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In the case of maize farmers, access to seeds for planting is essential. We describe access to and exchange of maize seed in three sub-regions (central, eastern and western) in the states of Puebla and Tlaxcala, in order to analyze the use of maize seed in a rain-fed plateau region, based on local diversity. In 2013, 86 local maize producers were interviewed, 43 of whom participated in the Custodian program for the National System of Plant Genetic Resources (Sistema Nacional de Recursos Fitogenéticos), and 43 others, who did not participate, but were chosen by non-probabilistic sampling. The 86 farmers maintain 193 lots of seeds, differentiated according to grain color (white, red, blue, yellow, pinto and moradillo) and the Cacahuacintle type. There were significant differences between sub-regions in terms of access, exchange and loss of seed lots. 92.7% of the seed used in the area is native maize derived from self-sufficiency within the community or family (81.9%), with a low replacement rate (79.8%) and when a new batch of seeds is required, this is acquired within the community itself (86.0%); there is limited exchange (55.9%), between family members or close social networks. A community seed supply system prevails, due to being very accessible and people's confidence in the adaptability of the acquired genetic material, promoting in situ conservation of native maize; even though farmers do have access to improved varieties. [ABSTRACT FROM AUTHOR]

In Spain, health competencies are decentralized, and each autonomous community implements its own plans. Our aim is to determine if the existence of regional palliative care plans implies an improvement in health care coverage. We reviewed regional palliative care plans published in Spain and analyzed the following variables: number and profile of palliative care resources, guidelines and objectives of implementation of resources of these plans, and compliance with European standards. The publication of regional plans is associated with an increase in specific resources in the following years. From 2004 to 2009, the implementation of plans in 6 autonomous communities was associated with an increase in palliative care resources compared to those without a strategy (odds ratio: 1.58, P =.02) or with a settled plan (odds ratio: 1.40, P =.07). The same phenomenon was observed between 2009 and 2015 in 4 autonomous communities and 2 autonomous cities compared with those without a strategy (odds ratio: 2.49, P =.001) and those that implemented a plan before 2009 (odds ratio: 2.62, P <.001). Updating and evaluating these regional plans are also associated with the growth of palliative care resources. [ABSTRACT FROM AUTHOR]

Diversity among native maize populations in the highlands of the state of Puebla, Mexico has been studied through the association of those populations with some of the reported maize races; however, population variation within races has been little studied. The aim of the study was to characterize morphologically populations of native maize from the highlands of the state of Puebla and to define relationships among and within races to which they belong. In 2012, 41 native maize populations from the valleys of Serdan, Libres-Huamantla and Puebla were evaluated; 19 representative-race populations, two commercial and two experimental populations were included as controls in the trials. Forty morphological variables were recorded and an analysis of variance was applied, as well as multivariate techniques such as discriminant stepwise, principal component and cluster analyses. Statistical differences among populations for most of the variables were detected and it is considered as an indicator of diversity. Native populations were associated with Chalqueño, Conico, and Elotes Conicos races and with sub-race Elotes Chalqueños. Variation among and within groups was identified, suggesting that the environment and the dynamic process of selection from the farmers on native maize populations in the highlands of the state of Puebla, support an important variation among and within groups representative of the maize races in this area. On the basis of the identified variation, breeding and conservation in situ of maize races can be carried out. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, bioethical concerns were raised and there was even a ″resurgence of bioethics. ″ In this work, we review the scientific articles published by Spanish authors in relation to bioethical issues in the three years following the declaration of the pandemic. Seventy publications have been selected. Of all of them, the topic that lent itself to the most debate was that of prioritization in the use of health resources. A consensus was reached that ruled out that age could be considered as a sole exclusion criterion in healthcare or in a possible admission to the ICU. And the importance of taking special care of the most vulnerable and adapting care to the conditions of each patient without excluding anyone was recalled. Other relevant topics were the contrast between autonomy and the common good, the immune passport, vaccination, rigor in research and the publication of results, the professionalism of health personnel, misinformation, care for nursing homes, telemedicine, and the importance of the exercise of virtues. After the experience of both vulnerability and the need to exercise solidarity, many works raise the desire and the possibility of being able to overcome the pandemic being better.

Twenty-five years ago, in 1998, the Italian Parliament approved to implement clinical trials in patients with advanced cancer to know the efficacy of an alternative cancer treatment that associated hormones, vitamins and, occasionally, chemotherapy proposed by Professor Luigi Di Bella. It was the answer to people demanding Public Health assume the cost of this therapy. Although parallel phase II trials in various tumors demonstrated the lack of activity, some professionals have continued to use this method since then and have published apparently promising results a few various scientific journals. This real example raises three interesting ethical scenarios. The first one is the ethics of alternative treatments proposed by medical professionals or from the academic field. In these cases, the difficulty in differentiating between hypothesis and real efficacy. This problem impacts on patients and relatives' expectations who must face a potentially fatal disease with little or no hope of a cure with traditional treatments. The second scenario is the design and good practice in the development of clinical trials, which was also the subject of debate in relation to the Di Bella method. And the last one, the ethics of scientific publications. Di Bella's followers published since 2000 12 papers with limited quality on series of patients treated with his method, the majority in a pay-per-publication journal of which Giuseppe Di Bella, son of Professor Di Bella, is included in the board of editors.

Objective: "Medicina Paliativa" is the official journal of the Spanish Society of Palliative Care ("Sociedad Española de Cuidados Paliativos"; SECPAL) and it reflects the interests, also on bioethics, of the professionals caring terminal people. We want to know what the bioethical questions they discuss and their approaches are., Methods: From all the published articles in "Medicina Paliativa" from 1994 to 2013 we selected those referred to bioethics topics. We analysed: number of publications, author, subtype of article, year of publication, topic, philosophic approach, and the presence of answers and discussion. Qualitative topics were reviewed and agreed by at least two authors., Results: There were 60 (9%) publications with bioethics profile from a total of 672 analyzed articles. A majority were signed by only one author. 31 (51%) were published as letter. The most relevant topics were: euthanasia, dignity, proportionality of treatment and care, sedation, principles of bioethics, and information. The orientation of these papers was, in a majority, according to principles of palliative care. Most bioethics topics have been answered and even answered back., Conclusion: Bioethics is an interesting topic in palliative care. The arguments usually fit the principles of palliative care.