Mireia Baylina

Selling the countryside: Representations of rurality in Norway and Spain

This paper analyses how rurality is represented in two lifestyle magazines about country living: LevLandlig in Norway and Vivir en el Campo in Spain. Since material, imaginative and practised ruralities are intertwined and research indicates that representations of the rural affect residential preferences and other consumption activities, we argue that it is important to critically investigate potentially influential representations. Given that the majority of works on representations of the rural in mass media originate mainly from the United Kingdom and the United States, we aim to add the perspectives of a Scandinavian and a Mediterranean country. Furthermore, we analyse the gendering of the visions of the rural. We reveal that the ‘rural idyll’ is the main vision ‘sold’ in both magazines, and in both the same four sub-themes — ‘home’, ‘family’, ‘nature’ and ‘how to make a living in a rural area’ — stand central in the idyll. The gendering of the idyll and the meanings attached to the sub-themes vary between the Spanish and the Norwegian magazines, thus illustrating the contextual character of knowledge about rurality.

Systematic review and meta-analysis: susceptibility-guided versus empirical antibiotic treatment for Helicobacter pylori infection

BACKGROUND The cure rate of standard triple therapy for Helicobacter pylori infection is unacceptably low. Susceptibility-guided therapies (SGTs) have been proposed as an alternative to standard empirical treatments. The aim of this study was to perform a systematic review and meta-analysis evaluating the efficacy of SGTs. METHODS A systematic search was performed in multiple databases. Randomized controlled trials comparing cure rates of SGTs versus those of empirical therapy were selected and analysed separately for first- and second-line treatments. A meta-analysis was performed using risk ratio (RR) and number needed to treat (NNT) to measure the effect. RESULTS Twelve studies were included in the meta-analysis. In first-line treatment, SGT was more efficacious than empirical 7-10 day triple therapy (RR 1.16, 95% CI 1.10-1.23, I (2) = 33%; NNT = 8). Most studies used a 7-10 day triple therapy and randomized the patients after endoscopy and/or culture, thus precluding the comparison of SGT versus non-invasive testing and empirical treatment in clinical practice. For second-line therapy, only four studies were found. Results were highly heterogeneous and no significant differences were found (RR 1.11, 95% CI 0.82-1.51, I (2) = 87%). CONCLUSIONS Once endoscopy and culture have been performed, SGT is superior to empirical 7 or 10 day triple therapy for first-line treatment. Further studies are needed to evaluate the effectiveness of SGT in clinical practice, especially when compared with currently recommended first-line quadruple therapies.

How and When Should NSAIDs Be Used for Preventing Post-ERCP Pancreatitis? A Systematic Review and Meta-Analysis

Background Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be efficacious to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). However, the target patients, the type of NSAID, the route of administration and the time of drug delivery remain unclear, as well as the potential efficacy in reducing the severity of pancreatitis, length of hospital stay and mortality. The objective of the study was to evaluate these questions by performing a systematic review and meta-analysis. Methods Multiple searches were performed in the main databases. Randomized controlled trials (RCTs) comparing NSAIDs vs. placebo in the prevention of post-ERCP pancreatitis were included. Primary endpoint of the study was the efficacy for pancreatitis prevention. Sub-analyses were performed to determine the risk reduction in high and low risk patients, and to define optimal time, route of administration, and type of NSAID. Secondary endpoints were safety, moderate to severe pancreatitis prevention and reduction of hospital stay and mortality. Results Nine RCTs enrolling 2133 patients were included. The risk of pancreatitis was lower in the NSAID group than in the placebo group (RR 0.51; 95%CI 0.39–0.66). The number needed to treat was 14. The risk of moderate to severe pancreatitis was also lower in the NSAID group. (RR 0.46; 95%CI 0.28–0.76). No adverse events related to NSAID use were reported. NSAIDs were effective in both high-risk and unselected patients (RR 0.53; 95%CI 0.30–0.93 and RR 0.57; 95%CI 0.37–0.88). In the subanalyses, only rectal administration of either indomethacin (RR 0.54; 95%CI 0.38–0.75) or diclofenac (RR 0.42; 95%CI 0.21–0.84) was shown to be effective. There were not enough data to perform a meta-analysis in hospital stay reduction. No deaths occurred. Conclusion A single rectal dose of indomethacin or diclofenac before or immediately after ERCP is safe and prevents procedure-related pancreatitis both in high risk and in unselected patients.

Systematic review: third-line susceptibility-guided treatment for Helicobacter pylori infection

Background: Susceptibility-guided therapies (SGTs) have been proposed as preferable to empirical rescue treatments after two treatment failures. The aim of this study was to perform a systematic review and meta-analysis evaluating the effectiveness and efficacy of SGT as third-line therapy. Methods: A systematic search was performed in multiple databases. Studies reporting cure rates of Helicobacter pylori with SGT in third-line therapy were selected. A qualitative analysis describing the current evidence and a pooled mean analysis summarizing the cure rates of SGT in third-line therapy was performed. Results: No randomized controlled trials or comparative studies were found. Four observational studies reported cure rates with SGT in third-line treatment, and three studies which mixed patients with second- and third-line treatment also reported cure rates with SGT. The majority of the studies included the patients when culture had been already obtained, and so the effectiveness of SGT and empirical therapy has never been compared. A pooled mean analysis including four observational studies (283 patients) showed intention-to-treat and per-protocol eradication rates with SGT of 72% (95% confidence interval 56–87%; I2: 92%) and 80% (95% confidence interval 71–90%; I2: 80%), respectively. Conclusions: SGT may be an acceptable option as rescue treatment. However, cure rates are, at best, moderate and this approach has never been compared with a well-devised empirical therapy. The evidence in favor of SGT as rescue therapy is currently insufficient to recommend its use.

Homework in Germany and Spain: Industrial restructuring and the meaning of homework for women

This article seeks to show the characteristics of homework in the traditional industrial sectors of clothing and footwear in Germany and Spain. We focus, first, on the national contexts in order to grasp how homework is embedded in the economic, political and social environment, and second, on the womens perspective regarding how homework is integrated into their everyday lives and vital expectatives. Finally, we compare the two different national and cultural contexts and draw some conclusions with which we would like to enrich further discussions on homework. The analysis is based mainly on in-depth interviews and participant observation. The study in Germany was carried out in urban and rural areas of Bavaria, and the Spanish study occurred in rural areas of Catalunya, Galicia, Andalusia, and Valencia.

Farm women, gender relations and household strategies on the coast of Galicia

Abstract The aim of this paper is to present an empirical analysis of the survival strategies of family farms in Galicia within the framework of restructuring theory, integrating into it the gender perspective. Our top priority is to discuss the role of women farmers within the context of the household survival strategies that are being put into effect in Galicia during the process of restructuring the Spanish economy. In order to grasp womens role in this process at the household level we could not rely on statistical data, but had to gather data through fieldwork. To obtain broadly representative information we conducted a survey of a sample of households, and to explore issues that are hard to quantify we completed a series of in-depth interviews. This paper has five major sections. The first one focuses on the general economic context of the study region—Galicia—while the second refers to our previous statistical work on the subject and points to the need for fieldwork. The third section is devoted to the methodology of the fieldwork, the questionnaire and the sample, as well as the in-depth interviews. The following section draws on the survey data as well as the in-depth interviews, and deals with the results in relation to topics such as womens reproductive and productive work, the gender division of labour and other aspects of womens work and life. In the final section, we present some conclusions on gender roles and relations in the farm households of Galicia within the context of a changing and uncertain economic environment.

Systematic review and meta-analysis: triple therapy combining a proton-pump inhibitor, amoxicillin and metronidazole for Helicobacter pylori first-line treatment

BACKGROUND Due to clarithromycin resistance, the current efficacy of Helicobacter pylori first-line triple therapies including clarithromycin is low. It seems reasonable to explore alternative clarithromycin-free therapies. OBJECTIVES The objective of this study was to evaluate the efficacy of triple therapy including a proton-pump inhibitor (PPI), amoxicillin and metronidazole (PAM) as first-line H. pylori therapy by systematic review and meta-analysis. METHODS Studies evaluating PAM in adult patients were included. Meta-analyses comparing PAM with other treatments were performed. The primary endpoint was the ITT eradication rate for H. pylori first-line treatment. In addition, sensitivity analyses ascertained the effects of treatment schedule, dosage and duration on cure rates. RESULTS Ninety-four studies (8061 patients) were included. Meta-analyses comparing PAM versus clarithromycin-including triple therapies showed a significant difference in favour of PPI, amoxicillin and clarithromycin (PAC) (70% versus 77.1%; OR = 0.70, 95% CI = 0.56-0.88) and PPI, metronidazole and clarithromycin (PMC) therapy (66.4% versus 77.7%; OR = 0.55, 95% CI = 0.39-0.76). Sensitivity analyses showed a similar efficacy of PAM versus PAC when drugs were administered for 14 days (80% versus 84%; OR = 0.70, 95% CI = 0.44-1.12). There were not enough studies to perform further comparisons. Number of antibiotic doses (P = 0.012), length of treatment (P < 0.001) and use of high metronidazole doses (P = 0.021) were related to higher cure rates in the sensitivity analysis including observational studies. CONCLUSIONS PAM was less efficacious than clarithromycin-including triple therapies. However, its efficacy was similar to that of PAC when drugs were administered for 14 days, although ITT cure rates did not reach 90%. Use of 14 day, thrice daily and high-metronidazole-dose PAM treatments markedly increased the cure rate.

Safety and effectiveness of outpatient parenteral antimicrobial therapy in older people

OBJECTIVES We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients. METHODS We prospectively evaluated all adults admitted to our home hospitalization unit (HHU) for s-OPAT in the period 2008-12 in whom the bacteria responsible for the infection were identified. We divided patients into three age groups: <65, 65-79 and ≥80 years. s-OPAT was administered by patients or their caregivers using elastomeric infusion devices. Effectiveness was assessed by analysing readmissions to hospital for inadequate control of underlying infection. Safety was assessed by analysing adverse events, catheter-related complications and readmission to hospital for causes unrelated to inadequate control of underlying infection. RESULTS During the study period, 420 episodes of s-OPAT were registered in 351 patients: 139 (33.1%) in patients aged <65 years, 182 (43.3%) in those aged 65-79 years and 99 (23.6%) in those aged ≥80 years. Patients aged ≥80 years had a significantly lower Barthel index. The length of stay for s-OPAT and the complete HHU stay were similar in the three groups. Older people had similar changes in antibiotic treatment and hospital readmission rates due to poor control of underlying infection but higher readmission rates due to worsening of underlying diseases than younger adults. Adverse events and catheter-related complications were similar in the three age groups. CONCLUSIONS s-OPAT administered by patients or their caregivers using elastomeric devices was safe and effective in the treatment of infections in older people.

The Second International Conference on Geographies of Children, Youth and Families, Barcelona 2009: a report

The Second International Conference on Geographies of Children, Youth and Families, organised by the Group of Geography and Gender Studies, of the Department of Geography of the Universitat Autònoma de Barcelona, took place from 16 to 18 July 2009. The Conference was the second bi-annual International Conference series on Geographies of Children, Youth and Families and came after the first conference, held at the University of Reading in 2007 with the support of the Geographies of Children, Youth and Families Study Group of the Royal Geographical Society (with the Institute of British Geographers). Both had the precedent of an international conference celebrated at the University of Northampton in 2006 under the title of New Directions in Children’s Geographies (described in Norton et al. 2008). This conference series provides a collaborative attempt to enhance geographical conceptualisations of childhood and youth by more fully establishing children and young people in their diverse socio-spatial contexts and focusing on, and exploring, diversity among children, youth and families. At the same time, the conferences provide a forum to begin to collectively address some of the critiques recently levelled at geographies of children and youth, drawing upon stimulating current research. The aim of the Second International Conference was to provide a forum for the exchange of different knowledge, ideas and experiences from researchers and practitioners working in a variety of international contexts and disciplinary fields, but who were all interested in exploring and advancing any aspect of geographies of children, youth and families. The unifying conference theme was ‘Diverse childhoods in international contexts: gender and other social and cultural differences’ with the intention to build upon and enhance dialogue between feminists and other scholars of social difference and researchers of geographies of children, youth and families working within a range of international contexts. The organisers invited researchers to present papers on any of the issues suggested for discussion and to incorporate gender and other categories of social differentiation in an explicit or implicit way. The issues for consideration were: Children’s Geographies Vol. 8, No. 4, November 2010, 437–440

Systematic review, meta-analysis, and meta-regression: Successful second-line treatment for Helicobacter pylori.

Multiple Helicobacter pylori second‐line schedules have been described as potentially useful. It remains unclear, however, which are the best combinations, and which features of second‐line treatments are related to better cure rates. The aim of this study was to determine that second‐line treatments achieved excellent (>90%) cure rates by performing a systematic review and when possible a meta‐analysis. A meta‐regression was planned to determine the characteristics of treatments achieving excellent cure rates.