Els serveis socials en l'administració comarcal : marc legal i institucional

El govern de la Comuniata Autònoma de Catalunya ha reinstituït l'organització comarcal que ja havia implantat la Generalitat durant la II República, Ara però, s'ha otorgat als Consells Comarcals, com a òrgan de govern de les comarques, un marcat caràcter institucional i administratiu. Per tant, l'administració comarcal a Catalunya s'adscriu entre les administracions locals, i com un nou nivell intermedi entre el municipi i la província (mentre aquesta subsisteix) o bé la Comunitat Autònoma. Aquesta modificació del model estatal d'Administracions Públiques, evidentment, condiciona l'organització del sistema de serveis socials.El present treball pretén estudiar, a través del repositoir legislatiu, el marc institucional en el qual s'organitzen els serveis social d'àmbit comarcal. Això ens ha de permetre conèixer més el context pròxim en el què actuen els equips i professionals del medi comarcal. Ells són els principals destinataris d¡aquesta proposta d'anàlisis: però igualment pot ajudar als altres professionals a reflexionar sobre el procés d'estructuració dels serveis de benestar social que s'està desenvolupant a Catalunya

Nuevo marco legal sobre prestaciones económicas: anotaciones críticas a la Ley 13/2006 + despliegue

Las prestaciones económicas son un complemento necesario y, a menudo, un soporte indispensable para los objetivos de inclusión y de autonomía que procura el sistema de Servicios Sociales. El Parlament de Catalunya aprobó hace un año la primera ley que regula específicamente las prestaciones de carácter económico vinculadas al sistema, y que se añade, por tanto, al ordenamiento jurídico de los Servicios Sociales. Este artículo quiere ser una presentación comentada de dicha ley –incluyendo su despliegue hasta la fecha2 – haciendo lo que se podría decir una lectura crítica y desde una perspectiva de Servicios Sociales. El análisis repasa, a grandes rasgos, los aspectos más importantes de la ley, e intenta hacer compatible una exposición pedagógica con una interpretación más personal de búsqueda de significado.

Méta-analyses d'essais randomisés sur données individuelles dans le traitement des cancers ORL non métastatiques : principes, résultats, perspectives [Individual patient data meta-analyses of randomized trials for the treatment of non-metastatic head and neck squamous cell carcinomas: Principles, results and perspectives].

Meta-analyses are considered as an important pillar of evidence-based medicine. The aim of this review is to describe the main principles of a meta-analysis and to use examples of head and neck oncology to demonstrate their clinical impact and methodological interest. The major role of individual patient data is outlined, as well as the superiority of individual patient data over meta-analyses based on published summary data. The major clinical breakthrough of head and neck meta-analyses are summarized, regarding concomitant chemotherapy, altered fractionated chemotherapy, new regimens of induction chemotherapy or the use of radioprotectants. Recent methodological developments are described, including network meta-analyses, the validation of surrogate markers. Lastly, the future of meta-analyses is discussed in the context of personalized medicine.

Production Control Principles in Printed Wiring Board Fabrication

Työn tavoitteena oli kuvata piirilevyvalmistaja Aspocomp Oy:n Espoon tehtaan tämän hetkinen tuotannonohjausperiaate ja tunnistaa siinä esiintyvät puutteet sekä kehittää vaihtoehtoinen tuotannonohjausperiaate piirilevyvalmistukseen. Vaihtoehtoisen ohjausperiaatteen lähtökohtana oli tuotannonohjauksen sopeuttaminen vaativaan ja jatkuvasti muuttuvaan liiketoimintaympäristöön. Työn teoreettinen osa keskittyi tuotannonohjauksen eri lähestymistapoihin. Kirjallisuuskatsauksessa esitetään eri tuotannonohjausperiaatteiden keskeiset sisällöt, jotka muodostavat rungon toimivalle tuotannonohjauskäytännölle. Työn kokeellinen osa keskittyi Espoon piirilevytehtaan tuotannonohjausperiaatteen selvittämiseen. Espoon piirilevytehtaan nykyisessä tuotannonohjausperiaatteessa havaittujen ongelmakohtien ja liiketoimintaympäristön vaatimusten perusteella kehitettiin vaihtoehtoinen tuotannonohjaustapa. Vaihtoehtoisen tuotannonohjaustavan päämääränä oli läpimenoajan lyhentäminen sekä tuotannon parempi hallittavuus. Vaihtoehtoinen toimintamalli tavoitteiden saavuttamiseksi perustuu pullonkaulateoriaan, jossa keskeisin muutos nykyiseen toimintamalliin oli puolivalmisteiden varastointi toimitusajan lyhentämiseksi sekä tuotantovolyymin heilahdusten vaikutusten vähentämiseksi. Työn kokeellisessa osassa ilmeni, että kysynnän muutokset ja kapasiteetin suunnittelun puute aiheuttivat ongelmia piirilevytehtaan tuotannonohjauksessa.

Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care.

The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel.

First principles analysis of the stability and diffusion of oxygen vacancies in meetal oxides

Oxygen vacancies in metal oxides are known to determine their chemistry and physics. The properties of neutral oxygen vacancies in metal oxides of increasing complexity (MgO, CaO, alpha-Al2O3, and ZnO) have been studied using density functional theory. Vacancy formation energies, vacancy-vacancy interaction, and the barriers for vacancy migration are determined and rationalized in terms of the ionicity, the Madelung potential, and lattice relaxation. It is found that the Madelung potential controls the oxygen vacancy properties of highly ionic oxides whereas a more complex picture arises for covalent ZnO.

MgO/Ag(001) interface structure and STM images from first principles

The interface of MgO/Ag(001) has been studied with density functional theory applied to slabs. We have found that regular MgO films show a small adhesion to the silver substrate, the binding can be increased in off-stoichiometric regimes, either by the presence of O vacancies at the oxide film or by a small excess of O atoms at the interface between the ceramic to the metal. By means of theoretical methods, the scanning tunneling microscopy signatures of these films is also analyzed in some detail. For defect free deposits containing 1 or 2 ML and at low voltages, tunnelling takes place from the surface Ag substrate, and at large positive voltages Mg atoms are imaged. If defects, oxygen vacancies, are present on the surface of the oxide they introduce much easier channels for tunnelling resulting in big protrusions and controlling the shape of the image, the extra O stored at the interface can also be detected for very thin films.

Participação da radiologia nas perícias necroscópicas de baleados realizadas no Instituto Médico-Legal do Rio de Janeiro

OBJETIVO: Este trabalho aborda as conseqüências de laudos necroscópicos incompletos de baleados, nos casos em que não foi possível o uso de recursos radiológicos para localizar os projéteis de arma de fogo. MATERIAIS E MÉTODOS: Foram analisados 8.185 laudos necroscópicos do Instituto Médico-Legal Afrânio Peixoto, Rio de Janeiro, RJ, referentes à demanda total de cadáveres no período de 1º de janeiro a 31 de dezembro de 2001, dos quais 3.122 casos corresponderam a necropsias de baleados. RESULTADOS: Desses casos, 309 corpos foram sepultados contendo ainda, no seu interior, projéteis de arma de fogo, podendo suscitar futuras indagações judiciais. No mesmo período foram solicitadas 23 exumações, 12 delas com a finalidade de recolher projéteis. Foram calculados os gastos relacionados à realização de necropsias de baleados - R$ 996,85 - e custos alusivos à realização de exumações com a finalidade de recolher projéteis de arma de fogo - R$ 1.155,40, visando a estabelecer o montante financeiro que poderia ser poupado pelos cofres públicos, a ser alocado para finalidades outras, se a perícia médico-legal de baleados, no exame inicial, obtivesse sucesso. CONCLUSÃO: Os resultados permitiram concluir que todos os atos necroscópicos de baleados devem seguir protocolos específicos, uma vez que perícias incompletas exigem exumação posterior, com gastos adicionais desnecessários.

Net Neutrality: Measuring the Problem, Assessing the Legal Risks

Network neutrality is a growing policy controversy. Traffic management techniques affect not only high-speed, high-money content, but by extension all other content too. Internet regulators and users may tolerate much more discrimination in the interests of innovation. For instance, in the absence of regulatory oversight, ISPs could use Deep Packet Inspection (DPI) to block some content altogether, if they decide it is not to the benefit of ISPs, copyright holders, parents or the government. ISP blocking is currently widespread in controlling spam email, and in some countries in blocking sexually graphic illegal images. In 1999 this led to scrutiny of foreclosure of Instant Messaging and video and cable-telephony horizontal merger. Fourteen years later, there were in 2013 net neutrality laws implemented in Slovenia, the Netherlands, Chile and Finland, regulation in the United States and Canada , co-regulation in Norway, and self-regulation in Japan, the United Kingdom and many other European countries . Both Germany and France in mid-2013 debated new net neutrality legislation, and the European Commission announced on 11 September 2013 that it would aim to introduce legislation in early 2014. This paper analyses these legal developments, and in particular the difficulty in assessing reasonable traffic management and ‘specialized’ (i.e. unregulated) faster services in both EU and US law. It also assesses net neutrality law against the international legal norms for user privacy and freedom of expression

Dual-Energy CT: Basic Principles, Technical Approaches, and Applications in Musculoskeletal Imaging (Part 1).

In recent years, technological advances have allowed manufacturers to implement dual-energy computed tomography (DECT) on clinical scanners. With its unique ability to differentiate basis materials by their atomic number, DECT has opened new perspectives in imaging. DECT has been used successfully in musculoskeletal imaging with applications ranging from detection, characterization, and quantification of crystal and iron deposits; to simulation of noncalcium (improving the visualization of bone marrow lesions) or noniodine images. Furthermore, the data acquired with DECT can be postprocessed to generate monoenergetic images of varying kiloelectron volts, providing new methods for image contrast optimization as well as metal artifact reduction. The first part of this article reviews the basic principles and technical aspects of DECT including radiation dose considerations. The second part focuses on applications of DECT to musculoskeletal imaging including gout and other crystal-induced arthropathies, virtual noncalcium images for the study of bone marrow lesions, the study of collagenous structures, applications in computed tomography arthrography, as well as the detection of hemosiderin and metal particles.

Dual-Energy CT: Basic Principles, Technical Approaches, and Applications in Musculoskeletal Imaging (Part 2).

In recent years, technological advances have allowed manufacturers to implement dual-energy computed tomography (DECT) on clinical scanners. With its unique ability to differentiate basis materials by their atomic number, DECT has opened new perspectives in imaging. DECT has been successfully used in musculoskeletal imaging with applications ranging from detection, characterization, and quantification of crystal and iron deposits, to simulation of noncalcium (improving the visualization of bone marrow lesions) or noniodine images. Furthermore, the data acquired with DECT can be postprocessed to generate monoenergetic images of varying kiloelectron volts, providing new methods for image contrast optimization as well as metal artifact reduction. The first part of this article reviews the basic principles and technical aspects of DECT including radiation dose considerations. The second part focuses on applications of DECT to musculoskeletal imaging including gout and other crystal-induced arthropathies, virtual noncalcium images for the study of bone marrow lesions, the study of collagenous structures, applications in computed tomography arthrography, as well as the detection of hemosiderin and metal particles.

A utilização de imagens na identificação humana em odontologia legal

Este artigo de revisão sistemática tem por objetivo citar os métodos de identificação humana por meio da radiologia, utilizados em odontologia legal. Para isso, realizou-se revisão de literatura com 19 trabalhos selecionados dentre 45 encontrados, após aplicação de critérios de inclusão. Há diversas técnicas radiológicas que podem ser utilizadas para auxiliar na identificação humana, tanto individual como geral, incluindo a determinação do gênero, do grupo étnico e, principalmente, da idade. A análise de radiografias e tomografias ante-mortem e post-mortem tornou-se uma ferramenta fundamental nos processos de identificação em odontologia legal, principalmente com o refinamento das técnicas adquiridas com o avanço da própria radio-logia e com a incorporação da informática. Conclui-se que a partir do conhecimento adequado dos métodos disponíveis, o profissional em odontologia legal pode optar pelo método que melhor preencha as características necessárias para o sucesso da identificação, tendo cuidado na aplicação correta da técnica e na interpretação precisa das informações obtidas.