Manual de gestión documental para el Ayuntamiento de León

En este trabajo se exponen las normas y procedimientos para la implantación en el Ayuntamiento de León de un sistema de gestión documental basado en la norma ISO 15489. Se desarrollan los conceptos básicos para la comprensión del manual, los tipos de documentos administrativos, el uso del lenguaje administrativo, los instrumentos, los diagramas, los formularios y la legislación para llevar a la práctica los sistemas de organización de fondos, clasificación, ordenación, valoración y descripción de documentos y los procesos de instalación, transferencias, régimen de acceso al documento, consultas, préstamos y reproducción de documentos en los archivos de gestión de las oficinas. Palabras clave: Sistema de gestión documental, ISO 15489, Ayuntamiento de León (España), organización de fondos, clasificación de documentos, ordenación de documentos, evaluación de documentos, descripción de documentos, archivos de gestión.

Improving interMediAte Risk management. MARK study

Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect