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Reverse mortgage is one of the products (perhaps the main one) that is good to obtain additional income by using the habitual residence as collateral. The main objective of this paper is to analyse the effects that reverse mortgage contracting has on household finances over the lifetime of a family according to the socioeconomic group to which it belongs in Spain. Four indicators are employed to measure the immediate and long-term effects. We use a stochastic model with a double source of randomness, survival and entry into dependency, and apply it to the three socioeconomic groups obtained with cluster methodology from the 2017 Spanish Household Financial Survey data. We conclude that the effects are very different depending on the group: regarding only the effects of hiring a reverse mortgage on the income of the family, widowed women aged between 81 and 85 years, with low income and expenses as well as little net wealth, and a habitual residence that represents half of her net wealth (Cluster 1) are the most benefited; considering that the highest impact indicators are on the probability of illiquidity and on the value of lack of liquidity, the use of reverse mortgages benefits more the families in Cluster 3 (high income and expenses and really high net wealth, head of household aged between 76 and 80 years) and less the families in Cluster 2 (medium income, net wealth and expenses, head of household aged between 65 and 75 years). First published online 17 April 2024

Introduction Pre-eclampsia affects ~5%–7% of pregnancies. Although improved obstetric care has significantly diminished its associated maternal mortality, it remains a leading cause of maternal morbidity and mortality in the world. Term pre-eclampsia accounts for 70% of all cases and a large proportion of maternal–fetal morbidity related to this condition. Unlike in preterm pre-eclampsia, the prediction and prevention of term pre-eclampsia remain unsolved. Previously proposed approaches are based on combined third-trimester screening and/or prophylactic drugs, but these policies are unlikely to be widely implementable in many world settings. Recent evidence shows that the soluble fms-like tyrosine kinase-1 (s-Flt-1) to placental growth factor (PlGF) ratio measured at 35–37 weeks’ gestation predicts term pre-eclampsia with an 80% detection rate. Likewise, recent studies demonstrate that induction of labour beyond 37 weeks is safe and well accepted by women. We hypothesise that a single-step universal screening for term pre-eclampsia based on sFlt1/PlGF ratio at 35–37 weeks followed by planned delivery beyond 37 weeks reduces the prevalence of term pre-eclampsia without increasing the caesarean section rates or worsening the neonatal outcomes.Methods and analysis We propose an open-label randomised clinical trial to evaluate the impact of a screening of term pre-eclampsia with the sFlt-1/PlGF ratio followed by planned delivery in asymptomatic nulliparous women at 35–37 weeks. Women will be assigned 1:1 to revealed (sFlt-1/PlGF known to clinicians) versus concealed (unknown) arms. A cut-off of >90th centile is used to define the high risk of subsequent pre-eclampsia and offer planned delivery from 37 weeks. The efficacy variables will be analysed and compared between groups primarily following an intention-to-treat approach, by ORs and their 95% CI. This value will be computed using a Generalised Linear Mixed Model for binary response (study group as fixed effect and the centre as intercept random effect).Ethics and dissemination The study is conducted under the principles of Good Clinical Practice. This study was accepted by the Clinical Research Ethics Committee of Hospital Clinic Barcelona on 20 November 2020. Subsequent approval by individual ethical committees and competent authorities was granted. The study results will be published in peer-reviewed journals and disseminated at international conferences.Trial registration number NCT04766866.

The aim of this study is to present new data on vegetation dynamics and plant collecting practices during the Late Glacial and the Early Holocene in southwestern France. La Tourasse cave is located in the Pyrenean piedmont plain, where the Azilian cultural complex was initially defined. The last excavations of the site took place in the 1980s and 1990s and the recovered materials are currently being studied or revisited from a multidisciplinary perspective. We present here the results of the charcoal analysis performed on La Tourasse’s Azilian (ca. 13000–11500 cal. BP) and Mesolithic (ca. 10500–9000 cal. BP) levels, complemented by the study of a small seed assemblage. Our results document the shift from an open landscape towards a forested environment, with the gradual passage from open vegetation dominated by shrubs of the Rose family (Prunus spp.) to the mixed oak forest, which speaks in favor of the biochronological coherence of this sequence. However, marked differences in taxonomic richness and state of the wood from one level to another, unrelated to the prevailing environmental conditions, suggest variable behavior of humans toward wood that could be the result of differing mobility strategies, hearth functionalities, or taxonomic preferences.

Sweden received worldwide attention for its approach to managing the COVID-19 pandemic. Notably, throughout the pandemic, Sweden was one of the few countries that did not implement any lockdown measures. This meant that primary schools remained open and classes proceeded as usual, including the delivery of physical education (PE). This paper explores PE teachers' perceptions of the effects of the COVID-19 pandemic on Swedish PE. Data were collected through semi-structured interviews with seven PE teachers. Results suggest that teaching PE during COVID-19 has led to disparate challenges and changes for teachers, including modifications in context, content, roles and responsibilities, as well as the handling of issues concerning physical contact and proximity among students and teachers. The conclusions of this study reveal that in the midst of the COVID-19 pandemic, the parameters of PE in Sweden are changing more rapidly now than ever before. Understanding how the pandemic has impacted the subject of PE and its delivery might create opportunities for further discussions, possible solutions and subsequent necessary adjustments in dealing with the ongoing COVID-19 situation.

An empirical question that has motivated demographers is whether there is convergence or divergence in mortality/longevity around the world. The epidemiological transition is the starting point for studying a global process of mortality convergence. This manuscript aims to provide an update on the concept of mortality convergence/divergence. We perform a comprehensive examination of nine different mortality indicators from a global perspective using clustering methods in the period 1990-2030. In addition, we include analyses of projections to provide insights into prospective trajectories of convergence clubs, a dimension unexplored in previous work. The results indicate that mortality convergence clubs of 194 countries by sex resemble the configuration of continents. These five clubs show a common steady upward trend in longevity indicators, accompanied by a progressive reduction in disparities between sexes and between groups of countries. Furthermore, this paper shows insights into the historical evolution of the convergence clubs in the period 1990-2020 and expands their scope to include projections of their expected future evolution in 2030.

El presente artículo analiza las consecuencias de la interpretación realizada por el Tribunal Supremo de la legislación en materia de patrimonio cultural en el juicio sobre las ventas a la Generalitat de Cataluña y al Museo Nacional de Arte de Cataluña de los bienes del Real Monasterio de Santa María de Sijena, en la provincia de Huesca. A diferencia de los juzgadores de instancia, el Tribunal Supremo realiza una interpretación de las leyes de patrimonio de 1926, 1933 y 1985 que conlleva una menor protección de la integridad de los bienes de interés cultural y no garantiza el mantenimiento de su indivisibilidad. El trabajo trata de mostrar que una interpretación más acorde con las leyes revela la voluntad del legislador de proteger la indivisibilidad y la integridad de dichos bienes, pero, en todo caso, como consecuencia del análisis se proponen una serie de modificaciones legislativas que permitan contrarrestar en lo sucesivo la interpretación del Tribunal Supremo y evitar sus posibles perjuicios. Para finalizar, se realiza una breve reflexión sobre diversos aspectos relativos al patrimonio cultural a propósito del polémico caso de los bienes de Sijena.

BACKGROUND: Preterm labor is one of the leading causes of perinatal death and is currently considered a syndrome with many causes. One of the most important causes of preterm birth is ascending infection from bacterial vaginosis. Chlorhexidine has proven to be effective against bacterial vaginosis and against bacterial biofilms without affecting gestation. OBJECTIVE: We aimed to evaluate the effectiveness of a universal primary prevention strategy for preterm birth using intravaginal chlorhexidine applied before 16 weeks (Preterm Labor Prevention Using Vaginal Antiseptics study). STUDY DESIGN: We performed a prospective observational study with 2 cohorts of pregnant women that were assigned either to prevention of preterm birth by means of intravaginal chlorhexidine (Cum Laude Chlorhexidine, chlorhexidine digluconate 0.2%) before 16 weeks (n=413), or to no treatment following the usual hospital protocol (n=704). Primary outcomes were the incidence of spontaneous preterm birth before 34 and 37 weeks; the incidence of preterm birth before 34 and 37 weeks, including inductions for premature rupture of membranes; and the incidence of preterm birth before 34 and 37 weeks, including any indication for termination of pregnancy. Both cohorts were compared using Mann-Whitney and Fisher tests. Finally, a multivariable analysis, including the odds ratio was performed, adjusting for clinical parameters, to evaluate the importance of the different determinants in the prediction of preterm birth. RESULTS: In pregnancies treated with chlorhexidine, the incidences of spontaneous preterm birth; preterm birth, including induction for premature rupture of membranas; and preterm birth, including any indication for termination of pregnancy were at 34 and 37 weeks: 0% and 0%, 0.24% and 1.69, and 2.90% and 3.15%, respectively; whereas in nontreated pregnancies, these incidences were 9% and 11%, 12% and 23%, and 35% and 43%, respectively. According to the multivariable analysis, the incidence of preterm birth among women treated with chlorhexidine before 16 weeks was halved (Odds ratio, 0.52; P

The internet has become a key environment for children's learning and leisure at an increasing early age. Yet, little is known about what children understand about the internet. We conducted semi-structured interviews with 111 children aged five to nine to assess their notions about the internet, the authorship of online content and the trustworthiness they attribute to it. Considering the socio-cognitive advances throughout these ages, we expected a significant improvement in children's concept of the internet. However, the results showed modest age differences, and only in some basic notions (e.g., internet functions). Misconceptions about the internet and naïve ideas about the reliability of its content were present at all ages. Only a very few older children envisaged the risk of finding malicious information online and the need to consult other sources in case of doubt. We discuss the necessity to address children's misconceptions at least from the beginning of primary school, when most of them are cognitively ready to understand many of the issues addressed in this study, provided they receive guided instruction.

Background: Physical education (PE) has been traditionally considered as a practical and 'hands-on' subject in schools, where close proximity and physical contact is common, particularly in Spain which has a high proximity culture. Significantly, the delivery of PE has changed because of the COVID-19 pandemic, and this brings significant consequences for preservice PE teachers. Purpose: The aim of the paper is to explore the changes of PE during COVID-19 and the effects on pre-service teachers. Methods: Semi-structured interviews were used to produce data with a group of 12 preservice PE teachers from Spain (four women and eight men) who were undertaking their practicum in PE when the COVID-19 lockdown was imposed in Spain [14 March 2020]. Dredging was used as an analytical technique to identify the relations and affects that comprised assemblages of bodies, things and social formations. Findings: Results suggest that preservice teachers are having difficulties in re-assembling PE in the age of COVID-19, and that this produces the affects of precarity, fear and insecurity. Furthermore, the PE re-assemblage also results in a shift of pedagogical affects. The participants particularly struggled to think on a PE assemblage that does not include the affect of physical encounters with their students. The new assemblage of PE also included encounters with digital technologies, which allowed for particular openings and closings for a re-alignment into the shifted PE. Conclusions: Pre-service teachers were unfamiliar with the way the PE assemblage has shifted, and this shifting affected their ability to produce affects in the 'new PE'. The new PE assemblage leads to a significant change in the culture of PE teaching in Spain, where physical contact between teachers and students was previously normal and taken for granted.

Abstract We present a co-axial acoustic-based optical coherence vibrometry probe (CoA-OCV) for vibro-acoustic resonance quantification in biological tissues. Sample vibrations were stimulated via a loudspeaker, and pre-compensation was used to calibrate the acoustic spectrum. Sample vibrations were measured via phase-sensitive swept-source optical coherence tomography (OCT). Resonance frequencies of corneal phantoms were measured at varying intraocular pressures (IOP), and dependencies on Young´s Modulus (E), phantom thickness and IOP were observed. Cycling IOP revealed hysteresis. For E = 0.3 MPa, resonance frequencies increased with IOP at a rate of 3.9, 3.7 and 3.5 Hz/mmHg for varied thicknesses and 1.7, 2.5 and 2.8 Hz/mmHg for E = 0.16 MPa. Resonance frequencies increased with thickness at a rate of 0.25 Hz/µm for E = 0.3 MPa, and 0.40 Hz/µm for E = 0.16 MPa. E showed the most predominant impact in the shift of the resonance frequencies. Full width at half maximum (FWHM) of the resonance modes increased with increasing thickness and decreased with increasing E. Only thickness and E contributed to the variance of FWHM. In rabbit corneas, resonance frequencies of 360–460 Hz were observed. The results of the current study demonstrate the feasibility of CoA-OCV for use in future OCT-V studies.

O presente artigo problematiza as dificuldades de operacionalização da Agenda 2030 das Nações Unidas, comprometida com a redução das desigualdades e a promoção de um desenvolvimento sustentável. Partindo do conceito de vulnerabilidade urbana, recorre-se a um caso de estudo concreto – o processo de reabilitação das ilhas do Porto –, representativo das dificuldades e desafios a ultrapassar, mas também das ferramentas a mobilizar na concretização das metas assumidas. A análise das causas históricas da vulnerabilidade nas ilhas permite identificar as implicações que hoje têm na exclusão e nas iniquidades em saúde de quem aí reside, os principais fatores de risco, as ferramentas concretas adotadas e os resultados atingidos. Conclui-se que a intervenção sobre o meio físico pode, nestes territórios, ser uma forma eficaz de combater a vulnerabilidade urbana, mas também que a implementação do Objetivo do Desenvolvimento Sustentável 11 – cidades e comunidades sustentáveis – está dependente da capacidade de articular uma nebulosa de ações e intervenientes. O grande desafio das políticas públicas passa assim por criar uma agenda para que os procedimentos, a nível local, orientem a ação do poder público e dos intervenientes privados no alcance da mudança preconizada.

El grupo de primates al que pertenece nuestra especie muestra mayoritariamente un ciclo de actividad diurno, de tal manera que los partos se inician de noche y se completan de madrugada o en las primeras horas de la mañana. La preservación de un parto nocturno debió de ser muy importante para la supervivencia de nuestros ancestros a partir de Homo erectus, hace 1,8 millones de años, dado que la intensa cerebralización fetal que protagonizó esta especie complicó paulatinamente el parto al combinarse con una pelvis más estrecha, consecuencia de la adopción del bipedalismo millones de años atrás. Los estudios más antiguos sobre el patrón horario del parto se limitan a datos hospitalarios de las décadas de 1930 y 1940, antes de la medicalización extensiva del parto institucionalizado, y describen un patrón predominantemente nocturno. En el presente trabajo se analiza la distribución horaria del parto en dos series muy anteriores, de finales del siglo XIX y primera década del XX, un total de 21 340 nacimientos en 27 años. Corresponden a la Casa de Maternidad de Madrid, una institución benéfica inicialmente vinculada a la Inclusa de la capital, pero que fue paulatinamente convirtiéndose, a lo largo de la primera mitad del siglo XX, en la principal maternidad de la ciudad. Los resultados confirman la preservación de un patrón circadiano del parto ancestral, de inicio predominantemente nocturno y finalización en la madrugada y primeras horas de la mañana.

IntroductionThe long-term effects of SARS-CoV-2 are unclear, as are the factors influencing the evolution. Objective: to assess health-related quality of life 1 year after a hospital admission due to COVID-19 and to identify factors that may influence it.Materials and methodsRetrospective observational study in a tertiary hospital from March 2021 to February 2022. Inclusion criteria: ≥18 years old and admitted for SARS-CoV-2 infection. Exclusion criteria: death, not located, refusal to participate, cognitive impairment, and language barrier. Variables: demographic data, medical history, clinical and analytical outcomes during hospital admission, treatment received, and vaccination against SARS-CoV-2 following admission. Participants were interviewed by phone 1 year after admission, using the SF-36 quality of life questionnaire.ResultsThere were 486 included patients. The domains yielding the lowest scores were general health (median 65%, interquartile range [IQR] 45–80), vitality (median 65%, IQR 45–80), and mental health (median 73.5%, IQR 60–100). Multivariable analysis showed that female sex and fibromyalgia/fatigue had a negative influence on all domains. Obesity was associated with worse outcomes in physical functioning, physical role, bodily pain, and vitality. Other factors associated with worse scores were an older age in physical functioning and high age-adjusted Charslon comorbidity in physical functioning and general health. Age was associated with better results in emotional role and High C-reactive protein at admission on vitality.ConclusionOne year after admission for COVID-19, quality of life remains affected, especially the domains of general health, vitality, and mental health. Factors associated with worse outcomes are female sex, fibromyalgia/chronic fatigue, and obesity.

Introduction: Hip fractures pose a significant challenge for older individuals given their high incidence and one-year mortality rate. The objective of this study was to identify the primary predictors of one-year mortality in older adults hospitalized for hip fractures. Methods: We conducted a retrospective cohort study involving adults aged 70 years or older who were admitted to the hospital for fragility hip fractures between 1 January 2014 and 31 December 2021. A total of 3229 patients were recruited, with 846 (26.2%) experiencing one-year mortality. Results: Respiratory complications (HR 2.42, 95%CI 1.42–4.14; p = 0.001) were the most significant predictors of one-year mortality, followed by hospital readmission (HR 1.96, 95%CI 1.66–2.32; p < 0.001), the male sex (HR 1.88, 95%CI 1.46–2.32; p < 0.001), cardiac complications (HR 1.88, 95%CI 1.46–2.32; p < 0.001), and a diagnosis of dementia at admission (HR 1.37, 95%CI 1.13–1.66; p = 0.001). The Charlson Index and the American Society of Anesthesiologists physical status classification system also significantly increased the mortality risk. Conversely, higher hemoglobin levels at admission and elevated albumin at discharge significantly reduced the mortality risk. Conclusions: The one-year mortality rate is substantial in older adults with hip fractures who are admitted to an orthogeriatric unit. The appropriate management of anemia, nutritional disorders, and comorbidity at admission and during the follow-up could potentially mitigate long-term mortality after hip fractures.