En el presente trabajo se hace una aproximación a la definición de economía social y a una de sus organizaciones, las cooperativas, relacionándolas con la participación, pues este no es sólo uno de los principios que orientan al cooperativismo, sino una condición de existencia a la economía social misma. Se trata de una investigación descriptiva y documental en la que se realizan precisiones sobre el movimiento cooperativo y las cooperativas, las que fundadas en un conjunto de valores y principios, constituyen un binomio muy particular, el de asociación y empresa, rasgos definitorios de la especificidad cooperativa. Asimismo, se estudia brevemente como ha sido la evolución del movimiento cooperativo y el impulso al mismo como política pública en Venezuela, para concluir que el sólo empuje proporcionando por el Estado no es suficiente, que las cooperativas deben nacer del deseo e interés colectivo de resolver problemas comunes, pues en caso contrario, se trata de organizaciones la mayoría de las veces oportunistas y en lo absoluto participativas ni democráticas, que sucumben rápidamente una vez que se reduce o desaparece el apoyo estatal, y lo más importante, que sólo puede haber participación a partir de la formación y capacitación de sus integrantes.
A proof-of-concept design of a patient monitoring solution for intensive care unit environments has been presented. It is end-to-end standard-based, using ISO/IEEE 11073 (X73) in the bedside environment and EN13606 to communicate the information to an electronic healthcare record (EHR) server. At the bedside end, the system is a plug-and-play sensor network communicating with a gateway that collects medical information and sends the data to a monitoring server. The monitoring server transforms this information into an EN13606 extract to be stored on the EHR server. The system has been implemented to comply with the last X73 and EN13606 available versions and tested in a laboratory environment to demonstrate the feasibility of an end-to-end standard-based solution. ; This research work has been financially supported in part by projects PI05-0847, PI05-1416 and G03/117 from Fondo de investigaciones Sanitarias, Ministerio de Sanidad y Consumo (Spanish Government); TSI2005-07068-C02-01 and TSI2004-04940-C02-01 from Ministerio de Educatio´n y Ciencia (Spanish Government), and a personal grant to Miguel Galarraga from Departmento de Salud (Navarra Regional Government).
Proceeding of: 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBS), Cité Internationale, Lyon, France, August 23-26, 2007. ; This paper presents a proof-of-concept design of a patient monitoring solution for Intensive Care Unit (ICU). It is end-to-end standards-based, using ISO/IEEE 11073 (X73) in the bedside environment and EN13606 to communicate the information to an Electronic Healthcare Record (EHR) server. At the bedside end a plug-and-play sensor network is implemented, which communicates with a gateway that collects the medical information and sends it to a monitoring server. At this point the server transforms the data frame into an EN13606 extract, to be stored on the EHR server. The presented system has been tested in a laboratory environment to demonstrate the feasibility of this end-to-end standardsbased solution. ; This research work has been partially supported by projects TSI2005-07068-C02-01 and TSI2004-04940-C02-01 from Ministerio de Educación y Ciencia (Spanish Government), and a personal grant to both M.Galarraga and M. Martínez-Espronceda from Navarre Regional Government.
Esta investigación de tipo documental recoge los planteamientos de la doctrina respecto al fenómeno del mobbing o acoso moral en el trabajo, y establece sus causas, tipos y características, a fin de diferenciarlo de otros fenómenos que también tienen lugar en el ámbito laboral, y sobre todo, determinar el tratamiento que la legislación venezolana proporciona al mismo, a sabiendas de que no existe una ley especial para regularlo. Se analizan las normas vigentes que pueden tener aplicación frente al mobbing, así como las decisiones jurisprudenciales que han sentado precedente y han fijado los criterios que el juez debe considerar al momento de decidir, para finalmente estudiar la protección que brinda el Sistema de Seguridad Social al trabajador que como consecuencia de estas acciones hostigadoras padece una enfermedad considerada como profesional u ocupacional. ; This documentary investigation analyzes doctrinal positions regardingthe phenomenon of mobbing or moral harassment in the workplace,establishing its causes, types and characteristics in order to differentiate itfrom other phenomena that also take place in the working environment andabove all, determine the treatment given to it by Venezuelan legislation,understanding that no special law exists for its regulation. The studyanalyzes regulations in effect that could be applied to mobbing, as wellas legal decisions that have established precedents and set criteria thata judge should consider when pronouncing his or her verdict. Finally,it examines the protection offered by the Social Security System for theworker who suffers from an illness considered professional or occupationalas a consequence of these annoying actions.
Proceeding of: 29th Annual International Conference of IEEE Engineering in Medicine and Biology Society, (EMBS 2007), Lyon, France, 23-26th august 2007. ; Remote patient monitoring in e-Health is everyday closer to be a mature technology / service. However, there is still a lack of development in areas such as standardization of the sensor's communication interface, integration into Electronic Healthcare Record systems or incorporation in ambient-intelligent scenarios. This work identifies a set of use cases involved in the personal monitoring scenario and highlights the related features and functionalities, as well as the integration and implementation difficulties found when these are to be implemented in a system based on the ISO/IEEE11073 (X73) standard. It is part of a cooperative research effort devoted to the development of an end-to-end standards-based telemonitoring solution. Standardization committees are working towards adapting the X73 standard to this emerging personal health devices market and use case identification is essential to direct these revisions. ; This research work has been partially supported by projects TSI2005-07068-C02-01 and TSI2004-04940-C02-01 from Ministerio de Educación y Ciencia (Spanish Government), and a personal grant to both M.Galarraga and M. Martinez-Espronceda from Navarre Regional Government
Since 2006, our research team has been establishing in the islands of Livingston and Deception, (South Shetland archipelago, Antarctica) several monitoring stations of the active layer thickness within the international network Circumpolar Active Layer Monitoring (CALM), and the ground thermal regime for the Ground Terrestrial Network-Permafrost (GTN-P). Both networks were developed within the International Permafrost Association (IPA). In the GTN-P stations, in addition to the temperature of the air, soil, and terrain at different depths, the snow thickness is also monitored by snow poles. Since 2006, a delay in the disappearance of the snow layer has been observed, which could explain the variations we observed in the active layer thickness and permafrost temperatures. Therefore, in late 2015 our research group started the PERMASNOW project (2015-2019) to pay attention to the effect of snow cover on ground thermal This project had two different ways to study the snow cover. On the first hand, in early 2017 we deployed new instrumentation, including new time lapse cameras, snow poles with high number of sensors and a complete and complex set of instruments and sensors to configure a snow pack analyzer station providing 32 environmental and snow parameters. We used the data acquired along 2017 and 2018 years with the new instruments, together with the available from all our already existing sensors, to study in detail the snow cover. On the other hand, remote sensing data were used to try to map the snow cover, not only at our monitoring stations but the entire islands in order to map and study the snow cover distribution, as well as to start the way for future permafrost mapping in the entire islands. MODIS-derived surface temperatures and albedo products were used to detect the snow cover and to test the surface temperature. Since cloud presence limited the acquisition of valid observations of MODIS sensor, we also analyzed Terrasar X data to over-come this limitation. Remote sensing data validation required the acquirement of in situ ground-true data, consisting on data from our permanent instruments, as well as ad hoc measurements in the field (snow cover mapping, snow pits, albedo characterization, etc.). Although the project is finished, the data analysis is still ongoing. We present here the different research tasks we are developing as well as the most important results we already obtained about the snow cover. These results confirm how the snow cover duration has been changing in the last years, affecting the ground thermal behavior. ; With funding from the Spanish government through the "María de Maeztu Unit of Excellence" accreditation (MDM-2017-0737)
Rabies is a lethal and notifiable zoonotic disease for which diagnostics have to meet the highest standards. In recent years, an evolution was especially seen in molecular diagnostics with a wide variety of different detection methods published. Therefore, a first international ring trial specifically designed on the use of reverse transcription polymerase chain reaction (RT-PCR) for detection of lyssavirus genomic RNA was organized. The trial focussed on assessment and comparison of the performance of conventional and real-time assays. In total, 16 European laboratories participated. All participants were asked to investigate a panel of defined lyssavirus RNAs, consisting of Rabies virus (RABV) and European bat lyssavirus 1 and 2 (EBLV-1 and -2) RNA samples, with systems available in their laboratory. The ring trial allowed the important conclusion that conventional RT-PCR assays were really robust assays tested with a high concordance between different laboratories and assays. The real-time RT-PCR system by Wakeley et al. (2005) in combination with an intercalating dye, and the combined version by Hoffmann and co-workers (2010) showed good sensitivity for the detection of all RABV samples included in this test panel. Furthermore, all used EBLV-specific assays, real-time RT-PCRs as well as conventional RT-PCR systems, were shown to be suitable for a reliable detection of EBLVs. It has to be mentioned that differences were seen in the performance between both the individual RT-PCR systems and the laboratories. Laboratories which used more than one molecular assay for testing the sample panel always concluded a correct sample result. Due to the markedly high genetic diversity of lyssaviruses, the application of different assays in diagnostics is needed to achieve a maximum of diagnostic accuracy. To improve the knowledge about the diagnostic performance proficiency testing at an international level is recommended before using lyssavirus molecular diagnostics e.g. for confirmatory testing.
Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe. Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures. Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis. Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.