The pandemic caused by the spread of Covid-19 is giving rise to an exceptional social situation because of the great speed of propagation of the illness and the high level of mortality it has ...occasioned in a very short time. Moreover, the lockdown measures decreed in Spain prohibit the holding of wakes to avoid contagion, and limit funerals to three people plus the officiant. Thus, coronavirus is robbing people of the opportunity of a final farewell, stripping the dead of their dignity and worsening the grief of the living. This article investigates the situation and the social and cultural impact it has provoked. The method used takes the line of critical dialogue analysis (CDA) applied to information contained in the mass media, employing qualitative material from a related small-scale study. The results show that in countries like Spain where there is a strong Roman Catholic tradition the importance of these rituals is unquestionable. Although the country has become laicized over recent years, many traditions around death are still maintained. Hence, the impossibility of holding funerals is triggering a large number of social and personal conflicts. Furthermore, they indicate that lockdown, and the lack of rituals and of accompaniment constitute some of the most crucial stressors in the epidemic. Grief in solitude has become widespread and all the more fundamental in a society that values social support from close friends and family members. The conclusions show that the social distancing imposed by the epidemic is especially hard to bear when relatives are passing into death.
The Spasticity-Plus Syndrome (SPS) in multiple sclerosis (MS) refers to a combination of spasticity and other signs/symptoms such as spasms, cramps, bladder dysfunction, tremor, sleep disorder, pain, ...and fatigue. The main purpose is to develop a user-friendly tool that could help neurologists to detect SPS in MS patients as soon as possible.
A survey research based on a conjoint analysis approach was used. An orthogonal factorial design was employed to form 12 patient profiles combining, at random, the eight principal SPS signs/symptoms. Expert neurologists evaluated in a survey and a logistic regression model determined the weight of each SPS sign/symptom, classifying profiles as SPS or not.
72 neurologists participated in the survey answering the conjoint exercise. Logistic regression results of the survey showed the relative contribution of each sign/symptom to the classification as SPS. Spasticity was the most influential sign, followed by spasms, tremor, cramps, and bladder dysfunction. The goodness of fit of the model was appropriate (AUC = 0.816). Concordance between the experts' evaluation vs. model estimation showed strong Pearson's (
= 0.936) and Spearman's (
= 0.893) correlation coefficients. The application of the algorithm provides with a probability of showing SPS and the following ranges are proposed to interpret the results: high (> 60%), moderate (30-60%), or low (< 30%) probability of SPS.
This study offers an algorithmic tool to help healthcare professionals to identify SPS in MS patients. The use of this tool could simplify the management of SPS, reducing side effects related with polypharmacotherapy.
The period of reform and opening-up that occurred between 1978 and 1991 revolutionised what had been the economic structure of the People's Republic of China since its foundation, changing the ...traditional social structure that had endured for thousands of years in rural settings. This change had a significant impact on rural mobility in contemporary China; it brought about a shift in the rural population's values and led directly to the largest migrant mobility in China's history. This article analyses these changes in terms of family and marriage and their consequences for rural families. The method employed was ethnographic fieldwork carried out in Sichuan Province. 7 men and 14 women, aged between 25 and 64 took part in the research and were both members of different families, as well as teachers involved in the education of their children. The information obtained from these 21 people was supplemented with data from other sources, including references in the literature and statistics. The results show that the changes taking place in Chinese family and rural society are of such magnitude that traditional values are being replaced by others associated with economic activity and a new individualism. Additionally, the effects of the phenomenon of left behind children are shown.
The objective of this article is to present a brief overview of the long history of anthropology in Spain. Of primary importance is positioning this history both within Spain’s wider social and ...political contexts, and also against the development of scientific research throughout the country. Methodologically, this study is based on extensive existing literature concerning the history of the discipline, from the start of the twentieth century to contemporary times, which informed the decision to structure this writing in four sections, segmenting the period of history covered. The first section considers the primary or formative development of a regionalist Spanish ethnography at the beginning of the twentieth century. Following this, in the second section, we explore the Francoist era when the twentieth century was well underway; this was a period marked by the strong influence of foreign research on the establishment of teaching methods and practical approaches to anthropology. In the third section, we observe how, as Spain transitioned from a dictatorship to a strong democratic state formed of autonomous regions, a uniquely Spanish anthropology emerged and, as we discuss in the fourth section, the country entered a time of consolidation and institutionalisation throughout the wider field of Spanish scientific endeavour. In this way, we examine Spanish anthropology from the context of intellectual development not dissimilar to that taking place on a global scale. The article concludes with an exploration of the current challenges facing Spanish anthropology.
•Data regarding clinical long-term outcomes after OHCA are scarce.•OHCA survivors face significant morbidity and mortality after the index event.•Neurological outcome, time from CA to CPR, age and ...LVEF were predictors of worse f/u.•Clinically relevant events during f/u were not always directly related with the CA.•Survivors may benefit from multidisciplinary teams providing integral management.
Information regarding long-term outcomes in patients surviving out-of-hospital cardiac arrest (OHCA) is scarce. Our aim was to study the long-term clinical outcomes of a large cohort of OHCA patients surviving until hospital discharge and to identify predictors of mortality and cardiovascular events.
Consecutive OHCA patients admitted in the Acute Cardiac Care Unit who survived at least until hospital discharge between 2007 and 2019 were included. All received therapeutic hypothermia according to the local protocol. Pre- and intra-hospital clinical and analytical variables were analyzed, as well as the clinically relevant events during follow-up.
A total of 201 patients were included, with a mean age of 57.6 ± 14.2 years, 168 (83.6%) were male. Thirty-six (17.9%) died during a median follow-up of 40.3 months (18.9–69.1), the most frequent causes of death being cardiovascular and neurological, followed by cancer. We calculated a predictive model for mortality during follow-up using Cox regression that included the following variables: poor neurological outcome HR 3.503 (1.578–7.777), non-shockable rhythm HR 2.926 (1.390–6.163), time to onset of CPR HR 1.063 (0.997–1.134), older age 1.036 (1.008–1.064)) and worse ejection fraction at discharge 1.033 (1.009–1.058).
Even though few patients experience recurrent cardiac arrest events, survivors after OHCA face high morbidity and mortality during long-term follow-up. Therefore, they may benefit from multidisciplinary teams providing an integral management and ensuring continuity of care.
Tourism is a driving force of the economy for many countries around the world. The large number of architectural and intangible World Heritage Sites have consolidated those countries in their strong ...positions as cultural tourism destinations. Within cultural tourism, religious tourism is particularly prominent. This work focuses on Spain and specifically on some of its regions which lack beaches but possess a wealth of religious cultural heritage, such as Castile and León, which have viewed such heritage as an asset to attract a different kind of tourist. The objectives of this study are to highlight the value of religious heritage as a tourist attraction, analyse the potential of religious heritage for religious and non-religious tourism, and observe religious tourism as an asset in depressed areas. The criterion that governs the study is to determine the profile of these tourists and their relationship with the destination. Methodologically, this work is an analysis, assessment and reflection of different processes, practices and events from a social anthropology perspective. The results identify a type of tourist more aware of sustainability and more respectful of the environment and culture, and therefore, more in tune with religion and religious heritage.
This study aimed to assess long-term cognitive and functional outcomes in out-of-hospital cardiac arrest (OHCA) patients treated with targeted-temperature management, investigate the existence of ...prognostic factors that could be assessed during initial admission and evaluate the usefulness of classic neurological scales in this clinical scenario.
Patients admitted due to OHCA from August 2007 to November 2015 and surviving at least one year were included. Each patient completed a structured interview focused on the collection of clinical, social and demographic data. All available information in clinical records was reviewed and a battery of neurocognitive and psychometric tests was performed.
Seventy-nine patients were finally included in the analysis. Forty-three patients (54.4%) scored below the usual cut-off points for the diagnosis of mild cognitive impairment, even though most of these deficits went unnoticed when patients were assessed using CPC and modified Rankin scale. Nineteen (24%) developed certain degree of impairment in their attention capacity and executive functions. A significant proportion developed new memory-related disorders (43%), depressive symptoms (17.7%), aggressive/uninhibited behavior (12.7%) and emotional lability (8.9%). A greater number of weekly hours of intellectual activity and a qualified job were independent protective factors for the development of cognitive impairment. However, being older at the time of the cardiac arrest was identified as a poor prognostic factor.
There is a high prevalence of long-term cognitive deficits and functional limitations in OHCA survivors. Most commonly used clinical scales in clinical practice are crude and lack sensitivity to detect most of these deficits.
Background: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study ...aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. Method: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. Results: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. Conclusions: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.
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