The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

Background: Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours. Methods: We conducted a prospective randomised clinical trial on patients undergoing thyroid surgery. Patients were randomly assigned to a drain group (n = 49) or a no-drain group (n = 44) immediately prior to wound closure. Patients underwent a neck ultrasound on day 1 and day 2 postoperatively. After surgery, we evaluated visual analogue scale pain scores, postoperative analgesic requirements, self-reported scar satisfaction at 6 weeks and complications. Results: There was significantly less mean fluid accumulated in the drain group on both day 1, 16.4 versus 25.1 ml (P-value = 0.005), and day 2, 18.4 versus 25.7 ml (P-value = 0.026), following surgery. We found no significant differences between the groups with regard to length of stay, scar satisfaction, visual analogue scale pain score and analgesic requirements. There were four versus one wound infections in the drain versus no-drain groups. This finding was not statistically significant (P = 0.154). No life-threatening bleeds occurred in either group. Conclusions: Fluid accumulation after thyroid surgery was significantly lessened by drainage. However, this study did not show any clinical benefit associated with this finding in the non-emergent setting. Drains themselves showed a trend indicating that they may augment infection rates. The results of this study suggest that the frequency of acute life-threatening bleeds remains extremely low following abandoning drains. We advocate abandoning routine use of thyroid drains. Trial registration: ISRCTN94715414.

Placental contribution to the origins of sexual dimorphism in health and diseases: sex chromosomes and epigenetics

Sex differences occur in most non-communicable diseases, including metabolic diseases, hypertension, cardiovascular disease, psychiatric and neurological disorders and cancer. In many cases, the susceptibility to these diseases begins early in development. The observed differences between the sexes may result from genetic and hormonal differences and from differences in responses to and interactions with environmental factors, including infection, diet, drugs and stress. The placenta plays a key role in fetal growth and development and, as such, affects the fetal programming underlying subsequent adult health and accounts, in part for the developmental origin of health and disease (DOHaD). There is accumulating evidence to demonstrate the sex-specific relationships between diverse environmental influences on placental functions and the risk of disease later in life. As one of the few tissues easily collectable in humans, this organ may therefore be seen as an ideal system for studying how male and female placenta sense nutritional and other stresses, such as endocrine disruptors. Sex-specific regulatory pathways controlling sexually dimorphic characteristics in the various organs and the consequences of lifelong differences in sex hormone expression largely account for such responses. However, sex-specific changes in epigenetic marks are generated early after fertilization, thus before adrenal and gonad differentiation in the absence of sex hormones and in response to environmental conditions. Given the abundance of X-linked genes involved in placentogenesis, and the early unequal gene expression by the sex chromosomes between males and females, the role of X- and Y-chromosome-linked genes, and especially those involved in the peculiar placenta-specific epigenetics processes, giving rise to the unusual placenta epigenetic landscapes deserve particular attention. However, even with recent developments in this field, we still know little about the mechanisms underlying the early sex-specific epigenetic marks resulting in sex-biased gene expression of pathways and networks. As a critical messenger between the maternal environment and the fetus, the placenta may play a key role not only in buffering environmental effects transmitted by the mother but also in expressing and modulating effects due to preconceptional exposure of both the mother and the father to stressful conditions.

How to map the diversity of the audiovisual industry in the digital era. A Methodological Proposition

This article presents a methodological proposition to map the diversity of the audiovisual industry in the digital scenario by portraying the most important interactions between those who create, produce, distribute and disseminate audiovisual productions on line, paying special attention to powerful intermediaries and to small and medium independent agents. Taking as a point of departure a flexible understanding of social network analysis, the aim is to understand the structure of the audiovisual industry on the internet so that, taking into consideration a given sector, agents, their relations and the networks they give place to – as well as the structural conditions under which they operate – are studied. The aim is to answer questions such as: what is mapping, what is of interesting to map, how can it be done and what advantages and disadvantages the results will present.

Organizaciones regionales y diversidad cultural: la diplomacia de la Unión Europea con el Mercosur entre la sombra de Hollywood y la acción intergubernamental

El objetivo de este artículo es doble: por un lado explorar la habilidad de la Unión Europea para llevar a cabo una política audiovisual dirigida al Mercosur y promover las normas de la Convención sobre la diversidad de las expresiones culturales; por otro, analizar el impacto del modelo de política audiovisual de la UE en el desarrollo de la cooperación audiovisual con el Mercosur y centrarse en los principales vectores que configuran el paisaje audiovisual del Mercosur. El texto pretende destacar cómo y por qué la UE persigue una política audiovisual con esa región, cuáles son los propósitos y los límites de actuación. En este sentido, se preocupa por entender cómo la diplomacia audiovisual de la UE interactúa con otros actores, como las acciones gubernamentales llevadas a cabo desde la propia UE y el Mercosur, así como las prácticas del sector privado (Hollywwod y los grandes conglomerados de medios).

Measuring the Diversity and the Integration of Film Production in Mercosur: A Social Network Analysis

Based on an original and comprehensive database of all feature fiction films produced in Mercosur between 2004 and 2012, the paper analyses whether the Mercosur film industry has evolved towards an integrated and culturally more diverse market. It provides a summary of policy opportunities in terms of integration and diversity, emphasizing the limiter role played by regional policies. It then shows that although the Mercosur film industry remains rather disintegrated, it tends to become more integrated and culturally more diverse. From a methodological point of view, the combination of Social Network Analysis and the Stirling Model opens up interesting research tracks to analyse creative industries in terms of their market integration and their cultural diversity.

Almetrics: measuring the influence of the media on the social impact of research

Social media is changing the way we interact, present ideas and information and judge the quality of content and contributions. In recent years there have been hundreds of platforms to freely share all kinds of information and connect across networks. These new tools generate activity statistics and interactions among users such as mentions, retweets, conversations, comments on blogs or Facebook; managers references showing popularity ratings of more references shared by other researchers or repositories that generate statistics of visits or downloads of articles. This paper analyzes that have meaning and implications altmetrics, what are its advantages and critical platforms (Almetric.com, ImpactStory, Plos altmetrics, PlumX), reports progress and benefits for authors, publishers and librarians. It concluded that the value of alternative metrics as a complementary tool citation analysis is evident, although it is suggested that you should dig deeper into this issue to unravel the meaning and the potential value of these indicators to assess their potential.

Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

What is social innovation? The paradigm shift and its relationship with Social Work

Innovation is a fundamental part of social work. In recent years there has been a shift in the innovation paradigm, making it easier to accept this relationship. National and supranational policies aimed at promoting innovation appear to be specifically guided by this idea. To be able to affirm this hypothesis, it is necessary to review the perception that social workers have of their duties. It is also useful to examine particular cases that show how such social innovation arises.

Utilizing ICT to prevent loneliness and social isolation of the elderly. A literature review

Ageing of the population is a worldwide phenomenon. Numerous ICT-based solutions have been developed for elderly care but mainly connected to the physiological and nursing aspects in services for the elderly. Social work is a profession that should pay attention to the comprehensive wellbeing and social needs of the elderly. Many people experience loneliness and depression in their old age, either as a result of living alone or due to a lack of close family ties and reduced connections with their culture of origin, which results in an inability to participate actively in community activities (Singh & Misra, 2009). Participation in society would enhance the quality of life. With the development of information technology, the use of technology in social work practice has risen dramatically. The aim of this literature review is to map out the state of the art of knowledge about the usage of ICT in elderly care and to figure out research-based knowledge about the usability of ICT for the prevention of loneliness and social isolation of elderly people. The data for the current research comes from the core collection of the Web of Science and the data searching was performed using Boolean? The searching resulted in 216 published English articles. After going through the topics and abstracts, 34 articles were selected for the data analysis that is based on a multi approach framework. The analysis of the research approach is categorized according to some aspects of using ICT by older adults from the adoption of ICT to the impact of usage, and the social services for them. This literature review focused on the function of communication by excluding the applications that mainly relate to physical nursing. The results show that the so-called ‘digital divide’ still exists, but the older adults have the willingness to learn and utilise ICT in daily life, especially for communication. The data shows that the usage of ICT can prevent the loneliness and social isolation of older adults, and they are eager for technical support in using ICT. The results of data analysis on theoretical frames and concepts show that this research field applies different theoretical frames from various scientific fields, while a social work approach is lacking. However, a synergic frame of applied theories will be suggested from the perspective of social work.

Narrativa periodística en la convergencia de medios

El de hoy es un entorno en el que todos los días los medios sufren cambios estructurales y funcionales que los obligan a replantear su accionar y reinventar sus usos y esquemas de comunicación, de ahí la importancia de esta investigación mixta, cuantitativa y cualitativa, que recurrió a seguimiento en redes sociales y análisis de contenidos; detectando el cómo los medios responden al estar inmersos en un mundo en el que se pasó de una cultura de imprenta a una cultura de la pantalla donde surgen nuevas prácticas sociales que crean dispositivos a la medida de cada uno, elementos en los que conjugan el texto, el audio y el video configurando nuevos medios en los que se generan otras formas de interacción, y se replantea el quehacer profesional del Comunicador Social Periodista.

El impacto de la presencia online en las cuentas de Twitter de las universidades vascas y navarras

Las Universidades han tenido que adaptarse a los nuevos modelos de comunicación surgidos en la época de Internet. Dentro de estos nuevos paradigmas las redes sociales han irrumpido y Twitter se ha establecido como una de las más importantes. El objetivo de esta investigación es demostrar que existe una relación entre la presencia online de una Universidad, definida por la cantidad de información disponible en Internet, y su cuenta en Twitter. Para ello se analizó la relación entre la presencia online y los perfiles oficiales de las cinco universidades del País Vasco y Navarra. Los resultados demostraron la existencia de una correlación significativa entre la presencia online de las instituciones y el número de seguidores de sus respectivas cuentas. En segundo lugar, esta investigación se planteó si Twitter puede servir para potenciar la presencia online de una Universidad. Es por eso que se formuló una segunda hipótesis que buscaba analizar si tener varias cuentas en Twitter aumentaría la presencia online de las Universidades. Los hallazgos para esta segunda hipótesis demostraron una correlación muy significativa entre tener varios perfiles en Twitter y la presencia online de las Universidades. Así queda demostrada la importancia de la presencia online para las cuentas de Twitter y la relevancia de Twitter a la hora de potenciar la presencia online de los centros.

El interés de la audiencia por las intervenciones televisivas de Pablo Iglesias: estrategia comunicativa de Podemos

Este artículo analiza la eclosión mediática y política del partido político Podemos durante sus primeros meses de vida tras las elecciones europeas. Comprobaremos si el interés que despierta el partido en sus inicios, en intención de voto, se traslada a las audiencias de televisión con dos hipótesis que muestran la estrategia comunicativa de Podemos y su repercusión: la H1 afirma que los programas en los que participa Pablo Iglesias obtienen mayor audiencia de la habitual y la H2 plantea que la apuesta del líder de Podemos por el medio televisivo es muy superior y con mejores resultados con respecto a los partidos clásicos. Los resultados demuestran que los programas en los que participa (N=14) crecen un 62% y baten récord de audiencia. Concluimos que la estrategia comunicativa de Podemos da importancia a la televisión, además de continuar con la estrategia en redes aprendida en el 15M.

Return Migration in the Ecuadorian and Bolivian population: motivations, strategies and discourses

This article analyses the motivations for return migration among the Ecuadorians and Bolivians who, after living in Spain, returned to their countries of origin during the economic crisis that started in 2008. From the analysis of 22 interviews in-depth which took place in Ecuador and 38 in Bolivia to women, men and young people from migrant families, this decision-making process is shown to be embedded into a gendered dynamics of relationships. Particular detail is given to affective and economic elements that had an influence on the decision to return, as well as to the strategies deployed to project their readjustment back in origin. Males and females occupy differential positions within the family, work and social circle, their expectations being built in a gendered manner. Despite the fact migration has brought women greater economic power within the family group, their reintegration upon return redefines their role as main managers in the household and the dynamics that allow their social reproduction. Men, for their part, aspire to refresh their role as providers in spite of their frail labour position upon return. Social mobility for females is passed on through generations by a strong investment on education for their daughters and sons, while for males this mobility revolves around setting up family businesses and around their demonstrative abilities.

Rethinking Care Through Social Reproduction: Articulating Circuits of Migration

Care has come to dominate much feminist research on globalized migrations and the transfer of labor from the South to the North, while the older concept of reproduction had been pushed into the background but is now becoming the subject of debates on the commodification of care in the household and changes in welfare state policies. This article argues that we could achieve a better understanding of the different modalities and trajectories of care in the reproduction of individuals, families, and communities, both of migrant and nonmigrant populations by articulating the diverse circuits of migration, in particular that of labor and the family. In doing this, I go back to the earlier North American writing on racialized minorities and migrants and stratified social reproduction. I also explore insights from current Asian studies of gendered circuits of migration connecting labor and marriage migrations as well as the notion of global householding that highlights the gender politics of social reproduction operating within and beyond households in institutional and welfare architectures. In contrast to Asia, there has relatively been little exploration in European studies of the articulation of labor and family migrations through the lens of social reproduction. However, connecting the different types of migration enables us to achieve a more complex understanding of care trajectories and their contribution to social reproduction.

Weaving Futures. Family Transnationalism in the migration from Dominican Republic and Brazil to Spain

This article explores forms of migrant families’ reorganization within a (new) global economic crisis and the hardening of migration control in Europe; based on the cases of Dominican and Brazilian migration to Spain.Our goal is not to characterize the wholeness of strategies from these collectives, instead visualize its heterogeneity. Displacement of Dominican and Brazilian population to Spain shares the role of women as the first link of migration chains. In both cases women are the economic support of transnational families and they lead reunification's processes. Nevertheless, differences in the time spent in the destination country, migratory status, origin (rural-urban), level of education, class and labor insertion in destination country, affect differently, the planning and start up of migration projects, the organization of care and family reunification strategies. These findings question the predominant place granted to national origin in the study of international migration.