ABSTRACT
The COVID-19 pandemic has provided an ultimate testing ground for evaluating the resilience and effectiveness of federal and decentralized systems. The article analyses how the Spanish asymmetrical system of decentralization has responded to the pandemic, focusing on the management developed by the sub-central governments (Autonomous Communities) during the first two waves of the pandemic in 2020. The research, which is both quantitative and qualitative, employs multidisciplinary tools and information sources, analyzing and linking fiscal and budgetary sources with the available statistics and information on health. Although the health, economic and social crisis caused by COVID-19 has highlighted appreciable shortcomings related to the decentralized model of territorial organization - in questions of both regional financing and health management - the research concludes that decentralization has not per se been a handicap when confronting the pandemic in Spain.
ABSTRACT
Using new and original nineteenth-century sources, we analysed the epidemiology, clinical features and virology of the 1889 pandemic, which was referred to at the time as 'Russian flu' or 'Asiatic flu'. However, we rejected this identification of the disease as an 'influenza', which we believe to have been based on insufficient knowledge of the causative agent and instead posit that the pandemic was caused by a coronavirus. We provide a new account of the 1889-1893 pandemic, with a more detailed chronology that included at least four epidemiological waves. At the end of 1889, a new virus appeared in Europe, which could be identified as the coronavirus HCoV-OC43, causing crude death rates of 1.3 per 1000 population in St Petersburg; 2.1 per 1000 in Paris; 2.8 per 1000 in Bilbao and on the French-Spanish border; between 2.9 and 5.2 per 1000 in small towns in the Basque Country; and 5.8 deaths per 1000 in Madrid, which had the highest death rate. The clinical features of the disease differed from classical influenza pandemics in terms of the latency phase, duration, symptomatology, convalescence, immunity, age and death rates. Another factor to be considered was the neurotropic capacity of the disease. The most frequent form of the 1889 pandemic was the 'nervous form', with specific symptoms such as 'heavy headache' (céphalalgie gravative), tiredness, fever and delirium. There are strong parallels between the 1889-1894 pandemic and the COVID-19 pandemic, and a better understanding of the former may therefore help us to better manage the latter.
ABSTRACT
El Museo Vasco de Historia de la Medicina y de la Ciencia es, en la actualidad, un centro reconocido de investigación en historia de las pandemias y en la relación entre la física y la industria en la sociedad del siglo XX, aunando las funciones museísticas e investigadoras. Se ubica en el campus de Bizkaia (Leioa) de la Universidad del País Vasco, UPV/EHU. Fundado en 1982, durante estos 40 años de existencia ha reunido más de 6.000 objetos de los siglos XIX y XX relacionados con la historia de la medicina y de la ciencia que se exponen en 24 salas. Como culminación de su actividad investigadora, el Museo ha editado más de medio centenar de libros y sus investigadores han publicado un elevado número de artículos y libros en medios nacionales e internacionales especializados en historia de la medicina y de las ciencias.(AU)
The Basque Museum for the History of Medicine and Science is currently a recognized research center in the history of pandemics and in the relationship between physics and industry in 20th century society. In this center, museum and research functions are combined. It is located on the Campus of Biscay (Leioa) of the University of the Basque Country, UPV / EHU. Founded in 1982, during these 40 years of existence it has gathered more than 6,000 objects from the 19th and 20th centuries related to the history of medicine and science that are exhibited in 24 rooms. As the culmination of its research activity, the Museum has published more than fifty books and its researchers have published a large number of articles and books in national and international specialized publishers in the history of medicine and science.(AU)
Subject(s)
Humans , History, 19th Century , History, 20th Century , History of Medicine , Scientific Exhibitions , Research , Biomedical Research , Pandemics , Medicine , Spain , BooksABSTRACT
Since 2006, the production of Pacific oyster Crassostrea gigas in the Ebro Delta area has dramatically declined from around 800 metric tons (MT) per year to 138 MT in 2011. This decline in production has had a significant socio-economic impact in a region where the shellfish sector is a traditional economic activity for many families. The identified agent responsible for this reduction in C. gigas production was Ostreid Herpesvirus microvar (OsHV-1 µvar), which has been associated with C. gigas spat mortalities in France, and in many other countries. In Spain the episodes of mortality became critical for the regional shellfish production between 2008 until 2014, with mortality percentage up to 100%. In this study, local hatchery C. gigas spat was used as sentinel animals for epidemiological studies and management tests carried out with the aim of reducing oyster mortality in the Ebro Delta area. A production calendar mainly based on water temperature dynamics was designed around an optimal schedule for spat immersion. The immersion calendar included two optimal periods for spat immersion, in summer when temperatures are ≥25°C and at the end of autumn and beginning of winter when they are ≤13°C. Such production planning has reduced mortalities from 80% (in 2014 and previous years) to 2-7.5% in 2015 in cemented oysters. Furthermore, other recommendations related to spat immersion size, culture density and methodology, and cementing calendar, which helped to achieve the results presented, were also recorded and transferred to local producers. This work presents a successfully tested management strategy reducing OsHV-1 µvar impact by designing new field management practices mainly focused on the handling and timing of spat immersion. This approach could be used as a management model in areas presenting similar production practices and environmental characteristics.
ABSTRACT
Las fracturas por fragilidad o secundarias a la osteoporosis se pueden considerar como un importante problema de Salud Pública por las consecuencias en términos de mortalidad y morbilidad que generan. Y las previsiones para el futuro, teniendo en cuenta el progresivo envejecimiento de la población y el aumento de la esperanza de vida, no son nada optimistas. Suponen y supondrán un importante consumo de recursos. Una de las estrategias que ha demostrado eficacia para su prevención, es el tratamiento farmacológico. Pero este tratamiento puede afectar de una manera u otra al proceso de consolidación, uno de los objetivos primarios fundamentales en su manejo. En este trabajo de revisión queremos establecer, en base a la evidencia actual, cómo afectan todos y cada uno de los fármacos indicados para el tratamiento de la osteoporosis al proceso de consolidación de las fracturas por fragilidad, una cuestión que genera dudas e incertidumbres en el traumatólogo, cuya responsabilidad y papel en el escenario de la prevención, es fundamental
Osteoporotic fragility fractures can be seen as a major public health problem because their consequences in terms of mortality and morbidity. Taking into account the progressive ageing of the population and the increase in life expectancy, the expectative in the next future are not optimistic. They are and will be an important focus of health resources consumption. One of the strategies that have proven be effective for fracture prevention, is the antiosteoporotic pharmacological treatment. This type of treatments can affect bone healing process in one way or another. In this review, based on the current scientific evidence, we want to establish how each one of the drugs prescribed for the osteoporosis treatment affects the bone healing process of fragility fractures, an issue that generates doubts and uncertainties in the orthopaedic surgeon, whom responsibility and role in fracture prevention is essential
Subject(s)
Humans , Male , Female , Osteoporosis/mortality , Osteoporosis/prevention & control , Osteoporosis/therapy , Osteoporotic Fractures/diagnosis , Osteoporotic Fractures/mortality , Osteoporotic Fractures/therapy , Morbidity/trends , Population Dynamics , Life Expectancy/trends , Pharmacology, Clinical/instrumentation , Pharmacology, Clinical/methods , Pharmacology, Clinical/economics , Treatment Outcome , Bone Regeneration/physiology , Diphosphonates/pharmacology , Diphosphonates/therapeutic use , Risedronic Acid/pharmacology , Risedronic Acid/therapeutic use , Denosumab/pharmacology , Denosumab/therapeutic use , Vitamin D/therapeutic use , Public HealthABSTRACT
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