the cause of renal failure in cirrhosis. METHODS: Five hundred sixty-two consecutive patients with cirrhosis and renal failure (as defined by serum creatinine 1.5 mg/dL on 2 successive determinations within 48 hours) hospitalized over a 6-year period in a single institution were included in a prospective study. The cause of renal failure was classified into 4 groups: renal failure associated with bacterial infections, renal failure associated with volume depletion, hepatorenal syndrome (HRS), and parenchymal nephropathy. The primary end point was survival at 3 months. RESULTS: Four hundred sixty-three patients (82.4%) had renal failure that could be classified in 1 of 4 groups. The most frequent was renal failure associated with infections (213 cases; 46%), followed by hypovolemia-associated renal failure (149; 32%), HRS (60; 13%), and parenchymal nephropathy (41; 9%). The remaining patients had a combination of causes or miscellaneous conditions. Prognosis was markedly different according to cause of renal failure, 3-month probability of survival being 73% for parenchymal nephropathy, 46% for hypovolemia-associated renal failure, 31% for renal failure associated with infections, and 15% for HRS (P .0005). In a multivariate analysis adjusted for potentially confounding variables, cause of renal failure was independently associated with prognosis, together with MELD score, serum sodium, and hepatic encephalopathy at time of diagnosis of renal failure. CONCLUSIONS: A simple classification of patients with cirrhosis according to cause of renal failure is useful in assessment of prognosis and may help in decision making in liver transplantation.

Measuring the effects through time of the influence of visuomotor and visuotactile synchronous stimulation on a virtual body ownership illusion

Previous studies have examined the experience of owning a virtual surrogate body or body part through specific combinations of cross-modal multisensory stimulation. Both visuomotor (VM) and visuotactile (VT) synchronous stimulation have been shown to be important for inducing a body ownership illusion, each tested separately or both in combination. In this study we compared the relative importance of these two cross-modal correlations, when both are provided in the same immersive virtual reality setup and the same experiment. We systematically manipulated VT and VM contingencies in order to assess their relative role and mutual interaction. Moreover, we present a new method for measuring the induced body ownership illusion through time, by recording reports of breaks in the illusion of ownership ("breaks") throughout the experimental phase. The balance of the evidence, from both questionnaires and analysis of the breaks, suggests that while VM synchronous stimulation contributes the greatest to the attainment of the illusion, a disruption of either (through asynchronous stimulation) contributes equally to the probability of a break in the illusion.