Estudio Económico y social de América Latina 1961 = Economic and Social Survey of Latin America 1961

Incluye Bibliografía

Estudio económico de América Latina 1962 = Economic and social survey of Latin America 1962

Incluye Bibliografía

Peginterferon plus ribavirin and sustained virological response rate in HCV-related advanced fibrosis: a real life study

Background: Tolerance and response to antiviral HCV treatment is poor in advanced fibrosis. The aim of this study was to assess SVR rate and its predictive factors in HCV advanced fibrosis patients treated in real life with full dose PEG-IFN plus RBV and to evaluate the adverse events related to treatment. Methods: A multicentric, retrospective study was conducted at six university hospitals. METAVIR F3 and F4 HCV monoinfected patients who were treated with PEG-IFN and RBV had their data analyzed. A stepwise logistic regression analysis was performed to identify the variables independently related to SVR. Adverse events were recorded during treatment. Results: 308 patients were included, 75% genotype 1 and 23% genotype 3. METAVIR F3 was present in 39% and F4 in 61% of patients. The median Child Pugh score for F4 patients was 5 (5–9). The global SVR rate was 34%, 11% were relapsers and 55% were nonresponders. SVR rates were similar between patients treated with PEG-IFN alfa 2a or alfa 2b (p = 0.24). SVR rates according to Child–Pugh score were 26% (Child A) and 18% (Child B). The independent factors related to SVR in F4 patients were genotype 3, RVR and fewer Child Pugh score points. Treatment interruption occurred in 31% patients and death occurred in 1.9%, all with liver cirrhosis. Conclusion: Treatment of HCV in patients with advanced fibrosis should not be postponed. However, a very careful evaluation of cirrhotic patients must be performed before treatment is indicated and careful monitoring is required during treatment.

Die politische Integration der zweiten Migrantengeneration in der Bundesrepublik Deutschland : eine quantitativ-empirische Analyse der politischen Partizipation auf Grundlage des European Social Surveys

Vor dem Hintergrund der demokratiegefährdenden Folgen, die eine strukturell verursachte Ungleichheit politischer Partizipation nach sich zieht, hat sich die Partizipationsforschung verstärkt der Frage zugewandt, ob zwischen partizipierenden Bürgern und ihren politisch passiven Mitbürgern systematische Unterschiede hinsichtlich ihrer Ausstattung mit partizipationsrelevanten Ressourcen bestehen. Der Fokus bisheriger empirischer Untersuchungen richtet sich jedoch ausschließlich auf die US-amerikanische Gesellschaft. Allerdings setzen sich auch die deutsche Gesellschaft aus einer Vielzahl von Einwanderergruppen zusammen, die unter der Bezeichnung ‚Personen mit Migrationshintergrund' subsummiert werden können. Laut Mikrozensus besitzen zum gegenwärtigen Zeitpunkt 19,6 Prozent der deutschen Bevölkerung einen Migrationshintergrund. Der Ursprung dieser Einwanderungsbewegung liegt in der sogenannten Gastarbeiterphase, in der zwischen 1952 und 1973 ausländische Arbeitskräfte zur Unterstützung der deutschen Wirtschaft angeworben wurden. Während dieser Ära herrschte in der deutschen Gesellschaft die Annahme, die Arbeitsmigranten würden spätestens nach zwei Jahren aufgrund eines gesetzlich vorgeschriebenen Rotationsverfahrens in ihre Heimatländer zurückkehren. Vor diesem Hintergrund wurde die Frage nach der politischen Integration der Arbeitsmigranten und ihrer Nachkommen in der Integrationsforschung weitgehend vernachlässigt – eine politische Beteiligung der Arbeitsmigranten war gesellschaftlich nicht erwünscht. Obwohl die Mehrheit der Arbeitsmigranten tatsächlich in ihre Heimatländer zurückkehrte, entschied sich ein Teil der Gastarbeiter, ihren Lebensmittelpunkt dauerhaft nach Deutschland zu verlagern und einen Nachzug ihrer Familienangehörigen zu arrangieren. Da aus den Gastarbeitern bleibende Mitbürger geworden sind und ihre in Deutschland geborenen und aufgewachsenen Nachkommen immer zahlreicher werden, kann die Integrationsforschung die Frage nach ihrer politischen Mitwirkung – insbesondere die der zweiten Migrantengeneration – nicht länger ignorieren. In Anknüpfung an die demokratiegefährdenden Folgen, die eine strukturell bedingte, ungleiche Wahrnehmung der politischen Partizipationsrechte nach sich zieht, soll im Rahmen der Magisterarbeit die Frage geklärt werden: Sind in Deutschland geborene Personen der zweiten Migrantengeneration politisch integriert, d.h. weisen sie ein ähnliches Partizipationsverhalten auf wie Deutsche ohne Migrationshintergrund?

Sampling-Design Effects on Properties of Species-Area Relationships - A Case Study from Estonian Dry Grassland Communities

Despite widespread use of species-area relationships (SARs), dispute remains over the most representative SAR model. Using data of small-scale SARs of Estonian dry grassland communities, we address three questions: (1) Which model describes these SARs best when known artifacts are excluded? (2) How do deviating sampling procedures (marginal instead of central position of the smaller plots in relation to the largest plot; single values instead of average values; randomly located subplots instead of nested subplots) influence the properties of the SARs? (3) Are those effects likely to bias the selection of the best model? Our general dataset consisted of 16 series of nested-plots (1 cm(2)-100 m(2), any-part system), each of which comprised five series of subplots located in the four corners and the centre of the 100-m(2) plot. Data for the three pairs of compared sampling designs were generated from this dataset by subsampling. Five function types (power, quadratic power, logarithmic, Michaelis-Menten, Lomolino) were fitted with non-linear regression. In some of the communities, we found extremely high species densities (including bryophytes and lichens), namely up to eight species in 1 cm(2) and up to 140 species in 100 m(2), which appear to be the highest documented values on these scales. For SARs constructed from nested-plot average-value data, the regular power function generally was the best model, closely followed by the quadratic power function, while the logarithmic and Michaelis-Menten functions performed poorly throughout. However, the relative fit of the latter two models increased significantly relative to the respective best model when the single-value or random-sampling method was applied, however, the power function normally remained far superior. These results confirm the hypothesis that both single-value and random-sampling approaches cause artifacts by increasing stochasticity in the data, which can lead to the selection of inappropriate models.

International palliative care experts' view on phenomena indicating the last hours and days of life

BACKGROUND Providing the highest quality care for dying patients should be a core clinical proficiency and an integral part of comprehensive management, as fundamental as diagnosis and treatment. The aim of this study was to provide expert consensus on phenomena for identification and prediction of the last hours or days of a patient's life. This study is part of the OPCARE9 project, funded by the European Commission's Seventh Framework Programme. METHOD The phenomena associated with approaching death were generated using Delphi technique. The Delphi process was set up in three cycles to collate a set of useful and relevant phenomena that identify and predict the last hours and days of life. Each cycle included: (1) development of the questionnaire, (2) distribution of the Delphi questionnaire and (3) review and synthesis of findings. RESULTS The first Delphi cycle of 252 participants (health care professionals, volunteers, public) generated 194 different phenomena, perceptions and observations. In the second cycle, these phenomena were checked for their specific ability to diagnose the last hours/days of life. Fifty-eight phenomena achieved more than 80% expert consensus and were grouped into nine categories. In the third cycle, these 58 phenomena were ranked by a group of palliative care experts (78 professionals, including physicians, nurses, psycho-social-spiritual support; response rate 72%, see Table 1) in terms of clinical relevance to the prediction that a person will die within the next few hours/days. Twenty-one phenomena were determined to have "high relevance" by more than 50% of the experts. Based on these findings, the changes in the following categories (each consisting of up to three phenomena) were considered highly relevant to clinicians in identifying and predicting a patient's last hours/days of life: "breathing", "general deterioration", "consciousness/cognition", "skin", "intake of fluid, food, others", "emotional state" and "non-observations/expressed opinions/other". CONCLUSION Experts from different professional backgrounds identified a set of categories describing a structure within which clinical phenomena can be clinically assessed, in order to more accurately predict whether someone will die within the next days or hours. However, these phenomena need further specification for clinical use.

Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals' Likelihood of Speaking up about Safety Concerns

PURPOSE To investigate the likelihood of speaking up about patient safety in oncology and to clarify the effect of clinical and situational context factors on the likelihood of voicing concerns. PATIENTS AND METHODS 1013 nurses and doctors in oncology rated four clinical vignettes describing coworkers' errors and rule violations in a self-administered factorial survey (65% response rate). Multiple regression analysis was used to model the likelihood of speaking up as outcome of vignette attributes, responder's evaluations of the situation and personal characteristics. RESULTS Respondents reported a high likelihood of speaking up about patient safety but the variation between and within types of errors and rule violations was substantial. Staff without managerial function provided significantly higher levels of decision difficulty and discomfort to speak up. Based on the information presented in the vignettes, 74%-96% would speak up towards a supervisor failing to check a prescription, 45%-81% would point a coworker to a missed hand disinfection, 82%-94% would speak up towards nurses who violate a safety rule in medication preparation, and 59%-92% would question a doctor violating a safety rule in lumbar puncture. Several vignette attributes predicted the likelihood of speaking up. Perceived potential harm, anticipated discomfort, and decision difficulty were significant predictors of the likelihood of speaking up. CONCLUSIONS Clinicians' willingness to speak up about patient safety is considerably affected by contextual factors. Physicians and nurses without managerial function report substantial discomfort with speaking up. Oncology departments should provide staff with clear guidance and trainings on when and how to voice safety concerns.

Social Inequality in Political Participation: The Dark Sides of Individualisation

Has the participatory gap between social groups widened over the past decades? And if so, how can it be explained? Based on a re-analysis of 94 electoral surveys in eight Western European countries between 1956 and 2009, this article shows that the difference in national election turnout between the half of the population with the lowest level of education and the half with the highest has increased. It shows that individualisation – the decline of social integration and social control – is a major cause of this trend. In their electoral choices, citizens with fewer resources – in terms of education – rely more heavily on cues and social control of the social groups to which they belong. Once the ties to these groups loosen, these cues and mobilising norms are no longer as strong as they once were, resulting in an increasing abstention of the lower classes on Election Day. In contrast, citizens with abundant resources rely much less on cues and social control, and the process of individualisation impacts on their participatory behaviour to a much lesser extent. The article demonstrates this effect based on a re-analysis of five cumulative waves of the European Social Survey.

Social status regulates growth rate: Consequences for life-history strategies

The life-history strategies of organisms are sculpted over evolutionary time by the relative prospects of present and future reproductive success. As a consequence, animals of many species show flexible behavioral responses to environmental and social change. Here we show that disruption of the habitat of a colony of African cichlid fish, Haplochromis burtoni (Günther) caused males to switch social status more frequently than animals kept in a stable environment. H. burtoni males can be either reproductively active, guarding a territory, or reproductively inactive (nonterritorial). Although on average 25–50% of the males are territorial in both the stable and unstable environments, during the 20-week study, nearly two-thirds of the animals became territorial for at least 1 week. Moreover, many fish changed social status several times. Surprisingly, the induced changes in social status caused changes in somatic growth. Nonterritorial males and animals ascending in social rank showed an increased growth rate whereas territorial males and animals descending in social rank slowed their growth rate or even shrank. Similar behavioral and physiological changes are caused by social change in animals kept in stable environmental conditions, although at a lower rate. This suggests that differential growth, in interaction with environmental conditions, is a central mechanism underlying the changes in social status. Such reversible phenotypic plasticity in a crucial life-history trait may have evolved to enable animals to shift resources from reproduction to growth or vice versa, depending on present and future reproductive prospects.