Impacte de les tecnologies de la informació i la comunicació en l’Administració de justícia: modernització i eficiència

L’Administració de Justícia, com servei públic que ha de donar als ciutadans una eficaç resolució dels conflictes, ha de comptar per al correcte compliment de la seva funció institucional, amb una sèrie de mitjans, no tan sols personals i materials, sinó també tecnològics, que li permetin assegurar la consecució de les seves finalitats. Per tant, es precisa una Administració oberta i transparent, caracteritzada per l’efectivitat i per la seva proximitat al ciutadà. La introducció de les TIC en l’Administració de Justícia és un procés bastant recent i encara no tancat, si es compara amb la resta del sector públic, especialment d’altres àmbits de l’Administració molt més avançats en la incorporació de les TIC, com són el tributari i el de la Seguretat Social. No obstant això, avui en dia, on majors èxits s’han assolit en aquest camp en l’Administració de Justícia és en el de la seva utilització interna: informatització interna, gestió interna dels procediments, intranets, etc. Per això, on queda un llarg camí per recórrer encara és en el camp de les relacions telemàtiques entre Administració de Justícia i els operadors jurídics, però especialment amb els ciutadans. D’altra banda, el legislador és sensible cada vegada més a aquest tema i s’ha preocupat de regular determinats aspectes on les TIC incideixen en l’àmbit de la justícia: actuacions dels procuradors, advocats, notificacions telemàtiques, el valor del document electrònic en el procés judicial... Així queda reflectit, per exemple, a la Llei Orgànica del Poder Judicial o la Llei d’Enjudiciament Civil. No obstant això, de lege ferenda, seria convenient l’existència d’un marc normatiu únic regulador de l’aplicació de les TIC en la Justícia. Així mateix, també ha d’assenyalar-se que en el procés institucional d’introducció de les noves tecnologies en la Justícia alguns dels acords adoptats així com les previsions contingudes en la normativa aplicable, no deixen de ser en la majoria dels casos simplement programàtics.

Epidemiology and antifungal susceptibility of bloodstream fungal isolates in pediatric patients: a Spanish multicenter prospective survey.

Data on fungemia epidemiology and antifungal susceptibility of isolates from children are scarce, leading frequently to pediatric empirical treatment based on available adult data. The present study was designed to update the epidemiological, mycological, and in vitro susceptibility data on fungal isolates from children with fungemia in Spain. All fungemia episodes were identified prospectively by blood culture over 13 months at 30 hospitals. Tests of susceptibility to amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin were performed at participant institutions by a microdilution colorimetric method. New species-specific clinical breakpoints for fluconazole, voriconazole, and echinocandins were also applied. A total of 203 episodes of fungemia in 200 children were identified. A higher proportion of fungal isolates was from general wards than intensive care units (ICU). Candida parapsilosis (46.8%), Candida albicans (36.5%), Candida tropicalis (5.9%), Candida glabrata (3.9%), and Candida guilliermondii (2.5%) were the leading species. C. parapsilosis was the predominant species except in neonates. C. albicans was the most frequent in neonatal ICU settings (51.9%). Intravascular catheter (79.3%), surgery (35%), prematurity (30%), and neutropenia (11%) were the most frequent predisposing factors. Most Candida isolates (95.1%) were susceptible to all antifungals. When the new species-specific clinical breakpoints were applied, all C. parapsilosis isolates were susceptible to echinocandins except one, which was micafungin resistant. This is the largest published series of fungemia episodes in the pediatric setting. C. parapsilosis is the most prevalent species in Spain, followed by C. albicans and C. tropicalis. Resistance to azole and echinocandin agents is extremely rare among Candida species. The fluconazole resistance rate in Spain has decreased in the last 10 years.

Les habilitats adaptatives : L'ajuda i l'acompanyament d'un alumne amb discapacitat intel·lectual

Aquest projecte s'ha creat amb la intenció d'elaborar i implementar tasques i/o activitats que, amb els suports i ajuts adequats, han potenciat i han fomentat les habilitats adaptatives, prioritzant aquelles que guarden relació amb les habilitats d'interacció social i les habilitats d'autocura de l'alumnat.

Cáncer colorrectal : proceso asistencial integrado. 2ª ed

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Atención al paciente quirúrgico : proceso asistencial integrado

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Evaluación del estado nutricional en pacientes trasplantados renales durante 5 años de seguimiento.

INTRODUCTION: Weight gain and malnutrition after kidney transplantation is common and the resulting overweight and obesity is associated with serious health complications. By contrast, the prevalence of malnutrition in patients with renal transplantation and its impact on the outcome of kidney transplantation is underestimated. OBJECTIVES: The aim of this study was to evaluate the nutritional status of renal transplant patients and determine if the five-year follow-up, these patients undergo alterations that suggest nutritional deterioration. METHODS: The sample consisted of 119 renal transplant patients who attended for five years post-transplant consultation. All patients measurements of total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides and ferritin (Ft) were performed. and anthropometric measurements were made of weight, height and BMI. Patients were divided into three groups according to GFR Group 1: <60 mL/min, Group 2: 89-60 mL/min Group 3: ≥ 90 mL/min. RESULTS: The weight and BMI tended to decrease in group 3 while increasing in the other groups. A decrease in total cholesterol, HDL, LDL, Triglycerides and Ferritin less pronounced in group 3 occurs. CONCLUSIONS: After five years you can see a significant reduction in nutritional biochemical parameters in general, likewise the nutritional status is closely related, and is directly proportional to the function of the graft.

Correcting non cephalic presentation with moxibustion: study protocol for a multi-centre randomised controlled trial in general practice.

BACKGROUND Non cephalic presentation in childbirth involves various risks to both the mother and the foetus. The incidence in Spain is 3.8% of all full-term pregnancies. The most common technique used to end the gestation in cases of non cephalic presentation is that of caesarian section, and although it provokes a lower rate of morbi-mortality than does vaginal delivery in such situations, there remains the possibility of traumatic injury to the foetal head and neck, while maternal morbidity is also increased. The application of heat (moxibustion) to an acupuncture point, in order to correct non cephalic presentation, has been practised in China since ancient times, but as yet there is insufficient evidence of its real effectiveness. METHODS/DESIGN The experimental design consists of a multi-centre randomised controlled trial with three parallel arms, used to compare real moxibustion, sham moxibustion and the natural course of events, among pregnant women with a non cephalic presentation and a gestational duration of 33-35 weeks (estimated by echography). The participants in the trial will be blinded to both interventions. The results obtained will be analyzed by professionals, blinded with respect to the allocation to the different types of intervention. In addition, we intend to carry out a economic analysis. DISCUSSION This trial will contribute to the development of evidence concerning moxibustion in the correction of non cephalic presentations. The primary outcome variable is the proportion of cephalic presentations at term. As secondary outcomes, we will evaluate the proportion of cephalic presentations at week 38 of gestation, determined by echography, together with the safety of the technique, the specificity of moxibustion and the control of the blinding process. This study has been funded by the Health Ministry of the Andalusian Regional Government. TRIAL REGISTRATION Current Controlled Trials ISRCTN10634508.

Accesibilidad en los espacios públicos urbanizados

El libro, coordinado por el Director de ACCEPLAN, Fernando Alonso López, viene a ser un reflejo de los avances entorno a la búsqueda de accessibilidad universal en los espacios públicos urbanizados. Para aproximarse a la realidad normativa y técnica de la Orden Ministerial el libro se estructura en artículos referentes al contexto normativo, a los contenidos de la Orden, y a reflexiones y criterios en torno a la accesibilidad en la ciudad. Del conjunto de artículos, por su variedad y por su carácter multidiciplinar, se extrae un libro de referencia que ofrece la variedad de enfoques del tema y que ayuda a interpretar mejor la Orden Ministerial, su contribución a los objetivos de la Ley 51/2003 de Igualdad de Oportunidades No Discriminación y Accesibilidad Universal, LIONDAU, y su utilidad en la comformación de unas ciudades cada vez más abiertas a la diversidad funcional y a la convivencia.

Evaluation of the speed-oligo direct Mycobacterium tuberculosis assay for molecular detection of mycobacteria in clinical respiratory specimens.

We present the first evaluation of a novel molecular assay, the Speed-oligo Direct Mycobacterium tuberculosis (SO-DMT) assay, which is based on PCR combined with a dipstick for the detection of mycobacteria and the specific identification of M. tuberculosis complex (MTC) in respiratory specimens. A blind evaluation was carried out in two stages: first, under experimental conditions on convenience samples comprising 20 negative specimens, 44 smear- and culture-positive respiratory specimens, and 11 sputa inoculated with various mycobacterium-related organisms; and second, in the routine workflow of 566 fresh respiratory specimens (4.9% acid-fast bacillus [AFB] smear positives, 7.6% MTC positives, and 1.8% nontuberculous mycobacteria [NTM] culture positives) from two Mycobacterium laboratories. SO-DMT assay showed no reactivity in any of the mycobacterium-free specimens or in those with mycobacterium-related organisms. Compared to culture, the sensitivity in the selected smear-positive specimens was 0.91 (0.92 for MTC and 0.90 for NTM), and there was no molecular detection of NTM in a tuberculosis case or vice versa. With respect to culture and clinical data, the sensitivity, specificity, and positive and negative predictive values for the SO-DMT system in routine specimens were 0.76 (0.93 in smear positives [1.0 for MTC and 0.5 for NTM] and 0.56 in smear negatives [0.68 for MTC and 0.16 for NTM]), 0.99, 0.85 (1.00 in smear positives and 0.68 in smear negatives), and 0.97, respectively. Molecular misidentification of NTM cases occurred when testing 2 gastric aspirates from two children with clinically but not microbiologically confirmed lung tuberculosis. The SO-DMT assay appears to be a fast and easy alternative for detecting mycobacteria and differentiating MTC from NTM in smear-positive respiratory specimens.

Determinació de la calor de combustió d’una closca d’arròs

Determinació mitjançant una bomba calorimètrica de la calor de combustió d'una closca d'arròs.

Sickness presenteeism in Spanish-born and immigrant workers in Spain

Background: Previous studies have shown that immigrant workers face relatively worse working and employment conditions, as well as lower rates of sickness absence than native-born workers. This study aims to assess rates of sickness presenteeism in a sample of Spanish-born and foreign-born workers according to different characteristics. Methods: A cross-sectional survey was conducted amongst a convenience sample of workers (Spanish-born and foreign-born), living in four Spanish cities: Barcelona, Huelva, Madrid and Valencia (2008-2009). Sickness presenteeism information was collected through two items in the questionnaire ("Have you had health problems in the last year?" and "Have you ever had to miss work for any health problem?") and was defined as worker who had a health problem (answered yes, first item) and had not missed work (answered no, second item). For the analysis, the sample of 2,059 workers (1,617 foreign-born) who answered yes to health problems was included. After descriptives, logistic regressions were used to establish the association between origin country and sickness presenteeism (adjusted odds ratios aOR; 95% confidence interval 95%CI). Analyses were stratified per time spent in Spain among foreign-born workers. Results: All of the results refer to the comparison between foreign-born and Spanish-born workers as a whole, and in some categories relating to personal and occupational conditions. Foreign-born workers were more likely to report sickness presenteeism compared with their Spanish-born counterparts, especially those living in Spain for under 2 years [Prevalence: 42% in Spanish-born and 56.3% in Foreign-born; aOR 1.77 95%CI 1.24-2.53]. In case of foreign-born workers (with time in Spain < 2 years), men [aOR 2.31 95%CI 1.40-3.80], those with university studies [aOR 3.01 95%CI 1.04-8.69], temporary contracts [aOR 2.26 95%CI 1.29-3.98] and salaries between 751-1,200€ per month [aOR 1.74 95% CI 1.04-2.92] were more likely to report sickness presenteeism. Also, recent immigrants with good self-perceived health and good mental health were more likely to report presenteeism than Spanish-born workers with the same good health indicators. Conclusions: Immigrant workers report more sickness presenteeism than their Spanish-born counterparts. These results could be related to precarious work and employment conditions of immigrants. Immigrant workers should benefit from the same standards of social security, and of health and safety in the workplace that are enjoyed by Spanish workers.

Invisible work, unseen hazards: the health of women immigrant household service workers in Spain

Backgroud: Household service work has been largely absent from occupational health studies. We examine the occupational hazards and health effects identified by immigrant women household service workers. Methods: Exploratory, descriptive study of 46 documented and undocumented immigrant women in household services in Spain, using a phenomenological approach. Data were collected between September 2006 and May 2007 through focus groups and semi-structured individual interviews. Data were separated for analysis by documentation status and sorted using a mixed-generation process. In a second phase of analysis, data on psychosocial hazards were organized using the Copenhagen Psychosocial Questionnaire as a guide. Results: Informants reported a number of environmental, ergonomic and psychosocial hazards and corresponding health effects. Psychosocial hazards were especially strongly present in data. Data on reported hazards were similar by documentation status and varied by several emerging categories: whether participants were primarily cleaners or carers and whether they lived in or outside of the homes of their employers. Documentation status was relevant in terms of empowerment and bargaining, but did not appear to influence work tasks or exposure to hazards directly. Conclusions:Female immigrant household service workers are exposed to a variety of health hazards that could be acted upon by improved legislation, enforcement, and preventive workplace measures, which are discussed.

A qualitative study about immigrant workers’ perceptions of their working conditions in Spain

Background: Spain has recently become an inward migration country. Little is known about the occupational health of immigrant workers. This study aimed to explore the perceptions that immigrant workers in Spain had of their working conditions.Methods: Qualitative, exploratory, descriptive study. Criterion sampling. Data collected between September 2006 and May 2007 through semi-structured focus groups and individual interviews, with a topic guide. One hundred and fifty-eight immigrant workers (90 men/68 women) from Colombia (n = 21), Morocco (n = 39), sub-Saharan Africa (n = 29), Romania (n = 44) and Ecuador (n = 25), who were authorised (documented) or unauthorised (undocumented) residents in five medium to large cities in Spain.Results: Participants described poor working conditions, low pay and health hazards. Perception of hazards appeared to be related to gender and job sector. Informants were highly segregated into jobs by sex, however, so this issue will need further exploration. Undocumented workers described poorer conditions than documented workers, which they attributed to their documentation status. Documented participants also felt vulnerable because of their immigrant status. Informants believed that deficient language skills, non-transferability of their education and training and, most of all, their immigrant status and economic need left them with little choice but to work under poor conditions.Conclusions: The occupational health needs of immigrant workers must be addressed at the job level, while improving the enforcement of existing health and safety regulations. The roles that documentation status and economic need played in these informants' work experiences should be considered and how these may influence health outcomes.

Informe de Salud Laboral. España, 2006

El objetivo principal de este Informe de Salud Laboral, España 2006, esayudar a definir y evaluar las políticas en seguridad y salud en el trabajo ennuestro país. Para ello, con la mejor información disponible, se ha descrito elcontexto sociolaboral en el que se insertan las condiciones de trabajo, así comolos principales daños a la salud, fundamentalmente las lesiones, relacionadas conestas condiciones de trabajo.Entre sus resultados destaca que aunque las muertes por lesionestraumáticas por accidentes de trabajo producidas in itínere o en desplazamientodisminuyen entre 1994 y 2004, como también se observa en las que ocurren enlos centros de trabajo, esta disminución no es tan pronunciada. Asimismo, elriesgo de morir por un accidente de trabajo se concentra de manera particularen las Comunidades Autónomas del noroeste de España.

Psychological distress in health sciences college students and its relationship with academic engagement

Objective: To determine the prevalence of psychological distress and its relationship with academic engagement (absorption, dedication and vigor), sex and degree among students from four public universities. Method: A non-experimental,comparative correlational, quantitative investigation without intervention. Study population: 1840 nursing and physical therapy students. The data collection tool used was a questionnaire. Results: A 32.2% prevalence of psychological distress was found in the subjects; a correlation between vigor and psychological distress was found for all of the subjects and also for women. High absorption and dedication scores and low psychological distress scores predicted higher vigor scores. Conclusion: The risk of psychological distress is high, especially for women. Women seem to have a higher level of psychological distress than men. Vigor, energy and mental resilience positively influence psychological distress and can be a vehicle for better results during the learning and studying process.